UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
(Mark
One)
☒
ANNUAL
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the fiscal year ended December 31 , 2025
OR
☐
TRANSITION
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the transition period from to
Commission
file number: 001-41002
Tevogen
Bio Holdings Inc.
(Exact
name of registrant as specified in its charter)
Delaware
98-1597194
(State
or other jurisdiction of
incorporation or organization)
(I.R.S.
Employer
Identification No.)
15
Independence Boulevard , Suite #210
Warren ,
New Jersey
07059
(Address
of principal executive offices)
(Zip
Code)
Registrant’s
telephone number, including area code: (877) 838-6434
Securities
registered pursuant to Section 12(b) of the Act:
Title
of each class
Trading
Symbol(s)
Name
of each exchange on which registered
Common
Stock, $0.0001 par value per share
Warrants,
each exercisable for one share of Common Stock for $575 per share
TVGN
TVGNW
The
Nasdaq Stock Market LLC
The
Nasdaq Stock Market LLC
Securities
registered pursuant to Section 12(g) of the Act: None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes
☐ No ☒
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Act. Yes
☐ No ☒
Indicate
by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. Yes ☒ No
☐
Indicate
by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule
405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant
was required to submit such files). Yes ☒ No
☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company,
or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller
reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large
accelerated filer
☐
Accelerated
filer
☐
Non-accelerated
filer
☒
Smaller
reporting company
☒
Emerging
growth company
☒
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered
public accounting firm that prepared or issued its audit report. ☐
If
securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant
included in the filing reflect the correction of an error to previously issued financial statements. ☐
Indicate
by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation
received by any of the registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes
☐ No ☒
The
aggregate market value of the common stock held by non-affiliates of the registrant, computed by reference to the price at which the
common stock was last sold on The Nasdaq Stock Market on June 30, 2025 (the last business day of the registrant’s most recently
completed second fiscal quarter), was $ 63.7 million.
The
number of shares of registrant’s common stock outstanding as of March 27, 2026 was 4,164,205 .
Portions
of the registrant’s Definitive Proxy Statement relating to the registrant’s 2026 Annual Meeting of Stockholders are incorporated
by reference into Part III of this Annual Report on Form 10-K where indicated. Such Definitive Proxy Statement will be filed with the
Securities and Exchange Commission within 120 days after the end of the registrant’s fiscal year ended December 31, 2025.
Table
of Contents
TEVOGEN
BIO HOLDINGS INC.
FORM
10-K
INDEX
Page
PART I
Item
1
Business
6
Item
1A
Risk Factors
40
Item
1B
Unresolved Staff Comments
80
Item
1C
Cybersecurity
80
Item
2
Properties
81
Item
3
Legal Proceedings
81
Item
4
Mine Safety Disclosures
81
PART II
Item
5
Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
82
Item
6
[Reserved]
82
Item
7
Management’s Discussion and Analysis of Financial Condition and Results of Operations
82
Item
7A
Quantitative and Qualitative Disclosures About Market Risk
94
Item
8
Financial Statements and Supplementary Data
94
Item
9
Changes in and Disagreements With Accountants on Accounting and Financial Disclosure
94
Item
9A
Controls and Procedures
94
Item
9B
Other Information
95
Item
9C
Disclosure Regarding Foreign Jurisdictions that Prevent Inspection
95
PART III
Item
10
Directors, Executive Officers, and Corporate Governance
96
Item
11
Executive Compensation
96
Item
12
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
96
Item
13
Certain Relationships and Related Transactions, and Director Independence
96
Item
14
Principal Accounting Fees and Services
96
PART IV
Item
15
Exhibits and Financial Statement Schedule
97
Item
16
Form 10-K Summary
97
SIGNATURES
100
2
SPECIAL
NOTE REGARDING FORWARD-LOOKING STATEMENTS
This
Annual Report on Form 10-K (this “Annual Report”) contains statements that constitute “forward-looking statements”
for purposes of the federal securities laws. Forward-looking statements include, but are not limited to, statements that discuss future
events, hopes, expectations, beliefs, intentions, or strategies regarding the future, projections of results of operations or financial
condition, changes in the markets in which we compete, and trends in our business. In addition, any statements that refer to projections,
forecasts, or other characterizations of future events or circumstances, including any underlying assumptions, are forward-looking statements.
The words “anticipate,” “believe,” “contemplate,” “continue,” “could,” “estimate,”
“expect,” “intends,” “may,” “might,” “plan,” “possible,” “potential,”
“predict,” “project,” “should,” “will,” “would,” and similar expressions
or their opposites may identify forward-looking statements, but the absence of these words does not mean that a statement is not forward-looking.
Forward-looking statements in this Annual Report may include, for example, statements about:
●
the
development of, potential benefits of, and patient access to our product candidates for the treatment of infectious diseases, cancer,
and neurological disorders, including TVGN 489 for the treatment of COVID-19 and Long COVID;
●
our
ability to develop additional product candidates, including through the use of our ExacTcell TM technology;
●
the
anticipated benefits of ExacTcell;
●
our
expectations regarding our future clinical trials;
●
our
manufacturing plans;
●
our
ability to generate revenue in the future;
●
our
ability to manage, grow, and diversify our business and execute our business initiatives and strategy;
●
expectations
regarding the healthcare and biopharmaceutical industries;
●
the
potential liquidity and trading of our securities;
●
the
future business, operations, and financial performance of our Company.
The
forward-looking statements contained in this Annual Report are based on management’s current expectations, assumptions, and beliefs
concerning future developments and their potential effects on us. There can be no assurance that future developments affecting us will
be those that we have anticipated. These forward-looking statements involve a number of risks, uncertainties (some of which are beyond
our control), or other assumptions that may cause actual results or performance to be materially different from those expressed or implied
by these forward-looking statements. These risks and uncertainties include, but are not limited to, the factors set forth below in “Summary
of Risk Factors.”
Forward-looking
statements should be considered in light of these factors and the factors described elsewhere in this Annual Report, including in the
sections titled “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of
Operations.” You should read these factors and the other cautionary statements made in this Annual Report as being applicable to
all related forward-looking statements wherever they appear in this Annual Report. It is not possible to predict or identity all such
risks. We undertake no obligation to update or revise any forward-looking statements, whether as a result of new information, future
events, or otherwise, except as may be required under applicable law.
Unless
the context otherwise requires or unless stated otherwise, references to “Tevogen”, “we,” “us,” “our,”
“the Company” and “our Company” refer to Tevogen Bio Holdings Inc. and its consolidated subsidiary.
3
SUMMARY
OF RISK FACTORS
We
are subject to a variety of risks and uncertainties, including risks that could have a material adverse effect on our business, financial
condition, results of operations, and cash flows. The following summary of the principal factors that make an investment in our securities
speculative or risky should not be relied upon as an exhaustive summary of the material risks facing us. You should read the following
summary together with the more detailed description of risks under “Risk Factors” in Part I, Item 1A of this Annual Report
and the other information contained in this Annual Report before investing in our securities. Capitalized terms not otherwise defined
below have been defined elsewhere in this Annual Report.
Risks
Related to Our Financial Position and Need for Additional Capital
●
We
have a limited operating history, no products approved for commercial sale, have never generated revenue from product sales, and
have a history of significant losses.
●
We
are relying in part on an additional $7.0 million of grant funding that we have not yet received to meet our liquidity needs.
●
We
will require substantial additional financing to achieve our business objectives and to fund our operations.
Risks
Related to Development, Regulatory Review, and Product Approval
●
Regulation
of cellular therapy product candidates is rigorous, complex, uncertain, and subject to change.
●
We
have limited experience designing and implementing preclinical and clinical trials, which are complex, expensive, time-consuming,
difficult to design and implement, and involve uncertain outcomes.
●
We
may be unable to develop, receive regulatory approval for, and commercialize our product candidates.
●
We
may encounter substantial delays and disruptions in the development of our product candidates.
●
The
FDA regulatory approval process is lengthy and time-consuming.
●
We
may never receive regenerative medicine advanced therapy designation for any product candidate, and this designation may not lead
to a faster development or regulatory review or approval process.
●
Our
business is highly dependent on our first product candidate, TVGN 489.
●
Results
from our clinical trials may change and are subject to audit, validation, and verification procedures.
●
Initial
results and results of earlier trials may not be predictive of future results.
●
Our
TVGN 489 proof-of-concept clinical trial results may be less reliable than results in larger clinical trials.
●
Changes
in product candidate manufacturing or formulation may result in additional costs or delay.
●
ExacTcell
is unproven and may not result in marketable products.
●
We
may fail to demonstrate the safety and efficacy of our product candidates, or serious adverse or unacceptable side effects may be
identified during development.
●
We
may encounter difficulties enrolling patients in our clinical trials.
●
We
may be required to suspend, repeat, or terminate our clinical trials if they are not conducted in accordance with regulatory requirements,
the results are negative or inconclusive, or the trials are not well designed.
●
We
may not achieve our projected development goals in the time frames we announce and expect.
●
Disruptions
at government agencies could hinder or prevent product development and commercialization.
●
Development
of product candidates in combination with other therapies presents additional regulatory risks.
●
We
could fail utilizing new and evolving technologies, such as artificial intelligence (“AI”), in our business.
Risks
Related to Business Development and Commercialization
●
Our
commercial success depends upon attaining significant market acceptance of our product candidates.
●
Regulated
biologics may be subject to biosimilar competition.
●
The
incidence and prevalence of target patient populations are based on estimates and third-party sources.
●
We
will face extensive ongoing regulatory requirements and regulatory review after regulatory approval.
●
We
may be unable to establish sales and marketing capabilities.
●
Failure
to comply with or adapt to changes in data protection, privacy, and similar laws could materially and adversely harm our business.
●
Increasing
use of AI could lead to liability, violation of data security and privacy laws, or reputational damage.
●
Computer
systems may fail or suffer security breaches.
4
●
Coverage
and reimbursement may be limited or unavailable in certain market segments.
●
Healthcare
reform may negatively impact our ability to sell our product candidates profitably.
●
We
could violate healthcare fraud and abuse, false claims, and health information privacy and security laws.
●
We
could fail to comply with environmental, health and safety laws and regulations.
Risks
Related to Manufacturing and Reliance on Third Parties
●
The
manufacture of cell therapies is subject to a multitude of manufacturing risks.
●
Our
efforts to establish manufacturing capabilities will involve time and expense and may not be successful.
●
The
loss of suppliers or their inability to supply us with adequate materials could harm our business.
●
We
may not obtain marketing approval for or successfully commercialize product candidates as a result of failures by third parties.
●
We
may not be able to establish collaborations on commercially reasonable terms.
Risks
Related to Intellectual Property
●
We
may be unable to obtain and maintain sufficient patent protection for our product candidates or ExacTcell.
●
Our
patent protection could be reduced or eliminated for non-compliance with patent agency requirements.
●
We
may not be able to protect our intellectual property rights throughout the world.
●
Changes
in patent law could diminish the value of patents in general.
●
We
may become involved in lawsuits to protect or enforce our intellectual property.
●
Issued
patents covering our product candidates could be found invalid or unenforceable if challenged in court.
●
Third
parties may initiate legal proceedings alleging that we are infringing their intellectual property rights.
●
Others
may claim an ownership interest in our intellectual property and our product candidates.
●
We
may be unable to protect the confidentiality of our proprietary information.
●
We
may be subject to claims asserting that our agents have wrongfully used or disclosed alleged trade secrets.
●
Our
trademarks and trade names may be inadequately protected.
●
Intellectual
property rights do not necessarily address all potential threats.
Risks
Related to Our Business
●
We
are highly dependent on our key personnel.
●
We
may face substantial competition.
●
We
will need to grow the size of our organization.
●
We
may not realize the benefits of any acquisitions, strategic alliances, or similar arrangements that we enter into.
●
Product
liability lawsuits against us could cause us to incur substantial liabilities and limit commercialization.
●
We
may be limited in our ability to use our net operating loss carryforwards.
Risks
Related to Being a Public Company and Ownership of Securities
●
The
price of our common stock, par value $0.0001 per share (the “Common Stock”), or warrants to purchase our Common Stock
(the “Warrants”) may fluctuate significantly.
●
If
we fail to meet Nasdaq’s continued listing requirements, our Common Stock and our outstanding public warrants to purchase Common
Stock could be delisted
●
We
have previously failed to timely file certain periodic reports with the SEC and could fail to timely file such reports in the future.
●
We
may not have the funds necessary to satisfy our future obligations under the terms of our outstanding preferred stock (the “Preferred
Stock”).
●
We
incur increased costs due to operating as a public company, and our management devotes substantial time to compliance initiatives
and corporate governance practices.
●
We
may issue additional shares of our Common Stock or other equity securities without your approval.
●
We
are an “emerging growth company” and a “smaller reporting company”.
●
Our
management team has limited experience managing a public company.
●
Analysts
may not publish research about us or may change their recommendation regarding our Common Stock.
●
We
could become subject to securities litigation or stockholder activism.
●
We
may be required to take write-downs or write-offs, restructuring and impairment or other charges.
●
We
could fail to maintain proper and effective internal control over financial reporting.
●
Sales
of a substantial number of our securities by existing securityholders could cause their price to fall.
●
Certain
individuals have substantial control over us.
5
PART
I
Item
1. Business.
Overview
We
are a clinical-stage specialty immunotherapy company harnessing one of nature’s most powerful immunological weapons, CD8+ cytotoxic
T lymphocytes (“CTLs”), to develop off-the-shelf, precision T cell therapies for the treatment of infectious diseases, cancers,
and other disorders, with the aim of addressing the significant unmet needs of large patient populations. We believe that sustainability
and commercial success in the forthcoming era of medicine will rely on ensuring patient accessibility through advanced science, innovative
business models and engagement throughout various stages of the drug development and commercialization lifecycle. We believe the full
potential of T cell therapies remains largely untapped, and aspire to be the first biotechnology company offering commercially attractive,
economically viable, and cost-effective personalized T cell therapies.
We
believe our precision T cell technology, ExacTcell TM , represents a significant scientific breakthrough with the potential
to mainstream cell therapy with a new class of off-the-shelf – pre-manufactured and ready-to-use – allogeneic T cell
therapies with diverse applications across virology, oncology, and other areas. Allogeneic therapeutics are intended to be infused
into individuals other than the original donor. ExacTcell is a set of processes and methodologies to develop, enrich, and expand
single human leukocyte antigen (“HLA”) restricted CTL therapies with proactively selected, precisely defined targets.
HLA molecules are proteins that play an important role in the immune system’s ability to recognize “self” versus
“foreign.” There are numerous HLA types that vary from person to person. CD8+ CTLs, also known as killer T cells, are
white blood cells that are part of the immune system and destroy infected, malignant, or otherwise damaged cells.
ExacTcell
therapies are based on carefully selected, naturally occurring CTLs that are designed to recognize targets of interest from the body’s
native T cell receptor pool, unlike genetically engineered T cell therapies. CD8+ CTLs in ExacTcell-based products target multiple and
distinct antigens, with the aim to circumvent the impact of mutations in viruses and virally driven as well as sporadic cancer cells,
which can render existing treatments focused on a single target ineffective. ExacTcell is designed to maximize the immunologic specificity
of our products in order to eliminate malignant and virally infected cells while allowing healthy cells to remain intact. We believe
this high degree of specificity has the potential to significantly reduce the chances of cross-reactivity or adverse impact on healthy
cells. Our confidence in ExacTcell is reflected in our development pipeline, which has been carefully tailored to address the unmet needs
of patient populations grappling with life-threatening viral diseases, cancers, and other disorders.
The
first clinical product of ExacTcell, TVGN 489, is initially being developed to fill a critical gap in COVID-19 therapeutics for the immunocompromised
and the high-risk elderly, with potential applications in both treatment and prevention of chronic, lingering symptoms of the disease
(“Long COVID”). Viruses, including COVID-19, hijack cellular machinery to transform infected cells into virus production
plants. Elimination of infected cells is necessary to allow them to be replaced by healthy, uninfected counterparts. TVGN 489 consists
of CTLs designed to be active against multiple precise, well defined, and well characterized targets spread across the SARS-CoV-2 genome.
The product progressed from pre-discovery to the clinic in less than 18 months, and in January 2023, we completed the Phase 1 proof-of-concept
clinical trial of TVGN 489 for the treatment of ambulatory, high-risk adult COVID-19 patients. No dose-limiting toxicities or significant
treatment-related adverse events were observed in the treatment arm. Secondary endpoints showed a rapid reduction of viral load and that
infusion of TVGN 489 did not prevent the development of the patients’ own T cell-related (cellular) or antibody-related (humoral)
anti-COVID-19 immunity. None of the treated patients reported progression of infection, reinfection, or the development of Long COVID
during the six-month follow-up period. These clinical observations were mirrored by laboratory evidence of the persistence of TVGN 489
cells for at least six months after treatment. The results of the trial were published in Blood Advances in June 2024 following
peer review. We believe these findings validate our initiative to develop off-the-shelf T cell therapies for outpatient administration,
targeting diseases that affect large patient populations - for the very first time. We are planning a pivotal trial of TVGN 489 in COVID-19
patients with B cell malignancies, with studies of other highly vulnerable populations thereafter. TVGN 489 is also in development for
treatment and prevention of Long COVID based on evidence of a persistent viral reservoir in Long COVID patients.
6
Our
Pipeline
We
are leveraging our understanding of immunotherapy and our ExacTcell technology to discover, validate, and build a proprietary pipeline
of T cell therapies with diverse targets in infectious disease, cancer, and other disorders. The figure below details our pipeline of
product candidates and their targets:
1 Phase 1 clinical
trials are designed in part to generate proof of concept data and safety-related data on tolerability and side effects.
2 A pivotal trial
is a trial designed to generate data sufficient to support the filing of an application for regulatory approval. A pivotal trial may
not necessarily be denoted as a Phase 3 clinical trial and instead may be a Phase 2 or Phase 2/3 clinical trial. We believe that Phase
2, Phase 2/3, or Phase 3 clinical trials may serve as pivotal trials for TVGN 489.
3 We believe that
the safety data from our completed Phase 1 clinical trial should be sufficient to serve as the basis for one or more later stage, potentially
pivotal trials in acute SARS-CoV-2 patients with B-cell cancer immune suppression, other B cell immune suppressed acute SARS-CoV-2 patients
with a B cell cancer indication, and for Long COVID prevention and treatment. We cannot be certain whether we will be permitted to move
from a Phase 1 trial directly to a pivotal trial covering any specific target population until FDA reviews and concurs with or rejects
our proposed plans, and FDA may require us to conduct further trials to generate additional safety and efficacy data prior to approval.
7
Our
Strategy
Our
goal is to have a positive impact on patients’ health and treatment equity by developing and commercializing personalized cell
therapies to treat infectious disease, cancer, and other diseases. Our strategy is to target large or underserved patient populations
for each pipeline product. Key elements of our strategy to advance toward this goal include the following:
●
Advancing
the clinical development of TVGN 489 for the treatment of COVID-19 and Long COVID . We completed a Phase 1 proof-of-concept
trial of TVGN 489 for the treatment of high-risk ambulatory adult COVID-19 patients in January 2023 and plan to launch a pivotal
trial in COVID-19 patients with B cell malignancies. TVGN 489 is also in development for other highly vulnerable COVID-19 patients
and sufferers of Long COVID. A Phase 2 treatment trial examining the safety and efficacy of TVGN 489 in individuals with Long COVID
is currently under consideration.
●
Leveraging
our ExacTcell technology to develop therapies for additional indications . In addition to TVGN 489, we are leveraging our
ExacTcell technology to advance product candidates in virology, oncology, and other conditions. For example, our process identifies
those peptide targets to which T cells respond. While currently focused on developing CTL products for the treatment of active disease,
these same targets could be used preventatively in the form of a T cell vaccination.
●
Developing
manufacturing capabilities, including through acquisitions . We will need to develop manufacturing capabilities for clinical
and, if approved, commercial supply of our cell therapy products. Our efforts to develop manufacturing capability are currently focused
on acquiring a manufacturing and research and development facility, including through collaboration with a potential facility development
partner.
●
Forming
strategic alliances, collaborating with partners, and entering into business combinations to augment our capabilities . We
may pursue strategic alliances with other biopharmaceutical companies with well-established presences in the specialties we aim to
target for our indications. This may include co-marketing, co-promotion, and co-development relationships, or a partnership with
a diagnostics company to help improve availability of HLA testing (rapid testing in acute illnesses and prompt testing in more chronic
conditions). We also intend to explore options to work with partners to augment the study and treatment of patients and the impact
of our product candidates, including medical professionals, healthcare professional networks, pharmacy benefit managers, insurance
companies, and artificial intelligence companies. In addition, from time to time we enter into letters of intent to explore potential
acquisitions. For example, in March 2026, we entered into a letter of intent to acquire a greater than 50% economic ownership stake
in a company with a clinical research organization (CRO).
We
believe that positive data from studies and clinical trials can help pave the way for positive regulatory discussions, strategic partnerships,
and future label expansions, furthering our ability to meet our goal.
Our
ExacTcell Technology
Our
ExacTcell technology and our therapies harness one of nature’s own approaches to eradicating cancer and other diseases: the cytotoxic
or killer T cell. We believe that our patented ExacTcell precision allogeneic T cell development technology has the potential to be a
broadly applicable approach for developing convenient and reasonably priced cellular immunotherapies for the treatment of acute viral
infections, long-term consequences of viral infections such as Long COVID, viral- and non-viral-induced cancers, and other disorders.
Although our initial product development has been in the area of infectious disease, we believe our technology also holds promise for
applications in cancers and autoimmune diseases, which would increase our total addressable market. We also believe that ExacTcell can
enable us to deliver products faster, at a greater scale, and at lower cost than future competing cell therapies, if any.
8
ExacTcell
focuses on the selection and expansion of naturally occurring, genetically unmodified CD8+ CTLs to target multiple, distinct, preselected
antigenic peptides present only on virus-infected or malignant cells and to kill those cells. We believe that by relying on CD8+ CTLs,
ExacTcell has the potential to produce an entirely new class of drugs that could present numerous benefits over existing platforms. In
contrast to other approaches, ExacTcell enables a single, specific HLA molecule to be targeted in a clinical product and the specific
target peptides to be known with certainty and precision. HLA molecules are proteins present on the cell surface that play an important
role in the immune system’s ability to recognize “self” versus “foreign.” Specifically, HLA molecules present
foreign antigens to T cells for eradication. There are numerous HLA types that vary from person to person.
Killer
T cells are white blood cells that play a vital role in the immune system’s defense against diseases, including viruses and cancer.
CTLs, including those developed with ExacTcell, express T cell receptors (“TCRs”), which are surface proteins that provide
each T cell with its unique immune specificity to recognize and react against specific foreign antigenic peptides of infected or malignant
cells. These foreign antigenic peptides are presented in conjunction with an HLA molecule. The CTLs destroy their infected or malignant
cell targets by inducing them to undergo apoptosis, or programmed cell death, by releasing cytolytic granules that produce pores in the
target cell’s membrane. CTLs also possess a protein that spans the entirety of the cell membrane, known as Cluster Differentiation
8 (which makes them CD8+), that aids in the reaction. CD8+ T cells work in conjunction with HLA-class I molecules, and CD4+ T cells work
in conjunction with HLA-class II molecules.
9
Currently
available allogeneic cell-based immunotherapy approaches include genetically unmodified T cells applied to the treatment of viruses early
after transplant and genetically modified chimeric antigen receptor (“CAR”) T cells used to treat a selected subset of malignancies.
We believe that to date, cellular therapy has not been harnessed to its full potential for clinical application. We believe that our
proprietary approach will allow T cell products to be generated with a much higher target-specific CD8+ content and better-defined target
specificity than existing commercially available approaches. Contrasted with our approach, the genetically unmodified T cells used after
hematopoietic stem cell transplantation for the treatment of viral infections have used large viral proteins, pools of peptides, or infected
cells to stimulate CTLs. These broader targets may stimulate both CD4+ and CD8+ T cell responses, resulting in more heterogeneous T cell
products with little information regarding the specific peptide targets recognized by the T cells. By stimulating with only carefully
selected smaller peptides that are known to bind to a single HLA-class I molecule and to be recognized by CTLs, our approach elicits
a high degree of target-specific CD8+ responses, which we believe may result in improved outcomes as compared to these other approaches.
Knowing the specific peptide targets also allows rapid identification of the impact of mutations on our CTL products. Having multiple
targets within a product also blunts the impact of any one mutation.
Due
to the targeted nature of the cells ExacTcell can produce, we also believe we may be able to avoid some of the unwanted corollary effects
observed in other T cell immunotherapies. For example, we believe products developed through ExacTcell could potentially avoid the high
incidence of adverse events, some life-threatening, such as cytokine release syndrome and neurotoxicity, that have been observed with
autologous and allogeneic CAR-T platforms. Data from our Phase 1 trial strongly supports this belief. Autologous cell therapies are derived
from a donor’s own cells, as contrasted with allogenic therapies such as ours, where cells are from third party donors.
In
order to select candidate peptides for ExacTcell products, we rely on computer-facilitated prediction of the ability of specific peptide
candidates to bind to specific HLA molecules. Once candidates are selected and used to stimulate T cells in the laboratory, we use tetramer
staining to assess whether T cells recognize the target peptides and assess cytotoxicity against individual peptide-pulsed and non-pulsed
targets. This allows us to rapidly and proactively select multiple, precise, candidate T cell targets and then quickly experimentally
confirm their effectiveness. Through our Tevogen.AI artificial intelligence initiative, we are exploring ways to deploy artificial intelligence-powered
target detection to accelerate our product development pace, either internally or in collaboration with leading entities in the field
of artificial intelligence, such as through our enrollment in the Microsoft for Startups program and use of Microsoft Azure.
As
illustrated in the figure below, we begin the ExacTcell process by collecting cells from a healthy donor. T cells from the donor are
exposed to the preselected targeted peptides and through a repetitive process of selection and expansion. CD8+ CTLs specific for the
targeted, antigenic peptides become the major cellular component of the final product. The expansion of the antigen-specific CTLs is
extensive enough to produce over 100, and up to hundreds, of doses from a single donor. Those doses can then be used to treat hundreds
of patients who share the same HLA type.
ExacTcell
stands in contrast with both autologous and allogeneic CAR-T platforms, which target antigens present on both healthy and diseased cells
and require genetic modification of the T cells. In autologous CAR-T approaches, the quantity and health of desired T cells in patient
blood samples used to manufacture the CAR-T product have been among the largest obstacles for T cell therapies to date. Much of this
is due to the chemotherapy treatments the patients have already received. Some existing CAR-T therapies may take weeks to manufacture,
may require patients to receive pre-infusion lymphodepleting ( i.e. , immunosuppressing) chemotherapy as part of a lengthy preparation
process, and be hospitalized in many cases during the CAR-T cell infusion or afterwards due to the frequency of side effects from the
therapy such as cytokine release syndrome. These treatments may also require lifelong monitoring for the development and treatment of
infections due to eradication of normal parts of the immune system along with the cancer.
10
In
November 2023, FDA announced that it had “received reports of T-cell malignancies” in patients who received certain CAR T
cell immunotherapies. In January 2024, FDA required a class-wide black box warning be added to the label of these CAR T products regarding
this risk, and continues to recommend long-term monitoring. Currently approved autologous CAR-T platforms utilize the patient’s
own T cells to manufacture their products. These cells have previously been exposed to cancer therapy and are genetically altered and
subsequently expanded.
In
contrast, CTLs generated using the ExacTcell technology come from a healthy donor with a normal immune system. ExacTcell CTLs are not
genetically altered in the manufacturing process and although they expand during manufacture, this is the expected response of a T-lymphocyte
when encountering its target antigen. Moreover, in contrast to CAR-T cell products, secondary malignancies have not been described in
the unmodified T cell products given to hundreds of post-transplant patients. Although products from our ExacTcell technology are not
designed to be genetically modified, they are still in the early stages of testing, and only limited human and laboratory study data
are available regarding the risk profiles of our products. Allogeneic CAR-T approaches are in early-stage development, but concerns exist
regarding side effects similar to autologous CAR-T, and additionally, the development of graft versus host disease with allogeneic CAR-T
products, both of which we believe will be of lower risk with our technology.
Hundreds
of doses per donor can be obtained using the ExacTcell approach, which is expected to facilitate off-the-shelf use and the ability to
administer doses within hours of diagnosis when rapid therapeutic intervention is crucial. Use of TVGN 489, for example, is expected
to begin with a confirmatory COVID-19 test and rapid HLA typing for which results would be available in six to eight hours, allowing
selection of the proper product based on HLA type. After confirmation of HLA type, thawing takes minutes, and cells are infused within
ten minutes of thawing.
The
convenience of “off-the-shelf” – pre-manufactured and ready-to-use - therapy has the potential to offer timely and
cost-efficient therapeutics by potentially eliminating the need for specialized medical facilities, unlike existing platforms. By producing
products in which the active CD8+ T cell components are present at high concentrations, we believe relatively small volumes will be required,
allowing our therapies to be easily and promptly delivered in the ambulatory setting as a very brief intravenous administration such
as in a physician’s office.
We
are working to further advance ExacTcell with a new, proprietary T cell receptor-engineered process, which we believe may substantially
increase the number of doses that can be produced from a single donor. Available technology can be used to allow us to interrogate over
a thousand individual T cells to determine which one kills peptide-pulsed targets fastest or kills the most in a given timeframe. This
highest performing T cell can then be isolated, and its T cell receptor sequenced, allowing us to make an artificial TCR gene that can
be introduced into CD8+ T cells collected from healthy donors. We believe this could allow at least a several-fold increase in the number
of desired CTLs as compared to our current approach. We expect efforts to produce second generation products based on this process may
begin shortly after and if initial regulatory approval of the first-generation product is obtained.
11
Our
First Product Candidate
Our
first product candidate, TVGN 489, is an off-the-shelf, allogeneic cytotoxic CD8+ T cell therapy designed to fill a critical remaining
gap in COVID-19 therapeutic solutions for the immunocompromised and the high-risk elderly, who remain at substantial risk for poor outcomes,
with potential applications in both treatment and prevention of Long COVID. Treatment for these groups represents an area of unmet or
incompletely met need which we believe TVGN 489 can significantly address. We rapidly progressed TVGN 489 from pre-discovery to the clinic
in only 18 months. TVGN 489 cells are derived from healthy donors who recovered from a prior COVID-19 infection, and TVGN 489 is active
against multiple, precise targets spread across the SARS-CoV-2 genome.
In
January 2023, we completed a Phase 1 proof-of-concept trial of TVGN 489 for the treatment of ambulatory high-risk adult COVID-19 patients.
No dose-limiting toxicities or significant TVGN 489-related adverse events were observed in this trial at any of the four dosing levels
tested. Secondary endpoint analysis showed a rapid reduction in COVID-19 viral load and that the infusion of TVGN 489 did not prevent
the development of the patient’s own T cell-related (cellular) and antibody-related (humoral) anti-COVID-19 immunity. In addition,
none of the patients in the treatment arm reported progression of infection, reinfection, or the development of Long COVID during the
six-month follow-up period. Two patients on this trial were admitted for autologous and allogeneic hematopoietic stem cell transplantation
within one month of treatment with TVGN 489, and neither patient developed evidence of recurrent COVID-19 despite the significant immunocompromised
state related to transplantation. The TVGN 489 in the Phase 1 trial was formulated to match patients expressing HLA-A*02:01, the most
common HLA type in the population.
We
believe that TVGN 489 targets are less susceptible to viral mutations due to their small size than monoclonal antibody targets and less
susceptible to drug resistance than antivirals. As evidence of this, despite selection of T cell targets in 2020, more than 95% of the
targets for the HLA-A*02:01 TVGN 489 product targets have remained intact through March 2026. In contrast, most monoclonal
antibodies were withdrawn from the market for lack of efficacy related to the lack of recognition of new variants, providing what we
believe to be evidence of decreased susceptibility of TVGN 489 to viral mutation. In addition, knowing the precise peptide targets of
our therapy helps allow rapid assessment regarding their preservation or loss as soon as new variants are sequenced. We check emerging
COVID-19 variants against TVGN 489 targets on an ongoing basis.
COVID-19
Background
COVID-19,
caused by the SARS-CoV-2 virus, has killed millions and infected hundreds of millions since its emergence in late 2019. Groups most at
risk for poor outcomes due to COVID-19 are immunocompromised individuals unable to mount an adequate immune response, such as those with
immune system cancers, immunodeficiency disorders, transplant recipients, patients with immune-mediated disorders requiring immunosuppressive
therapy, or high doses of corticosteroids, the elderly and the unvaccinated. Data shows that the majority of COVID-19 deaths occur in
people over the age of 65. The risk of severe illness from COVID-19 for an individual tends to escalate with an increase in their number
of underlying medical conditions. In addition to the acute impacts of infection, a significant portion of those who have been infected
by COVID-19 in the past develop more chronic and potentially debilitating symptoms afterwards, a condition termed Long COVID. Despite
the availability of vaccines and emergence of initial therapeutics, significant gaps and shortcomings in treatment remain both for vulnerable
patients experiencing an acute infection and for Long Covid sufferers for whom there are no treatment options approved for the indication
or its underlying causes.
Like
other viruses that have RNA as their genetic material, SARS-CoV-2 is constantly evolving through random mutations. New mutations can
potentially increase or decrease infectiousness and virulence. In addition, mutations can increase the virus’ ability to evade
adaptive immune responses from past SARS-CoV-2 infection or vaccination. New variants of the SARS-CoV-2 virus continue to emerge, and
many people continue to be adversely affected by COVID-19, particularly those at the highest risk and sufferers of Long COVID. Moreover,
a growing body of scientific data suggests new immune-evasive variants are more likely to arise in immunocompromised patients because
they are less able to eradicate the virus. The longer duration of infection within the host affords the virus more opportunity to mutate
so as to evade the immune system. The potential rise of immune-evasive variants in immunocompromised patients provides a public health
rationale for the treatment of immunocompromised patients in order to more rapidly and aggressively eliminate the virus and avoid generation
of new variants.
12
A
large number of Americans remain highly vulnerable to COVID-19 infection, including immunocompromised and elderly patients. For example,
the rate of hospitalization in cancer patients with COVID-19 infection remains high, specifically for those under active chemotherapy
or immunosuppression. There is therefore a high unmet need to have an effective treatment available for these populations. Classic herd
immunity leading to eradication of COVID-19 is unlikely, much as is the case for influenza, respiratory syncytial virus (RSV), and other
endemic respiratory viruses. This contrasts with smallpox, for example, where both natural infection and vaccination eliminated virus
transmission. SARS-CoV-2 infection and vaccination produce a steadily waning natural and vaccine-induced immunity, respectively, but
do not eliminate transmission. Although the number of daily reported cases and deaths has declined, the emergence of more transmissible
variants has led to spikes in cases and mortality, and variants are expected to continue to evolve over time.
The
current COVID-19 landscape is also characterized by continued vaccine hesitancy among a significant portion of the population, unequal
access to vaccines and treatment, lack of response in some immunocompromised and other high-risk groups, and breakthrough cases among
the vaccinated due in part to increased immune evasion by current and emerging variants and the relatively short duration of protection
by booster shots. We expect these circumstances to continue, which could adversely impact long-term community-level protective immunity.
In addition, we believe that the expiration of the U.S. federal Public Health Emergency and U.S. government funding for COVID-19 testing,
surveillance, and treatment could lead to higher pricing for diagnostics and therapeutics.
Only
two antiviral agents, Paxlovid (nirmatrelvir with ritonavir) and Veklury (remdesivir), have been FDA-approved for the treatment of COVID-19, with Lagevrio (molnupiravir) available under emergency use authorization (“EUA”).
While Paxlovid is indicated for treatment in individuals at high risk for viral progression, these drugs have not been specifically authorized
for use in immunocompromised patients, creating a need for the development of novel therapies in this area. These therapies also present
challenges for subsets of patients. Paxlovid is associated with many drug-drug interactions, resulting in the need to temporarily stop
ongoing medications or seek alternative therapy and thereby making it difficult for some patients to take. This is especially true for
patients taking multiple medications, which is often true of high-risk patients requiring anti-COVID-19 treatment. Paxlovid is also known
to be associated with COVID-19 rebound, which has been calculated as high as 21% in ambulatory patients, according to a study published
in the Annals of Internal Medicine in November 2023. Although the rate of rebound in high-risk subgroups is less well-documented, we
anticipate it may be as high or higher in this group. Paxlovid also must be started within five days of symptom development to be effective.
Remdesivir must be given within seven days and is only available in intravenous form, requiring three daily infusions in a treatment
center. Remdesivir has also been associated with liver enzyme abnormalities and gastrointestinal side effects. Lagevrio (molnupiravir)
is an anti-viral agent that has received emergency use authorization for the treatment of COVID-19, but is rarely used due to reports
of limited efficacy. Monoclonal antibodies to the viral spike protein were introduced early in the pandemic for treatment of COVID-19
but typically have been rendered ineffective over time as the virus continues to evolve. One prophylactic monoclonal antibody for COVID-19
prevention, Pemgarda (Pemivibart), has received emergency use authorization for moderate to severely immune compromised patients. Whether
this monoclonal antibody will remain more durable than other monoclonal antibody remains to be seen, although resistance to the drug
has already been observed in some variants. No therapies have been approved to treat the underlying causes of the symptoms of Long COVID,
and significant research is ongoing to determine why some patients fully recover while others develop long-term complications.
13
Key
Advantages of TVGN 489
Given
the persistence of COVID-19 and its effects and continued gaps in treatment, there is a clear need for alternatives to current therapeutic
options for COVID-19. We have shown that TVGN 489 is less susceptible to viral mutations than monoclonal antibodies and thus able to
overcome the increased immune evasion of current and emerging COVID-19 variants. We also believe TVGN 489 has the potential to be less
susceptible to drug resistance than antivirals. As contrasted with existing therapies, TVGN 489 is designed to recognize multiple specific
target peptides from distinct COVID-19 proteins, versus one or two targets typically derived only from the spike protein. Whereas other
viral therapies buy time for natural immunity to emerge and definitively control the virus, TVGN 489 provides natural immunity directly
and immediately to patients.
TVGN
489’s targets have also persisted in studied COVID-19 variants. We have observed TVGN 489’s targets to be generally retained,
in nearly all cases at greater than a 95% level of retention, in the genome of all of the isolates of SARS-CoV-2 variants that we have
studied to date. This is in significant contrast with the target loss of anti-spike monoclonal antibody therapies, which has led to the
withdrawal of EUAs that had been granted during the now-expired COVID-19 National Public
Health Emergency.
14
COVID-19
variants have demonstrated how this virus is able to escape our immune system through mutation. However, we believe our proprietary approach
to manufacturing TVGN 489 may allow us to monitor the sequences of emerging variants and, if necessary, to proactively adjust or fine
tune our products to ensure that they continue to recognize and treat current and future variants of this and other viruses. For example,
with our approach, if a product contains T cells that recognize and target seven different peptides and one is lost through mutation,
that peptide can be dropped from future product batches. Similarly, if the mutation generates a new peptide target, that target can be
added to future batches. However, making these types of changes to TVGN 489 may require additional regulatory approvals, and there is
no guarantee that we will receive such approvals.
TVGN
489 is also designed to be fast acting, as the cells are fully mature and crafted to be primed to act as soon as they find their way
to infected cells. All patients in the interventional arm of our Phase 1 clinical trial noted improved symptoms within two to three days,
which is shorter than the average noted by patients in the observational arm, and there was a ≥ 99% viral load reduction in all patients
by PCR within 14 days. The consistency of the resolution was suggestive of a treatment effect and the rapidity of nasal swab COVID-19
resolution was shown in a population where five individuals were on active immunosuppression for cancer (three with hematological malignancy,
two with solid tumors) and one for lupus at the time of COVID-19 infection. Moreover, a more recent study showed that the median time
to SARS-CoV-2 nasal swab PCR negativity was 72 days for patients with a hematologic malignancy highlighting the rapidity of response
in the Tevogen phase I study. Two patients on the trial went on to stem cell transplantation, an immunosuppressive procedure, within
a month of treatment. Neither experienced COVID-19 reactivation, which we believe further attests to the rapid acting nature of this
product. When immunocompromised patients get sick from COVID-19, their current treatment regimens for existing conditions are often stopped.
For oncology patients, this can be especially disruptive or even harmful to the curative potential of their treatment. Given TVGN 489’s
design and these results, we believe TVGN 489 may allow immunocompromised patients to recover and be able to return to their pre-COVID-19
treatment regimen with minimal delays.
Production
of TVGN 489 and Mechanism of Action
TVGN
489 cells are sourced from healthy donors who have recovered from a previous COVID-19 infection. These donor cells are subsequently expanded
by 600-fold or more by restimulating them toward specific peptide targets. This is accomplished by exposing them to antigen-presenting
cells and selectively isolating the T cells that recognize the specific targets. TVGN 489 is formulated to precisely target multiple
peptide targets spread across the SARS-CoV-2 genome, rather than focusing solely on the mutation-susceptible spike protein, which is
the primary target of most vaccines and monoclonal antibodies. Upon completion of the manufacturing process, the cells are frozen and
stored for future intravenous infusion.
Administration
of TVGN 489 infuses the body with killer T cells that have been designed to attack COVID-19 infected cells. These highly purified, multi-target
CD8+ CTLs are intended to bind to and eliminate infected cells expressing the targeted peptides against which the CTLs were manufactured.
Peptides are presented in conjunction with the HLA molecule and the CTLs eradicate diseased cells expressing these viral or malignant
targets. To be clinically effective, a T cell therapy must be compatible with the patient’s specific HLA type. Therefore, a panel
of HLA-specific CTL products is necessary to broadly cover and treat the population. In our next clinical trial of TVGN 489, we expect
to treat patients with the six most common HLA types, which we believe would represent between 60% and 65% of the COVID-19 infected population.
We plan to continue expansion into additional HLA types until we are confident that between 90% and 95% of the population could be treated
based on our research.
15
We
believe that once bound to infected cells, TVGN 489 cells then destroy the infected cells through formation of an immunological synapse
between the killer cell and target and the release of cytotoxic granules from TVGN 489 into the target. These both produce pores in the
target cell’s membrane and also trigger a process known as apoptosis, or programmed cell death, which is built into all our cells.
Then, once the infected cells die, new, healthy cells are able to grow in their place.
Discovery
and Preclinical Data
Our
approach to identifying CTL targets starts with computer-based prediction and then tests candidate peptides functionally with T cells.
We use a technique known as tetramer staining to assess whether T cells recognized these target peptides, assessed cytotoxicity against
individual peptide-pulsed and non-pulsed targets, and selected final peptides for use in TVGN 489 on that basis.
We
conducted multiple in-vitro studies of TVGN 489 in preparation for filing the IND with FDA and observed strong antiviral activity against
SARS-CoV-2 in these laboratory studies. In preclinical studies, we observed that TVGN 489 cells kill target cells that are exposed to
SARS-CoV-2 peptides, but not cells that are not exposed to those peptides. This is illustrated in the figure below, which shows the percentage
of cells killed over a four-hour period when targets were pulsed with the peptides and when they were not, with the x-axis showing the
lysis rates based on the ratio of CTLs to target cells.
Identification
of appropriate COVID-19 peptide targets for additional HLA molecules remains ongoing, and we plan to continue this testing until we are
confident that between 90% and 95% of the COVID-19 infected population could be treated based on our research. We have completed final
peptide selection for six HLA restrictions (HLA-A*02:01, HLA-A*01:01, HLA-A*03:01, HLA-A*11:01, HLA-A*23:01, and HLA-A*24:02), which
we believe would cover approximately two thirds of the U.S. population. We believe generating these CTLs can provide treatment for SARS-CoV-2
or, with the appropriate targets, for other viral infections. Immunizing an individual to these specific targets could form the basis
of helping to prevent a subsequent infection through a T cell vaccine. Target identification thus has the potential to assist with prevention
as well as treatment. Over the last year, we have moved toward a more enclosed manufacturing process and increased the number of active
CTLs in our candidates. In the proof-of-concept trial, TVGN 489 contained 68.5% SARS-CoV-2-specific CTLs. Modifications to the ExacTcell
platform have increased the content of active CTLs to over 80% on a consistent basis.
16
Clinical
Development for COVID-19 Patients
FDA
permitted our IND for TVGN 489 to proceed in May 2021, and we began enrolling patients in the Phase 1 proof-of-concept trial of TVGN
489 for the treatment of high-risk ambulatory adult COVID-19 patients in October 2021. Patients in the trial were newly diagnosed with
COVID-19 and were deemed to be at high risk for complications due to the presence of one or more underlying medical conditions defined
as high risk by the Centers for Disease Control and Prevention, including among others cancer, hypertension, obesity, diabetes, cardiovascular
disease, and old age. The trial, which was conducted at Thomas Jefferson University Hospital in Philadelphia, was completed in January
2023.
The
trial included two arms, with 12 patients in the treatment (or interventional) arm and 18 patients in the observational arm. Assignment
to the interventional arm versus the observational arm was based on each patient’s HLA type. Patients expressing HLA-A*02:01, the
most common HLA type in the population, matched the CTLs and were enrolled in the interventional arm. Patients in the treatment arm had
been infected with either the delta variant or one of three omicron variants of COVID-19. Patients on the interventional arm had a higher
median number of comorbid conditions, a higher incidence of immune compromise, and a higher number of patients who were unvaccinated
or failed to respond to vaccination versus patients on the observational arm.
Each
patient in the treatment arm received a single intravenous infusion of TVGN 489 within four days of diagnosis. Analysis of COVID-19 viral
load showed that the patients were early in their COVID-19 disease course at the time of treatment. Patients were treated with TVGN 489
at one of four dose levels: 1 x 10 5 /kg; 3 x 10 5 /kg; 1 x 10 6 /kg; or 3 x 10 6 /kg. Patients treated
on the first dosing level had the high-risk delta variant of COVID-19. These dose levels were chosen based on data regarding antiviral
T cell therapy in hematopoietic transplant patients involving the administration of similar cell numbers. Three patients were enrolled
at each dosing level with the option to enroll three more if a significant side effect was observed. Each dose level concluded with three
patients rather than six and the treatment arm concluded with a total of 12 patients rather than 24, due to the absence of appreciable
toxicities across all dose levels. The comparative arm, which was designed to end enrollment when treatment arm enrollment was completed,
concluded with 18 patients, appreciably less than what would have occurred if the treatment group required additional enrollment. Observational
arm patients received standard of care treatment, including monoclonal antibodies. Interventional arm patients were monitored in the
hospital for four days before being discharged and then were observed daily at home for ten additional days and again at the one, two,
three, and six-month anniversary of the initial infusion. Observational arm patients were monitored at home over the same interval.
The
primary endpoints of the trial, which were safety-related, were met. No dose-limiting toxicities or significant adverse events related
to TVGN 489, including acute infusion reactions, cytokine release syndrome, neurotoxicity, or instances of graft versus host disease,
were observed in any patient at any dose level of our Phase 1 trial of TVGN 489.
Secondary
endpoints showing a rapid reduction of COVID-19 viral load and showing that infusion of TVGN 489 did not prevent development of the patient’s
own T cell-related (cellular) and antibody-related (humoral) anti-COVID-19 immunity were also met. In other words, observations indicate
that TVGN 489 did not prevent the body from responding to the infection and generating its own CTLs and antibodies to COVID-19.
17
All
treatment arm patients reported returning to their baseline level of health without COVID-19 symptoms within 14 days of treatment. All
such patients also reported symptom improvement within two to three days of treatment, which corresponded with a decrease in the COVID-19
viral load on PCR testing in the majority of patients. None of the patients who participated in the trial reported progression of their
COVID-19 infection and none developed recurrent COVID-19 or Long COVID during the six-month follow-up period. These clinical observations
were mirrored by laboratory evidence of the persistence of infused TVGN 489 cells for at least six months after treatment.
Persistence
of infused therapeutic cells remains a significant issue in the T cell therapy space, leading to challenges in controlling viral infections,
preventing viral recurrence, and managing cancer relapse. The shorter the CTLs persist in the recipient, the less opportunity they have
to perform their intended therapeutic tasks. Genetic differences between donor and recipient in allogeneic cell products and new genes
introduced into autologous products can be recognized by the patient’s immune system, which can encourage elimination of the administered
cells. This is one of the reasons why lymphodepleting therapy is commonly administered prior to CAR-T treatments. Maximizing the percentage
of CTLs in the products is also useful as the CTLs may receive re-stimulation from the virus infecting the patient and have a better
ability to protect themselves against elimination by the patient’s immune system. Most studies of genetically unmodified CTLs have
suggested that they are eliminated within weeks, with three months, in highly immune-suppressed hematopoietic blood and marrow transplant
(“HSCT”) patients, being the longest that they typically are reported to persist. The highly immune-suppressed nature of
the HSCT patient group is thought to allow for longer than typical persistence.
In
our Phase 1 clinical trial for TVGN 489, following infusion, peripheral blood of six patients was collected at various timepoints throughout
the follow-up period. These samples were sent to Adaptive Biotechnologies (“Adaptive”) to evaluate the persistence of infused
TVGN 489 in the patients following treatment, and Adaptive conducted analyses by sequencing protein chains of TCRs in the samples. Four
of these patients had samples analyzed through the six-month end of study follow-up, and as seen in the figure below, Adaptive’s
data showed persistence of T cells present in the TVGN 489 product but absent from the recipients prior to administration of TVGN 489.
This subset of CTLs was found in all samples tested, including at the final study assessment at six months. The TCRs used to recognize
TVGN 489’s peptides were also shown to be largely distinct from person to person, making it highly unlikely that the cells from
later timepoints derive from anything other than the product in these five different patients. Taken together, we believe this data shows
the persistence of TVGN 489 cells six months after administration.
18
TVGN
489 COVID-19 Reactive CD8+ T Cells Detected Throughout the Six-Month Follow Up Period
Expansion
and persistence of allogeneic T cells has been associated with disease control in many settings. Whether the prolonged persistence of
the CTLs used in this study is of benefit in the treatment of COVID-19, Long COVID, or alternate future viral or oncologic targets for
these CTLs merits further examination. However, the evidence of their prolonged persistence provides us with encouragement for future
applications of the ExacTcell technology, particularly in oncology.
We
believe based on precedential industry examples, including in areas with high unmet needs or strong early phase clinical trial results,
that we may be able to commence pivotal trials of TVGN 489 on the basis of the results of our completed Phase 1 trial. A pivotal trial
is a trial designed to generate data sufficient to support the filing of an application for regulatory approval. Although the clinical
trial process usually includes three phases, a pivotal trial may not necessarily be denoted as a Phase 3 clinical trial and instead may
be a Phase 2 or Phase 2/3 clinical trial. We hope to begin a pivotal trial of TVGN 489 for the treatment of COVID-19 in select vulnerable
populations with humoral immune suppression due to B cell malignancy or the treatment thereof. Patients with hematological malignancies
continue to experience higher rates of hospitalization and death as compared to the general population and those with solid tumors. Increased
mortality, hospitalization, and persistence of COVID-19 infection are higher in patients with B cell malignancies due to inadequate vaccination
response and the immunosuppressive consequences of treatment received for B cell cancers. While the major acute outcomes of patients
with hematological malignancies and COVID-19 have improved with increasing experience, for cancer patients who contract COVID-19, uninterrupted
treatment is critical, as delays can impact long-term outcomes. Whereas treatment arm patients in our Phase 1 proof-of-concept clinical
trial all had a single HLA type, we expect to treat patients in this pivotal trial who have any of the six most common HLA types, which
we believe would represent between 60% and 65% of the population. The primary endpoint of this trial is planned to be reduction in SARS-CoV-2
viral load and reduction in the delays of cancer treatment. Secondary endpoints include the incidence and duration of hospitalization,
intensive care unit admissions, hours on supplemental oxygen, mortality, COVID-19 recurrence, and Long COVID diagnosis. At this stage,
however, we cannot be certain whether we will be permitted to move from a Phase 1 trial directly to a pivotal trial until FDA reviews
and concurs with or rejects our proposed plans, and FDA may require us to conduct further trials to generate additional safety and efficacy
data.
19
As
development of TVGN 489 continues, we may also seek FDA’s RMAT designation for TVGN 489, which as explained in “Regulatory
Environment - Expedited Development and Review Programs” below, is intended to facilitate efficient development and expedited review
or potentially, the FDA Commissioner’s National Priority Voucher pilot program, which the FDA is exploring as a pathway to reduce
review times, even as compared to other priority review programs, for candidates meeting certain criteria.
Other
Target Patient Populations and Indications for TVGN 489
Although
the majority of younger and healthier adults with COVID-19 avoid poor outcomes after infection without treatment, there remain subsets
of the population (such as humorally suppressed patients with B cell malignancies, as described above) who are vulnerable to significant
complications from COVID-19 because of a weak immune system or suboptimal responses to vaccines. Treatment of these individuals is an
area of unmet need that we believe TVGN 489 therapy has the opportunity to fill. These target populations also include COVID-19 patients
with a non-B-cell cancer indication, elderly and infirm acute COVID-19 patients, and those with immune suppression due to solid organ
or hematopoietic transplantation or autoimmunity or treatment of these conditions. Regardless of age or comorbidity, individuals with Long
COVID represent another critical area of unmet need. As noted above, these patients are among those with the greatest need for effective
treatment. We believe that the safety and the clinical benefit data from our completed Phase 1 clinical trial in ambulatory, high-risk
adult patients should be sufficient to serve as the basis for later-stage and potentially pivotal trials in these patient groups as well
as for the prevention of Long COVID. However, whether such trials may serve as pivotal trials, the phase of these trials, and the dose
level to be selected in each trial remains subject to discussions with and agreement by FDA.
Recent
studies have detected persistent viral spike and nucleocapsid proteins in some Long COVID patients, suggesting a persistent viral reservoir
in those patients. If that is correct, we believe that TVGN 489 may circumvent Long COVID by preventing such a reservoir from being established
or by minimizing its size. No treated patients in our Phase 1 proof-of-concept trial developed Long COVID. We expect considerable additional
information on Long COVID prevention to be obtained from our planned acute COVID-19 treatment trials in which patients treated with TVGN
489 are expected to be compared to patients receiving standard of care treatment. We believe that the comparative data with respect to
patients in these trial arms going on to develop Long COVID should provide sufficient information to obviate a separate Phase 1 Long
COVID prevention trial, and that the significant unmet need for treatment in vulnerable patients as well as the efficacy data in preventing
Long COVID generated in these studies will lend further support for a streamlined development pathway. However, we cannot be certain
whether FDA will require us to conduct a separate prevention trial until FDA reviews and concurs with or rejects our proposed plans.
Studies
have indicated that there is not an HLA class I-based predisposition to Long COVID. Therefore, it was not necessary for us to undertake
a genetic prediction study to determine optimal class I HLA types for CTL donor selection. Instead, a Phase 2 study is in development
that will examine the effect of treatment with TVGN 489 on specific categories of Long COVID sufferers such as those with fatigue or
brain fog based on the existence of a SARS-CoV-2 reservoir which may cause these symptoms. This protocol is in a very early stage of
development.
20
Other
Discovery Programs, Product Candidates and Indications
In
addition to TVGN 489, we have several product candidates under early-stage development in virology, neurology, and oncology using our
ExacTcell technology. For example, investigative work is also underway to develop product candidates targeted at human papilloma virus
(“HPV”)-related diseases, including TVGN 920 in cervical cancer and TVGN 960 in oropharyngeal cancer, which is a type of
mouth and throat cancer. Cervical cancer and oropharyngeal cancer are both commonly caused by HPV. According to the World Health Organization
(the “WHO”), HPV is responsible for 99% of cervical cancers. Mouth and throat cancers are more diverse, but the WHO estimates
that in the U.S., about 60% to 70% of oropharyngeal cancers are due to HPV. Although a vaccine for HPV exists, the National Cancer Institute
estimates that as of 2023, only 57.3% of adolescents between the ages of 13 and 15 had received the recommended doses, estimated vaccination
among older populations is lower, and the COVID pandemic has shown that significant portions of the population will avoid vaccination.
We believe that as with other viral infections, the availability of both a preventative strategy and a treatment strategy is important
to reduce incidence and impact of disease and we are investigating peptide candidates for HPV to further the development of TVGN 920
and TVGN 960. We are also beginning investigative work to develop TVGN 116, a product candidate targeted at chronic hepatitis B, with
the hope of avoiding the need for liver transplant due to cirrhosis or liver cancer. While treatments for hepatitis B exist, these are
generally not curative and require patient compliance for a lifetime. We believe that a single treatment with hepatitis B-specific CTLs
may produce better treatment acceptance and compliance. We are also developing Epstein-Barr virus (“EBV”) specific CTLs for
potential use in multiple sclerosis (“MS”) and EBV-associated lymphomas. Our TVGN 601 is being developed for MS, and our
TVGN 930 is being developed for EBV-associated lymphomas. EBV is a common virus that infects over 90% of the world’s adult population,
according to the WHO, and is mainly transmitted through saliva, but also through other body fluids such as blood and semen. EBV is the
leading cause of infectious mononucleosis, and infects B-cells, a type of immune cell. Recent studies have suggested a potential link
between infection with EBV and later onset of inflammation that causes MS, and EBV infection can lead to a variety of cancers and cancer-like
disorders, including lymphomas, nasopharyngeal cancers, Post-Transplant Lymphoproliferative Disorder, and others. Given the widespread
nature of EBV and the serious health problems it can cause, investigative work is underway to identify effective peptide targets for
this virus to further the development of TVGN 601 and TVGN 930. Testing of EBV peptides in our laboratory is currently underway.
We
believe that our ExacTcell approach also presents a novel and highly specific technique to combating virally induced cancers with T cell
therapy. Unlike CAR-T or Bispecific T-cell Engager (BiTE) antibody approaches, which recruit a heterogeneous group of T cells to the
tumor, our approach would instead focus a highly purified population of CTLs on the tumor, which we believe may provide more potential
to accomplish the task of eradicating the cancer. Non-viral (sporadic) cancers may not always express an ideal T cell target on their
own. However, it is possible to coat this sort of cancer cell with a well-recognized target peptide using monoclonal antibodies or liposomes.
We believe this would allow our target specific CTLs to then attack the cancer cells. We also believe that our approach has the potential
to eventually bring the benefits of cell therapies to first-line options in oncology, as well as to create products that may overcome
current limitations of checkpoint inhibitors.
T
cells can lose their ability to fight viruses and tumors in prolonged infections and cancer in a state called T cell exhaustion that
is characterized by the presence of certain biomarkers. Expression of these markers, which include PD-1, PDL-1, and LAG-3, has been observed
to be low level to absent in TVGN 489 cells. Moreover, TVGN 489 cells are functionally tested after generation, and have been observed
to remain strongly cytolytic at very low ratios of CTLs to target cells, which shows that they are not displaying the functional limitations
associated with T cell exhaustion.
Manufacturing
We
relied on a Clinical Trial Services and Materials Agreement with Thomas Jefferson University for the manufacture of TVGN 489 for our
Phase 1 proof-of-concept trial. However, we will need to develop manufacturing capabilities for clinical and, if approved, commercial
supply of our cell therapy products. Our efforts to develop manufacturing capability are currently focused on finding a manufacturing
and research and development facility, including through collaboration with a potential facility development partner.
Our
Commercialization Plans
If
approved, we plan to globally commercialize TVGN 489 and our other product candidates aimed at serving a large patient population suffering
from infectious diseases, cancer, and other disorders. Our commercial and market access team has been diligently working alongside our
research and development team and external experts to better understand market dynamics, identify segments with high unmet needs, map
the patient journey, understand the competition within each segment, and identify opportunities for our product candidates. The same
team continues to offer input in portfolio planning and target prioritization for our research pipeline. We are also proactive in identifying
potential collaboration and service partners, including distribution partners for our sophisticated, cryopreserved cell therapy products
like TVGN 489. As part of our Company’s mission of patient centricity, we aim to collaborate with all stakeholders, including patients,
healthcare professionals, sales channel partners, public and private payers, and service providers. Essential commercial capabilities,
such as market analytics, pricing, and commercial operations functions, are continuously being developed as we progress toward the later-stage
development of TVGN 489.
21
We
believe that the U.S. opportunity for our key pipeline products includes:
●
TVGN
489: Approximately 750,000 patients with B cell hematologic cancer, 2,175,000 addressable patients with other cancers, including
lung, breast, colon, pancreatic and liver, and 18 million addressable patients with Long COVID.
●
TVGN
920: Approximately 5.5 million patients with high-risk HPV infections, of which 200,000 are diagnosed with high grade dysplasia
per year.
●
TVGN
930: Approximately 92,000 patients with the main EBV-associated lymphomas.
●
TVGN
960: Approximately 110,000 patients with HPV-related mouth and throat cancer.
●
TVGN
601: Approximately 1 million patients with EBV-related multiple sclerosis.
●
TVGN
116: Approximately 500,000 to 1 million patients with high-risk chronic Hepatitis B for prevention of liver cancer.
Artificial
Intelligence
In
October 2023, we announced Tevogen.AI, a new early-stage initiative focused on harnessing the potential of artificial intelligence to
expedite drug development, optimize laboratory processes and clinical trials, unravel complex biological data, improve patient outcomes,
and pass on related savings to patients. We intend to assemble a team of research scientists, physicians, data scientists, and artificial
intelligence and machine learning engineers to help accomplish these goals by leveraging tools and techniques that might include large,
curated data sets, algorithmic models, pattern recognition, data analyses, automation, and artificial intelligence-powered software such
as chatbots. As an initial part of this initiative, we are specifically exploring ways to deploy artificial intelligence-powered target
detection to further accelerate our product development pace, either internally or in collaboration with leading entities in the field
of artificial intelligence. We also intend to explore the potential use of artificial intelligence to power tools that could anticipate
potential adverse reactions, efficacy concerns, and identify patients who would be most likely to respond to an investigational therapy.
The ability to search the human genome for specific peptide sequences might, for example, eliminate some peptide targets simplifying
the peptide screening/selection process. We have filed patents for algorithms to be trained against a curated dataset to predict immunologically
active HLA-peptide complexes and additionally to predict T cell receptor engagement tied to specific HLA-peptide complexes.
Since
its inception, Tevogen.AI has begun investigating individual viral isolates with a keen focus on target selection of peptides for our
pipeline of products. We continue curating a highly refined dataset across 14 isolates, with more targets planned, to train future machine
learning and predictive artificial intelligence foundational models. Further, we are investigating the human genome to understand immunologically
active HLA-peptide complexes related to our first patent filing. We intend to create an interface we call PredicTcell to take inputs
in the form of proteins and suggest a viable T cell receptor design to bind to the given protein. To aid this effort, we have entered
into agreements with leading artificial intelligence and technology companies. The collaborative nature of these agreements affords Tevogen.AI
access to experts and other resources to fulfill its mission of creating foundational algorithmic models of T cell interactions with
proteins. Tevogen.AI is also exploring how we can leverage datasets from partners and enrich them with internal insights to drive clinical
trial recruitment and monitoring to ensure efficacy of a given T cell product.
Our
Team and History
Our
senior leadership team is composed of accomplished scientists and biopharmaceutical leaders. The team brings together diverse experience
across the entire life sciences spectrum, including biotechnology, pharmaceuticals, hospitals, public and private insurance, education,
and health policy. Additionally, our team holds substantial expertise in drug development, global product launches, and commercialization
and ensuring patient access across a range of therapeutic areas.
In
February 2024, Tevogen Bio Inc (n/k/a Tevogen Bio Inc.) (“Tevogen Bio”) completed a business combination with Semper Paratus
Acquisition Corporation (“Semper Paratus”), a special purpose acquisition company, pursuant to which Semper Paratus changed
its name from “Semper Paratus Acquisition Corporation” to “Tevogen Bio Holdings Inc.” and Tevogen Bio became
a subsidiary of Tevogen Bio Holdings Inc. Tevogen Bio was established in June 2020 as a Delaware corporation, and Semper Paratus was
incorporated as a Cayman Islands exempted company in April 2021.
22
Competition
The
biotechnology industry, and in particular the cell therapy sector, are characterized by the rapid evolution of technologies and understanding
of disease etiology, and strong pursuit and defense of intellectual property. We believe that our approach, strategy, scientific development
capabilities, know-how, access to global experts, and experience provide us with competitive advantages. However, we expect future competition
in some of the indications we are targeting and from existing or emerging pharmaceutical and biotechnology companies as well as possibly
from governmental agencies, academic institutions, and public and private research institutions, among others. Some of our competitors,
either alone or through collaborations, have greater financial resources and expertise in research and development, conducting clinical
trials, manufacturing, obtaining regulatory approvals, and marketing approved products than we do. Smaller or early-stage companies may
also prove to be competitors, particularly through collaborative arrangements with large and established companies. Entities in the biotechnology
industry also compete with us in recruiting and retaining qualified scientific, clinical, and management personnel and may compete with
us in establishing clinical trial sites and enrolling patients in clinical trials as well as in acquiring technologies complementary
to, or necessary for, our programs. As a result, our competitors may discover, develop, license, or commercialize products before or
more successfully than we do.
TVGN
489 is being developed to fill the critical gaps that exist in COVID-19 therapeutics for the immunocompromised, the high-risk elderly,
and Long COVID. Only one product has been FDA licensed to date for treatment of COVID-19 specific to the immunocompromised population.
This treatment provides passive immunity in the form of high-titer COVID-19 convalescent plasma (“CCP”) , available from
the non-profit blood donation center, OneBlood, serving the southeastern United States. Blood banks nationwide can request CCP from OneBlood,
but it is unclear how long it takes to transport the therapy. In one trial, CCP was administered to young (median age 43 years) patients
with few comorbidities other than multiple sclerosis or neuromyelitis optica, for which they were receiving anti-CD 20 therapy. Treated
patients with persistent symptoms before therapy had resolution of fever in seven days and the majority had reduction of viremia after
CCP treatment. In another trial of immune compromised patients with mild COVID-19 within seven days of infection, CCP did not prevent
the evolution of SARS-CoV-2 mutations in either the treated or untreated groups, and only two of 117 patients studied had B cell deficiency.
While the majority of patients had undergone solid organ transplantation, only one patient in the treatment group underwent allogeneic
hematopoietic stem cell transplant, and there were minimal differences in outcomes between CCP-treated and non-treated groups. The only
significant finding was a reduced rate of hospitalization in the CCP treatment group versus the non-treated group, with zero hospitalizations
out of 59 patients versus five out of 58. In both of these studies, CCP was dosed multiple times. A randomized trial in immunocompromised
patients with mild COVID-19, the result of which were published in March 2025, showed that treatment with CCP is associated with decreased
rates of hospitalization and death. In the U.S., CCP therapy is an FDA licensed treatment through a blood donation center and is not
marketed. Therefore, widespread availability if needed would be questionable.
Clinical
trial data of other approved treatments in immunocompromised patients is limited. The National Institutes of Health’s COVID-19
Treatment Guidelines Panel, a group of clinical experts that developed guidance on COVID-19 care (the “NIH Panel
Guidelines”), recommended prompt treatment of COVID-19 in non-hospitalized immunocompromised patients with antiviral drugs but
acknowledged the limitations of these drugs and related research in such patients. Two antivirals are currently FDA-approved for
COVID-19 treatment: Gilead Science’s Veklury ® (Remdesivir) for the treatment of mild-to-moderate COVID-19 in
hospitalized or non-hospitalized adults who are at high risk for progression to severe COVID-19, and Pfizer’s Paxlovid
(Nirmatrelvir/Ritonavir tablets) for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to
severe COVID-19. The NIH Panel Guidelines highlight the limitation of the insights that clinical trials conducted for Remdesivir and
for Nirmatrelvir/Ritonavir tablets in broader populations can provide with respect to immunocompromised patients, as each trial
enrolled only limited numbers of such patients. For example, a retrospective study examining the use of Nirmatrelvir/Ritonavir
tablets in vulnerable individuals with COVID-19 included only 13.2% highly immunocompromised and 10.6% moderately immunocompromised
patients with cancer, with cancer type and type immunosuppressive medications not otherwise specified. Although the NIH Panel
Guidelines acknowledge observation in retrospective studies of “some potential benefits” of the use of Paxlovid for
patients with “various immunocompromising conditions,” they also note that because the pivotal trial of
Nirmatrelvir/Ritonavir tablets did not enroll many immunocompromised participants, “efficacy ... was not established for this
population.” Based on our target product profile, therefore, we anticipate that these products may not be direct competitors
in our target patient population. Moreover, we believe that TVGN 489’s anticipated single outpatient infusion may be easier to
administer than Veklury’s multiple infusions over a number of days. Additionally, Paxlovid requires daily doses, has a
significant number of drug interaction issues, as discussed in “COVID-19 Background” and noted by the NIH Panel
Guidelines, and has experienced numerous patient reports of disease relapse or rebound, which in each case we do not anticipate for
TVGN 489 based on its design and our Phase 1 proof of concept trial results. We do expect that these products may present direct
competition in high-risk elderly patients, but we are initially targeting immunocompromised indications. Lagevrio (molnupiravir) is
recommended as an alternative therapy for non-hospitalized adults with mild-to-moderate SARS-CoV-2 but only when preferred options
(Paxlovid or Remdesivir) are not available, feasible, or clinically appropriate. There remains no documented effective treatments
for Long COVID, with a recent study showing no benefit from the use of Paxlovid (Nirmatrelvir/Ritonavir tablets) in patients with
Long COVID.
23
Monoclonal
antibodies have also previously been considered promising as an effective therapeutic option for COVID-19, including in immunocompromised
patients, and several had been granted EUAs. Most of these treatments have had their EUAs revoked by FDA due to lack of efficacy stemming
from viral mutations. There are nonetheless ongoing efforts to develop additional anti-COVID monoclonal antibodies for treatment and
prevention of COVID-19 infection. For example, in March 2024, Invivyd, Inc. received an EUA of its product, Pemgarda (pemivibart), a
broadly neutralizing monoclonal antibody used for COVID-19 prevention in immunocompromised individuals who have not either been exposed
to or developed active COVID infection. While press releases from Invivyd confirmed continued activity of Pemivibart against circulating
strains of SARS-CoV-2, third-party research showed that inhibitory concentrations needed for neutralization of the JN.1 sublineages increased
for Pemivibart, and that activity was substantially adversely impacted by the currently highest circulating variant at the time of the
research.
Pemivibart
and other monoclonal antibodies remain vulnerable to novel viral mutations. Antibodies, unlike T-cells, recognize intact molecules. Consequently,
even remote mutations, not directly where the antibodies bind, may alter how the target molecule folds and its overall shape and therefore
prevent antibody binding. T-cells, in contrast, recognize small peptide breakdown products of proteins and are only affected if the mutation
is directly within the target peptide.
More
broadly, known companies developing virus-specific T cell therapies include Atara Biotherapeutics, Inc. (“Atara Bio”), whose
Ebvallo (tabelecleucel) has received approval in Europe for treating a rare hematologic cancer caused by EBV. However, in a recent setback,
the FDA declined approval for this therapy in the U.S. in January of 2026. AlloVir, Inc. (“AlloVir”), which merged with Kalaris
Therapeutics, Inc. (“Kalaris”) in March 2025, was another company developing allogeneic T cell therapies for viral diseases.
Following the merger, the company focuses on ophthalmological products. Neither Atara Bio nor Kalaris has an active development program
for the treatment of COVID-19. AlloVir conducted a Phase 1b trial of an allogeneic, partially HLA-matched product candidate in COVID-19
and reported results of the trial in 2021 but did not continue clinical development. One patient in the trial experienced a recurrence
of the disease and died four weeks after treatment. Atara Bio paused development of its T cell therapy, ATA188, after announcing in November
2023 that the Phase 2 trial of ATA188 targeting EBV-infected B cells and plasma cells in progressive forms of multiple sclerosis failed
to meet efficacy or biomarker endpoints. ATA188 targets only three latent EBV proteins, whereas our CTL peptide targets are selected
from all proteins expressed at the appropriate point in the viral life cycle, whether unique to that point in the viral life cycle or
not. This approach provides far more immunologic targets and thus more opportunities for viral control. In addition, ATA188 is generated
against targets restricted by several HLA alleles, which is likely to reduce the functional dose of drug targeting any one HLA allele,
as contrasted with CTLs developed with ExacTcell, which are generated against a single HLA specificity and therefore allow a more precise
understanding and control of dosage.
We
anticipate that we will continue to face competition as new therapies enter the market and advanced technologies become available from
time to time. We expect that any treatments which we develop and commercialize will need to compete on, among other things, efficacy,
safety, convenience of administration and delivery, and price. Commercialization of any treatments we develop will be affected by the
level of competition from original and biosimilars products and the availability of reimbursement from government and other third-party
payors.
24
Our
ability to commercialize our proprietary cell products could be significantly and adversely affected if our competitors develop and commercialize
products that are more effective, have a better safety profile, are more convenient or are less expensive than our products. Our competitors
also may obtain relevant regulatory approvals for their products more rapidly than we may be able to obtain approval for ours, which
could result in our competitors obtaining a head start and establishing a frontrunner position before we are ready to commercialize.
If we are not able to compete effectively against our existing and potential competitors, our business, financial condition, results
of operations and growth prospects may be materially and adversely affected.
Intellectual
Property
Our
commercial success depends in part on our ability to obtain and maintain patent and other proprietary protection for our products and
methods, preserve the confidentiality of our trade secrets, operate without infringing, misappropriating, or otherwise violating the
valid, enforceable proprietary rights of others, and prevent others from infringing, misappropriating, or otherwise violating our proprietary
rights. We rely on a combination of patents, patent applications, trademarks, and trade secrets to establish and protect our intellectual
property rights. Our ability to stop third parties from making, using, selling, offering to sell, or importing our products without the
right to do so may depend on the extent to which we have rights under valid and enforceable patents, trademarks or trade secrets that
cover these activities.
We
continue to build our intellectual property portfolio and seek to protect our proprietary position by, among other things, filing patent
applications. Our patent estate includes patents and patent applications with claims relating to our product candidates, methods of use,
and methods of preparing the product candidates. As of March 27, 2026, our U.S. intellectual property portfolio includes three U.S. patents
relating to TVGN 489 for the treatment of COVID-19, nine pending U.S. patent applications, including two patent applications relating
to the treatment of COVID-19, six relating to the treatment of other viruses or cancer, and one related to artificial intelligence-driven
T cell target identification and receptor engagement, as well as thirteen ex-U.S. patent applications, including applications in Australia,
Canada, Europe, Japan, Qatar, United Arab Emirates, and the Patent Cooperation Treaty (PCT) directed at viral specific T cells, methods
of treating and preventing viral infections, methods for developing CD3+CD+ cells against multiple viral epitopes for the treatment of
viral infections, and systems for predicting immunologically active peptides with machine learning models, which have anticipated expiration
dates through December 16, 2044.
In
the United States, our three issued utility patents, all of which will expire on December 9, 2040, are U.S. Patent No. 11,191,827 covering
methods of treating COVID-19 infection using COVID-19 peptide specific CTLs, U.S. Patent No. 11,207,401 covering COVID-19 peptide-specific
CTLs, and U.S. Patent No. 11,219,684 covering methods of manufacturing COVID-19 peptide specific CTLs. A pending utility patent application
in the United States directed at viral specific T cells and methods of treating and preventing viral infections has an anticipated expiration
of December 9, 2041.
We
determine strategy for claim scope for our patent applications on a case-by-case basis, taking into account advice of counsel and our
business model and needs. We file patents containing claims for protection of useful applications of our proprietary technologies and
any product candidates, including new applications or uses we discover for existing technologies and product candidates, based on our
assessment of their strategic value. We continuously reassess the number and type of patent applications, as well as our pending and
issued patent claims, to ensure maximum coverage and value are obtained for our processes and compositions, given existing patent office
rules and regulations.
In
addition, we own a registered trademark for “Tevogen Bio” (and design), and have applied for a registered trademark protection
for “AdapTcell”, “ExacTcell”, “PredicTcell”, and “Tevogen.AI” (and logo) with the USPTO.
Human
Capital Resources
Our
success depends on our ability to attract and retain highly qualified management and personnel. As of March 27, 2026, we had 18 full-time
and no part-time employees. We value a work culture that encourages employees, contractors, and vendors to contribute their unique and
diverse perspectives, to harness optimism and creativity, and to be ready to learn and develop solutions towards a common and greater
purpose of developing accessible immunotherapies. Our work culture is centered around four “CORE” values: Curiosity, Optimism,
Respect, and Equality. We believe it is essential and necessary that these values are instilled and maintained in each of our employees
to foster a collaborative culture. At our current size, ensuring this culture is primarily achieved through the recruitment process. Talent
recruitment at our current stage is setting the foundation for further company growth. When attracting talent, we ensure that every job
description mentions our core values, and the importance of these values in achieving our mission. Beyond evaluating experience, job applicants
are also evaluated based on their values and passions. We believe it is necessary that each employee represents our four core values.
As our employee numbers increase, we plan to create more defined programs to further enhance our company culture and retention of personnel.
25
Facilities
Our
corporate headquarters are located in Warren, New Jersey, and consist of 13,242 square feet dedicated to corporate, operational, and
pre-commercial activities under a lease that expires February 28, 2033. We also have one research and development facility located
in Philadelphia, which is a shared facility with laboratory space dedicated to us that is focused on preclinical and pharmacodynamic
activities.
We
anticipate expansion of both our corporate office and research and development facilities and intend to facilitate both in-house clinical
and commercial manufacturing and are currently engaged in active discussions regarding such expansion.
Regulatory
Environment
Government
Regulation and Product Approval
In
the United States, biological products are subject to regulation under the Federal Food, Drug, and Cosmetic Act (the “FDCA”),
and the Public Health Service Act (the “PHSA”), and other federal, state, and local statutes and regulations. Both the FDCA
and PHSA and their corresponding regulations govern, among other things, the research, development, clinical trials, testing, manufacturing,
quality control, safety, purity and potency (efficacy), labeling, packaging, storage, record keeping, distribution, reporting, marketing,
promotion, advertising, post-approval monitoring, and post-approval reporting involving biological products. Along with third-party contractors,
we will be required to navigate the various preclinical and clinical regulatory obligations and the commercial approval requirements
of the governing regulatory agencies of the countries in which we wish to conduct studies or seek approval or licensure of our product
candidates. The processes for obtaining regulatory approvals in the United States, along with subsequent compliance with applicable laws
and regulations and other regulatory authorities, require the expenditure of substantial time and financial resources.
Government
policies may change and additional government regulations may be enacted that could prevent, delay, or present significant new challenges
and costs for further development or regulatory approval of any product candidates, product or manufacturing changes, additional disease
indications or label changes. We cannot predict the likelihood, nature or extent of government regulation that might arise from future
legislative or administrative action.
Review
and Approval for Licensing Biologics in the United States
In
the United States, FDA regulates our current product candidates as biological products, or biologics, under the FDCA, the PHSA, and associated
implementing regulations. Biologics, like other drugs, are used for the diagnosis, cure, mitigation, treatment, or prevention of disease
in humans. In contrast to low molecular weight drugs, which have a well-defined structure and can be thoroughly characterized, biologics
are generally derived from living material (human, animal, or microorganism), are complex in structure, and thus are usually not fully
characterized.
Biologics
are also subject to other federal, state, and local statutes and regulations. The failure to comply with applicable statutory and regulatory
requirements at any time during the product development process, approval process, or after approval may subject a sponsor or applicant
to administrative or judicial enforcement actions. These actions could include the suspension or termination of clinical trials by FDA,
FDA’s refusal to approve pending applications or supplemental applications, suspension or withdrawal of an approval, issuance of
warning or untitled letters, product recalls, product seizures, total or partial suspension of production or distribution, import detention,
injunctions, fines, refusals of government contracts, restitution, disgorgement of profits, or civil or criminal investigations and penalties
brought by FDA, the Department of Justice (“DOJ”), and other governmental entities.
26
An
applicant seeking approval to market and distribute a biologic in the United States must typically undertake the following:
●
completion
of non-clinical laboratory tests and studies performed in accordance with FDA’s Good Laboratory Practice (“GLP”)
regulations;
●
manufacture,
labeling and distribution of investigational drugs in compliance with FDA’s current Good Manufacturing Practice (“cGMP”)
requirements;
●
submission
to FDA of an Investigational New Drug application (“IND”), which must become effective before clinical trials may begin
and must be updated annually and when significant changes are made;
●
approval
by an Investigational Review Board (“IRB”) for each clinical site before each clinical trial may be initiated;
●
performance
of adequate and well-controlled human clinical trials in accordance with FDA’s Good Clinical Practice (“GCP”) requirements
to establish the safety, purity, and potency of the proposed biological product candidate for its intended purpose;
●
after
completion of all pivotal clinical trials, preparation of and submission to FDA of a Biologics License Application (“BLA”)
requesting marketing approval, which includes providing sufficient evidence to establish the efficacy, safety, purity, and potency
of the proposed biological product for its intended use, including from results of nonclinical testing and clinical trials;
●
satisfactory
completion of an FDA advisory committee review, when appropriate, as may be requested by FDA to assist with its review;
●
satisfactory
completion of one or more FDA inspections of the manufacturing facility or facilities at which the proposed product, or certain components
thereof, are produced to assess compliance with cGMP and data integrity requirements to assure that the facilities, methods, and
controls are adequate to preserve the biological product’s identity, strength, quality, and purity and, if applicable, FDA’s
Good Tissue practice (“GTP”) requirements for certain human cellular and tissue products;
●
satisfactory
completion of FDA inspections of selected clinical investigation sites to assure compliance with GCP requirements and the integrity
of the clinical data;
●
satisfactory
completion of an FDA sponsor GCP inspection, often conducted at the applicant’s headquarters facility;
●
payment
of user fees (unless there is a waiver, exemption, or reduction) under the Prescription Drug User Fee Act (“PDUFA”) for
the relevant year;
●
FDA’s
review and approval of the BLA to permit commercial marketing of the licensed biologic for particular indications for use in the
United States; and
●
compliance
with post-approval requirements, including the potential requirements to implement a Risk Evaluation and Mitigation Strategies (“REMS”),
to report adverse events and biological product deviations, and to complete any post-approval studies such as confirmatory trials
or pediatric studies.
From
time to time, legislation is drafted, introduced, and passed in Congress that could significantly change the statutory provisions governing
the testing, approval, manufacturing, and marketing of biological products regulated by FDA. In addition to new legislation, FDA regulations,
guidance documents, and policies are often revised or interpreted by the agency in ways that may significantly affect the regulation
of biological products in the United States. It is impossible to predict whether further legislative changes will be enacted or whether
FDA regulations, guidance, policies, or interpretations will change, and the effects of any such changes.
27
Preclinical
and Clinical Development
Before
an applicant can begin testing the potential product candidate in human subjects, the applicant must first conduct preclinical studies.
Preclinical studies may include laboratory evaluations of product chemistry, toxicity, and formulation, as well as in vitro and animal
studies to assess the potential safety and activity of the drug for initial testing in humans and to establish a rationale for therapeutic
use. Preclinical studies are subject to federal regulations and requirements, including GLP regulations, which govern the conduct of
animal studies designed to test a product’s safety. None of our preclinical studies to date have been animal studies. The results
of an applicant’s preclinical studies are submitted to FDA as part of an IND.
An
IND is a request for authorization from FDA to administer an investigational new drug product to humans. An IND is an exemption from
the FDCA that allows an unapproved drug to be shipped in interstate commerce for use in a clinical trial. Such authorization must be
secured prior to interstate shipment and administration of a biological drug that is not subject of an approved BLA. In support of an
IND, applicants must submit a protocol for each clinical trial, which details, among other things, the objectives of the trial, the parameters
to be used in monitoring safety and the effectiveness criteria to be evaluated. A separate submission to the existing IND must be made
for each successive clinical trial conducted during product development and for any subsequent protocol amendments.
Human
clinical trials may not begin until an IND is effective. The IND automatically becomes effective 30 days after receipt by FDA, unless
FDA raises safety concerns or questions about the proposed clinical trial within the 30-day time period. In such a case, FDA may place
the IND on clinical hold and the IND sponsor must resolve any of FDA’s outstanding concerns or questions before the clinical trial
can begin. Submission of an IND therefore may or may not result in regulatory authorization to begin a clinical trial.
FDA
may also place a clinical hold or partial clinical hold on a clinical trial following commencement of the trial under an IND. A clinical
hold is an order issued by FDA to the sponsor to delay a proposed clinical investigation or to suspend an ongoing investigation. A partial
clinical hold is a delay or suspension of only part of the clinical work requested under the IND. For example, under a partial clinical
hold, FDA may instruct a sponsor not to enroll any new patients into a study, but permit the previously enrolled patients to continue
in the study. No more than 30 days after imposition of a clinical hold or partial clinical hold, FDA will provide the sponsor a written
explanation of the basis for the hold. Following issuance of a clinical hold or partial clinical hold, an investigation may only resume
after FDA has notified the sponsor that the investigation may proceed. FDA will base that determination on information provided by the
sponsor addressing the deficiencies previously cited or otherwise satisfying FDA that the investigation can proceed.
Clinical
trials involve the administration of the investigational product to human subjects under the supervision of qualified investigators in
accordance with GCP regulations, which include the requirement that all research subjects provide their informed consent for their participation
in any clinical trial. If a sponsor chooses to conduct a foreign clinical study under an IND, all FDA IND requirements must be met unless
waived. When the foreign clinical study is not conducted under an IND, the sponsor must ensure that the study complies with GCP regulations
in order to use the study as support for an IND or application for marketing approval, including review and approval by an IRB and informed
consent from subjects.
Furthermore,
an independent IRB for all sites participating in a clinical trial must review and approve the plan for any clinical trial and its informed
consent form before the clinical trial begins at each site, and must monitor the trial until completed. Regulatory authorities, the IRB,
or the sponsor may suspend a clinical trial at any time on various grounds, including a finding that the subjects are being exposed to
an unacceptable health risk or that the trial is unlikely to meet its stated objectives.
Some
trials also include oversight by an independent group of qualified experts organized by the clinical trial sponsor, known as a DSMB.
DSMBs review unblinded study data at pre-specified times during the course of the study. If the DSMB determines that there is an unacceptable
safety risk for subjects or other grounds, such as no demonstration of efficacy, the DSMB can make a recommendation to the sponsor to
modify or stop the trial.
Other
grounds for a sponsor’s decision to suspend or terminate a study may be made based on evolving business objectives or competitive
climate.
28
For
purposes of BLA approval, clinical trials are typically conducted in the following sequential phases:
●
Phase
1: The investigational product is initially introduced into a small group of healthy human subjects or patients with the target disease
or condition. These trials are designed to test the safety, dosage tolerance, absorption, metabolism and distribution of the investigational
product in humans and the side effects associated with increasing doses. These trials may also yield early evidence of effectiveness.
●
Phase
2: The investigational product is administered to a slightly larger patient population with a specified disease or condition to evaluate
the preliminary efficacy, optimal dosages, and dosing schedule and to identify possible adverse side effects and safety risks. Multiple
Phase 2 clinical trials may be conducted to obtain information prior to beginning larger and more expensive Phase 3 clinical trials.
●
Phase
3: The investigational product is administered to an expanded patient population to further evaluate dosage, to provide statistically
significant evidence of clinical efficacy and to further test for safety, generally at multiple geographically dispersed clinical
trial sites. These clinical trials are intended to generate sufficient data to statistically demonstrate the efficacy and safety
of the product, to establish the overall risk/benefit ratio of the investigational product, and to provide an adequate basis for
product approval by FDA.
These
phases may overlap or be combined. In some cases, FDA may require, or companies may voluntarily pursue, additional clinical trials after
a product is approved to gain more information about the product, referred to as Phase 4 trials. Such post-approval trials are conducted
following initial approval, often to develop additional data and information relating to the use of the product in new indications.
Progress
reports detailing the results of the clinical trials must be submitted at least annually to FDA. In addition, IND safety reports must
be submitted to FDA for any of the following: serious and unexpected suspected adverse reactions in study subjects; findings from epidemiological
studies, pooled analysis of multiple studies, animal or in vitro testing, or other clinical studies, whether or not conducted under an
IND, and whether or not conducted by the sponsor, that suggest a significant risk in humans exposed to the drug; and any clinically important
increase in the rate of a serious suspected adverse reaction over such rate listed in the protocol or investigator brochure.
A
sponsor’s planned clinical trials may not be completed successfully within any specified period, or at all. Furthermore, FDA or
the sponsor may suspend or terminate a clinical trial at any time on various grounds, including a finding that the research subjects
are being exposed to an unacceptable health risk. Similarly, an IRB can suspend or terminate approval of a clinical trial at its institution,
or an institution it represents, if the clinical trial is not being conducted in accordance with the IRB’s requirements or if the
drug has been associated with unexpected serious harm to patients. FDA will typically inspect one or more clinical sites to assure compliance
with GCP and the integrity of the clinical data submitted.
During
clinical development, the sponsor often refines the indication and endpoints on which the BLA will be based. For endpoints based on patient-reported
outcomes (“PROs”), the process typically is an iterative one. FDA has issued guidance on the framework it uses to evaluate
PRO instruments. Although the agency may offer advice on optimizing PRO instruments during the clinical development process, FDA usually
reserves final judgment until it reviews the BLA.
Concurrent
with clinical trials, companies often complete additional animal studies, and develop additional information about the chemistry and
physical characteristics of the drug and finalize a process for manufacturing the product in commercial quantities in accordance with
cGMP. The manufacturing process must be capable of consistently producing quality batches of the drug candidate and, among other things,
must develop methods for testing the identity, strength, quality, purity and potency of the final drug. Additionally, appropriate packaging
must be selected and tested, and stability studies must be conducted to demonstrate that the drug candidate does not undergo unacceptable
deterioration over its shelf life.
29
BLA
Submission and Review
Assuming
successful completion of all required clinical testing in accordance with all applicable regulatory requirements, an applicant may submit
a BLA requesting licensing to market the biologic for one or more indications in the United States. The BLA must include the results
of nonclinical studies and clinical trials; detailed information on the product’s chemistry, manufacture, controls; and proposed
labeling. Under the PDUFA, a BLA submission is subject to an application user fee, unless a waiver, reduction, or exemption applies.
FDA
will initially review the BLA for completeness before accepting it for filing. Under FDA’s procedures, the agency has 60 days from
its receipt of a BLA to determine whether the application will be accepted for filing and substantive review. If the agency determines
that the application does not meet this initial threshold standard, FDA may refuse to file the application and request additional information,
in which case the application must be resubmitted with the requested information and review of the application delayed.
After
the BLA is accepted for filing, FDA reviews the BLA to determine, among other things, whether a product is safe, pure, and potent and
if the facility in which it is manufactured, processed, packed, or held meets standards designed to assure the product’s continued
identity, strength, quality, safety, purity, and potency. To ensure cGMP, GLP, GCP, GTP, and other regulatory compliance, an applicant
must incur significant expenditure of time, money, and effort in the areas of training, record keeping, production and quality control.
In addition, FDA expects that all data be reliable and accurate, and requires sponsors to implement meaningful and effective strategies
to manage data integrity risks. Data integrity is an important component of the sponsor’s responsibility to ensure the safety,
efficacy and quality of its product or products.
For
cellular products, FDA will not approve the product if the manufacturer is not in compliance with the GTPs, to the extent applicable.
GTPs are FDA regulations and guidance documents that govern the methods used in, and the facilities and controls used for, the manufacture
of human cells, tissue, and cellular and tissue-based products (“HCT/Ps”), which are human cells or tissue intended for implantation,
transplant, infusion, or transfer into a human recipient. The primary intent of the GTP requirements is to ensure that cell and tissue-based
products are manufactured in a manner designed to prevent the introduction, transmission, and spread of communicable disease. FDA regulations
also specify how HCT/P establishments must register and list their HCT/Ps with FDA and how they must evaluate donors through screening
and testing, where applicable.
If
FDA determines that the application, manufacturing process or manufacturing facilities are not acceptable, it will outline the deficiencies
in the submission and often will request additional testing or information. Notwithstanding the submission of any requested additional
information, FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.
The
performance goals and policies implemented by FDA under the PDUFA generally provide for FDA action on an original BLA within 10 months
of filing, which (as discussed above) typically occurs within 60 days of submission, but that deadline is extended in certain circumstances.
Furthermore, the review process is often significantly extended by FDA’s requests for additional information or clarification.
FDA
may refer applications for novel products or products that present difficult questions of safety or efficacy to an advisory committee.
Typically, an advisory committee consists of a panel that includes clinicians and other experts who will review, evaluate, and provide
a recommendation as to whether the application should be approved and, if so, under what conditions. FDA is not bound by the recommendations
of an advisory committee, but it considers such recommendations carefully when making decisions and usually has followed such recommendations.
After
FDA evaluates a BLA and conducts inspections of manufacturing facilities where the investigational product and/or its components will
be produced, FDA may issue an approval letter or a Complete Response Letter (“CRL”). An approval letter authorizes commercial
marketing of the biologic with specific prescribing information for specific indications. A CRL will describe all of the deficiencies
that FDA has identified in the BLA, except that where FDA determines that the data supporting the application are inadequate to support
approval, FDA may issue the CRL without first conducting required inspections, testing submitted product lots and/or reviewing proposed
labeling. If and when the deficiencies have been addressed to FDA’s satisfaction in a resubmission of the BLA, FDA will issue an
approval letter. In issuing the CRL, FDA may recommend actions that the applicant might take to place the BLA in condition for approval,
including requests for additional data, information, or clarification. FDA may delay or refuse approval of a BLA if applicable regulatory
criteria are not satisfied, and may require additional testing or information and/or require new clinical trials. Even with submission
of this additional information, FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.
30
During
the approval process, FDA will determine whether a REMS is necessary to help ensure the benefits outweigh the risks of the biologic.
A REMS is a safety strategy to manage a known or potential serious risk associated with a product and to enable patients to have continued
access to such medicines by managing their safe use, and could include medication guides, physician communication plans or elements to
assure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. If FDA concludes that
a REMS is needed, the BLA sponsor must submit a proposed REMS and FDA will not approve the BLA without a REMS that the agency has determined
is acceptable.
If
FDA approves a product, it may limit the approved indications for use for the product, or require that contraindications, warnings, or
precautions be included in the product labeling. FDA may also require that post-approval studies, including Phase 4 clinical trials,
be conducted to further assess the drug’s safety after approval. FDA may prevent or limit further marketing of a product based
on the results of post-market studies or surveillance programs.
FDA
may also require testing and surveillance programs to monitor the product after commercialization. For biologics, such testing may include
official lot release, which requires the manufacturer to perform certain tests on each lot of the product before it is released for distribution.
The manufacturer then typically must submit samples of each lot of product to FDA, together with a release protocol showing a summary
of the history of manufacture of the lot and the results of all of the manufacturer’s tests performed on the lot. FDA may also
perform certain confirmatory tests on lots of some products itself, before releasing the lots for distribution by the manufacturer.
In
general, an approved BLA only allows the sponsor to market the biologic as approved, without modification. If, for example, a sponsor
modifies an approved T cell product to target different peptides or in our case to target another HLA type, the sponsor would be required
to either file a supplemental BLA with FDA or receive FDA approval for a comparability protocol in order to implement this change into
the final product.
FDA
may withdraw the product approval if compliance with pre- and post-marketing requirements is not maintained or if problems occur after
the product reaches the marketplace.
Post-Approval
Requirements
Any
products manufactured or distributed pursuant to FDA approvals are subject to pervasive and continuing regulation by FDA, including,
among other things, requirements relating to recordkeeping, periodic reporting, reporting of certain deviations and adverse experiences,
product sampling and distribution, and advertising and promotion of the product. After approval, many types of changes to the approved
product, such as adding new indications, manufacturing changes and additional labeling claims, are often subject to further testing requirements
and FDA review and approval, depending on the nature of the post-approval change. There also are continuing user fee requirements, under
which FDA assesses an annual program fee for each product identified in an approved BLA. Biologic manufacturers and their third-party
contractors are required to register their facilities with FDA and certain state agencies. These facilities are subject to routine and
periodic unannounced inspections by FDA and certain state agencies for compliance with cGMP, post-marketing safety reporting and data
integrity requirements, which impose certain procedural and documentation requirements to assure quality of manufacturing and product.
FDA has increasingly observed cGMP violations involving data integrity during site inspections and is a significant focus of its oversight.
Requirements with respect to data integrity include, among other things, controls ensuring complete and secure data; activities documented
at the time of performance; audit trail functionality; authorized access and limitations; validated computer systems; and review of records
for accuracy, completeness, and compliance with established standards.
Post-approval
changes to the manufacturing process are strictly regulated, and, depending on the significance of the change, may require FDA approval
before being implemented. FDA regulations also require investigation and correction of any deviations from cGMP and impose reporting
requirements upon the sponsor and any third-party manufacturers that the sponsor may use. Accordingly, manufacturers must continue to
expend time, money, and effort in the area of production and quality control to maintain compliance with cGMP, data integrity, pharmacovigilance,
and other aspects of regulatory compliance.
31
FDA
may withdraw the 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 a product, including adverse events of unanticipated severity
or frequency, or with manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved
labeling to add new safety information; imposition of post-approval studies to assess new safety risks; or imposition of distribution
or other restrictions under a REMS. Other potential consequences include, for example:
●
restrictions
on the marketing or manufacturing of a product, complete withdrawal of the product from the market, or product recalls;
●
fines,
warning or untitled letters, or holds on post-approval clinical studies;
●
refusal
of FDA to approve pending applications or supplements to approved applications, or suspension or revocation of existing product approvals;
●
product
seizure or detention, or refusal of FDA to permit the import or export of products; or
●
permanent
injunctions and consent decrees, including the imposition of civil or criminal penalties.
FDA
strictly regulates the marketing, labeling, advertising, and promotion of prescription drug products placed on the market. A company
can make only those claims relating to safety and efficacy, purity and potency that are approved by FDA and in accordance with the provisions
of the approved labeling. FDA’s regulation includes, among other things, standards and regulations for direct-to-consumer advertising,
communications regarding unapproved uses, industry-sponsored scientific and educational activities and promotional activities involving
the Internet and social media. Promotional claims relating to a product’s safety or effectiveness are prohibited before the drug
is approved. After approval, a product generally may not be promoted for uses that are not approved by FDA, as reflected in the product’s
prescribing information. In the United States, healthcare professionals are generally permitted to prescribe drugs for such uses not
described in the drug’s labeling, known as off-label uses, because FDA does not regulate the practice of medicine. However, FDA
regulations impose rigorous restrictions on manufacturers’ communications and prohibit the promotion of off-label uses. It may
be permissible, under very specific, narrow conditions, for a manufacturer to engage in non-promotional, non-misleading communication
regarding off-label information, such as distributing scientific or medical journal information.
If
a company is found to have promoted off-label uses, it may become subject to adverse public relations and administrative and judicial
enforcement by FDA, the DOJ, or the Office of the Inspector General of the Department of Health and Human Services (“HHS”),
as well as other federal and state authorities. This could subject a company to a range of penalties that could have a significant commercial
impact, including civil, administrative, and criminal fines, penalties, and agreements that materially restrict the manner in which a
company promotes or distributes products. The federal government has levied large civil, administrative, and criminal fines and penalties
against companies for alleged improper promotion, and has also requested that companies enter into Corporate Integrity Agreements and
Consent Decrees of Permanent Injunction under which specified promotional conduct is changed or curtailed.
The
distribution of prescription drugs and biologics are subject to the Drug Supply Chain Security Act (“DSCSA”), which requires
manufacturers and other stakeholders to comply with product identification, tracing, verification, detection and response, notification,
and licensing requirements. In addition, the Prescription Drug Marketing Act and its implementing regulations and state laws limit the
distribution of prescription pharmaceutical product samples, and the DSCSA imposes requirements to ensure accountability in distribution
and to identify and remove prescription drug and biological products that may be counterfeit, stolen, contaminated, or otherwise harmful
from the market.
32
Expedited
Development and Review Programs
FDA
offers a number of expedited development and review programs for qualifying product candidates. The fast-track program is intended to
expedite or facilitate the process for reviewing new products that meet certain criteria. Specifically, new products are eligible for
fast-track designation if they are intended to treat a serious or life-threatening disease or condition and demonstrate the potential
to address unmet medical needs for the disease or condition. A product intended to treat a serious or life-threatening disease or condition
may also be eligible for breakthrough therapy designation to expedite its development and review. Any marketing application for a biologic
submitted to FDA for approval, including a product with a fast-track designation and/or breakthrough therapy designation, may be eligible
for other types of FDA programs intended to expedite FDA review and approval process, such as priority review and accelerated approval.
FDA also may grant accelerated approval to certain products studied for their safety and effectiveness in treating serious or life-threatening
diseases or conditions.
The
RMAT designation, which we are currently planning to seek for some of our therapies, is intended to facilitate an efficient development
program for, and expedite review of, any drug that meets the following criteria: (1) the drug is a cell therapy, therapeutic tissue engineering
product, human cell and tissue product, or any combination product using such therapies or products, with limited exceptions; (2) the
drug is intended to treat, modify, reverse, or cure a serious or life-threatening disease or condition; and (3) preliminary clinical
evidence indicates that the drug has the potential to address unmet medical needs for such a disease or condition. Like breakthrough
therapy designation, RMAT designation provides potential benefits that include more frequent meetings with FDA to discuss the development
plan for the product candidate and eligibility for rolling review and priority review. Products granted RMAT designation may also be
eligible for accelerated approval on the basis of a surrogate or intermediate endpoint reasonably likely to predict long-term clinical
benefit, or reliance upon data obtained from a meaningful number of sites (including through expansion to additional sites) so as to
remove any likelihood of site-specific or investigator-specific bias on the evidence of effectiveness. Once approved, when appropriate,
FDA can permit fulfillment of post-approval requirements for RMATs receiving accelerated approval through the submission of clinical
evidence, clinical studies, patient registries, or other sources of real-world evidence such as electronic health records; through the
collection of larger confirmatory datasets; or through post-approval monitoring of all patients treated with the therapy prior to approval.
Fast
track designation, breakthrough therapy designation, priority review, accelerated approval, and RMAT designation do not change the standards
for approval but may expedite the development or approval process.
Patent
Term Restoration and Marketing Exclusivity
After
approval, owners of relevant drug or biological product patents may apply for up to a five year term patent extension to restore a portion
of patent term lost during product development and FDA review of a BLA if approval of the application is the first permitted commercial
marketing or use of a drug or biologic containing the active ingredient under the Drug Price Competition and Patent Term Restoration
Act of 1984, referred to as the Hatch-Waxman Act. The allowable patent term extension is calculated as one-half of the product’s
testing phase, which is the time between the effective date of an IND and initial BLA submission, and all of the approval phase, which
is the time between BLA submission and approval, up to a maximum of five years. The time can be shortened if FDA determines that the
applicant did not pursue approval with due diligence. The total patent term after the extension may not exceed 14 years from the date
of FDA approval of the product. Only one patent claiming each approved product is eligible for restoration and the patent holder must
apply for restoration within 60 days of approval, even if the product cannot be commercially marketed at that time. The USPTO, in consultation
with FDA, reviews and approves the application for patent term restoration.
For
patents that might expire during the BLA application phase, the patent owner may request an interim patent extension. An interim patent
extension increases the patent term by one year and may be renewed up to four times. For each interim patent extension granted, the post-approval
patent extension is reduced by one year. The director of the USPTO must determine that approval of the product candidate covered by the
patent for which a patent extension is being sought is likely. Interim patent extensions are not available for a product candidate for
which a BLA has not been submitted.
33
Biosimilars
and Marketing Exclusivities
The
BPCIA created an abbreviated approval pathway for biological product candidates shown to be highly similar to or interchangeable with
an FDA licensed biological product. A biological product on which another biological product candidate’s BLA relies to establish
biosimilarity is known as a reference product. Biosimilarity sufficient to reference a prior FDA-approved product requires that there
be no differences in conditions of use, route of administration, dosage form and strength, and no clinically meaningful differences between
the biological product candidate and the reference product in terms of safety, purity, and potency. Biosimilarity must be shown through
analytical trials, animal trials and at least one clinical trial, unless the Secretary of HHS waives a required element. A biosimilar
product candidate may be deemed interchangeable with a prior approved product if it meets the higher hurdle of demonstrating that it
can be expected to produce the same clinical results as the reference product and, for products administered multiple times, the biological
product candidate and the reference biologic may be switched after one has been previously administered without increasing safety risks
or risks of diminished efficacy relative to exclusive use of the reference biologic. Complexities associated with the larger, and often
more complex, structures of biologics, as well as the process by which such products are manufactured, pose significant hurdles to implementation
of the abbreviated approval pathway that are still being resolved by FDA.
A
reference biologic is granted 12 years of exclusivity from the time of first licensure of the reference product, and no application for
a biosimilar can be submitted for four years from the date of licensure of the reference product. The first biological product candidate
submitted under the abbreviated approval pathway that is determined to be interchangeable with the reference product has exclusivity
against a finding of interchangeability for other biologics for the same condition of use for the lesser of (i) one year after first
commercial marketing of the first interchangeable biosimilar, (ii) 18 months after the first interchangeable biosimilar is approved if
there is no patent challenge, (iii) 18 months after resolution of a lawsuit over the patents of the reference biologic in favor of the
first interchangeable biosimilar applicant, or (iv) 42 months after the first interchangeable biosimilar’s application has been
approved if a patent lawsuit is ongoing within the 42 month period. At this time, it is unclear whether products deemed “interchangeable”
by FDA will, in fact, be readily substituted by pharmacies, which are governed by state pharmacy laws and regulations.
Healthcare
Regulation
Coverage,
Pricing, and Reimbursement
Our
ability to successfully commercialize any products for which we receive regulatory approval for commercial sale will depend, in part,
on the extent to which third-party payors provide coverage and establish adequate reimbursement levels for such products, and significant
uncertainty exists as to the coverage and reimbursement status of any products for which may we obtain regulatory approval. In the United
States, third-party payors include federal and state health care programs, private managed care providers, health insurers and other
organizations. The process for determining whether a third-party payor will provide coverage for a product may be separate from the process
for setting the price of a product or for establishing the reimbursement rate that such a payor will pay for the product. Third-party
payors may limit coverage to specific products on an approved list, also known as a formulary, which might not include all of the FDA-approved
products for a particular indication. Third-party payors are increasingly challenging the price, examining the medical necessity, and
reviewing the cost-effectiveness of medical products, therapies, and services, in addition to questioning their safety and efficacy.
We may need to conduct expensive pharmaco-economic studies in order to demonstrate the medical necessity and cost-effectiveness of our
products, in addition to the costs required to obtain FDA approvals. Our product candidates may not be considered medically necessary
or cost-effective. A payor’s decision to provide coverage for a product does not imply that an adequate reimbursement rate will
be approved. Further, one payor’s determination to provide coverage for a product does not assure that other payors will also provide
coverage for the product. Adequate third-party reimbursement may not be available to enable us to maintain price levels sufficient to
realize an appropriate return on our investment in product development.
The
marketability of any product candidates for which we receive regulatory approval for commercial sale may suffer if the government and
third-party payors fail to provide adequate coverage and reimbursement. In addition, emphasis on managed care in the United States has
increased and we expect will continue to increase the pressure on healthcare pricing. Coverage policies and third-party reimbursement
rates may change at any time. Even if favorable coverage and reimbursement status is attained for one or more products for which we receive
regulatory approval, less favorable coverage policies and reimbursement rates may be implemented in the future.
34
Other
Healthcare Laws and Compliance Requirements
Although
we currently do not have any commercialized products, our current and future business operations may be subject to additional healthcare
regulation and enforcement by the federal government and by authorities in the states and foreign jurisdictions in which we conduct our
business. Such laws include, without limitation, state and federal anti-kickback, fraud and abuse, false claims, privacy and security,
price reporting and physician sunshine laws. Some of our pre-commercial activities are subject to some of these laws.
The
federal Anti-Kickback Statute makes it illegal for any person or entity, including a prescription drug manufacturer or a party acting
on its behalf to knowingly and willfully, directly or indirectly, solicit, receive, offer, or pay any remuneration in cash or in kind
that is intended to induce or reward the referral of business, including the purchase, order, or lease of any item or service for which
payment may be made under a federal healthcare program, such as Medicare or Medicaid. The term “remuneration” has been broadly
interpreted to include anything of value. The Anti-Kickback Statute has been interpreted to apply to arrangements between pharmaceutical
manufacturers on one hand and prescribers, purchasers, formulary managers and beneficiaries on the other.
Although
there are a number of statutory exceptions and regulatory safe harbors protecting some common activities from prosecution, the exceptions
and safe harbors are drawn narrowly. Practices that involve remuneration that may be alleged to be intended to induce prescribing, purchases
or recommendations may be subject to scrutiny if they do not qualify for an exception or safe harbor. Failure to meet all of the requirements
of a particular applicable statutory exception or regulatory safe harbor does not make the conduct per se illegal under the Anti-Kickback
Statute. Instead, the legality of the arrangement will be evaluated on a case-by-case basis based on a cumulative review of all its facts
and circumstances. Several courts have found that the Anti-Kickback Statute may be violated if any one purpose of an arrangement involving
remuneration is to induce referrals of federal healthcare program business. In addition, liability may be established without actual
knowledge of the statute or specific intent to violate it. Violations of this law are punishable by up to ten years in prison, and can
also result in criminal fines, civil money penalties and exclusion from participation in federal healthcare programs.
Moreover,
a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent
claim for purposes of the federal civil False Claims Act.
The
federal civil False Claims Act prohibits, among other things, individuals or entities from knowingly presenting, or causing to be presented,
a false or fraudulent claim for payment of government funds or knowingly making, using, or causing to be made or used, a false record
or statement material to an obligation to pay money to the government or knowingly concealing or knowingly and improperly avoiding, decreasing,
or concealing an obligation to pay money to the federal government. Persons and entities can be held liable under these laws if they
are deemed to “cause” the submission of false or fraudulent claims by, for example, providing inaccurate billing or coding
information to customers or promoting a product off-label. Many pharmaceutical and other healthcare companies have been investigated
and have reached substantial financial settlements with the federal government under the civil False Claims Act for a variety of alleged
improper marketing activities, including: providing free product to customers with the expectation that the customers would bill federal
programs for the product; providing sham consulting fees, grants, free travel and other benefits to physicians to induce them to prescribe
our products; and inflating prices reported to private price publication services, which are used to set drug payment rates under government
healthcare programs. Penalties for federal civil False Claims Act violations may include up to three times the actual damages sustained
by the government, plus mandatory per claim civil penalties, and the potential for exclusion from participation in federal healthcare
programs. In addition, although the federal False Claims Act is a civil statute, False Claims Act violations may also implicate various
federal criminal statutes.
The
healthcare fraud provisions of The Health Insurance Portability and Accountability Act (“HIPAA”) prohibit knowingly and willfully
executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private third-party payors, knowingly
and willfully embezzling or stealing from a healthcare benefit program, willfully obstructing a criminal investigation of a healthcare
offense, and knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious
or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services. Like the federal Anti-Kickback
Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed
a violation.
35
Many
states have analogous laws and regulations, such as: state anti-kickback and false claims laws that may apply to sales or marketing arrangements
and claims involving healthcare items or services reimbursed by non-governmental third-party payors, including private insurers; 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 certain healthcare providers;
laws that require drug manufacturers to report information related to clinical trials or information related to payments and other transfers
of value to physicians and other healthcare providers or marketing expenditures; laws that restrict the ability of manufacturers to offer
co-pay support to patients for certain prescription drugs; and laws and local ordinances that require identification or licensing of
sales representatives.
HIPAA,
as amended by the Health Information Technology for Economic and Clinical Health Act (“HITECH”), and their implementing regulations,
mandates, among other things, the adoption of uniform standards for the electronic exchange of information in common healthcare transactions,
as well as standards relating to the privacy and security of individually identifiable health information, which require the adoption
of administrative, physical and technical safeguards to protect such information. Among other things, HITECH makes HIPAA’s security
standards directly applicable to business associates, defined as independent contractors or agents of covered entities that create, receive,
or obtain protected health information in connection with providing a service for or on behalf of a covered entity. HITECH also increased
the civil and criminal penalties that may be imposed against covered entities and 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 attorney’s
fees and costs associated with pursuing federal civil actions. In addition, certain state laws govern the privacy and security of health
information in certain circumstances, some of which are more stringent than HIPAA and many of which differ from each other in significant
ways and may not have the same effect, thus complicating compliance efforts. Failure to comply with these laws, where applicable, can
result in the imposition of significant civil and/or criminal penalties.
The
U.S. federal Physician Payment Sunshine Act, implemented as the Open Payments Program, requires manufacturers of drugs, devices, biologics,
and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain
exceptions) to report annually to the Centers for Medicare and Medicaid Services (“CMS”) information related to direct or
indirect payments and other transfers of value to physicians and teaching hospitals (and certain other practitioners as of 2022), as
well as ownership and investment interests held in the Company by physicians and their immediate family members.
Because
we intend to commercialize products that could be reimbursed under a federal health care program and other governmental healthcare programs,
we intend to develop a comprehensive compliance program that establishes internal control to facilitate adherence to the rules and program
requirements to which we will or may become subject. Although the development and implementation of compliance programs designed to establish
internal control and facilitate compliance can mitigate the risk of investigation, prosecution, and penalties assessed for violations
of these laws, the risks cannot be entirely eliminated.
If
our operations are found to be in violation of any of such laws or any other governmental regulations that apply to us, we may be subject
to penalties, including, without limitation, administrative, civil and criminal penalties, damages, fines, disgorgement, contractual
damages, reputational harm, diminished profits and future earnings, the curtailment or restructuring of our operations, exclusion from
participation in federal and state healthcare programs and individual imprisonment, any of which could adversely affect our ability to
operate our business and our financial results.
Health
Care Reform
In
the United States and some foreign jurisdictions, there have been, and continue to be, legislative and regulatory changes and proposed
changes regarding the healthcare system that could prevent or delay marketing approval of product candidates, restrict or regulate post-approval
activities, and affect the ability to profitably sell product candidates for which marketing approval is obtained. Among policy makers
and payors in the United States and elsewhere, there is significant interest in promoting changes in healthcare systems with the stated
goals of containing healthcare costs, improving quality and/or expanding access. In the United States, the pharmaceutical industry has
been a particular focus of these efforts and has been significantly affected by major legislative initiatives.
36
For
example, the Affordable Care Act (“ACA”) substantially changed the way healthcare is financed by both the government and
private insurers, and significantly impacts the U.S. pharmaceutical industry. The ACA contains provisions that may reduce the profitability
of drug products through increased rebates for drugs reimbursed by Medicaid programs, extension of Medicaid rebates to Medicaid managed
care plans, mandatory discounts for certain Medicare Part D beneficiaries, and annual fees based on pharmaceutical companies’ share
of sales to federal health care programs. The ACA made several changes to the Medicaid Drug Rebate Program, including increasing pharmaceutical
manufacturers’ rebate liability by raising the minimum basic Medicaid rebate. The ACA also expanded the universe of Medicaid utilization
subject to drug rebates by requiring pharmaceutical manufacturers to pay rebates on Medicaid managed care utilization and by enlarging
the population potentially eligible for Medicaid drug benefits.
There
have been judicial challenges to certain aspects of the ACA, as well as efforts by Congress to modify, and by agencies to alter the implementation
of, certain aspects of the ACA. For example, Congress eliminated the tax penalty for failure to comply with the ACA’s individual
mandate to carry health insurance. Further, the Bipartisan Budget Act of 2018, among other things, amended the ACA to increase from 50
percent to 70 percent the point-of-sale discount that is owed by pharmaceutical manufacturers who participate in Medicare Part D to close
the coverage gap in most Medicare drug plans, commonly referred to as the donut hole (this existing coverage gap program is sunset by
the Inflation Reduction Act beginning in 2025 and replaced with a new manufacturer discount program).
It
is possible that the ACA, as currently enacted or as may be amended in the future, as well as other healthcare reform measures, including
those that may be adopted in the future, may result in more rigorous coverage criteria, and less favorable payment methodologies, or
other downward pressure on coverage and payment and the price that we receive for any approved product. Any reduction in reimbursement
or restriction on coverage under Medicare or other federal health care programs may result in a similar reduction or restriction by private
payors.
Other
legislative changes have been proposed and adopted in the U.S. since the ACA was enacted. For example, the Inflation Reduction Act introduces
several changes to the Medicare Part D benefit, including a limit on annual out-of-pocket costs and a change in manufacturer liability
under the program which could negatively affect the profitability of our product candidates. The IRA sunsets the current Part D coverage
gap discount program starting in 2025 and replaces it with a new manufacturer discount program. Failure to pay a discount under this
new program will be subject to a civil monetary penalty. In addition, the IRA established a Medicare Part B inflation rebate scheme effective
January 2023 and a Medicare Part D inflation rebate scheme effective October 2022, under which, generally speaking, manufacturers will
owe rebates if the price of a Part B or Part D drug increases faster than the pace of inflation. Failure to timely pay a Part B or D
inflation rebate is subject to a civil monetary penalty. The IRA also created a drug price negotiation program under which the prices
for Medicare units of certain high Medicare spend drugs and biologicals without generic or biosimilar competition will be capped by reference
to, among other things, a specified non-federal average manufacturer price starting in 2026. Failure to comply with requirements under
the drug price negotiation program is subject to an excise tax and/or a civil monetary penalty. Congress continues to examine various
policy proposals that may result in pressure on the prices of prescription drugs with respect to the government health benefit programs
and otherwise. The IRA or other legislative changes could impact the market conditions for our product candidates.
In
general, there has been heightened governmental scrutiny over the manner in which drug manufacturers set prices for their commercial
products, which has resulted in several Congressional inquiries and proposed and enacted federal and state legislation designed to, among
other things, bring more transparency to drug product pricing, review the relationship between pricing and manufacturer patient programs,
and reform government program reimbursement methodologies for drug products. At the state level, legislatures have increasingly passed
legislation and implemented regulations designed to control pharmaceutical and biological product pricing, including price or patient
reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency measures,
and, in some cases, designed to encourage importation from other countries and bulk purchasing.
37
Privacy
We
may also be subject to federal, state, national and international laws and regulations governing the privacy and security of health-related
and other personal data we collect and maintain (e.g., Section 5 of the Federal Trade Commission Act (the “FTC Act”), the
California Consumer Privacy Act, as amended by the California Privacy Rights Act (the “CCPA”), and the European Union’s
(“EU”) General Data Protection Regulation). These laws and regulations are evolving and subject to interpretation and may
impose limitations on our activities or otherwise adversely affect our business. In addition, state laws govern the privacy and security
of health information in specified circumstances, many of which differ from each other in significant ways and may not have the same
effect, thus complicating compliance efforts.
If
we or our third party partners fail to comply or are alleged to have failed to comply with these or other applicable data protection
and privacy laws and regulations, or if we were to experience a data breach involving personal data, we could be subject to government
enforcement actions or private lawsuits. Any associated claims, inquiries, or investigations or other government actions could lead to
unfavorable outcomes that have a material impact on our business including through significant penalties or fines, monetary judgments
or settlements including criminal and civil liability for us and our officers and directors, increased compliance costs, delays or impediments
in the development of new products, negative publicity, increased operating costs, diversion of management time and attention, or other
remedies that harm our business, including orders that we modify or cease existing business practices.
Available
Information
We
maintain a website at the following address: www.tevogen.com. The information on our website is not incorporated by reference in this
report. We make available on or through our website certain reports and amendments to those reports that we file with or furnish to the
Securities and Exchange Commission (the “SEC”) in accordance with the Securities Exchange Act of 1934, as amended (the “Exchange
Act”). These include our Annual Reports on Form 10-K, our Quarterly Reports on Form 10-Q and our Current Reports on Form 8-K. We
make this information available on our website free of charge as soon as reasonably practicable after we electronically file the information
with, or furnish it to, the SEC. In addition, we routinely post on the “Investors” page of our website news releases, announcements
and other statements about our business and results of operations. We may use the “Investors” page of our website as a means
of disclosing material, non-public information and to comply with our disclosure obligations under Regulation FD. Therefore, we encourage
investors to monitor the “Investors” page of our website and review the information we post on that page.
The
SEC maintains a website that contains reports, proxy and information statements, and other information regarding issuers that file electronically
with the SEC at the following address: http://www.sec.gov.
Information
About Our Executive Officers
The
table below sets forth certain information concerning our executive officers serving as of the filing of this Annual Report:
Name
Age
Current
Position
Dr.
Ryan Saadi
61
Chief
Executive Officer, Chairperson and Director
Kirti
Desai
69
Chief
Financial Officer
Dr.
Neal Flomenberg
72
Chief
Scientific Officer and Global R&D Lead
Sadiq
Khan
64
Chief
Commercial Officer
Dr.
Ryan Saadi has served as our Chief Executive Officer and Chairperson since February 2024, and served as Chief Executive Officer
and Chairperson of Tevogen Bio beginning in June 2020. Dr. Saadi has been a member of the Leadership Council of the Yale School of Public
Health since 2021. Prior to founding Tevogen Bio, Dr. Saadi was the Global Vice President of Evidence, Market Access, and Strategic Pricing
for CSL Behring, a biopharmaceutical company that manufactures plasma-derived and recombination therapeutic products, from September
2018 to October 2019. Before CSL Behring, Dr. Saadi served as Global Head, Market Access and Policy, Oncology for Janssen from 2012 to
September 2018 and Worldwide Vice President, Health Policy, Reimbursement, Strategic Pricing and Market Access for Johnson & Johnson’s
Cordis business from 2008 to 2012. Earlier, Dr. Saadi was Global Vice President, Health Outcomes & Pricing for Genzyme and Global
Head, Health Outcomes and Market Access for Sanofi-Aventis’ oncology, bone and arthritis product portfolio. From 2010 through 2019,
Dr. Saadi has also served as a Voting Member of the CMS Medicare Evidence Development & Coverage Advisory Committee, which provides
independent guidance and expert advice to CMS on clinical topics.
38
Kirti
Desai has served as our Chief Financial Officer since February 2024, and served as Chief Financial Officer of Tevogen Bio beginning
in June 2020. Mr. Desai previously served as President of Star Accounting Services Inc., an accounting firm providing accounting and
tax services to businesses and individuals, from January 2005 to December 2021. Mr. Desai is a certified public accountant. Mr. Desai
also serves as the Treasurer of Shrimad Rajchandra Mission Dharampur (USA) Inc., a community outreach and development nonprofit.
Dr.
Neal Flomenberg has served as our Chief Scientific Officer and Global R&D Lead since February 2024, and served as Chief Scientific
Officer and Global R&D Lead of Tevogen Bio beginning in July 2022. Prior to joining Tevogen Bio, Dr. Flomenberg served as professor
and Chair of the Department of Medical Oncology at Sidney Kimmel Medical College of Thomas Jefferson University from 2008 to July 2022
and Deputy Director of Thomas Jefferson University’s Sidney Kimmel Cancer Center from 2015 to July 2022. Prior to those positions,
Dr. Flomenberg held a number of leadership roles in the academia, hospital, and research settings. Dr. Flomenberg’s career has
focused on blood cancers, particularly those requiring bone marrow or peripheral blood stem cell transplants, and he has authored over
175 peer reviewed publications. At Jefferson, Dr. Flomenberg also maintained an active medical practice and was continually listed in
Philadelphia Magazine’s “Top Doctors in Philadelphia” for more than 15 years prior to joining Tevogen Bio.
Sadiq
Khan has served as our Chief Commercial Officer since February 2024, and served as Chief Commercial Officer of Tevogen Bio beginning
in April 2022. Previously, Mr. Khan held several roles at the New Jersey Institute of Technology (“NJIT”), a public research
university, and its subsidiaries from 2014 to March 2022. Most recently, Mr. Khan served as Senior Director and then Executive Director
of Operations & Business Planning at BioCentriq, a for-profit cell and gene therapy contract development and manufacturing organization
owned by New Jersey Innovation Institute (“NJII”), which was itself a non-profit subsidiary of NJIT, from September 2018
to March 2022. While at BioCentriq, Mr. Khan was part of the leadership team that prepared BioCentriq for its spin-off from NJII. Mr.
Khan held several roles at NJII from 2014 to February 2020, including Director of Business Development, Biopharma Innovation beginning
in 2018, where he worked to facilitate academic, government, and industry collaboration in the biopharmaceutical field. From 2008 to
March 2018, Mr. Khan also acted as Founder and Chief Strategist for Pharmique Health LLC, where he advised corporations on strategic
commercial planning and other matters. Previously, Mr. Khan co-founded Tegelix Therapeutics, a now-defunct pharmaceutical company, and
held various regional and global commercialization and alliance management roles at Hoechst Marion Roussel, Aventis, and then Sanofi-Aventis.
39
Item
1A. Risk Factors.
RISK
FACTORS
Investing
in our shares of Common Stock or Warrants involves a high degree of risk. Before making an investment, you should carefully consider
the following risks and uncertainties, as well as general economic and business risks, and the other information contained in this Annual
Report. These risk factors are not exhaustive, and investors are encouraged to perform their own investigation with respect to our business,
financial condition and prospects. 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 Common Stock and Warrants could decline and you could
lose all or part of your investment.
Risks
Related to Our Financial Position and Need for Additional Capital
We
have a limited operating history and no products approved for commercial sale and have never generated revenue from product sales. We
have a history of significant losses, expect to continue to incur significant losses for the foreseeable future and may never achieve
or maintain profitability.
We
are a clinical-stage specialty immunotherapy company with a limited operating history. Investment in immunotherapy product development
entails substantial upfront capital expenditures and significant risk that product candidates will fail to prove safe or effective, gain
regulatory approval or become commercially viable. Since our founding in 2020, we have incurred significant net losses. We have funded
our operations to date primarily with proceeds from offerings of convertible notes and preferred stock and have devoted substantially
all of our efforts and financial resources to organizing and staffing our Company, conducting discovery, research, and development activities,
securing intellectual property rights related to our product candidates and ExacTcell technology, raising capital, and the business combination.
We
expect that it could be years, if ever, before we have a commercialized product. We expect to continue to incur significant expenses
and operating losses for the foreseeable future. The net losses we incur may fluctuate significantly from year to year. We anticipate
that our expenses will increase substantially if, and as, we:
●
continue
to advance the development of TVGN 489 and our preclinical product candidates;
●
leverage
our ExacTcell technology to advance additional product candidates into preclinical and clinical development;
●
seek
regulatory approvals for any product candidates that successfully complete clinical trials and potential commercialization;
●
develop
and expand our current cGMP manufacturing capacity, including to provide drug supply for future clinical trials;
●
develop
our AI technologies;
●
hire
additional clinical, quality control, regulatory, scientific, and administrative personnel;
●
expand
our operational, financial, and management systems and increase personnel, including to support our clinical development, manufacturing,
and commercialization efforts and our operations as a public company;
●
maintain,
expand, and protect our intellectual property portfolio;
●
establish
a marketing, sales, distribution, and medical affairs infrastructure to commercialize any products for which we may obtain marketing
approval and commercialize, whether on our own or jointly with a partner;
●
acquire
or in-license other technologies or engage in strategic partnerships; and
●
incur
additional legal, accounting, or other expenses in operating our business.
To
date, we have not generated revenue. To become and remain profitable, we, whether on our own or jointly with a collaborator, must develop
and commercialize products with significant market potential. Our ability to generate revenue from product sales and achieve profitability
depends on our ability, alone or with collaboration partners, to successfully complete the development of, and obtain the regulatory
approvals necessary to commercialize, our product candidates. We do not anticipate generating revenue from product sales for some time,
if ever. Our ability to generate future revenue from product sales depends heavily on our, or our potential future collaborators’,
success in:
●
completing
preclinical studies and clinical trials of our product candidates;
●
seeking
and obtaining marketing approvals for any product candidates that we or our collaborators develop;
●
receiving
authorization of investigational new drug applications INDs for future product candidates;
40
●
identifying
and developing new product candidates;
●
manufacturing
cGMP supply of our product candidates for clinical trials and, if approved, commercial sales;
●
launching
and commercializing products for which we obtain marketing approval by establishing a marketing, sales, distribution, and medical
affairs infrastructure or, alternatively, collaborating with a commercialization partner;
●
achieving
coverage and adequate reimbursement by hospitals and third-party payors, including governmental authorities, such as Medicare and
Medicaid, private insurers, and managed care organizations, for product candidates, if approved, that we or our collaborators develop;
●
obtaining
market acceptance of product candidates, if approved, that we develop as viable treatment options;
●
addressing
any competing technological and market developments;
●
negotiating
favorable terms in any collaboration, licensing, or other arrangements into which we may enter and performing our obligations under
such arrangements;
●
maintaining,
protecting, and expanding our portfolio of intellectual property rights, including patents, trade secrets and know-how;
●
defending
against third-party interference or infringement claims, if any; and
●
attracting,
hiring, and retaining qualified personnel.
We
may never succeed in any or all of these activities and, even if we do, we may never generate revenue that is significant or large enough
to achieve profitability and may need to obtain additional funding to continue operations. If we do achieve profitability, we may not
be able to sustain or increase profitability on a quarterly or annual basis. Our failure to become and remain profitable would decrease
the value of our Company and could impair our ability to raise capital, maintain our research and development efforts, expand our business,
or continue our operations. A decline in the value of our Company could also cause you to lose all or part of your investment.
We
are relying in part on an additional $7.0 million of grant funding that we have not yet received to meet our liquidity needs.
Our
primary sources of funds to meet our near-term liquidity and capital requirements include cash on hand, amounts available under the Loan
Agreement (as defined below), proceeds from sales of Common Stock under our Sales Agreement with A.G.P./Alliance Global Partners (the
“Sales Agreement”), and an additional $7.0 million of grant funding we expect to receive in 2026 from
KRHP LLC, a New Jersey limited liability company (“KRHP”). In January 2025, we received a grant of $2.0 million from KRHP
to further our development of off-the-shelf, genetically unmodified precision T cell therapeutics to treat infectious diseases and cancers.
In August 2025, we received a grant of $1.0 million from KRHP to advance Tevogen.AI. KRHP also committed to provide an additional $7.0
million of grant funding to the Company to be used towards the Company’s ongoing operational expenses.
We
are relying in part on the additional grant funding to help meet our liquidity needs. Even if we receive all of such proceeds, we will
still need more capital to fully implement our business, operating, and development plans, in addition to proceeds from sales of Common
Stock under our Sales Agreement. At this time, we have not secured any additional financing. There can be no assurance that additional
capital will be available to us, or that, if available, it will be on terms satisfactory to us. If we do not obtain additional capital
on terms satisfactory to us, or at all, it may cause us to delay, curtail, scale back or forgo some or all of our research and development
or business operations, which could have a material adverse effect on our business and financial results.
We
will require substantial additional financing to pursue our business objectives and to fund our operations, which may not be available
on acceptable terms, or at all. A failure to obtain this necessary capital when needed could force us to delay, limit, reduce or terminate
our product development, commercialization efforts or other operations and affect our future viability as an ongoing business.
We
expect to spend substantial amounts of cash to continue the preclinical and clinical development of our current and future immunotherapy
programs, to fund our Tevogen.AI artificial intelligence initiative, and to pursue other potential business objectives. If we receive
marketing approval for any product candidates, including TVGN 489, we will require significant additional amounts of cash in order to
launch and commercialize such product candidates. In addition, other unanticipated costs may arise. Because the designs and outcomes
of our planned and anticipated clinical trials are highly uncertain, we cannot reasonably estimate the actual amounts necessary to successfully
complete the development of and commercialize any product candidate we develop.
41
Our
future capital requirements depend on many factors, including:
● the
scope, progress, timing, results, and costs of researching and developing TVGN 489 and our
other product candidates, including product candidates developed with our ExacTcell technology,
and of conducting preclinical studies and clinical trials;
● the
timing of, and the costs involved in, obtaining marketing approval for TVGN 489 and any future
product candidates we develop, if clinical trials are successful;
● the
costs of manufacturing TVGN 489 and any future product candidates for preclinical studies
and clinical trials and in preparation for marketing approval and commercialization;
● the
costs of commercialization activities, including marketing, sales, and distribution costs,
for TVGN 489 and any future product candidates we develop if any of these product candidates
are approved for sale;
● our
ability to establish and maintain strategic collaborations, licensing, or other arrangements
on favorable terms, if at all;
● the
costs involved in preparing, filing, prosecuting, maintaining, expanding, defending, and
enforcing patent claims, including litigation costs and the outcome of any such litigation;
● the
timing, receipt, and amount of sales of, or royalties on, our future products, if any; and
● the
emergence of competing therapies and other developments in the markets we intend to address.
Until
we can generate sufficient product and royalty revenue to finance our cash requirements, which we may never do, we expect to finance
our future cash needs through a combination of public or private equity offerings, debt financings, collaborations, strategic alliances,
and licensing arrangements.
As
a result of our cash balance, as well as our history of operating losses and negative cash flows from operations combined with our anticipated
use of cash to, among other things, fund the preclinical and clinical development of our products, identify and develop new product candidates,
and seek approval for TVGN 489 and our other product candidates and any other product candidates we develop, we will require substantial
additional financing to pursue our business objectives and fund our operations. Our future viability as an ongoing business is dependent
on our ability to generate cash from operating activities or to raise additional capital to finance our operations.
As
reflected in our balance sheets, we have significant accounts payable, accrued expenses and other liabilities. Proceeds from any capital-raising
transactions may be used to reduce our accounts payable accrued expenses and other liabilities. However, there can be no assurance that
we will raise sufficient funds to eliminate such amounts.
Additionally,
the terms of our Preferred Stock, our Loan Agreement, and our Sales Agreement may negatively impact our ability to raise additional capital
through equity or debt financings, due to the potential substantial dilution to our stockholders that could occur as a result of the
conversion of our convertible Preferred Stock or our issuance of shares under the Loan Agreement or Sales Agreement and due to the other
terms of our Preferred Stock and such agreements, or may negatively affect our ability to obtain favorable or acceptable terms in connection
with any such financing.
Furthermore,
if we raise additional capital through marketing, sales, and distribution arrangements or other collaborations, strategic alliances,
or licensing arrangements with third parties, we may have to relinquish certain valuable rights to our product candidates, future revenue
streams, research programs, or technologies or grant licenses on terms that may not be favorable to us. If we raise additional capital
through public or private equity offerings, the terms of these securities may include liquidation or other preferences that adversely
affect our stockholders’ rights. Further, to the extent that we raise additional capital through the sale of Common Stock or securities
convertible or exchangeable into Common Stock, your ownership interest will be diluted. If we raise additional capital through debt financing,
we 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, engaging in acquisition, merger, or collaboration transactions,
selling or licensing our assets, making capital expenditures, redeeming our stock, making certain investments, declaring dividends, or
other operating restrictions that could adversely impact our ability to conduct our business.
Any
future debt financing or other financing of securities senior to our Common Stock will likely include financial and other covenants that
will restrict our flexibility. Any failure to comply with these covenants may cause an event of default and acceleration of the obligation
to pay the debt, which would have a material adverse effect on our business, prospects, financial condition, and results of operations
and we could lose our existing sources of funding and impair our ability to secure new sources of funding.
Adequate
additional financing may not be available to us on acceptable terms, or at all, and may be impacted by the economic climate and market
conditions. If we are unable to obtain additional financing on favorable terms when needed, we may be required to delay, limit, reduce,
or terminate preclinical studies, clinical trials, or other research and development activities or one or more of our development programs.
42
Risks
Related to Development, Regulatory Review, and Product Approval
The
regulatory landscape that applies to cellular therapy product candidates is rigorous, complex, uncertain, and subject to change. Our
allogeneic T cell therapy product candidates represent new therapeutic approaches that could result in heightened regulatory scrutiny,
delays in clinical development or delays in or our ability to achieve regulatory approval, if at all, and commercialization or payor
coverage and reimbursement of our product candidates, if approved.
Our
future success is dependent on our unique approach to T cell therapy. Because these programs, particularly our pipeline of allogeneic
T cell product candidates that are developed from donors, represent a novel approach to immunotherapy for the treatment of virus-infected
cells in order to produce T cell immunity, developing and commercializing our product candidates subjects us to a number of challenges,
including:
●
obtaining
regulatory approval from FDA, which has relatively limited experience with regulating the development and commercialization of T
cell immunotherapies;
●
developing
and deploying consistent and reliable processes for procuring blood from consenting third-party donors, isolating T cells from the
blood of such donors, activating the isolated T cells against specific antigens, characterizing and storing the resulting activated
T cells for future therapeutic use, selecting and delivering a sufficient supply and breadth of appropriate human leukocyte antigen-matched
(“HLA-matched”) cells from among the available T cell lines, and finally infusing these activated T cells into patients
to eliminate virus-infected cells in the patient and induce anti-disease benefit;
●
relying
on healthcare provider site availability and accessibility to patients for receipt of T cell infusions;
●
utilizing
these product candidates in combination with other therapies currently used to treat patients in our target population, which may
increase the risk of adverse side effects;
●
educating
medical personnel regarding the potential side effect profile of each of our product candidates, particularly those that may be unique
to our allogeneic T cell therapy product candidates;
●
understanding
and addressing variability in the quality of a donor’s T cells, which could ultimately affect our ability to manufacture product
in a reliable and consistent manner;
●
developing
processes for the safe administration of these products, including long-term follow-up and registries, as applicable, for all patients
who receive these product candidates;
●
manufacturing
our product candidates to our specifications and in a timely manner to support our clinical trials and, if approved, commercialization;
●
sourcing
clinical and, if approved by FDA, commercial supplies for the materials used to manufacture and process these product candidates
that are free from viruses and other pathogens that may increase the risk of adverse side effects;
●
developing
a manufacturing process and distribution network that can provide a stable supply with a cost of goods that allows for an attractive
return on investment;
●
establishing
sales and marketing capabilities ahead of and after obtaining any regulatory approval to gain market acceptance, and obtaining adequate
coverage, reimbursement and pricing by third-party payors and government authorities; and
●
developing
therapies for types of diseases beyond those initially addressed by our current product candidates.
Adverse
developments in preclinical studies or clinical trials conducted by others in cellular therapy products may cause FDA and other regulatory
bodies to amend the requirements for approval of any product candidates we may develop or limit the use of products utilizing cellular
therapy technologies, either of which could harm our business. In addition, FDA’s clinical trial requirements and its criteria
for determining the safety and efficacy of a product candidate vary substantially according to the type, complexity, novelty, and intended
use and market of the potential products. The regulatory approval process for product candidates such as ours could be more expensive
and take longer than for other, better known, or more extensively studied pharmaceutical or other product candidates. Further, as we
are developing novel potential treatments for diseases in which in some cases there is relatively little clinical experience with new
endpoints and methodologies, there is heightened risk that FDA or other regulatory bodies may not consider the clinical trial endpoints
to provide clinically meaningful results, and the resulting clinical data and results may be more difficult to analyze. Regulatory agencies
administering existing or future regulations or legislation may not allow production and marketing of products utilizing cellular therapy
technology in a timely manner or under technically or commercially feasible conditions. In addition, regulatory action or private litigation
could result in expenses, delays, or other impediments to our research programs or the commercialization of resulting products.
We
cannot be sure that the manufacturing processes used in connection with our T cell immunotherapy product candidates will yield a sufficient
supply of satisfactory products that are safe, pure, and potent, scalable, or profitable.
Moreover,
actual or perceived safety issues, including adoption of new therapeutics or novel approaches to treatment, may adversely influence the
willingness of patients to participate in clinical trials, or if approved by FDA, of physicians to subscribe to the novel treatment mechanics.
FDA may ask for specific post-market requirements, such as establishment of a REMS, and additional information informing benefits or
risks of our products may emerge at any time prior to or after regulatory approval.
FDA’s
policies may change and additional government regulations may be enacted that could prevent, limit, or delay regulatory approval of any
current or future product candidate. We cannot predict the likelihood, nature or extent of government regulation that may arise from
future legislation or administrative action. If we are slow or unable to adapt to changes in existing requirements or to 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. In addition, the regulatory landscape applicable to AI is immature and changes to existing regulations or new regulations
could impede our use of AI, which could impair our ability to achieve our goals for our AI initiative and result in an adverse effect
on our business, results of operations and financial condition. For example, FDA’s Center for Biologics Evaluation and Research,
in coordination with others in FDA, has recently developed a regulatory framework for the safe and responsible use of AI throughout the
biological product lifecycle, which is outlined in a draft guidance document issued by FDA. If and when finalized, this and other guidance
documents, as well as other new FDA regulations and requirements, could present substantial and increasing costs for our compliance.
43
As
an organization, we have limited experience designing and implementing preclinical and clinical trials, which is a complex, expensive,
and time-consuming process and involves uncertain outcomes, and we have never conducted pivotal clinical trials. We may fail to adequately
design a trial, which could adversely affect the ability to initiate the trial, enroll patients, complete the trial, or obtain regulatory
approval on the basis of the trial results, as well as lead to increased or unexpected costs and in delayed timelines.
We
have limited experience designing and implementing preclinical and clinical trials, which is a complex, expensive, and time-consuming
process and involves uncertain outcomes. All of our product candidates are in preclinical or clinical development and their risk of failure
is high. The clinical trials and manufacturing of our product candidates are, and the manufacturing and marketing of our products, if
approved, will be, subject to extensive and rigorous review and regulation by numerous government authorities in the United States and
in other countries where we intend to test and market our product candidates. Before obtaining regulatory approvals for the commercial
sale of any of our product candidates, we must demonstrate through lengthy, complex, and expensive preclinical studies and clinical trials
that our product candidates are both safe and effective for use in each target indication. In particular, because our product candidates
are subject to regulation as biological products, we will need to demonstrate that they are safe, pure, and potent for use in their target
indications. Each product candidate must demonstrate an adequate risk versus benefit profile in its intended patient population and for
its intended use. We cannot be certain of the timely completion or outcome of our preclinical studies and clinical trials and cannot
predict if FDA will accept our proposed clinical programs or if the outcome of our preclinical studies and clinical trials will ultimately
support the further development of our current or future product candidates. As a result, we cannot be sure that we will be able to submit
INDs or similar applications for our preclinical programs on the timelines we expect, if at all, and we cannot be sure that such submission
will result in FDA allowing clinical trials to begin.
Furthermore,
we may not successfully or cost-effectively design and implement preclinical and clinical trials that achieve our desired clinical endpoints
efficiently, or at all. A clinical trial that is not well designed may delay or prevent initiation or completion of the trial, can lead
to increased difficulty in enrolling patients, may make it more difficult to obtain regulatory approval for the product candidate on
the basis of the study results, or, even if a product candidate is approved, could make it more difficult to commercialize the product
successfully or obtain reimbursement from third-party payors. Additionally, a trial that is not well-designed could be inefficient or
more expensive than it otherwise would have been, or we may incorrectly estimate the costs to implement the clinical trial, which could
lead to a shortfall in funding. We also expect to continue to rely on third parties to conduct our pivotal clinical trials. See “-
Risks Related to Reliance on Manufacturing and Third Parties .” If these third parties do not successfully carry out their
contractual duties, comply with regulatory requirements or meet expected deadlines, we may not be able to obtain marketing approval for
or commercialize TVGN 489 any future product candidates we develop, and our business could be materially harmed. We may require more
time and incur greater costs than our competitors and may not succeed in obtaining regulatory approvals of product candidates that we
develop.
If
we are unable to successfully develop, receive regulatory approval for, and commercialize our product candidates, our business will be
harmed.
All
of our product candidates are still in preclinical and clinical development and, with the exception of TVGN 489, we are early in our
development efforts. FDA permitted our IND for TVGN 489 to proceed in May 2021, and we began enrolling subjects in October 2021. Each
of our programs and product candidates will require additional preclinical and/or clinical development, regulatory approval, obtaining
manufacturing supply, capacity, and expertise, building a commercial organization or successfully outsourcing commercialization, substantial
investment, and significant marketing efforts, before we generate any revenue from product sales. We do not have any products that are
approved for commercial sale, and we may never be able to develop or commercialize marketable products.
44
Our
ability to generate revenue from our product candidates, which could take years to develop, if it ever does, will depend heavily on the
successful development, regulatory approval, and eventual commercialization of our product candidates. The success of our product candidates
or any other product candidates that we develop or otherwise may acquire will depend on several factors, including:
●
timely
and successful completion of preclinical studies and clinical trials;
●
effective
INDs submitted to FDA that allow commencement of our clinical trials for our product candidates;
●
sufficiency
of our financial and other resources to complete the necessary preclinical studies and clinical trials;
●
successful
development of, or making arrangements with third-party manufacturers for, our commercial manufacturing processes for our clinical
trials and any of our product candidates that receive regulatory approval at an acceptable cost and on a timely basis;
●
receipt
of timely marketing approvals from FDA;
●
launching
commercial sales of products, if approved;
●
acceptance
of the benefits and use of our products, if approved, by patients, the medical community, and third-party payors, for their approved
indications;
●
the
prevalence and severity of adverse events or other safety issues experienced with our product candidates;
●
the
availability, perceived advantages, cost, safety, and efficacy of alternative therapies for any product candidate, and any indications
for such product candidate, that we develop;
●
our
ability to produce any product candidates we develop on a commercial scale;
●
obtaining
and maintaining patent, trademark and trade secret protection and regulatory exclusivity for our product candidates and otherwise
protecting our rights in our intellectual property portfolio;
●
maintaining
compliance with regulatory requirements, including cGMP requirements;
●
obtaining
and maintaining coverage and adequate reimbursement by third-party payors, including government payors, for our products, if approved
by FDA;
●
maintaining
a continued acceptable safety, tolerability and efficacy profile of the products following approval; and
●
maintaining
and growing an organization of scientists and functional experts who can develop and commercialize our products and technology.
If
we do not succeed with respect to one or more of these factors in a timely manner or at all, we could experience significant delays or
an inability to successfully commercialize the product candidates we develop, which would materially harm our business. If we do not
receive marketing approvals for any product candidate we develop, we may not be able to continue our operations. Even if regulatory approvals
are obtained, we could experience significant delays or an inability to successfully commercialize our current and any future product
candidates we develop, which would materially harm our business. If we are not able to generate sufficient revenue through the sale of
any current or future product candidate, we may not be able to continue our business operations or achieve profitability.
We
may encounter substantial delays and disruptions in completing the development of our product candidates that could impair our ability
to successfully commercialize our product candidates and may harm our business and results of operations.
We
may experience delays in completing planned clinical trials for a variety of reasons, including the following:
●
the
extensive research and development required because our product candidates are based on new technologies;
●
the
availability of financial resources to commence and complete the planned trials;
●
reaching
agreement on acceptable terms with prospective clinical research organizations (“CROs”) and clinical trial sites, the
terms of which can be subject to extensive negotiation and may vary significantly among different CROs and trial sites;
●
FDA
or independent IRBs may not authorize us or our investigators to commence a clinical trial or conduct a clinical trial at a prospective
trial site;
●
recruiting
suitable patients to participate in a trial or sufficient patients to complete a trial;
●
having
patients complete a trial or return for post-treatment follow-up;
45
●
clinical
trial sites deviating from trial protocol or dropping out of a trial, which may require that we add new clinical trial sites or investigators;
●
manufacturing
the necessary product for use in the clinical trials;
●
clinical
trials of any product candidate may fail to show safety, purity, or potency, or may produce negative or inconclusive results, which
may cause us to decide, or regulators to require us, to conduct additional nonclinical trials or clinical trials or which may cause
us to decide to abandon product candidate development programs;
●
any
of our product candidates could cause undesirable side effects that could result in significant negative consequences, including
the inability to enter clinical development or receive regulatory approval; and/or
●
competition
from other clinical trial programs for similar indications and clinical trial patients.
A
clinical trial may also be suspended or terminated by us, the IRB for the institutions in which such trials are being conducted, the
data and safety monitoring board (“DSMB”) for such trial, or by FDA due to a number of factors. Those factors could include
failure to conduct the clinical trial in accordance with regulatory requirements or our clinical protocols, inspection of the clinical
trial operations or trial site by FDA, resulting in the imposition of a clinical hold, unforeseen safety issues or adverse side effects,
failure to demonstrate a benefit from using a product candidate, changes in governmental regulations or administrative actions or lack
of adequate funding to continue the clinical trial. In addition, FDA may order the temporary or permanent discontinuation of our clinical
trials at any time if it believes that the clinical trials are not being conducted in accordance with applicable regulatory requirements
or that they present an unacceptable safety risk to the patients enrolled in our clinical trials, or that the applicable INDs do not
contain sufficient information to assess the risks to patients in the proposed trials. For example, in November 2020, FDA placed a clinical
hold on our IND for TVGN 489 for the treatment of patients with COVID-19 infection, requested certain information regarding the manufacture
of TVGN 489, and asked us to revise our sterility testing approach so that such testing is performed on the final drug product, as opposed
to testing before harvesting the cells for cryopreservation. In May 2021, FDA found that we sufficiently addressed all of these issues
and lifted the clinical hold, permitting us to initiate our Phase 1 trial, which we completed in January 2023.
We
may experience regulatory delays or rejections as a result of many reasons. For example, we believe based on precedential industry examples,
including in areas with high unmet needs or strong early phase clinical trial results, that we may be able to commence pivotal trials
of TVGN 489 on the basis of the results of our completed Phase 1 trial. However, the clinical trial process usually includes three phases,
and our current plan to move TVGN 489 from its recently completed Phase 1 trial directly into pivotal trials may be rejected by FDA or
may be otherwise unfeasible. We may have to conduct additional Phase 1 testing or other Phase 2 trials, or may experience other delays,
prior to escalating TVGN 489 into a pivotal trial. At this stage, we cannot be certain whether we will be permitted to move from a Phase
1 trial directly to pivotal trials until FDA reviews and concurs with or rejects our proposed plans, and FDA may require us to conduct
further trials to generate additional safety and efficacy data. If regulatory inspectors conclude that we or our clinical trial sites
are not in compliance with applicable regulatory requirements for conducting clinical trials, we may receive reports of observations
or warning letters detailing deficiencies, and we will be required to implement corrective actions. If regulatory agencies deem our responses
to be inadequate, or are dissatisfied with corrective actions, our clinical trials may be temporarily or permanently discontinued, we
or our investigators may be precluded from conducting any ongoing or any future clinical trials, the government may refuse to approve
our marketing applications or allow us to manufacture or market our products, we may face civil enforcement actions from FDA, and we
may be criminally prosecuted.
If
we experience termination of, or delays in the completion of, any clinical trial of our product candidates, the commercial prospects
for our product candidates will be harmed, and our ability to generate product revenue will be delayed. In addition, any delays in completing
our clinical trials will increase our costs, slow down our product development and approval process, and jeopardize our ability to commence
product sales and generate revenue. Significant clinical trial delays could also allow our competitors to bring products to market before
we do or shorten any periods during which we have the exclusive right to commercialize our product candidates. In addition, many of the
factors that cause, or lead to, a delay in the commencement or completion of clinical trials may also ultimately lead to the denial of
regulatory approval of our product candidates or result in the development of our product candidates stopping early.
46
The
FDA regulatory approval process is lengthy and time-consuming and may lead to significant delays in the clinical development and regulatory
approval of our product candidates.
The
time required to obtain approval from FDA is unpredictable but typically takes many years following the commencement of clinical trials
and depends upon numerous factors, including the substantial discretion of FDA. Any delay in obtaining FDA and/or other necessary regulatory
approvals in the United States for any investigational new drug and failure to receive such approvals would have an adverse effect on
the investigational new drug’s potential commercial success and on our business, prospects, financial condition, and results of
operations.
We
have not obtained regulatory approval for any product candidate. We have not previously submitted a BLA to FDA. It is possible that none
of our current or future product candidates will ever obtain regulatory approval from FDA. The novel nature of our product candidates
may create further challenges in obtaining regulatory approval. The regulatory approval pathway for our product candidates may be uncertain,
complex, expensive, and lengthy, and approval may not be obtained. In addition, factors outside our control, such as government shutdowns,
natural disasters, and public health emergencies, could disrupt business at FDA, which could result in delays of reviews, approvals and
communications with FDA related to our clinical trials and product candidates.
Our
current and future product candidates could fail to receive regulatory approval for many reasons, including the following:
●
FDA
may disagree with the design or implementation of our clinical trials;
●
we
may be unable to demonstrate to the satisfaction of FDA that a product candidate is safe, pure, and potent for its proposed indication;
●
the
results of clinical trials may not meet the level of statistical significance required by FDA for approval;
●
we
may be unable to demonstrate that a product candidate’s clinical and other benefits outweigh its safety risks;
●
FDA
may disagree with our interpretation of data from clinical trials or preclinical studies;
●
the
data collected from clinical trials of our product candidates may not be sufficient to support the submission of a BLA to FDA to
obtain regulatory approval in the United States; and
●
FDA
may find deficiencies with or fail to approve our manufacturing processes or facility or the manufacturing processes or facilities
of third-party manufacturers with which we contract for clinical and commercial supplies.
The
lengthy approval process as well as the unpredictability of clinical trial results may result in our failing to obtain regulatory approval
to market any product candidate we develop, which would significantly harm our business, results of operations and prospects. Even if
we believe the data collected from current or future clinical trials of our product candidates are promising, such data may not be sufficient
to support approval by FDA.
Even
if we obtain approval, FDA may approve any of our product candidates for fewer or more limited indications, or a more limited patient
population, than we request; may grant approval contingent on the performance of costly post-approval clinical trials or other post-marketing
requirements; or may approve a product candidate with labeling that does not include the claims we believe are necessary or desirable
for the successful commercialization of such product candidates. Moreover, if we modify TVGN 489 and our other product candidates so
that they recognize and target new or more prevalent variants of COVID-19 and other viruses, we may have to either file a supplemental
BLA with FDA or receive FDA approval for a comparability protocol or obtain other regulatory approval. These requirements may be costly
and time-consuming and FDA ultimately may not approve of such changes.
FDA
may also change its policies, promulgate additional regulations, revise existing regulations, or take other actions that may prevent
or delay approval of our future products under development on a timely basis. Such policy or regulatory changes could impose additional
requirements upon us that could delay our ability to obtain approvals, increase the costs of compliance or restrict our ability to maintain
any marketing authorizations we may have obtained.
47
We
may never receive regenerative medicine advanced therapy (“RMAT”) designation for TVGN 489 or any other product candidate,
and receiving this designation may not lead to a faster development or regulatory review or approval process, and will not increase the
likelihood that such product candidates will receive marketing approval.
We
may seek RMAT designation from FDA for TVGN 489 for the treatment of COVID-19, or for our other product candidates. FDA may find that
TVGN 489 or our other product candidates do not meet the criteria for RMAT designation or may otherwise deny our requests for RMAT designation.
RMAT
designation provides potential benefits that include more frequent meetings with FDA to discuss the development plan for the product
candidate, and potential eligibility for rolling review and priority review. Products granted RMAT designation may also be eligible for
accelerated approval on the basis of a surrogate or intermediate endpoint reasonably likely to predict long-term clinical benefit, or
reliance upon data obtained from a meaningful number of sites, including through expansion to additional sites post-approval, if appropriate.
RMAT-designated products that receive accelerated approval may, as appropriate, fulfill their post-approval requirements through the
submission of clinical evidence, clinical studies, patient registries, or other sources of real world evidence; through the collection
of larger confirmatory data sets; or via post-approval monitoring of all patients treated with such therapy prior to approval of the
therapy. Under the Food and Drug Omnibus Reform Act of 2022 (“FDORA”), FDA is permitted to require that a post-approval confirmatory
study or studies be underway prior to approval or within a specified time period after the date of approval for a product granted accelerated
approval. FDORA also requires sponsors to send updates to FDA on the status of such studies and FDA must promptly post this information
publicly. FDORA also gives FDA increased authority to withdraw approval of a drug or biologic granted accelerated approval on an expedited
basis if the sponsor fails to conduct such studies in a timely manner, send the necessary updates to FDA, or if such post-approval studies
fail to verify the drug’s predicted clinical benefit. Under FDORA, FDA is empowered to take action, such as issuing fines, against
companies that fail to conduct with due diligence any post-approval confirmatory study or submit timely reports to the agency on their
progress. In addition, for products being considered for accelerated approval, FDA generally requires, unless otherwise informed by the
agency, that all advertising and promotional materials intended for dissemination or publication within 120 days of marketing approval
be submitted to the agency for review during the pre-approval review period. There can be no assurance that FDA would allow any of the
product candidates we may develop to proceed on an accelerated approval pathway, and even if FDA did allow such pathway, there can be
no assurance that such submission or application will be accepted or that any expedited development, review or approval will be granted
on a timely basis, or at all. Moreover, even if we received accelerated approval, any post-approval studies required to confirm and verify
clinical benefit may not show such benefit, which could lead to withdrawal of any approvals we have obtained. Receiving accelerated approval
does not assure that the product’s accelerated approval will eventually be converted to a traditional approval.
RMAT
designation does not change the standards for product approval, and there is no assurance that any such designation or eligibility will
result in expedited review or approval or that the approved indication will not be narrower than the indication covered by the RMAT designation.
Additionally, RMAT designation can be revoked if the criteria for eligibility cease to be met as clinical data emerges.
We
may also seek other accelerated approval pathways for our product candidates, which face some of the same risks as seeking RMAT designation,
and may not be successful or actually result in expedited review or approval. One of these programs is the FDA Commissioner’s National
Priority Voucher pilot program, which additionally is new and has only seen 18 products receive vouchers and one product see FDA approval
as of December 2025, therefore presenting additional unknown risks.
Our
business is highly dependent on our first product candidate, TVGN 489, and we must conduct clinical testing before we can obtain regulatory
approval and begin commercialization of any of our product candidates.
Because
we have limited financial and personnel resources and are placing significant focus on the development of TVGN 489, we may forgo or delay
pursuit of opportunities with other future product candidates that later 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 other future product candidates for specific indications may not yield any commercially
viable future product candidates. If we do not accurately evaluate the commercial potential or target market for a particular future
product candidate, we may relinquish valuable rights to those future product candidates 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
such future product candidates.
48
Interim
and preliminary results from our clinical trials that we announce or publish from time to time may change as more patient data become
available and are subject to audit, validation, and verification procedures that could result in material changes in the final data.
From
time to time, we may publish interim data, including interim top-line results or preliminary results from our clinical trials. Interim
data and results from our clinical trials are subject to the risk that one or more of the clinical outcomes may materially change as
patient enrollment continues and more patient data become available. Preliminary or top-line results also remain subject to audit, validation,
and verification procedures that may result in the final data being materially different from the interim and preliminary data we previously
published. As a result, interim and preliminary data may not be predictive of final results and should be viewed with caution until the
final data are available. Differences between preliminary or interim data and final data could significantly harm our business prospects
and may cause the trading price of our Common Stock to fluctuate significantly.
The
results of earlier preclinical and clinical trials may not be predictive of future clinical trial results. Initial positive results in
any of our clinical trials may not be indicative of results obtained when the trial is completed.
Failure
can occur at any time during the clinical trial process. Preclinical studies and early-stage clinical trials are primarily designed to
test safety, to study pharmacokinetics and pharmacodynamics, and to understand the side effects of product candidates at various doses
and schedules, and the results of preclinical studies and early clinical trials of our product candidates may not be predictive of the
results of larger, later-stage controlled clinical trials. For example, our current or future product candidates may demonstrate different
chemical, biological and pharmacological properties in patients than they do in laboratory studies or may interact with human biological
systems in unforeseen or harmful ways. Product candidates in later stages of clinical trials may fail to show desired pharmacological
properties or produce the necessary safety and efficacy results despite having progressed through preclinical studies and initial clinical
trials. In addition, initial success in clinical trials may not be indicative of results obtained when such trials are completed. Product
candidates that have shown promising results in early-stage clinical trials may still suffer significant setbacks in subsequent clinical
trials. Our sole clinical trial to date was conducted on a small number of patients in a single academic clinical site for a limited
number of indications. We will have to conduct larger, well-controlled trials in our proposed indications at multiple sites to verify
the results obtained to date and to support any regulatory submissions for further clinical development of our product candidates. Our
assumptions related to our product candidates, such as with respect to lack of toxicity, are based on an early limited clinical trial
and may prove to be incorrect.
A
number of companies in the pharmaceutical and biotechnology industries have suffered significant setbacks in clinical development even
after achieving promising results in earlier, smaller clinical trials, and any such setbacks in our clinical development could have a
material adverse effect on our business and operating results. Moreover, clinical data are often susceptible to varying interpretations
and analyses that may delay, limit, or prevent regulatory approval. We do not know whether any later stage clinical trials of TVGN 489
or other clinical trials we may conduct will demonstrate consistent or adequate efficacy and safety with respect to the proposed indication
for use sufficient to receive regulatory approval or market our product candidates.
Because
the number of patients in our proof-of-concept clinical trial of TVGN 489 was small, the results from this trial may be less reliable
than results achieved in larger clinical trials.
A
trial design that is considered appropriate includes a sufficiently large sample size with appropriate statistical power, as well as
proper control of bias, to allow a meaningful interpretation of the results. The preliminary results of studies with smaller sample sizes,
such as our proof-of-concept clinical trial of TVGN 489, can be disproportionately influenced by the impact the product had on a few
individuals, which limits the ability to generalize the results across a broader community, thus making the study results less reliable
than studies with a larger number of patients and making it difficult to predict final results from preliminary results. Our proof-of-concept
clinical trial only tested TVGN 489 in the most common HLA type, and while we intend to treat patients with the six most common HLA types
in our next clinical trial of TVGN 489, our results in our proof-of-concept clinical trial may not be predictive of results in other
HLA types. As a result, there may be less certainty that TVGN 489 would achieve a statistically significant effect in any future clinical
trials. If we conduct any future clinical trials of TVGN 489, we may not achieve a statistically significant result. Similarly, if we
conduct a clinical trial of any other product candidate we develop with a small sample size, the results of any such trial may be less
reliable than results achieved in larger clinical trials and may provide less certainty of achieving statistically significant effects
in any future clinical trials. Such results could negatively impact our business, financial condition, results of operations and prospects.
49
Changes
in methods of product candidate manufacturing or formulation may result in additional costs or delay.
As
product candidates proceed through preclinical studies to late-stage clinical trials towards potential approval and commercialization,
it is common that various aspects of the development program, such as manufacturing methods and formulation, are altered along the way
in an effort to optimize processes and results. Such changes carry the risk that they will not achieve these intended objectives. Any
of these changes could cause our product candidates to perform differently and affect the results of planned clinical trials or other
future clinical trials conducted with the materials manufactured using altered processes. Such changes may also require additional testing,
FDA notification, or FDA approval. This could delay completion of clinical trials, require the conduct of bridging clinical trials or
the repetition of one or more clinical trials, increase clinical trial costs, delay approval of our product candidates, and jeopardize
our ability to commence sales and generate revenue.
Our
approach to the discovery and development of product candidates using our ExacTcell technology is unproven and may not result in marketable
products.
The
success of our business depends in part upon our ability to develop and commercialize cell therapies based on our proprietary ExacTcell
technology. We have only conducted one Phase 1 trial based on a product developed using ExacTcell. Our approach to the development of
cell therapies using ExacTcell is novel. We may not continue to have access to effective HLA-typing diagnostics and may have difficulties
in obtaining or manufacturing significant quantities and breadth of single HLA-restricted cell lines to use in clinical trials or sufficient
to cover desired patient populations. We cannot assure the product candidates we develop with ExacTcell will be found to be safe and
effective in treating any disease so as to achieve marketing approval. If we uncover any previously unknown risks related to ExacTcell,
or if we experience unanticipated problems or delays in developing our ExacTcell product candidates, we may be unable to achieve our
strategy of building a broad pipeline of cell therapy product candidates.
Our
preclinical studies and clinical trials may fail to demonstrate the safety and efficacy of our product candidates, or serious adverse
or unacceptable side effects may be identified during the development of our product candidates, which could prevent or delay regulatory
approval and commercialization, increase our costs, or necessitate the abandonment or limitation of the development of some of our product
candidates.
Before
obtaining regulatory approvals for the commercial sale of our product candidates, we must demonstrate through lengthy, complex, and expensive
preclinical studies and clinical trials that our product candidates are safe, pure, and effective for use in each target indication,
and failures can occur at any stage of testing. Preclinical studies and clinical trials often fail to demonstrate safety or efficacy
of the product candidate studied for the target indication. The use of our current or future product candidates could be associated with
side effects or adverse events, which could vary in severity from minor reactions to death and in frequency from infrequent to prevalent.
In addition, if one or more of our product candidates or our T cell technology proves to be unsafe it would also materially harm our
business.
In
addition to side effects caused by the product candidate, the administration process or related procedures also can cause adverse side
effects. If any such adverse events occur, our clinical trials could be suspended or terminated. If we cannot demonstrate that any adverse
events were not caused by the drug or administration process or related procedures, FDA could order us to cease further development of,
or deny approval of, our product candidates for any or all targeted indications. Even if we are able to demonstrate that all future serious
adverse events are not product-related, such occurrences could affect patient recruitment or the ability of enrolled patients to complete
the trial. Moreover, if we elect, or are required, to not initiate, delay, suspend or terminate any future clinical trial of any of our
product candidates, the commercial prospects of such product candidates may be harmed and our ability to generate product revenues from
any of these product candidates may be delayed or eliminated. In addition, these side effects may not be appropriately recognized or
managed by the treating medical staff.
Although
our current and future product candidates have undergone and will undergo extensive safety testing and, where applicable, under such
conditions discussed with FDA, not all adverse effects of drugs can be predicted or anticipated. Immunotherapy and its method of action
of harnessing the body’s immune system are powerful and could lead to serious side effects that we only discover in clinical trials
or during commercial marketing. Unforeseen side effects could arise either during clinical development or after our product candidates
have been approved by FDA and the approved product has been marketed, resulting in the exposure of additional patients. If our product
candidates are associated with side effects in clinical trials or have characteristics that are unexpected, we may need to abandon their
development or limit development to more narrow uses in which the side effects or other characteristics are less prevalent, less severe,
or more acceptable from a risk-benefit perspective. So far, we have not demonstrated that TVGN 489 or any other product candidate is
safe in humans, and we cannot predict if ongoing or future clinical trials will do so. If any of our current or future product candidates
fail to demonstrate safety and efficacy in clinical trials or do not gain marketing approval, we will not be able to generate revenue
and our business will be harmed.
50
FDA
or an IRB may also require that we suspend, discontinue, or limit our clinical trials based on safety information, or that we conduct
additional preclinical studies regarding the safety and efficacy of our product candidates that we have not planned or anticipated. Such
findings could further result in FDA failing to provide marketing authorization for our product candidates or limiting the scope of the
approved indication, if approved. Many product candidates that initially showed promise in early-stage testing have later been found
to cause side effects that prevented further development of the product candidate.
Additionally,
if one or more of our product candidates receives marketing approval, and we or others identify undesirable side effects caused by such
products, a number of potentially significant negative consequences could result, including:
●
FDA
may withdraw approvals of such product;
●
FDA
may require additional warnings on the labels such as a “black box” warning or a contraindication;
●
we
may be required to create a medication guide outlining the risks of such side effects for distribution to patients or other requirements
subject to a REMS;
●
we
could be sued and held liable for harm caused to patients;
●
we
may not be able to achieve or maintain third-party payor coverage and adequate reimbursement;
●
we
may be required to recall a product or change the way such product is administered to patients;
●
additional
restrictions may be imposed on the marketing of the particular product or the manufacturing processes for the product or any component
thereof; and
●
our
reputation and physician or patient acceptance of our products may suffer.
There
can be no assurance that we will resolve any issues related to any product-related adverse events to the satisfaction of FDA in a timely
manner or at all.
If
we encounter difficulties enrolling patients in our clinical trials, our clinical development activities could be delayed or otherwise
be adversely affected.
The
successful and timely completion of clinical trials in accordance with their protocols depends on, among other things, our ability to
enroll a sufficient number of patients who remain in the trial until the trial’s conclusion, including any follow-up period. We
may experience difficulties in patient enrollment in our clinical trials for a variety of reasons. The enrollment of patients depends
on many factors, including:
●
the
patient eligibility criteria defined in the protocol;
●
the
nature and size of the patient population required for analysis of the trial’s primary endpoints and the process for identifying
patients;
●
the
number and location of participating clinical sites or patients;
●
the
design of the trial;
●
our
ability to recruit clinical trial investigators with the appropriate competencies and experience;
●
clinicians’
and patients’ perceptions as to the potential advantages and risks of the product candidate being studied in relation to other
available therapies, including any new products that may be approved for the indications we are investigating;
●
the
availability of competing commercially available therapies and other competing drug candidates’ clinical trials;
●
our
ability to obtain and maintain patient informed consents for participation in our clinical trials;
●
the
risk that patients enrolled in clinical trials will drop out of the trials before completion; and/or
●
factors
outside of our control, including as a result of business interruptions resulting from natural disasters and public health emergencies,
such as the coronavirus.
51
We
may experience difficulties in patient enrollment in our future clinical trials for a variety of reasons. A decrease in cases may reduce
the number of eligible candidates for trials testing COVID-19 therapeutics, such as TVGN 489. Additionally, as time passes, treating
COVID-19 is becoming a less critical issue in the eyes of the public, further limiting the potential patient population for COVID-19
therapeutics. Moreover, TVGN 489 may represent a departure from more commonly used methods for COVID-19 treatment, and potential patients
and their doctors may be inclined to use more conventional therapies for the treatment of COVID-19 rather than enroll in any future clinical
trial.
The
timely completion of clinical trials in accordance with their protocols depends, among other things, on our ability to enroll a sufficient
number of patients who remain in the study until its conclusion. In addition, our clinical trials may compete with existing therapies
and other clinical trials for product candidates that are in the same therapeutic areas as our product candidates, and this competition
may reduce the number and types of patients available to us, because some patients who might have opted to enroll in our trials may instead
opt to enroll in a trial being conducted by one of our competitors. Accordingly, we cannot guarantee that our clinical trials will progress
as planned or as scheduled. Delays from difficulties in patient enrollment in a clinical trial may result in increased costs or affect
the timing, outcome, or completion of the trial, which could delay or prevent our receipt of regulatory approval of the applicable product
candidate or to abandon the trial altogether.
We
may be required to suspend, repeat, or terminate our clinical trials if they are not conducted in accordance with regulatory requirements,
the results are negative or inconclusive, or the trials are not well designed.
Clinical
trials must be conducted in accordance with FDA’s GCP requirements. Clinical trials are subject to oversight by FDA and IRBs or
ethical committees at the study sites where the clinical trials are conducted. In addition, clinical trials must be conducted with product
candidates manufactured in accordance with applicable cGMP requirements. Clinical trials may be suspended by FDA, us, a DSMB, or by an
IRB with respect to a particular clinical trial site, for various reasons, including:
●
deficiencies
in the conduct of the clinical trials, including failure to conduct the clinical trial in accordance with regulatory requirements
or study protocols;
●
deficiencies
in the clinical trial operations or trial sites;
●
unforeseen
adverse side effects or the emergence of undue risks to study subjects;
●
deficiencies
in the trial design necessary to demonstrate efficacy;
●
the
product candidate may not appear to offer benefits over current therapies; or
●
the
quality or stability of the product candidate may fall below acceptable standards.
Any
such suspension or delay may result in us failing to obtain regulatory approval for our product candidates, which would materially harm
our business, results of operations and prospects.
If
we do not achieve our projected development goals in the time frames we announce and expect, the commercialization of our products may
be delayed.
From
time to time, we may estimate the timing of the accomplishment of various scientific, clinical, regulatory, manufacturing, and other
product development goals, which we may refer to as milestones. These milestones may include the commencement or completion of preclinical
studies and clinical trials and the submission of regulatory filings, including IND submissions. From time to time, we may announce the
expected timing of some of these milestones. All of these milestones are, and will be, based on a variety of assumptions. The actual
timing of these milestones can vary significantly compared to our estimates, in some cases for reasons beyond our control, including
with respect to challenges related to enrollment, manufacturing, and our reliance on third parties to conduct, supervise or monitor some
or all aspects of our clinical trials.
52
Disruptions
at FDA and other government agencies, such as those that may be caused by funding shortages, 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 FDA to review and approve new products can be affected by a variety of factors, including government budget and funding levels,
statutory, regulatory, and policy changes, FDA’s ability to hire and retain key personnel and accept the payment of user fees,
and other events that may otherwise affect FDA’s ability to perform routine functions. Average review times at the agency have
fluctuated in recent years as a result. Disruptions at FDA and other agencies may also increase the time necessary to meet with and provide
feedback to entities developing drug products, review and/or approve our submissions, conduct inspections, issue regulatory guidance,
or otherwise authorize our actions requiring regulatory approval, which would adversely affect our business. In addition, government
funding of FDA and other government agencies on which our operations may rely, including those that fund research and development activities,
is subject to the political process, which is inherently fluid and unpredictable. For example, the Trump Administration recently established
the Department of Government Efficiency, which implemented a federal government hiring freeze and large scale layoffs of current federal
employees, and also announced additional efforts to reduce federal government employee headcount and the size of the federal government.
The Trump Administration has also, for example, rescinded a previous executive order tasking the Center for Medicare and Medicaid Innovation
to consider new payment and healthcare models to limit drug spending and eliminated a previous executive order that directed HHS to establish
an artificial intelligence task force and develop a strategic plan. It is unclear how these executive actions or other potential actions
by the Trump Administration will impact the regulatory authorities that oversee our business. These budgetary pressures may reduce FDA’s
ability to perform its responsibilities. If a significant reduction in FDA’s workforce occurs, FDA’s budget is significantly
reduced, or there are other disruptions at FDA and other agencies, more time may be necessary for biological products, or biologics,
or modifications to approved biologics to be reviewed and/or approved by necessary government agencies, which could increase our costs
and would adversely affect our business. In addition, if a prolonged government shutdown occurs, it could significantly impact the ability
of FDA to timely review and process our regulatory submissions, which could have a material adverse effect on our business. For example,
over the last several years, the United States government has shut down several times and certain regulatory agencies, such as FDA, have
had to furlough critical FDA employees and stop critical activities. Additionally, Congress may introduce and ultimately pass healthcare
related legislation that could impact the drug approval process.
We
may develop future product candidates in combination with other therapies, which exposes us to additional regulatory risks.
We
may develop future product candidates in combination with one or more currently approved therapies. These combinations may, among other
things, fail to demonstrate synergistic activity, may fail to achieve superior outcomes relative to the use of single agents or other
combination therapies, or may fail to demonstrate sufficient safety or efficacy traits in clinical trials to enable us to complete those
clinical trials or obtain marketing approval for the combination therapy.
In
addition, even if any product candidate we develop were to receive marketing approval or be commercialized for use in combination with
other existing therapies, we would continue to be subject to the risk that FDA or a comparable foreign regulatory authorities could revoke
approval of the therapy used in combination with our product candidate or that safety, efficacy, manufacturing, or supply issues could
arise with these existing therapies. This could result in our own products being removed from the market or being less successful commercially.
We
may also evaluate future product candidates in combination with one or more other therapies that have not yet been approved for marketing
by FDA or comparable foreign regulatory authorities. We will not be able to market and sell TVGN 489 or any product candidate we develop
in combination with any such unapproved therapies that do not ultimately obtain marketing approval.
If
regulatory authorities do not approve these other biological products or revoke their approval of, or if safety, efficacy, manufacturing,
or supply issues arise with, the biologics we choose to evaluate in combination with any product candidate we develop, we may be unable
to obtain approval of or market any such product candidate.
53
The
use artificial intelligence in our business may require us to spend material resources and presents risks that could adversely impact
our business, including by posing security and other risks to our confidential and/or proprietary information.
We
intend to use AI in and integrate AI into our business processes, and this innovation presents risks and challenges that could affect
its adoption, and therefore our business. If we enable or offer solutions that draw controversy due to perceived or actual negative societal
impact, we may experience brand or reputational harm, competitive harm or legal liability. The use of certain AI technology can give
rise to intellectual property risks, including compromises to proprietary intellectual property and intellectual property infringement.
Additionally, we expect to see increasing government and supranational regulation related to AI use and ethics, which may also significantly
increase the burden and cost of research, development and compliance in this area. For example, the new Artificial Intelligence Act (the
“AI Act”) in the EU imposes significant obligations on providers and deployers of high-risk AI systems and encourages such
providers and deployers to account for specified ethical principles in the development and use of these systems. If we develop or use
AI systems that are governed by the AI Act or similar regulations, it may necessitate ensuring higher standards of data quality, transparency,
and human oversight, as well as adhering to specific and potentially burdensome and costly ethical, accountability, and administrative
requirements. The rapid evolution of AI will require the application of significant resources to design, develop, test and maintain our
products and services to help ensure that AI is implemented in accordance with applicable law and regulation and in a socially responsible
manner and to minimize any real or perceived unintended harmful impacts. Our vendors may also incorporate AI tools into their offerings,
and may not meet existing or rapidly evolving regulatory or industry standards, including with respect to privacy and data security.
Further, bad actors around the world use increasingly sophisticated methods, including the use of AI, to engage in illegal activities
involving the theft and misuse of personal information, confidential information and intellectual property. Any of these effects could
damage our reputation, result in the loss of valuable property and information, cause us to breach applicable laws and regulations, and
adversely impact our business.
Risks
Related to Business Development and Commercialization
Our
commercial success depends upon attaining significant market acceptance of our product candidates, if approved, among physicians, patients,
healthcare payors and the medical community, including hospitals and outpatient clinics.
Even
if we obtain regulatory approval for any of our product candidates that we may develop or acquire in the future, the product may not
gain market acceptance among physicians, healthcare payors, patients or the medical community that supports our product development efforts,
including hospitals and outpatient clinics. Market acceptance of any of our product candidates for which we receive approval depends
on a number of factors, including:
●
the
efficacy and safety of the product candidates as demonstrated in clinical trials;
●
the
clinical indications and patient populations for which the product candidate is approved;
●
acceptance
by physicians and patients of the drug as a safe and effective treatment;
●
the
administrative and logistical burden of treating patients, including the availability and accessibility of healthcare provider sites
for administering infusions to patients;
●
the
adoption of novel cellular therapies by physicians, hospitals, and third-party payors;
●
the
potential and perceived advantages of product candidates over alternative treatments;
●
the
safety of product candidates seen in a broader patient group, including its use outside the approved indications should physicians
choose to prescribe for such uses;
●
any
restrictions on use together with other medications;
●
the
prevalence and severity of any side effects;
●
FDA’s
product labeling or package insert requirements;
●
the
timing of market introduction of our products as well as competitive products;
●
the
development of manufacturing and distribution processes for our product candidates;
●
the
cost of treatment in relation to alternative treatments;
●
the
availability of coverage and adequate reimbursement from, and our ability to negotiate pricing with, third-party payors, providers,
and government authorities;
●
relative
convenience and ease of administration; and
●
the
effectiveness of our sales and marketing efforts.
54
We
expect the product candidates we develop will be regulated biologics and therefore they may be subject to biosimilar competition.
The
Biologics Price Competition and Innovation Act of 2009 (“BPCIA”) created an abbreviated pathway for the approval of for biological
product candidates shown to be highly similar to or interchangeable with an FDA licensed biological product. Under the BPCIA, an application
for a biosimilar product cannot be approved by FDA until 12 years after the reference product was approved under a BLA. The law is complex
and is still being interpreted and implemented by FDA. As a result, its ultimate impact, implementation, and meaning are subject to uncertainty.
Although it is uncertain when processes intended to implement BPCIA may be fully adopted by FDA, any of these processes could have a
material adverse effect on the future commercial prospects for our biological products.
We
believe that any of the product candidates we develop that is approved in the United States as a biological product under a BLA should
qualify for the 12-year period of exclusivity. However, there is a risk that this exclusivity could be shortened, potentially creating
the opportunity for competition sooner than anticipated. Moreover, the extent to which a biosimilar, once approved, will be substituted
for any one of the reference products in a way that is similar to traditional generic substitution for non-biological products is not
yet clear, and will depend on a number of marketplace and regulatory factors that are still developing. Additionally, the increased likelihood
of biosimilar competition has increased the risk of loss of innovators’ market exclusivity. Due to these risks, and uncertainties
regarding patent protection, if one of our product candidates are approved for marketing, it is not possible to predict the length of
market exclusivity for any particular product with certainty based solely on the expiration of the relevant patent(s) or the current
forms of regulatory exclusivity. The loss of market exclusivity for a product would likely materially and negatively affect revenues
from product sales of that product and thus our financial results and condition.
In
addition, the approval of a biologic product that is a biosimilar to one of our products could have a material adverse impact on our
business as it may be significantly less costly to bring to market and may be priced significantly lower than our products.
The
incidence and prevalence of the target patient population for TVGN 489 are based on estimates and third-party sources. If the market
opportunity for TVGN 489 or our other product candidates is smaller than we estimate or if any approval that we obtain is based on a
narrower definition of the patient population, our revenue and ability to achieve profitability might be materially and adversely affected.
Periodically,
we make estimates regarding the incidence and prevalence of target patient populations based on various third-party sources and internally
generated analysis. These estimates may be inaccurate or based on imprecise data. For example, the total addressable market opportunity
for TVGN 489 will depend on, among other things, acceptance of TVGN 489 by the medical community, patient access, drug pricing and reimbursement,
and the number of eligible patients with COVID-19, which may decrease. The number of patients in the addressable markets may turn out
to be lower than expected, patients may not be otherwise amenable to treatment with TVGN 489, or new patients may become increasingly
difficult to identify or gain access to or may not have the requisite HLA-typing to receive the drug, all of which may significantly
harm our business, financial condition, results of operations and prospects.
Even
if our product candidates receive regulatory approval, we will still face extensive ongoing regulatory requirements and continued regulatory
review, which may result in significant additional expense, and our products may still face future development and regulatory difficulties.
Even
if we obtain regulatory approval for a product candidate, it would be subject to ongoing requirements by FDA governing the manufacture,
materials and facilities, qualification testing, quality control, further development, labeling, packaging, storage, distribution, post-approval
clinical data, adverse event reporting, safety surveillance, import, export, advertising, promotion, recordkeeping and reporting of safety
and other post-marketing information. These requirements include submissions of safety and other post-marketing information and reports,
establishment registration and product listing, as well as continued compliance by us and/or our contract manufacturing organizations
(“CMOs”) and CROs for any post-approval clinical trials that we conduct. The safety profile of any product will continue
to be closely monitored by FDA after approval. If FDA become aware of new safety information after approval of any of our product candidates,
they may require labeling changes or establishment of a REMS, impose significant restrictions on a product’s indicated uses or
marketing or impose ongoing requirements for potentially costly post-approval studies or post-market surveillance.
55
In
addition, manufacturers of cell therapies and their facilities are subject to initial and continual review and periodic inspections by
FDA for compliance with cGMP, GCP, GLP, GTP and other regulations. For certain commercial prescription biological products, manufacturers,
and other parties involved in the supply chain must also meet chain of distribution requirements and build electronic, interoperable
systems for product tracking and tracing and for notifying FDA of counterfeit, diverted, stolen, and intentionally adulterated products
or other products that are otherwise unfit for distribution in the United States. If we or a regulatory agency discover previously unknown
problems with a product, such as adverse events of unanticipated severity or frequency, or problems with the facility where the product
is manufactured, a regulatory agency may impose restrictions on that product, the manufacturing facility or us, including requiring recall
or withdrawal of the product from the market or suspension of manufacturing. If we, our product candidates, or the manufacturing facilities
for our product candidates fail to comply with applicable regulatory requirements, a regulatory agency may:
●
issue
warning letters or untitled letters;
●
mandate
modifications to promotional materials or require us to provide corrective information to healthcare practitioners, or require other
restrictions on the labeling or marketing of such products;
●
require
us to enter into a consent decree, which can include imposition of various fines, reimbursements for inspection costs, required due
dates for specific actions and penalties for noncompliance;
●
seek
an injunction or impose civil or criminal penalties or monetary fines;
●
suspend,
withdraw, or modify regulatory approval;
●
suspend
or modify any ongoing clinical trials;
●
refuse
to approve pending applications or supplements to applications filed by us;
●
suspend
or impose restrictions on operations, including costly new manufacturing requirements; or
●
seize
or detain products, refuse to permit the import or export of products, or require us to initiate a product recall.
The
occurrence of any of the foregoing may inhibit our ability to successfully commercialize our products.
Advertising
and promotion of any product candidate that obtains approval in the United States will be heavily scrutinized by FDA, the FTC, the Department
of Justice, the Office of Inspector General of the Department of Health and Human Services, state attorneys general, members of the U.S.
Congress and the public. Violations, including actual or alleged promotion of our products for unapproved or off-label uses, are subject
to enforcement letters, inquiries and investigations, and potential civil and criminal sanctions by FDA. Any actual or alleged failure
to comply with labeling and promotion requirements may result in fines, warning letters, mandates to corrective information to healthcare
practitioners, injunctions, or civil or criminal penalties.
If
we are unable to establish sales and marketing capabilities or enter into agreements with third parties to market and sell our product
candidates, we may be unable to generate any revenue.
We
are at an early stage of establishing an organization that will be responsible for the sale, marketing and distribution of cell therapy
products and the cost of establishing and maintaining such an organization may exceed the cost-effectiveness of doing so. In order to
market any products that may be approved by FDA, we must build our sales, marketing, managerial and other non-technical capabilities
or make arrangements with third parties to perform these services. There are significant risks involved in building and managing a sales
organization, including our ability to hire, retain and incentivize qualified individuals, generate sufficient sales leads, provide adequate
training to sales and marketing personnel, and effectively manage a geographically dispersed sales and marketing team. Any failure or
delay in the development of our internal sales, marketing and distribution capabilities would adversely impact the commercialization
of these products. We may be competing with many companies that currently have extensive and well-funded sales and marketing operations.
Without a sufficiently scaled, appropriately timed, and trained internal commercial organization or the support of a third party to perform
sales and marketing functions, we may be unable to compete successfully against these more established companies.
56
Data
protection, privacy and similar laws restrict access, use, and disclosure of information, and failure to comply with or adapt to changes
in these laws could materially and adversely harm our business.
We
are subject to federal and state data privacy and security laws and regulations, state data breach notification laws, state health information
and/or genetic privacy laws, and federal and state consumer protection and consumer privacy laws (such as Section 5 of the FTC Act, the
FTC Health Breach Notification Rule, and the CCPA)). Laws and expectations relating to privacy continue to evolve. Changes in these laws
may limit our data access, use, and disclosure, and may require increased expenditures. In addition, data protection, privacy and similar
laws protect more than patient information and, although they vary by jurisdiction, these laws can extend to employee information, business
contact information, provider information, and other information relating to identifiable individuals. For example, the CCPA requires
covered businesses to, among other things, provide disclosures to California consumers regarding the collection, use and disclosure of
such consumers’ personal information and afford such consumers new rights with respect to their personal information, including
the right to opt out of certain sales of personal information. Comprehensive and sensitive data laws in a number of states have gone
into or will go into effect during the next few years. We believe that further increased regulation in additional jurisdictions is likely
in the area of data privacy. Any of the foregoing may have a material adverse effect on our ability to provide services to patients and,
in turn, our results of operations.
Failure
to comply with these laws may result in, among other things, civil and criminal liability, negative publicity, damage to our reputation,
and liability under contractual provisions. In addition, compliance with such laws may require increased costs to us or may dictate that
we not offer certain types of services in the future.
Increasing
use of AI could give rise to liability, breaches of data security and privacy laws, or reputational damage.
AI-based
solutions, including generative AI, are increasingly being used in the biopharmaceutical industry. There is a global trend towards more
regulation (e.g., the AI Act and AI laws passed in certain states) to ensure the ethical use, privacy, and security of AI and the data
that it processes. AI solutions that we may employ and rely upon may lead to the impermissible use or disclosure of confidential information
(including personal data and proprietary information) in contravention of our internal policies, data protection laws, other applicable
laws, or contractual requirements. The misuse of AI solutions may give rise to liability, lead to the loss of trade secrets or other
intellectual property, result in reputational harm, or lead to outcomes with unintended biases or other consequences. The misuse of AI
solutions could also result in unauthorized access and use of personal data of our employees, clinical trial participants, collaborators,
or other third parties. Any of these events could have a material adverse effect on our business, prospects, operating results, and financial
condition and could adversely affect the price of our Common Stock.
Our
internal computer systems, or those used by our contractors or consultants, may fail, or suffer security breaches.
Our
internal computer systems and the systems of our contractors and consultants are vulnerable to damage from cyber-attacks and unauthorized
access. While we have not experienced any such material system failure or security breach to date, if such an event were to occur and
cause interruptions in our operations, it could result in a material disruption of our development programs and our business operations.
For example, the loss of clinical trial data from future clinical trials could result in delays in our regulatory approval efforts and
significantly increase our costs to recover or reproduce the data. Despite our efforts and given the ever-changing threat landscape,
the possibility of these events occurring cannot be eliminated entirely and there can be no assurance that any measures we take will
prevent cyber-attacks or unauthorized access that could adversely affect our business. 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 liability and the further development and commercialization of our product candidates could be delayed.
Coverage
and reimbursement may be limited or unavailable in certain market segments for our product candidates, which could make it difficult
for us to sell our product candidates, if approved, profitably.
Successful
sales of our product candidates, if approved, depend on the availability of coverage and adequate reimbursement from third-party payors
including governmental healthcare programs, such as Medicare and Medicaid, managed care organizations and commercial payors, among others.
Significant uncertainty exists as to the coverage and reimbursement status of any product candidates for which we obtain regulatory approval.
Patients
who are provided medical treatment for their conditions generally rely on third-party payors to reimburse all or part of the costs associated
with their treatment. Obtaining coverage and adequate reimbursement from third-party payors is critical to new product acceptance. Third-party
payors decide which drugs and treatments they will cover and the amount of reimbursement. Reimbursement by a third-party payor may depend
upon a number of factors, including, but not limited to, the third-party payor’s determination that use of a product is a covered
benefit under its health plan, safe, effective, and medically necessary, appropriate for the specific patient, cost-effective, and neither
experimental nor investigational.
57
Obtaining
coverage and reimbursement of a product from a government or other third-party payor is a time consuming and costly process that could
require us to provide to the payor supporting scientific, clinical and cost-effectiveness data for the use of our products. Even if we
obtain coverage for a given product, if the resulting reimbursement rates are insufficient, hospitals may not approve our product for
use in their facility or third-party payors may require co-payments that patients find unacceptably high. Separate reimbursement for
the product itself may or may not be available. Instead, the hospital or administering physician may be reimbursed only for providing
the treatment or procedure in which our product is used. Further, at least annually, CMS revises the reimbursement systems used to reimburse
health care providers, which may result in reduced Medicare payments. In some cases, private third-party payers rely on all or portions
of Medicare payment systems to determine payment rates. Changes to government healthcare programs that reduce payments under these programs
may negatively impact payments from private third-party payers and reduce the willingness of physicians and providers to use our product
candidates.
In
the United States, no uniform policy of coverage and reimbursement for products exists among third-party payors. Therefore, coverage
and reimbursement for products can differ significantly from payor to payor. Further, one payor’s determination to provide coverage
for a product does not assure that other payors will also provide coverage for the product. Adequate third-party reimbursement may not
be available to enable us to maintain price levels sufficient to realize an appropriate return on our investment in product development.
Because our product candidate may have a higher cost of goods than conventional therapies, and may require long-term follow-up evaluations,
the risk that coverage and reimbursement rates may be inadequate for us to achieve profitability may be greater. There is significant
uncertainty related to insurance coverage and reimbursement of newly approved products. It is difficult to predict at this time what
third-party payors will decide with respect to the coverage and reimbursement for our product candidate. Moreover, payment methodologies
may be subject to changes in healthcare legislation and regulatory initiatives. Additional state and federal healthcare reform measures
are expected to be adopted in the future, any of which could limit the amounts that federal and state governments will pay for healthcare
products and services, which could result in reduced demand for certain pharmaceutical products or additional pricing pressures. We expect
to experience pricing pressures in connection with the sale of any of our product candidates due to the trend toward managed healthcare,
the increasing influence of health maintenance organizations, cost containment initiatives and additional legislative changes.
Net
prices for drugs may be reduced by mandatory discounts or rebates required by government healthcare programs or private payors and by
any future relaxation of laws that presently restrict imports of drugs from countries where they may be sold at lower prices than in
the United States. Increasingly, third-party payors are requiring that drug companies provide them with predetermined discounts from
list prices and are challenging the prices charged for medical products. In addition, many pharmaceutical manufacturers must calculate
and report certain price reporting metrics to the government, such as average sales price and best price. Penalties may apply in some
cases when such metrics are not submitted accurately and timely. Further, these prices for drugs may be reduced by mandatory discounts
or rebates required by government healthcare programs. Payment methodologies may be subject to changes in healthcare legislation and
regulatory initiatives.
We
intend to seek approval to market our product candidates in both the United States and in selected foreign jurisdictions. Increased efforts
by governmental and third-party payors in the United States and abroad to cap or reduce healthcare costs may cause such organizations
to limit both coverage and the level of reimbursement for newly approved products and, as a result, they may not cover or provide adequate
payment for our product candidate. If we obtain approval in one or more foreign jurisdictions for our product candidates, we will be
subject to rules and regulations in those jurisdictions. In some foreign countries, particularly those in Europe, the pricing of biologics
is subject to governmental control. In these countries, pricing negotiations with governmental authorities can take considerable time
after obtaining marketing approval of a product candidate. Some of these countries may require the completion of clinical trials that
compare the cost-effectiveness of a particular product candidate to currently available therapies. Other EU member states allow companies
to fix their own prices for medicines but monitor and control company profits. In addition, in some countries, cross-border imports from
low-priced markets exert a commercial pressure on pricing within a country.
58
The
marketability of any product candidates for which we receive regulatory approval for commercial sale may suffer if government and other
third-party payors fail to provide coverage and adequate reimbursement. We expect downward pressure on pharmaceutical pricing to continue.
Further, coverage policies and third-party reimbursement rates may change at any time. Even if favorable coverage and reimbursement status
is attained for one or more products for which we receive regulatory approval, less favorable coverage policies and reimbursement rates
may be implemented in the future.
The
advancement of healthcare reform may negatively impact our ability to sell our product candidates, if approved, profitably.
Third-party
payors, whether domestic or foreign, or governmental or commercial, are developing increasingly sophisticated methods of controlling
healthcare costs. In both the United States and certain foreign jurisdictions, there have been a number of legislative and regulatory
changes to the health care system that could impact our ability to sell our product candidates, if approved, profitably.
There
have been, and likely will continue to be, legislative and regulatory proposals at the foreign, federal, and state levels directed at
broadening the availability of healthcare and containing or lowering the cost of healthcare. The implementation of cost containment measures
or other healthcare reforms may prevent us from being able to generate revenue, attain profitability, or commercialize our products.
Such reforms could have an adverse effect on anticipated revenue from product candidates that we may successfully develop and for which
we may obtain regulatory approval and may affect our overall financial condition and ability to develop product candidates.
Additionally,
there has been heightened governmental scrutiny in the United States of pharmaceutical and biologics pricing practices in light of the
rising cost of prescription drugs and biologics. This scrutiny has resulted in various Congressional inquiries and proposed and enacted
federal and state legislation designed to, among other things, bring more transparency to product pricing, review the relationship between
pricing and manufacturer patient programs, and reform government program reimbursement methodologies for products.
We
expect that additional U.S. federal healthcare reform measures will be adopted in the future, any of which could limit the amounts that
the U.S. federal government will pay for healthcare drugs and services, which could result in reduced demand for our drug candidates
or additional pricing pressures. Any reduction in reimbursement from Medicare or other government programs may result in a similar reduction
in payments from private payors, which may adversely affect our future profitability. Individual states in the United States have also
become increasingly active in passing legislation and implementing regulations designed to control pharmaceutical and biological product
pricing, including price or patient reimbursement constraints, discounts, restrictions on certain drug access and marketing cost disclosure
and transparency measures, and designed to encourage importation from other countries and bulk purchasing. Additionally, some individual
states have begun establishing Prescription Drug Affordability Boards to review high-cost drugs and, in some cases, set upper payment
limits. Legally mandated price controls on payment amounts by third-party payors or other restrictions could harm our business, financial
condition, results of operations and prospects. In addition, regional healthcare authorities and individual hospitals are increasingly
using bidding procedures to determine what drug products and which suppliers will be included in their prescription drug and other healthcare
programs. The continuing efforts of the government, insurance companies, managed care organizations and other payors of healthcare services
to contain or reduce costs of healthcare and/or impose price controls may adversely affect our business, financial condition, results
of operations and prospects.
We
may be subject, directly or indirectly, to federal and state healthcare fraud and abuse laws, false claims laws, and health information
privacy and security laws. If we are unable to comply, or have not fully complied, with such laws, we could face substantial penalties.
If
we obtain FDA approval for any of our product candidates and begin commercializing those products in the United States, our operations
may be subject to various federal and state fraud and abuse laws, including, without limitation, the federal Anti-Kickback Statute, the
federal False Claims Act, and federal and state transparency laws and regulations. These laws may impact, among other things, our proposed
sales, marketing, and education programs. In addition, we may be subject to patient privacy regulation by both the federal government
and the states in which we conduct our business. These laws, described in further detail in “ Regulatory Environment - Healthcare
Regulation - Other Healthcare Laws and Compliance Requirements ,” include:
●
the
federal Anti-Kickback Statute, which prohibits, among other things, persons from knowingly and willfully soliciting, receiving, offering,
or paying remuneration, directly or indirectly, to induce, or in return for, the purchase or recommendation of an item or service
reimbursable under a federal healthcare program, such as the Medicare and Medicaid programs;
●
the
federal civil False Claims Act, which prohibits, among other things, individuals or entities from knowingly presenting, or causing
to be presented, a false or fraudulent claim for payment of government funds, or knowingly making, using or causing to be made or
used, a false record or statement material to an obligation to pay money to the government or knowingly concealing or knowingly and
improperly avoiding, decreasing or concealing an obligation to pay money to the federal government;
59
●
HIPAA,
which created new federal criminal statutes that prohibit executing a scheme to defraud any healthcare benefit program and making
false statements relating to healthcare matters;
●
HIPAA,
as amended by the Health Information Technology for Economic and Clinical Health Act, and its implementing regulations, which imposes
specified requirements relating to the privacy, security, and transmission of individually identifiable health information;
●
the
U.S. federal Physician Payment Sunshine Act, which requires manufacturers of drugs, devices, biologics, and medical supplies for
which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions) to
report annually to the CMS information related to direct or indirect payments and other transfers of value to physicians and teaching
hospitals (and certain other practitioners), as well as ownership and investment interests held in the Company by physicians and
their immediate family members; and
●
state
law equivalents of each of the above federal laws, such as anti-kickback and false claims laws that may apply to items or services
reimbursed by any third-party payor, including governmental and private payors, laws that require manufacturers to comply with the
pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated by the federal government,
or otherwise restrict payments that may be made to healthcare providers and other potential referral sources, state laws that require
drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers
or marketing expenditures, and state laws governing the privacy and security of health information in specified circumstances, many
of which differ from each other in significant ways and may not have the same scope or application, thus complicating compliance
efforts.
Efforts
to ensure that our collaborations with third parties, and our business generally, will comply with applicable United States and healthcare
laws and regulations will involve substantial costs. Governmental authorities could conclude that our business practices may not comply
with statutes, regulations or case law involving applicable fraud and abuse or other healthcare laws and regulations. If our operations
are found to violate any of these laws or any other governmental laws and regulations that may apply to us, we may be subject to significant
civil, criminal and administrative penalties, damages, fines, imprisonment, exclusion of products from government funded healthcare programs,
contractual damages, reputational harm, disgorgement or curtailment or restricting of our operations, any of which could substantially
disrupt our operations and diminish our profits and future earnings. If any of the physicians or other providers or entities with whom
we expect to do business is found not to be in compliance with applicable laws, they may be subject to criminal, civil or administrative
sanctions, including exclusions from government funded healthcare programs. The risk of our being found in violation of these laws is
increased by the fact that many of them have not been fully interpreted by the regulatory authorities or the courts, and their provisions
are open to a variety of interpretations.
Our
relationships with customers, physicians including clinical investigators, CROs and third-party payors are subject, directly or indirectly,
to federal and state healthcare fraud and abuse laws, false claims laws, health information privacy and security laws, transparency laws,
government price reporting and other healthcare laws and regulations. If we or our employees, independent contractors, consultants, commercial
partners, vendors, or other agents violate these laws, we could face substantial penalties.
These
laws may impact, among other things, our clinical research programs as well as our proposed and future sales, marketing, and education
programs. In particular, the promotion, sales and marketing of healthcare items and services is subject to extensive laws and regulations
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, sales commission, customer incentive and other business arrangements. We
may also be subject to federal, state, and foreign laws governing the privacy and security of identifiable patient information.
60
The
scope and enforcement of each of these laws is uncertain and subject to rapid change in the current environment of healthcare reform.
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. Because
of the breadth of these laws and the narrowness of the statutory exceptions and regulatory safe harbors available, it is possible that
some of our business activities, or our arrangements with physicians, could be subject to challenge under one or more of such laws. If
we or our employees, independent contractors, consultants, commercial partners, and vendors violate these laws, we may be subject to
investigations, enforcement actions and/or significant penalties.
It
is not always possible to identify and deter employee misconduct or business noncompliance, 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 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 themselves 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 federal healthcare programs, reputational harm, diminished profits and future earnings, additional reporting requirements
and/or oversight if we become subject to a corporate integrity agreement or similar agreement to resolve allegations of non-compliance
with these laws, 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.
If
we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incur
costs that could have a material adverse effect on the success of our business.
We
are subject to numerous environmental, health and safety laws and regulations, including those governing laboratory procedures and the
handling, use, storage, treatment and disposal of hazardous materials and wastes. Our operations involve the use of hazardous and flammable
materials, including chemicals and biological materials. Our operations also produce hazardous waste products. We cannot eliminate the
risk of contamination or injury from these materials. In the event of contamination or injury resulting from our use of hazardous materials,
we could be held liable for any resulting damages, and any liability could exceed our resources. We also could incur significant costs
associated with civil or criminal fines and penalties.
Risks
Related to Manufacturing and Reliance on Third Parties
The
manufacture of cell therapies is subject to a multitude of manufacturing risks, any of which could substantially increase our costs and
limit supply of our product candidates.
The
process of manufacturing cell therapies is complex, highly regulated, subject to multiple risks, and requires significant expertise.
Manufacturers of cell therapy products often encounter difficulties in production, particularly in scaling out and validating initial
production and ensuring the absence of contamination. These include difficulties with production costs and yields, quality control, shortages
of qualified personnel, and compliance with strictly enforced regulations. Cell therapy manufacturing facilities also require appropriate
commissioning and validation activities to demonstrate that they operate as designed. There are limited numbers of CMOs that operate
under cGMP regulations and that are capable of manufacturing cell therapies, and transferring manufacturing processes and know-how is
complex and may require utilization of new or different processes to meet the specific requirements of a given facility.
61
Cell
therapy manufacturing is susceptible to product loss due to contamination, equipment failure, and vendor or operator error. The facilities
in which our product candidates will be made could also be adversely affected by pandemics, natural disasters, equipment failures, labor
shortages, power failures, supply chain problems, changes in laws and regulations, and numerous other factors. Even minor deviations
from normal manufacturing and distribution for any of our product candidates could result in reduced production yields, impact to product
quality, and other supply disruptions. Manufacturing cell therapies is susceptible to risks associated with the need to maintain aseptic
conditions throughout the manufacturing process. Contamination with pathogens or ingress of microbiological material may result in unusable
product and could also delay the manufacture of product candidates, resulting in delays in development. If contamination is discovered,
the facilities in which our product candidates are made may need to be closed for an extended period of time for investigation and remediation.
Because our cell therapy product candidates are manufactured from the cells of third-party donors, the manufacturing process is also
susceptible to insufficient quantity or inadequate quality of third-party donor material.
Manufacturing
is also subject to FDA and comparable foreign regulation. For example, FDA will not approve a cellular product if the manufacturer is
not in compliance with cGMPs and GTPs, to the extent applicable. If we are unable to reliably produce products in accordance with specifications
acceptable to authorities, we may not obtain or maintain the approvals we need to commercialize our product candidates. Failure to comply
with manufacturing regulations may lead to regulatory enforcement actions against our third-party manufacturers or us that result in
fines and civil and criminal penalties, imprisonment, suspension, delay, or restriction of production, injunctions, delay or denial of
product approval, clinical holds or termination of clinical trials, warning or untitled letters, regulatory authority communications
warning the public about safety issues with the cell therapies, refusal to permit import or export, product seizure, detention, or recall,
lawsuits under the civil False Claims Act, or consent decrees.
Our
efforts to establish manufacturing capabilities, either on our own or through a contract relationship, will involve significant time
and expense and may not be successful.
Our
manufacturing experience as an organization and with our contractors is limited. We relied on a Clinical Trial Services and Materials
Agreement with Thomas Jefferson University for the manufacture of TVGN 489 for our Phase 1 proof-of-concept trial. However, we will need
to establish manufacturing capabilities, either on our own or through a contract relationship, in order to meet our projected supply
needs for clinical and commercial materials to support our activities through regulatory approval and commercial manufacturing of our
product candidates, if approved. Our efforts to develop manufacturing capability are currently focused on acquiring existing manufacturing
facilities or constructing one or more new manufacturing facilities, including through collaboration with a potential facility development
partner. Securing a manufacturing facility will involve considerable time and expense, and may not be successful. In addition, we cannot
ensure that we can successfully manufacture our products in compliance with cGMP, GTP, and any other applicable laws, regulations, and
standards in sufficient quantities for clinical trials or for commercial sale. We have no prior experience in establishing a manufacturing
facility and we may encounter challenges given the complexity of manufacturing cell therapies. We must also compete for the small number
of individuals with expertise in cell therapy manufacturing. Even if we are able to establish manufacturing operations, given the complexities
of manufacturing cell therapy products, there is no assurance that we will be able to successfully produce sufficient amounts, or sufficient
quality, of TVGN 489 in order to move forward with our clinical development plans.
We
depend on third-party suppliers for key materials used in our manufacturing processes, and the loss of these third-party suppliers or
their inability to supply us with adequate materials could harm our business.
We
rely on third-party suppliers for certain materials and components required for the production of our product candidates. Our dependence
on these suppliers and the challenges we may face in obtaining adequate supplies of materials involve several risks, including limited
control over pricing, availability, and quality and delivery schedules. We also face competition for supplies from other cell therapy
companies. Such competition may make it difficult for us to secure raw materials or the testing of such materials on commercially reasonable
terms or in a timely manner. Our negotiation leverage is limited, and we are likely to get lower priority than our competitors that are
larger than we are. In addition, the biotechnology market has recently experienced supply chain disruptions. We cannot be certain that
our suppliers will continue to provide us with the quantities of the raw materials that we require or satisfy our anticipated specifications
and quality requirements whether due to our size or otherwise. Any supply interruption in limited or sole sourced raw materials could
materially harm our ability to manufacture our product candidates until a new source of supply, if any, could be identified and qualified.
We may be unable to find a sufficient alternative supply channel in a reasonable time or on commercially reasonable terms. Significant
changes in global economic conditions, and an increase in the costs of goods and services, including as a result of tariffs, could negatively
impact testing volumes, the demand for biopharma laboratory services, cash collections, profitability, and the availability and cost
of credit. Any performance failure on the part of our suppliers could delay the development and potential commercialization of our product
candidates, including limiting supplies necessary for clinical trials and regulatory approvals, which would have a material adverse effect
on our business.
62
If
the third parties we rely on to help conduct our preclinical studies and clinical trials do not successfully carry out their contractual
duties, comply with regulatory requirements, or meet expected deadlines, we may not be able to obtain marketing approval for or commercialize
TVGN 489 and any future product candidates we develop, and our business could be materially harmed.
We
outsource some of the conduct and management of our clinical trials to third parties. Agreements with clinical investigators and medical
institutions for clinical testing and with other third parties for data management services and clinical trial management services place
substantial responsibilities on these parties that, if unmet, could result in delays in, or termination of, our clinical trials.
We
rely on universities, medical institutions, clinical investigators, contract laboratories and other third parties to conduct or help
us conduct GLP-compliant preclinical studies and GCP-compliant clinical trials on our product candidates properly and on time. While
we have agreements governing their activities, we control only certain aspects of their activities and have limited influence over their
actual performance. The third parties with whom we contract play a significant role in the conduct of these studies and trials and the
subsequent collection and analysis of data. These third parties are not our employees and, except for restrictions imposed by our contracts
with such third parties, we have limited ability to control the amount or timing of resources that they devote to our current or future
product candidates. Although we rely on these third parties to conduct our GLP-compliant preclinical studies and GCP-compliant clinical
trials, we remain responsible for ensuring that each of our preclinical studies and clinical trials is conducted in accordance with its
investigational plan and protocol and applicable laws and regulations, and our reliance on the CROs does not relieve us of our regulatory
responsibilities. If any of our clinical trial sites fail to comply with GCP, we may be unable to use the data gathered at those sites.
Many
of the third parties with whom we contract may also have relationships with other commercial entities, including our competitors, for
whom they may also be conducting clinical trials or other drug development activities that could harm our competitive position. Some
of our agreements may also be terminated by these third parties under certain other circumstances. If the third parties conducting our
preclinical studies or our clinical trials do not adequately perform their contractual duties or obligations, experience significant
business challenges, disruptions or failures, do not meet expected deadlines, terminate their agreements with us or need to be replaced,
or if the quality or accuracy of the data they obtain is compromised due to their failure to adhere to our protocols or to GLP and GCP,
or for any other reason, we may need to enter into new arrangements with alternative third parties. This could be difficult, costly,
or impossible, and our preclinical studies or clinical trials may need to be extended, delayed, terminated, or repeated. As a result,
we may not be able to obtain regulatory approval in a timely fashion, or at all, for the applicable product candidate, our financial
results and the commercial prospects for our product candidates would be harmed, our costs could increase and our ability to generate
revenues could be delayed.
We
may depend on third-party collaborators for the development and commercialization of certain of our current and future product candidates.
If our collaborations are not successful, we may not be able to capitalize on the market potential of these product candidates.
In
the future, we may form or seek strategic alliances, joint ventures, or collaborations, or enter into licensing arrangements with third
parties that we believe will complement or augment our development and commercialization efforts with respect to product candidates we
develop. Potential future collaborations involving our product candidates may pose the following risks to us:
●
collaborators
may have significant discretion in determining the efforts and resources that they will apply to these collaborations;
●
collaborators
could independently develop, or develop with third parties, products that compete directly or indirectly with our products or product
candidates;
63
●
collaborators
may not properly enforce, maintain, or defend our intellectual property rights or may use our proprietary information in a way that
gives rise to actual or threatened litigation or that could jeopardize or invalidate our intellectual property or proprietary information,
exposing us to potential litigation or other intellectual property proceedings;
●
collaborators
may infringe the intellectual property rights of third parties, which may expose us to litigation and potential liability;
●
disputes
may arise between a collaborator and us that cause the delay or termination of the research, development, or commercialization of
the product candidate, or that result in costly litigation or arbitration that diverts management attention and resources;
●
collaborators
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 products;
●
if
a present or future collaborator were to be involved in a business combination, the continued pursuit and emphasis on our product
development or commercialization program under such collaboration could be delayed, diminished, or terminated; and
●
collaboration
agreements may restrict our right to independently pursue new product candidates.
If
we enter into collaboration agreements and strategic partnerships or license our intellectual property, products, or businesses, we may
not be able to realize the expected benefit of such transactions if we are unable to successfully integrate them with our existing operations,
which could delay our timelines or otherwise adversely affect our business. We also cannot be certain that, following a strategic transaction
or license, we will achieve the revenue or net income that justifies such transaction. Any of the factors set forth above and any delays
in entering into new collaborations or strategic partnership agreements related to any product candidate we develop could delay the development
and commercialization of our product candidates, which would harm our business prospects, financial condition, and results of operations.
In
the event a present or future collaborator terminates their agreement with us, we would be prevented from receiving the benefits of any
such agreement, which could have a materially adverse effect on our results of operations.
We
may have to alter our development and commercialization plans if we seek to establish collaborations and are not able to establish them
on commercially reasonable terms.
The
advancement of our product candidates and development programs and the potential commercialization of our current and future product
candidates will require substantial additional cash to fund expenses. For some of our current or future product candidates, we may decide
to collaborate with third parties with respect to development and potential commercialization. Any of these relationships may require
us to incur non-recurring and other charges, increase our near- and long-term expenditures, issue securities that dilute our existing
stockholders, or disrupt our management and business.
We
face significant competition in seeking appropriate strategic partners and the negotiation process is time-consuming and complex. Whether
we reach a definitive agreement for other collaborations will depend, among other things, upon our assessment of the collaborator’s
resources and expertise, the terms and conditions of the proposed collaboration and the collaborator’s evaluation of a number of
factors. Those factors may include the design or results of clinical trials, the progress of our clinical trials, the likelihood of approval
by FDA or similar regulatory authorities outside the United States, the potential market for the subject product candidate, the costs
and complexities of manufacturing and delivering such product candidate to patients, the potential of competing products, the existence
of uncertainty with respect to our ownership of technology and market conditions generally. The collaborator may also consider alternative
product candidates or technologies for similar indications that may be available to collaborate on and whether such a collaboration could
be more attractive than the one with us for our product candidate.
We
may also be restricted under collaboration agreements from entering into future agreements on certain terms with potential collaborators.
Such exclusivity could limit our ability to enter into strategic collaborations with future collaborators. In addition, there have been
a significant number of business combinations among large pharmaceutical and biotechnology companies that have resulted in a reduced
number of potential future collaborators.
64
We
may not be able to negotiate collaborations on a timely basis, on acceptable terms, or at all. If we are unable to do so, we may have
to curtail the development of the product candidate for which we are seeking to collaborate, reduce or delay its development program
or one or more of our other development programs, delay its potential commercialization or reduce the scope of any marketing or sales
activities, or increase our expenditures and undertake development or commercialization activities at our own expense. If we elect to
increase our expenditures to fund development or commercialization activities on our own, we may need to obtain additional capital, which
may not be available to us on acceptable terms or at all.
Risks
Related to Intellectual Property
If
we are unable to obtain and maintain adequate patent protection for our product candidates or ExacTcell, our competitors could develop
and commercialize products similar or identical to ours, and our ability to successfully commercialize our product candidates may be
adversely affected.
Our
success depends, in large part, on our ability to obtain and maintain patent protection in the United States and other countries with
respect to our product candidates. We have sought, and intend to seek, to protect our proprietary position by filing patent applications
in the United States and abroad related to our product candidates and technology that are important to our business.
The
patent position of biotechnology and pharmaceutical companies generally is highly uncertain, involves complex legal and factual questions
and has, in recent years, been the subject of much litigation. As a result, the issuance, scope, validity, enforceability, and commercial
value of our patent rights are highly uncertain. Our issued patents may not, and our pending and future patent applications may not result
in patents being issued that adequately protect our technology or product candidates or prevent others from commercializing similar or
alternative competitive technologies and product candidates. There is no assurance that all potentially relevant prior art relating to
our patents and patent applications is known to us or has been found. We may be unaware of prior art that could be used to invalidate
an issued patent or prevent a pending patent application from issuing as a patent. Because patent applications in the United States and
most other countries are confidential for a period of time after filing, and some remain so until issued, we cannot be certain that we
were the first to file a patent application relating to any particular aspect of a product candidate. Furthermore, if third parties have
filed such patent applications, we may challenge their ownership, for example in a derivation proceeding before the U.S. Patent and Trademark
Office (the “USPTO”) to determine who has the right to the claimed subject matter in the applications. Similarly, if our
patent applications are challenged in a derivation proceeding, the USPTO may hold that a third party is entitled to certain patent ownership
rights instead of us. We may then be forced to seek a license from the third party that may not be available on commercially favorable
terms, or at all.
The
patent prosecution process is expensive, time-consuming, and complex, and we may not be able to file, prosecute, maintain, enforce, or
license all necessary or desirable patent applications at a reasonable cost or in a timely manner. It is also possible that we will fail
to identify patentable aspects of our research and development output before it is too late to obtain patent protection.
Obtaining
and maintaining our patent protection depends on compliance with various procedural, document submission, fee payment and other requirements
imposed by government patent agencies, and our patent protection could be reduced or eliminated for non-compliance with these requirements.
Periodic
maintenance fees, renewal fees, annuity fees and various other government fees on patents or applications will be due to be paid to the
USPTO and various government patent agencies outside of the United States over the lifetime of our patents or applications and any patent
rights we own or may own in the future. The USPTO and various non-U.S. government patent agencies require compliance with several procedural,
documentary, fee payment and other similar provisions during the patent application process. In many cases, an inadvertent lapse can
be cured by payment of a late fee or by other means in accordance with the applicable rules. There are situations, however, in which
non-compliance can result in abandonment or lapse of the patent or patent application, resulting in partial or complete loss of patent
rights in the relevant jurisdiction. In such an event, potential competitors might be able to enter the market and this circumstance
could have a material adverse effect on our business.
65
We
may not be able to protect our intellectual property rights throughout the world.
Filing,
prosecuting, and enforcing patents on product candidates in all countries throughout the world would be prohibitively expensive, and
our intellectual property rights in some countries outside the United States may be less extensive than those in the United States. In
addition, the laws of some foreign countries do not protect intellectual property rights to the same extent as federal and state laws
in the United States. Consequently, we may be less likely to be able to prevent third parties from infringing our patents in all countries
outside the United States, or from selling or importing products that infringe our patents in and into the United States or other jurisdictions.
Competitors may use our technologies in jurisdictions where we have not obtained patent protection to develop their own products and,
further, may export otherwise infringing products to territories where we have patent protection, but enforcement is not as strong as
that in the United States. These products may compete with our products and our patents or other intellectual property rights may not
be effective or sufficient to prevent them from competing.
Many
countries have compulsory licensing laws under which a patent owner may be compelled to grant licenses to third parties. In addition,
many countries limit the enforceability of patents against government agencies or government contractors. In these countries, the patent
owner may have limited remedies, which could materially diminish the value of such patent. If we are forced to grant a license to third
parties with respect to any patents relevant to our business, our competitive position may be impaired and our business, financial condition,
results of operations and prospects may be adversely affected.
Changes
in patent law could diminish the value of patents in general, thereby impairing our ability to protect our product candidates.
Changes
in either the patent laws or interpretation of the patent laws in the United States could increase the uncertainties and costs surrounding
the prosecution of patent applications and the enforcement or defense of issued patents. After March 2013, under the Leahy-Smith America
Invents Act (the “America Invents Act”), the United States transitioned to a first inventor to file system in which, assuming
that other requirements for patentability are met, the first inventor to file a patent application will be entitled to the patent on
an invention regardless of whether a third party was the first to invent the claimed invention. The America Invents Act also included
a number of significant changes that affected the way patent applications are prosecuted and also may affect patent litigation. These
include allowing third-party submission of prior art to the USPTO during patent prosecution and additional procedures to attack the validity
or ownership of a patent by USPTO administered post-grant proceedings, including post-grant review, inter partes review and derivation
proceedings. Additional changes in patent law could increase the uncertainties and costs surrounding the prosecution of our patent applications
and the enforcement or defense of our issued patents, all of which could have a material adverse effect on our business, financial condition,
results of operations and prospects.
In
addition, the patent positions of companies in the development and commercialization of biologics and pharmaceuticals are particularly
uncertain. Rulings from the U.S. Court of Appeals for the Federal Circuit and the U.S. Supreme Court have narrowed the scope of patent
protection available in certain circumstances and weakened the rights of patent owners in certain situations. This combination of events
has created uncertainty with respect to the validity and enforceability of patents. Depending on future actions by the U.S. Congress,
the federal courts and the USPTO, the laws and regulations governing patents could change in unpredictable ways that could have a material
adverse effect on our existing patent portfolio and our ability to protect and enforce our intellectual property in the future.
We
may become involved in lawsuits to protect or enforce our intellectual property, which could be expensive, time-consuming, and unsuccessful.
Competitors
may infringe our intellectual property rights, or we may be required to defend against claims of infringement. Countering infringement
or unauthorized use claims or defending against claims of infringement can be expensive and time-consuming. Even if resolved in our favor,
litigation or other legal proceedings relating to intellectual property claims may cause us to incur significant expenses and could distract
our technical and management personnel from their normal responsibilities. In addition, there could be public announcements of the results
of hearings, motions or other interim proceedings or developments, and if securities analysts or investors perceive these results to
be negative, it could have a substantial adverse effect on the price of our Common Stock. Such litigation or proceedings could substantially
increase our operating losses and reduce the resources available for development activities or any future marketing, sales, or distribution
activities. We may not have sufficient financial or other resources to adequately conduct such litigation or proceedings. Some of our
competitors may be able to sustain the costs of such litigation or proceedings more effectively than we can because of their greater
financial resources and more mature and developed intellectual property portfolios. Uncertainties resulting from the initiation and continuation
of patent litigation or other proceedings could have a material adverse effect on our ability to compete in the marketplace.
66
In
addition, many companies have encountered significant problems in protecting and defending intellectual property rights in foreign jurisdictions.
The legal systems of certain countries, particularly certain developing countries, do not favor the enforcement of patents, trade secrets
and other intellectual property, particularly those relating to biotechnology products, which could make it difficult for us to stop
the infringement of our patents or marketing of competing products in violation of our proprietary rights generally. Proceedings to enforce
our patent rights in foreign jurisdictions could result in substantial costs and divert our efforts and attention from other aspects
of our business, could put our patents at risk of being invalidated or interpreted narrowly and our patent applications at risk of not
issuing and could provoke third parties to assert claims against us. We may not prevail in any lawsuits that we initiate, and the damages
or other remedies awarded, if any, may not be commercially meaningful. Accordingly, our efforts to enforce our intellectual property
rights around the world may be inadequate to obtain a significant commercial advantage from the intellectual property that we own, develop
or license.
Issued
patents covering our product candidates could be found invalid or unenforceable if challenged in court. We may not be able to protect
our trade secrets in court.
If
we initiate legal proceedings against a third party to enforce any patent that is issued covering one of our product candidates, the
defendant could counterclaim that the patent covering our product candidate is invalid or unenforceable. In patent litigation in the
United States, defendant counterclaims alleging invalidity or unenforceability are commonplace. Grounds for a validity challenge could
be an alleged failure to meet any of several statutory requirements, including lack of novelty, obviousness, written description, or
non-enablement. In addition, patent validity challenges may, under certain circumstances, be based upon non-statutory obviousness-type
double patenting, which, if successful, could result in a finding that the claims are invalid for obviousness-type double patenting or
the loss of patent term, including a patent term adjustment granted by the USPTO, if a terminal disclaimer is filed to obviate a finding
of obviousness-type double patenting. Grounds for an unenforceability assertion could be an allegation that someone connected with prosecution
of the patent withheld information material to patentability from the USPTO, or made a misleading statement, during prosecution. Third
parties also may raise similar claims before administrative bodies in the United States or abroad, even outside the context of litigation.
Such mechanisms include re-examination, post grant review, inter partes review and equivalent proceedings in foreign jurisdictions.
Such proceedings could result in the revocation or cancellation of or amendment to our patents in such a way that they no longer cover
our product candidates. The outcome following legal assertions of invalidity and unenforceability is unpredictable. We cannot be certain
that there is no invalidating prior art of which the patent examiner and we were unaware during prosecution. If a defendant were to prevail
on a legal assertion of invalidity or unenforceability, we could lose part, and perhaps all, of the patent protection on one or more
of our product candidates. Such a loss of patent protection could have a material adverse impact on our business.
In
addition to the protection afforded by patents, we rely on trade secret protection and confidentiality agreements to protect proprietary
know-how that is not patentable or that we elect not to patent, processes for which patents are difficult to enforce and any other elements
of our product candidate discovery and development processes that involve proprietary know-how, information or technology that is not
covered by patents, including portions of our ExacTcell technology. However, trade secrets can be difficult to protect, and some courts
inside and outside the United States are less willing or unwilling to protect trade secrets.
67
Third
parties may initiate legal proceedings alleging that we are infringing their intellectual property rights, the outcome of which would
be uncertain and could have a material adverse effect on the success of our business and financial condition.
Our
commercial success depends upon our ability and the ability of any collaborators to develop, manufacture, market and sell our product
candidates and use our proprietary technologies without infringing the proprietary rights and intellectual property of third parties.
We cannot provide any assurances that third-party patents do not exist which might be enforced against our current manufacturing methods,
product candidates or future methods or products, resulting in either an injunction prohibiting our manufacture or sales, or, with respect
to our sales, an obligation on our part to pay royalties or other forms of compensation to third parties.
The
biotechnology and pharmaceutical industries are characterized by extensive and complex litigation regarding patents and other intellectual
property rights. We may in the future become party to, or be threatened with, adversarial proceedings or litigation regarding intellectual
property rights with respect to our product candidates and technology, including post grant review and inter partes review before
the USPTO. The risks of being involved in such litigation and proceedings may also increase as our product candidates approach commercialization
and as we gain greater visibility as a public company. Third parties may assert infringement claims against us based on existing patents
or patents that may be granted in the future, regardless of their merit. There is a risk that third parties may choose to engage in litigation
with us to enforce or to otherwise assert their patent rights against us. Even if we believe such claims are without merit, a court of
competent jurisdiction could hold that these third-party patents are valid, enforceable, and infringed, which could materially and adversely
affect our ability to commercialize any of our product candidates or technologies covered by the asserted third-party patents.
If
we are found to infringe a third party’s valid and enforceable intellectual property rights, we could be required to obtain a license
from such third party to continue developing, manufacturing, and marketing our product candidates and technology. However, we may not
be able to obtain any required license on commercially reasonable terms or at all. Even if we were able to obtain a license, it could
be non-exclusive, thereby giving our competitors and other third parties access to the same technologies licensed to us, and it could
require us to make substantial licensing and royalty payments. We could be forced, including by court order, to cease developing, manufacturing,
and commercializing the infringing technology or product candidates. In addition, we could be found liable for monetary damages, including
treble damages and attorneys’ fees, if we are found to have willfully infringed a patent or other intellectual property right.
A finding of infringement could prevent us from manufacturing and commercializing our product candidates or force us to cease some of
our business operations, which could materially harm our business. Claims that we have misappropriated the confidential information or
trade secrets of third parties could have a similar negative impact on our business, financial condition, results of operations and prospects.
Others
may claim an ownership interest in our intellectual property and our product candidates, which could expose us to litigation and have
a significant adverse effect on our prospects.
While
we are presently unaware of any claims or assertions by third parties with respect to our patents or other intellectual property, we
cannot guarantee that a third party will not assert a claim or an interest in any of such patents or intellectual property. For example,
a third party may claim an ownership interest in one or more of our patents or other proprietary or intellectual property rights. A third
party could bring legal actions against us to seek monetary damages or enjoin clinical testing, manufacturing, or marketing of the affected
product candidate or product. If we become involved in any litigation, it could consume a substantial portion of our resources and cause
a significant diversion of effort by our technical and management personnel. If any such action is successful, in addition to any potential
liability for damages, we could be required to obtain a license to continue to manufacture or market the affected product candidate or
product, in which case we could be required to pay substantial royalties or grant cross-licenses to patents. We cannot, however, assure
you that any such license would be available on acceptable terms, if at all. Ultimately, we could be prevented from commercializing a
product, or forced to cease some aspect of our business operations as a result of claims of patent infringement or violation of other
intellectual property rights. Further, the outcome of intellectual property litigation is subject to uncertainties that cannot be adequately
quantified in advance, including the demeanor and credibility of witnesses and the identity of any adverse party. This is especially
true in intellectual property cases, which may turn on the testimony of experts as to technical facts upon which experts may reasonably
disagree. Any of the foregoing could have a material adverse effect on our business, financial condition, results of operations or prospects.
68
If
we are unable to protect the confidentiality of our proprietary information, the value of our technology and products could be adversely
affected.
Trade
secrets and know-how can be difficult to protect. To maintain the confidentiality of trade secrets and proprietary information, we enter
into confidentiality agreements with our employees, consultants, collaborators, and others upon the commencement of their relationships
with us. These agreements require that all confidential information developed by the individual or made known to the individual by us
during the course of the individual’s relationship with us be kept confidential and not disclosed to third parties. Our agreements
with employees and consultants also provide that any inventions conceived by the individual in the course of rendering services to us
shall be our exclusive property. However, we cannot guarantee that we have entered into such agreements with each party that may have
or have had access to our trade secrets or proprietary technology and processes, and individuals with whom we have these agreements may
not comply with their terms. Thus, despite such agreement, there can be no assurance that such inventions will not be assigned to third
parties. In the event of unauthorized use or disclosure of our trade secrets or proprietary information, these agreements, even if obtained,
may not provide meaningful protection, particularly for our trade secrets or other confidential information. To the extent that our employees,
consultants, or contractors use technology or know-how owned by third parties in their work for us, disputes may arise between us and
those third parties as to the rights in related inventions. We also seek to preserve the integrity and confidentiality of our trade secrets
by other means, including maintaining physical security of our premises and physical and electronic security of our information technology
systems. However, these security measures may be breached, and we may be forced to bring claims against third parties, or defend claims
that they may bring against us, to determine the ownership of what we regard as our intellectual property.
Adequate
remedies may not exist in the event of unauthorized use or disclosure of our proprietary information. The disclosure of our trade secrets
would impair our competitive position and may materially harm our business, financial condition, and results of operations. Costly and
time-consuming litigation could be necessary to enforce and determine the scope of our proprietary rights, and failure to maintain trade
secret protection could adversely affect our competitive business position. In addition, others may independently discover or develop
our trade secrets and proprietary information, and the existence of our own trade secrets affords no protection against such independent
discovery. For example, a public presentation in the scientific or popular press on the properties of our product candidates could motivate
a third party, despite any perceived difficulty, to assemble a team of scientists having backgrounds similar to those of our employees
to attempt to independently reverse engineer or otherwise duplicate our cell therapy technologies to replicate our success.
We
may be subject to claims asserting that our employees, consultants, or advisors have wrongfully used or disclosed alleged trade secrets
of their current or former employers.
Many
of our employees, consultants or advisors are currently, or were previously, employed at universities or other biotechnology or pharmaceutical
companies. Although we try to ensure that our employees, consultants and advisors do not use the proprietary information or know-how
of others in their work for us, we may be subject to claims that these individuals, or we, have used or disclosed intellectual property,
including trade secrets or other proprietary information, of any such individual’s current or former employer, or that patents
and applications we have filed to protect inventions of these employees, even those related to one or more of our product candidates,
are rightfully owned by their former or current employer. Litigation may be necessary to defend against these claims. If we fail in defending
claims of misappropriation and similar claims, in addition to paying monetary damages, we may lose valuable intellectual property rights
or personnel. Even if we are successful in defending against such claims, litigation could result in substantial costs and be a distraction
to management.
If
our trademarks and trade names are not adequately protected, then we may not be able to build name recognition in our markets of interest
and our business may be adversely affected.
Any
registered trademarks or trade names may be challenged, circumvented, or declared generic or determined to be infringing on other marks.
We may not be able to protect our rights to these trademarks and trade names, which we need to build name recognition among potential
partners or customers in our markets of interest. At times, competitors may adopt trade names or trademarks similar to ours, thereby
impeding our ability to build brand identity and possibly leading to market confusion. In addition, there could be potential trade name
or trademark infringement claims brought by owners of other registered trademarks or trademarks that incorporate variations of our registered
or unregistered trademarks or trade names. Over the long term, if we are unable to establish name recognition based on our trademarks
and trade names, then we may not be able to compete effectively, and our business may be adversely affected. Our efforts to enforce or
protect our proprietary rights related to trademarks, trade secrets, domain names, copyrights or other intellectual property may be ineffective
and could result in substantial costs and diversion of resources and could adversely impact our financial condition or results of operations.
69
Intellectual
property rights do not necessarily address all potential threats.
The
degree of future protection afforded by our intellectual property rights is uncertain because intellectual property rights have limitations,
and may not adequately protect our business or permit us to maintain our competitive advantage. For example:
●
others
may be able to make products that are similar to our product candidates but that are not covered by the claims of the patents that
we own or may own in the future;
●
we,
or any partners or collaborators, might not have been the first to make the inventions covered by the issued patents or pending patent
applications that we own or may own in the future;
●
we,
or any partners or collaborators, might not have been the first to file patent applications covering certain of our or their inventions;
●
others
may independently develop similar or alternative technologies or duplicate any of our technologies without infringing our owned or
licensed intellectual property rights;
●
it
is possible that our pending patent applications or those that we may own in the future will not lead to issued patents;
●
issued
patents that we hold rights to may be held invalid or unenforceable, including as a result of legal challenges by our competitors;
●
our
competitors might conduct research and development activities in countries where we do not have patent rights and then use the information
learned from such activities to develop competitive products for sale in our major commercial markets;
●
we
may not develop additional proprietary technologies that are patentable;
●
the
patents of others may have an adverse effect on our business; and
●
we
may choose not to file a patent for certain trade secrets or know-how, and a third party may subsequently file a patent covering
such intellectual property.
Should
any of these events occur, they could significantly harm our business, financial condition, results of operations and prospects.
Risks
Related to Our Business
We
are highly dependent on our key personnel, and if we are not successful in attracting, motivating, and retaining highly qualified personnel,
we may not be able to successfully implement our business strategy.
We
are highly dependent on members of our executive team. The loss of the services of any of them may adversely impact the achievement of
our objectives. Any of our executive officers could leave our employment at any time, as all of our employees are “at-will”
employees, and we do not have “key person” insurance on them. The loss of the services of our Chief Executive Officer Ryan
Saadi, Chief Scientific Officer Neal Flomenberg, or one or more of our other executive officers or key employees could impede the achievement
of our research, development, and commercialization objectives.
Recruiting
and retaining qualified employees, consultants, and advisors for our business, including scientific and technical personnel, will also
be critical to our success. Competition for skilled personnel is intense and the turnover rate can be high. We may not be able to attract
and retain personnel on acceptable terms given the competition among numerous biotechnology and pharmaceutical companies and academic
institutions for skilled individuals. In addition, failure to succeed in preclinical studies, clinical trials or applications for marketing
approval may make it more challenging to recruit and retain qualified personnel. The inability to recruit, or the loss of services of
certain executives, key employees, consultants, or advisors, may impede the progress of our research, development and commercialization
objectives and have a material adverse effect on our business, financial condition, results of operations and growth prospects.
70
We
may face substantial competition, which may result in others discovering, developing, or commercializing products before or more successfully
than we do.
The
biotechnology and pharmaceutical industries, and in particular the immunotherapy sector, are characterized by the rapid evolution of
technologies and understanding of disease etiology, intense competition, and strong pursuit and defense of intellectual property. We
may face substantial competition from multiple sources, including major pharmaceutical, specialty pharmaceutical and existing or emerging
biotechnology companies, governmental agencies, academic institutions, public and private research institutions, technology companies
active in the AI space, and others. Our commercial opportunities will be significantly impacted if our competitors develop and commercialize
products that are safer, more effective, have fewer side effects, are less expensive or obtain more significant acceptance in the market
than any product candidates that we develop. Additionally, our commercial opportunities will be significantly impacted if novel upstream
products or changes in treatment protocols reduce the overall incidence or prevalence of diseases in our current or future target population.
Competition could result in reduced sales and pricing pressure on our product candidates, if approved by FDA. In addition, significant
delays in the development of our product candidates could allow our competitors to bring products to market before us and impair any
ability to commercialize our product candidates.
Some
of the approved or commonly used drugs and therapies for certain of our target diseases are well established and are widely accepted
by physicians, patients, and third-party payors. Some of these drugs are branded and subject to patent protection, and other drugs and
nutritional supplements are available on a generic basis. Insurers and other third-party payors may encourage the use of generic products
or specific branded products. If any of our product candidates are approved, although we expect they may be priced at a discount to existing
cell therapies, we also expect they will be priced at a significant premium over any competitive generic products. Absent differentiated
and compelling clinical evidence, pricing premiums may impede the adoption of our products over currently approved or commonly used therapies,
which may adversely impact our business. In addition, many companies are developing new therapeutics, and we cannot predict what the
standard of care will become as our products continue in clinical development. We anticipate that we could face intense and increasing
competition as new therapies enter the market and advanced technologies become available from time to time. We expect that any treatments
which we develop and commercialize will need to compete on, among other things, efficacy, safety, convenience of administration and delivery,
and price.
Many
of our competitors or potential competitors, either alone or through collaborations, have significantly greater market presence, financial
resources and expertise in research and development, preclinical studies, conducting clinical trials, manufacturing, obtaining regulatory
approvals and marketing approved products than we do, and as a result may have a competitive advantage over us. Smaller or early-stage
companies may also prove to be significant competitors, including through collaborative arrangements or mergers with large and established
companies. These third parties compete with us in establishing clinical trial sites and patient enrollment for clinical trials, as well
as in acquiring technologies and technology licenses complementary to our programs or advantageous to our business.
We
also face substantial competition for our AI initiatives and our computational approaches to drug discovery. Our competitors may have
significantly greater experience and expertise in using AI, algorithmic tool development, predictive analytics, and data science to expedite
drug development, optimize laboratory processes and clinical trials, unravel complex biological data, and improve patient outcomes than
we do, and significantly greater financial and other resources with which to do so. AI technologies are changing rapidly and we must
adapt and develop these technologies in a timely and effective manner at an acceptable cost in order to compete. There can be no assurance
that we will be able to develop, acquire, or integrate AI technologies, tools, and processes successfully or as quickly or cost-effectively
as our competitors, or that these technologies, tools, and processes will meet our needs or achieve our goals. In addition, if the technologies,
tools, or processes that we develop are incorrectly designed, do not operate properly, or are otherwise deficient, or if we do not have
the rights to use the data on which they rely, we may not achieve our goals for this initiative, our performance and reputation could
suffer or we could incur liability through the violation of laws, privacy rights, or contracts. Even with the successful use of AI, we
may fail to allocate resources efficiently, which could adversely impact our pipeline and ability to compete effectively.
Our
ability to attract and retain highly skilled personnel is critical to our operations and expansion. We also face competition for these
types of personnel from biotechnology and other companies and organizations, many of which have significantly larger operations and greater
financial, technical, human, and other resources than us. We may not be successful in attracting and retaining qualified personnel on
a timely basis, on competitive terms, or at all. If we are not successful in attracting and retaining these personnel, or integrating
them into our operations, our business, prospects, financial condition, and results of operations will be materially adversely affected.
In such circumstances, we may be unable to conduct certain research and development programs, unable to adequately manage our clinical
trials and development of our product candidates, and unable to adequately address our management needs.
71
As
a result of these factors, these competitors may obtain regulatory approval of their products before we are able to, which could result
in our competitors obtaining a head start and establishing a frontrunner position before we are ready to commercialize and will limit
our ability to develop or commercialize our product candidates. Our ability to commercialize our proprietary cell products could also
be reduced or eliminated if our competitors develop and commercialize products that are safer, more effective, have a better safety profile,
are more convenient or are less expensive than our products. Our competitors also may be more successful than us in manufacturing and
marketing their products. These appreciable advantages could render our product candidates obsolete or noncompetitive before we can recover
the expenses of development and commercialization. If we are not able to compete effectively against our existing and potential competitors,
our business, financial condition, results of operations and growth prospects may be materially and adversely affected.
We
will need to grow the size of our organization, and we may experience difficulties in managing this growth.
As
our development plans and strategies develop, we expect to need additional managerial, operational, marketing, sales, financial and other
personnel. Future growth would impose significant added responsibilities on members of management, including:
●
identifying,
recruiting, integrating, maintaining, and motivating additional employees;
●
managing
our internal development efforts effectively, including the clinical and FDA review process for TVGN 489 and any future product candidates
we develop, while complying with our contractual obligations to contractors and other third parties; and
●
improving
our operational, financial and management controls, reporting systems and procedures.
Our
future financial performance and our ability to advance development of and, if approved, commercialize TVGN 489 and any future product
candidates we develop will depend, in part, on our ability to effectively manage any future growth, and our management may have to divert
a disproportionate amount of its attention away from day-to-day activities in order to devote a substantial amount of time to managing
these growth activities.
We
currently rely, and for the foreseeable future will continue to rely, in substantial part on certain independent organizations, advisors
and consultants to provide certain services. We cannot assure you that the services of independent organizations, advisors and consultants
will continue to be available to us on a timely basis when needed, or that we can find qualified replacements. In addition, if we are
unable to effectively manage our outsourced activities or if the quality or accuracy of the services provided by consultants is compromised
for any reason, our clinical trials may be extended, delayed, or terminated, and we may not be able to obtain marketing approval of any
current or future product candidates or otherwise advance our business. We cannot assure you that we will be able to manage our existing
consultants or find other competent outside contractors and consultants on economically reasonable terms, or at all.
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 TVGN 489 and any future product
candidates we develop and, accordingly, may not achieve our research, development, and commercialization goals.
We
may not realize the benefits of any acquisitions, strategic alliances, or similar arrangements that we enter into.
In
the future, we may seek and form strategic alliances, create joint ventures or collaborations, or enter into acquisitions or licensing
arrangements with third parties that we believe will complement or augment our existing technologies and product candidates, including
other pharmaceutical companies and CROs.
These
transactions can entail numerous operational and financial risks, including exposure to unknown liabilities, disruption of our business
and diversion of our management’s time and attention in order to manage a collaboration or develop acquired products, product candidates
or technologies, incurrence of substantial debt or dilutive issuances of equity securities to pay transaction consideration or costs,
higher than expected collaboration, acquisition or integration costs, write-downs of assets or goodwill or impairment charges, increased
amortization expenses, difficulty and cost in facilitating the collaboration or combining the operations and personnel of any acquired
business, impairment of relationships with key suppliers, manufacturers or customers of any acquired business due to changes in management
and ownership and the inability to retain key employees of any acquired business. As a result, if we enter into acquisition or in-license
agreements or strategic partnerships, we may not consummate the transactions on a timely basis or at all, and may not be able to realize
the benefit of such transactions if we are unable to successfully integrate them with our existing operations and company culture, which
could delay our timelines or otherwise adversely affect our business. We also cannot be certain that, following a strategic transaction
or license, we will achieve the revenue or specific net income that justifies such transaction or such other benefits that led us to
enter into the arrangement.
Product
liability lawsuits against us could cause us to incur substantial liabilities and to limit commercialization of our product candidates.
We
face an inherent risk of product liability exposure related to the testing of our product candidates in human trials and may face greater
risk if we commercialize any products that we develop. Product liability claims may be brought against us by subjects enrolled in our
trials, patients, healthcare providers or others using, administering, or selling our products. If we cannot successfully defend ourselves
against such claims, we could incur substantial liabilities. Regardless of merit or eventual outcome, liability claims may result in:
●
decreased
demand for any product candidate we may develop;
●
withdrawal
of trial participants;
72
●
termination
of clinical trial sites or entire trial programs;
●
injury
to our reputation and significant negative media attention;
●
initiation
of investigations by regulators;
●
significant
time and costs to defend the related litigation;
●
substantial
monetary awards to trial subjects or patients;
●
diversion
of management and scientific resources from our business operations; and
●
the
inability to commercialize any product candidates that we may develop.
While
we currently hold liability insurance coverage consistent with industry standards, the amount of coverage may not adequately cover all
liabilities that we may incur. We may not be able to maintain insurance coverage at a reasonable cost or in an amount adequate to satisfy
any liability that may arise. We intend to expand our insurance coverage for products to include the sale of commercial products if we
obtain marketing approval for our product candidates, but we may be unable to obtain commercially reasonable product liability insurance.
A successful product liability claim or series of claims brought against us, particularly if judgments exceed our insurance coverage,
could decrease our cash and adversely affect our business and financial condition.
Our
ability to use our net operating loss carryforwards to offset future taxable income may be subject to certain limitations.
We
have incurred substantial losses during our history and do not expect to become profitable in the near future, and we may never achieve
profitability. To the extent that we continue to generate taxable losses, unused losses will carry forward to offset future taxable income,
if any, until such unused losses expire. Limitations imposed by the applicable jurisdictions on our ability to utilize net operating
loss carryforwards could cause income taxes to be paid earlier than would be paid if such limitations were not in effect and could cause
such net operating loss carryforwards to expire unused, in each case reducing or eliminating the benefit of such net operating loss carryforwards.
Furthermore, we may not be able to generate sufficient taxable income to utilize our net operating loss carryforwards before they expire.
If any of these events occur, we may not derive some or all of the expected benefits from our net operating loss carryforwards. In addition,
we may experience ownership changes in the future as a result of subsequent shifts in our stock ownership, some of which may be outside
of our control. As a result, even if we earn net taxable income, our ability to use our net operating loss and tax credit carryforwards
may be materially limited, which could harm our future operating results by effectively increasing our future tax obligations.
Risks
Related to Being a Public Company and Ownership of Securities
The
price of our Common Stock and Warrants may fluctuate significantly and you could lose all or part of your investment as a result.
The
market price of our Common Stock and Warrants has been and is likely to continue to be volatile. The stock market in general, and the
market for biopharmaceutical companies in particular, have experienced extreme volatility that has often been unrelated to the operating
performance or prospects of particular companies. As a result of this volatility, you could lose all or part of your investment. Many
factors may have a material adverse effect on the market price of our securities, including, but not limited to:
●
the
commencement, enrollment, delay, or results of our ongoing or future clinical trials, or changes in the development status of our
product candidates;
●
our
decision to initiate, not to initiate, or to terminate a clinical trial;
●
unanticipated
serious safety concerns related to the use of our product candidates;
●
any
delay in our regulatory filings for our product candidates and any adverse or perceived adverse development with respect to the applicable
regulatory authority’s review of such filings;
●
regulatory
actions, including failure to receive regulatory approval, with respect to our product candidates or our competitors’ products
or product candidates;
●
our
failure to commercialize our products;
●
our
failure to utilize AI technologies in the development of our product candidates;
73
●
the
success of competitive products or technologies;
●
announcements
by us or our competitors of significant acquisitions, strategic collaborations, joint ventures, collaborations, capital commitments,
significant development milestones, or product approvals;
●
our
failure to obtain new commercial partners;
●
our
failure to obtain adequate manufacturing capacity or product supply for any approved product or inability to do so at acceptable
cost;
●
our
failure to achieve expected product sales and profitability;
●
regulatory
or legal developments applicable to our product candidates;
●
the
level of expenses related to our product candidates or clinical development programs;
●
significant
lawsuits, including without limitation patent or stockholder litigation;
●
the
impact of the incidence and development of COVID-19 on our business and product candidates;
●
any
changes in our Board of Directors (the “Board”) or senior management;
●
actual
or anticipated fluctuations in our cash position or operating results;
●
changes
in financial estimates or recommendations by securities analysts;
●
fluctuations
in the valuation or financial results of companies perceived by investors to be comparable to us;
●
inconsistent
trading volume levels of our shares;
●
announcement
or expectation of additional financing efforts;
●
sales
of Common Stock by us, our executive officers or directors, or our stockholders, including under our Sales Agreement;
●
fluctuations
and market conditions in the U.S. equity markets generally and in the biotechnology sector;
●
general
economic, political and social conditions; and
●
other
events or factors, many of which are beyond our control, or unrelated to our operating performance or prospects.
In
recent years, the stock market in general has experienced significant price and volume fluctuations that have often been unrelated or
disproportionate to changes in the operating performance of the companies whose stock is experiencing those price and volume fluctuations.
Broad market and industry factors may seriously affect the market price of our Common Stock and Warrants, regardless of actual operating
performance. Following periods of such volatility in the market price of a company’s securities, securities class action litigation
has often been brought against that company. Because of the potential volatility of our Common Stock and warrant price, we may become
the target of securities litigation in the future. Securities litigation could result in substantial costs and divert management’s
attention and resources from our business. The realization of any of the above risks or any of a broad range of other risks, including
those described in this “ Risk Factors ” section, could have a dramatic and material adverse impact on the market price
of our Common Stock following the business combination.
If
we fail to meet Nasdaq’s continued listing requirements, our Common Stock and our outstanding public warrants to purchase Common
Stock could be delisted.
Our
Common Stock and our Warrants are listed on Nasdaq. We are required to meet specified financial and other requirements in order to maintain
such listing, including a requirement that the closing bid price for our Common Stock remain above $1.00 and that the market value of
our Common Stock is at least $50 million and the market value of publicly held shares of our Common Stock is at least $15 million.
On
September 23, 2025, we received a notification letter from Nasdaq’s Listing Qualifications Staff notifying us that the closing
bid price for our Common Stock had been below $1.00 for the previous 30 consecutive business days and that we therefore are not in compliance
with the minimum bid price requirement for continued inclusion on Nasdaq under Nasdaq Listing Rule 5450(a)(1) (the “Bid Price Requirement”).
On March 20, 2026, we received written notice (the “Notification Letter”) from Nasdaq that the Company had regained
compliance with the Bid Price Requirement. The Notification Letter was sent following the implementation of a 1-for-50 reverse stock
split of the Company’s Common Stock (the “Reverse Split”), which became effective on March 6, 2026.
74
There
is no guarantee that we will maintain compliance with the Bid Price Requirement. If we are once again notified by Nasdaq that we are
not in compliance with the Bid Price Requirement we do not regain compliance by the compliance deadline, we may be eligible for an additional
180 calendar days, provided that we submit an online transfer application to transfer the listing of our Common Stock to the Nasdaq Capital
Market, submit an application fee, and meet the continued listing requirement for market value of publicly held shares and all other
initial listing standards for the Nasdaq Capital Market, except the bid price requirement. In addition, we will be required to provide
written notice of our intention to cure the deficiency during the second compliance period by effecting a reverse stock split if necessary.
If it appears to Nasdaq that we will not be able to cure the deficiency during the second compliance period, or if we determine not to
submit a transfer application or make the required representation, Nasdaq will provide written notice to us that our Common Stock will
be subject to delisting. In the event of such notification, we may appeal Nasdaq’s determination to delist its securities, but
there can be no assurance that Nasdaq would grant our request for continued listing.
There
can be no assurance that we will be able to maintain compliance with the minimum bid price requirement or will otherwise be in compliance
with other Nasdaq listing criteria.
If
we fail to maintain compliance with the requirement to maintain a minimum closing bid price of $1.00 per share or to meet other Nasdaq
continued listing requirements, Nasdaq may take steps to delist our securities. Such a delisting would likely have a negative effect
on the price of our securities and would impair your ability to sell or purchase the securities when you wish to do so. In the event
of a delisting, we can provide no assurance that any action taken by us to restore compliance with listing requirements would allow our
securities to become listed again, stabilize the market price or improve the liquidity of our securities, prevent our securities from
dropping below the Nasdaq minimum bid price requirement or prevent future non-compliance with Nasdaq’s listing requirements. Additionally,
if our securities are not listed on, or become delisted from, Nasdaq for any reason, and are quoted on the OTC Bulletin Board, an inter-dealer
automated quotation system for equity securities that is not a national securities exchange, the liquidity and price of our securities
may be more limited than if our securities were quoted or listed on Nasdaq or another national securities exchange. You may be unable
to sell your securities unless a market can be established or sustained.
We
have previously failed to timely file certain periodic reports with the SEC. Potential future delays in the filing of our reports with
the SEC pose significant risks to our business, and could materially and adversely affect our financial condition and results of operations.
We
did not timely file our Annual Report on Form 10-K for the fiscal year ended December 31, 2023 or our Form 10-Q for the quarterly period
ended March 31, 2024 and missed the initial deadline for the filing of our Form 10-Q for the quarterly period ended September 30, 2024
and our Form 10-K for the fiscal year ended December 31, 2024. While we are now current in our filing of periodic reports under the Exchange
Act, there is no assurance that in the future our reporting will always be timely. Our access to financing may be impaired by any untimely
filing of our periodic reports. For example, we will not be eligible to register the offer and sale of our securities using a short-form
registration statement on Form S-3 unless we have timely filed all periodic reports required under the Exchange Act for a period of twelve
calendar months and any portion of a month immediately preceding the filing of such registration statement. In addition, in the event
the filing of our periodic reporting is delayed in the future, we may experience a material adverse effect on our ability to grow our
business.
Future
failures to timely file periodic reports with the SEC could subject us to enforcement action by the SEC and stockholder lawsuits, and
result in the delisting of our Common Stock and Warrants from the Nasdaq Stock Market LLC (“Nasdaq”), regulatory sanctions
from the SEC, or breach of covenants in any future credit facilities or of any preferred equity or debt securities that we may issue
in the future, any of which could have a material adverse impact on our operations, your investment in our Common Stock and Warrants,
and our ability to register with the SEC public offerings of our securities for our benefit or the benefit of our security holders. Additionally,
any potential failure to timely file future periodic reports could result in investors not receiving access to current or timely information
regarding our business and operations with which to make investment decisions.
75
We
may not have the funds necessary to satisfy our future obligations under the terms of our Preferred Stock and uncertainties with respect
to our obligations under the terms of our Preferred Stock could materially and adversely affect our ability to raise capital, our liquidity
position, our ability to operate our business and execute our business strategy, and the trading volatility and price of our securities.
Uncertainty
regarding our ability to satisfy our future obligations under the terms of our Preferred Stock could materially and adversely affect
our business. Our Series A Preferred Stock, which has an aggregate face value of $2.0 million, carries an annual 5% cumulative dividend,
increasing by 2% each year. The Series A Preferred Stock is callable if the volume weighted average price of the Common Stock for the
20 days prior to delivery of the call notice is greater than $5.00 per share and there is an effective resale registration statement
on file covering the underlying Common Stock. Our Series C Preferred Stock, which has an aggregate face value of $6.0 million, carries
an annual 7.5% cumulative dividend, compounded annually, payable in shares of Series C Preferred Stock, or at our election, in cash.
The Series C Preferred Stock is callable at any time after the fifth anniversary of the issuance date.
We
may not have sufficient funds or be able to obtain financing from third parties to pay the dividends applicable to our Preferred Stock
or to redeem the Preferred Stock pursuant to our call rights, and the amount of dividend we may be required to pay on the Preferred Stock
is uncertain. These uncertainties could materially and adversely affect our ability to raise capital, our liquidity position, our ability
to operate our business and execute our business strategy, and the trading volatility and price of our securities.
We
incur increased costs as a result of operating as a public company, and our management devotes substantial time to compliance initiatives
and corporate governance practices.
As
a public company, we incur significant legal, accounting, and other expenses that we did not incur as a private company. The Sarbanes-Oxley
Act, the Dodd-Frank Wall Street Reform and Consumer Protection Act, the listing requirements of Nasdaq, and other applicable securities
rules and regulations impose various requirements on public companies, including establishment and maintenance of effective disclosure
and financial controls and corporate governance practices. We expect that we will need to hire additional accounting, finance, and other
personnel in connection with our efforts to comply with the requirements of being, a public company, and our management and other personnel
devote a substantial amount of time towards maintaining compliance with these requirements. These requirements contribute significantly
to our legal and financial compliance costs. These rules and regulations are often subject to varying interpretations, in many cases
due to their lack of specificity, and, as a result, their application in practice may evolve over time as new guidance is provided by
regulatory and governing bodies. This could result in continuing uncertainty regarding compliance matters and higher costs necessitated
by ongoing revisions to disclosure and governance practices.
We
have issued and in the future may issue additional shares of our Common Stock or other equity securities without your approval, which
would dilute your ownership interests and may depress the market price of your shares.
We
have issued and sold shares of our Common Stock under our Sales Agreement and in the form of equity awards of to our officers and directors.
We may issue additional shares of our Common Stock or other equity securities of equal or senior rank in the future in connection with,
among other things, raising additional capital, future acquisitions, repayment of outstanding indebtedness, or award issuances under
the Tevogen Bio Holdings Inc. 2024 Omnibus Incentive Plan, without stockholder approval, in a number of circumstances. The additional
shares or other securities convertible into or exchangeable for our public shares may be offered at prices that may not be the same as
the price per share paid by other investors. Investors purchasing shares or other securities in the future could have rights superior
to existing stockholders. The price per share at which the additional shares or securities convertible or exchangeable into public shares,
will be sold in future transactions may be higher or lower than the price per share paid by other investors. If any of the above should
occur, our stockholders will experience additional dilution, and any such issuances may result in downward pressure on the price of our
Common Stock.
76
The
issuance of additional shares of Common Stock or other equity securities of equal or senior rank could have the following effects:
●
your
proportionate ownership interest in Tevogen will decrease;
●
the
relative voting strength of each previously outstanding share of Common Stock may be diminished; or
●
the
market price of your shares of Common Stock may decline.
We
are an “emerging growth company” and a “smaller reporting company”, and certain exemptions from disclosure requirements
available to us could make our securities less attractive to investors and may make it more difficult to compare our performance to the
performance of other public companies.
We
qualify as an “emerging growth company” as defined in Section 2(a)(19) of the Securities Act of 1933, as amended (the “Securities
Act”), as modified by the JOBS Act. As such, we are eligible for and intend to take advantage of certain exemptions from various
reporting requirements applicable to other public companies that are not emerging growth companies for as long as we continue to be an
emerging growth company, including, but not limited to, (a) not being required to comply with the auditor attestation requirements of
Section 404 of the Sarbanes-Oxley Act, (b) reduced disclosure obligations regarding executive compensation in our periodic reports and
proxy statements and (c) exemptions from the requirements of holding a nonbinding advisory vote on executive compensation and stockholder
approval of any golden parachute payments not previously approved. As a result, our stockholders may not have access to certain information
they may deem important. We cannot predict whether investors will find our securities less attractive because we rely on these exemptions.
If some investors find our securities less attractive as a result of our reliance on these exemptions, the trading prices of our securities
may be lower than they otherwise would be, there may be a less active trading market for our securities and the trading prices of our
securities may be more volatile.
We
will remain an emerging growth company until the earliest of : (i) the last day of the fiscal year (a) following the fifth anniversary
of the closing of Semper Paratus’ initial public offering, or December 31, 2026, (b) in which we have total annual gross revenue
of at least $1.235 billion, or (c) in which we are deemed to be a large accelerated filer, which means the market value of our common
equity that is held by non-affiliates exceeds $700 million as of the last business day of its most recently completed second fiscal quarter;
and (ii) the date on which we have issued more than $1.00 billion in non-convertible debt securities during the prior three-year period.
In addition, the JOBS Act also provides that an emerging growth company can delay the adoption of certain accounting standards until
those standards would otherwise apply to private companies. We have elected not to opt out of such extended transition period and, therefore,
we may not be subject to the same new or revised accounting standards as other public companies that are not emerging growth companies.
This may make comparison of our financial statements with the financial statements of other companies who comply with public company
adoption dates difficult or impossible because of the potential differences in accounting standards used. Investors may find our Common
Stock less attractive because it will rely on these exemptions, which may result in a less active trading market for our Common Stock
and its price may be more volatile.
Additionally,
we qualify as a “smaller reporting company” as defined in Item 10(f)(1) of Regulation S-K. Smaller reporting companies may
take advantage of certain reduced disclosure obligations, including, among other things, providing only two years of audited financial
statements. We will remain a smaller reporting company and may take advantage of certain scaled disclosures available to smaller reporting
companies for so long as the market value of our voting and non-voting common equity held by non-affiliates is less than $250.0 million,
measured on the last business day of our second fiscal quarter, or our annual revenue is less than $100.0 million during the most recently
completed fiscal year and the market value of our common equity held by non-affiliates is less than $700.0 million, measured on the last
business day of our second fiscal quarter. To the extent we take advantage of such reduced disclosure obligations, it may also make comparison
of its financial statements with other public companies difficult or impossible.
Our
management team has limited experience managing a public company.
Members
of our management team have limited experience managing a publicly traded company, interacting with public company investors, and complying
with the increasingly complex laws pertaining to public companies. Our management team may not successfully or efficiently manage our
transition to being a public company that is subject to significant regulatory oversight and reporting obligations under the federal
securities laws and the continuous scrutiny of securities analysts and investors. These new obligations and constituents require significant
attention from our senior management and could divert their attention away from the day-to-day management of our business, which could
harm our business, financial condition, and results of operations.
77
If
securities or industry analysts do not publish research or reports about our business, if they adversely change their recommendation
regarding our Common Stock or if our results of operations do not meet their expectations, including projections in those reports that
differ from our actual results, our share price and trading volume could decline.
The
trading market for our Common Stock may be influenced by research and reports that industry or securities analysts may publish about
us or our business. We do not have any control over these analysts. We have limited analyst coverage and we may continue to have limited
analyst coverage in the future.
If
securities or industry analysts fail to commence coverage of us, the trading price of our Common Stock may be negatively impacted. In
the event securities or industry analysts initiate coverage, and one or more of these analysts cease coverage of us or fail to publish
reports on us regularly, we could lose visibility in the financial markets, which in turn could cause the price of our Common Stock or
trading volume to decline. Moreover, if one or more of the analysts who cover us publish negative reports, downgrade our stock, or if
our results of operations do not meet their expectations, the price of our Common Stock could decline. Securities research analysts may
establish and publish their own periodic projections for us. These projections may vary widely and may not accurately predict the results
we actually achieve. Our share price may decline if our actual results do not match the projections of these securities research analysts.
Our
business and operations could be negatively affected if we become subject to any securities litigation or stockholder activism, which
could cause us to incur significant expense, hinder execution of business and growth strategy and impact its stock price.
In
the past, following periods of volatility in the market price of a company’s securities, securities class action litigation has
often been brought against that company. Stockholder activism, which could take many forms or arise in a variety of situations, has been
increasing recently. Volatility in the stock price of our Common Stock or other reasons may in the future cause it to become the target
of securities litigation or stockholder activism. Securities litigation and stockholder activism, including potential proxy contests,
could result in substantial costs and divert management’s and Board’s attention and resources from our business. Additionally,
such securities litigation and stockholder activism could give rise to perceived uncertainties as to our future, adversely affect our
relationships with service providers and make it more difficult to attract and retain qualified personnel. Also, we may be required to
incur significant legal fees and other expenses related to any securities litigation and activist stockholder matters. Further, our stock
price could be subject to significant fluctuation or otherwise be adversely affected by the events, risks and uncertainties of any securities
litigation and stockholder activism.
We
may be required to take write-downs or write-offs, restructuring and impairment or other charges that could have a significant negative
effect on its financial condition, results of operations and the share price of our securities, which could cause you to lose some or
all of your investment.
We
may be forced to write-down or write-off assets, restructure our operations, or incur impairment or other charges that could result in
our reporting losses. In addition, unexpected risks may arise and previously known risks may materialize in a manner not consistent with
prior risk analysis. If any of these risks materialize, this could have a material adverse effect on our financial condition and results
of operations and could contribute to negative market perceptions about our securities.
78
We
have identified material weaknesses in our internal control over financial reporting. If we are unable to develop and maintain proper
and effective internal control over financial reporting, our ability to produce accurate and timely financial statements could be impaired,
investors may lose confidence in our financial reporting and the trading price of our Common Stock may decline.
Our
management has previously concluded that we had material weaknesses in our internal controls over financial reporting related to our
not maintaining a sufficient complement of personnel commensurate with its accounting and reporting requirements resulting in inadequate
segregation of duties over the preparation, review, and posting of manual journal entries to the general ledger and in not having a sufficient
risk assessment process to identify and analyze risks of misstatement due to error and/or fraud. A material weakness is a deficiency,
or a combination of deficiencies, in internal control over financial reporting such that there is a reasonable possibility that a material
misstatement of our annual or interim financial statements will not be prevented or detected and corrected on a timely basis.
Although
we have remediated one material weakness as of December 31, 2025 and we continue to evaluate steps to remediate the remaining
material weakness, the material weakness will not be considered remediated until our plan has been fully implemented, the
applicable controls are fully operational for a sufficient period of time, and we have concluded, through testing, that the newly
implemented and enhanced controls are operating effectively. At this time, we cannot predict the success of such efforts or the
outcome of future assessments of the remediation efforts. If the material weakness is not remediated, or if we generally fail to
establish and maintain effective internal controls appropriate for a public company, we may be unable to produce timely and accurate
financial statements, and we may conclude that our internal control over financial reporting is not effective, which could adversely
impact our investors’ confidence and our stock price. In addition, these remediation measures may be time consuming and
costly.
If
we identify any new material weaknesses in the future, any such newly identified material weakness could limit our ability to prevent
or detect a misstatement of our accounts or disclosures that could result in a material misstatement of our annual or interim financial
statements. In such case, we may be unable to maintain compliance with securities law requirements regarding timely filing of periodic
reports in addition to applicable stock exchange listing requirements, investors may lose confidence in our financial reporting and our
stock price may decline as a result. We cannot assure you that the measures we have taken to date, or any measures we may take in the
future, will be sufficient to avoid potential future material weaknesses.
To
address the material weakness, we intend to hire additional accounting personnel with appropriate expertise in accounting and reporting
under U.S. generally accepted accounting principles (“GAAP”) and SEC regulations in order to perform appropriate risk assessment procedures to evaluate risks of material misstatement.
We
also cannot assure you that there will not be material weaknesses in our internal control over financial reporting in the future. Our
independent registered public accounting firm is not required to provide an attestation report on the effectiveness of our internal control
over financial reporting so long as we qualify as an “emerging growth company,” which may increase the risk that material
weaknesses or significant deficiencies in our internal control over financial reporting go undetected. Any failure to maintain internal
control over financial reporting could severely inhibit our ability to accurately report our financial condition, results of operations
or cash flows. If we are unable to conclude that our internal control over financial reporting is effective, or if our independent registered
public accounting firm determines we have a material weakness in our internal control over financial reporting, investors may lose confidence
in the accuracy and completeness of our financial reports, the market price of our Common Stock could decline, and we could be subject
to sanctions or investigations by Nasdaq, the SEC, or other regulatory authorities. Failure to remedy any material weakness in our internal
control over financial reporting, or to implement or maintain other effective control systems required of public companies, could also
restrict our future access to the capital markets.
A
significant portion of our total outstanding shares may be sold into the market in the near future. This could cause the market price
of our Common Stock to drop significantly, even if our business is doing well.
Sales
of a substantial number of shares of our Common Stock in the public market could occur at any time. In addition, until recently we had
a substantial number of restricted stock units. Sales, or the perception in the market that the holders of a large number of shares intend
to sell shares, could reduce the market price of our Common Stock.
As
restrictions on resale end and any registration statements we file for the resale of such shares are available for use, the market price
of our Common Stock could decline if the holders of previously restricted shares sell them or are perceived by the market as intending
to sell them.
79
Our
directors, executive officers, and principal stockholders, and Dr. Ryan Saadi in particular, have substantial control over our Company,
which could limit your ability to influence the outcome of key transactions, including a change of control.
Our
executive officers, directors, and principal stockholders and their affiliates beneficially own approximately 81% of the outstanding
shares of Common Stock and our Chief Executive Officer, Dr. Ryan Saadi, beneficially owns approximately 62% of the outstanding shares
of Common Stock. As a result, these stockholders exercise a significant level of control over all matters requiring stockholder approval,
including the election of directors and the approval of mergers, acquisitions or other extraordinary transactions. They may also have
interests that differ from our investors and may vote in a way with which our investors disagree. In addition, under the Nasdaq rules,
a company of which more than 50% of the voting power is held by an individual, group or another company is a “controlled company”
and need not comply with certain requirements, including the requirement that a majority of the board of directors consist of independent
directors and the requirements that our compensation and nominating and governance committees be composed entirely of independent directors.
We currently take advantage of certain of these exemptions. For so long as we qualify as a “controlled company,” we maintain
the option to rely on some or all of these exemptions. If we rely on these exemptions, we may not have a majority of independent directors
and our compensation and nominating and governance committees may not consist entirely of independent directors. Accordingly, in the
event we elect to rely on these exemptions in the future, our stockholders would not have the same protections afforded to stockholders
of companies that are subject to all of the corporate governance requirements of Nasdaq. This concentration of ownership may have the
effect of delaying, preventing or deterring a change of control, could deprive our stockholders of an opportunity to receive a premium
for their Common Stock as part of a sale, and might ultimately affect the market price of our Common Stock.
We
may redeem a warrant holder’s unexpired warrants prior to their exercise at a time that may be disadvantageous to such warrant
holder, thereby making its warrants worthless.
We
have the ability to redeem outstanding public warrants at any time after they become exercisable and prior to their expiration, at a
price of $0.01 per warrant, provided that the last reported sales price of Common Stock equals or exceeds $900.00 per share (as adjusted
for stock splits, stock capitalizations, reorganizations, recapitalizations and the like for certain issuances of public shares and equity-linked
securities for capital raising purposes in connection with the closing of its initial business combination) for any 20 trading days within
a 30 trading-day period ending on the third trading day prior to the date we send the notice of redemption to the warrant holders. We
may exercise our redemption right even if we are unable to register or qualify the underlying securities for sale under all applicable
state securities laws. Redemption of the outstanding warrants could force a warrant holder to: (i) exercise its warrants and pay the
exercise price at a time when it may be disadvantageous for such warrant holder to do so; (ii) sell its warrants at the then-current
market price when a warrant holder might otherwise wish to hold its warrants; or (iii) accept the nominal redemption price which, at
the time the outstanding warrants are called for redemption, is likely to be substantially less than the market value of a warrant holder’s
warrants.
The
value received upon exercise of the warrants (1) may be less than the value the holders would have received if they had exercised their
warrants at a later time where the underlying share price is higher and (2) may not compensate the holders for the value of the warrants.
Item
1B. Unresolved Staff Comments.
None.
Item
1C. Cybersecurity.
Cybersecurity
Program
The
security and availability of our information systems and the protection of the information we collect, create, process, and store are
important to our business. We have implemented a cybersecurity program that is designed to support both the effectiveness of our systems
and our preparedness for information security risks. This program includes a number of safeguards, such as: multi-factor authentication;
monitoring internal and cloud-based systems for threats; email filters; cybersecurity awareness training; limitation on the use of third-party
devices; conditional access rules; and regular evaluations of our cybersecurity program.
80
We
use a risk-based approach with respect to our use and oversight of third-party service providers and vendors, tailoring processes according
to the nature and sensitivity of the data accessed, processed, or stored by such third-party service provider. We use numerous means
to assess cyber risks related to our third-party service providers, including for example use of a managed security service provider
(“MSSP”) that monitors cybersecurity events for our cloud systems. We also seek to include appropriate security terms in
our contracts where applicable as part of our oversight of third-party service providers.
Governance
Management
Oversight
The
controls and processes employed to assess, identify, and manage material risks from cybersecurity threats are implemented and overseen
by our Chief Information Officer (“CIO”). Our CIO has more than 20 years of information technology experience, including
seven years specializing in cybersecurity. Our CIO is responsible for assessing the impact of cybersecurity threats and incidents, assessing
whether and to what extent they can be contained and mitigated, containing and mitigating them, remediating incidents, and performing
post-incident analysis and program enhancements. In the event of a significant cybersecurity incident, our CIO would engage senior management
to inform them of the incident and related threats and response. We would also likely engage a third-party incident response vendor to
assist us in the event of a significant cybersecurity incident. Our Chief Executive Officer directly oversees our CIO and receives information
on cybersecurity risks from our CIO. Our CIO, in turn, is informed about risks from cybersecurity threats through dashboards, email alerts,
reporting from the MSSP, and regular review of our systems and information technology environment.
Board
Oversight
While
the Board has overall responsibility for risk oversight, the Board delegated to the audit committee the responsibility for assisting
the Board with oversight and monitoring of matters relating to our risk assessment, risk management, and risk mitigation policies and
programs, including matters related to privacy, information technology, and cybersecurity, and for reviewing and discussing with management
our risk exposures related to these matters. In its oversight role, the Board is expected to specifically consider risks that relate
to our reputation and the general industry in which we operate, including with respect to privacy, information technology and cybersecurity,
and threats to technology infrastructure.
Our
CIO may report to and brief the Board and the audit committee on cybersecurity matters, including key risks, the potential impact of
those exposures on our business, financial results, operations, and reputation, as well as the programs and steps implemented by management
to monitor and mitigate risks. The reporting cadence and structure continues to develop.
Cybersecurity
Risks
Our
cybersecurity risk management processes are integrated into our overall approach to risk management. Given the nature and size of our
Company, we do not have a dedicated enterprise risk function, but our executives regularly consider and evaluate risks to our Company.
As part of that risk management process, members of our executive team identify, assess, and evaluate risks impacting our operations,
including those risks related to cybersecurity, and raise them for discussion with other executives, and where it is determined to be
appropriate, issues are also raised to the Board for consideration.
As
of the date of this Annual Report, we are not aware of any risks from cybersecurity threats, including as a result of any previous cybersecurity
incidents, that have materially affected our business strategy, results of operations, or financial condition or are reasonably likely
to have such a material effect. While we have implemented a cybersecurity program, the techniques used to infiltrate information technology
systems continue to evolve. Accordingly, we may not be able to timely detect threats or anticipate and implement security measures adequate
to prevent cybersecurity incidents or fully mitigate their impact. For additional information regarding risks relating to privacy and
cybersecurity, see “Item 1A-Risk Factors”.
Item
2. Properties.
Our
corporate headquarters are located in Warren Township, New Jersey, and consist of 13,242 square feet dedicated to corporate,
operational, and pre-commercial activities under a lease that expires February 28, 2033. We also have one research and development
facility located in Philadelphia, which is a shared facility with laboratory space dedicated to us that is focused on preclinical
and pharmacodynamic activities.
Item
3. Legal Proceedings.
From
time to time, we may become involved in litigation or other legal proceedings arising in the ordinary course of our business. We are
not currently a party to any material pending legal proceedings.
Item
4. Mine Safety Disclosures.
Not
applicable.
81
PART
II
Item
5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Our
Common Stock and public warrants began trading on Nasdaq under the symbols “TVGN” and “TVGNW.” As of March 27,
2026, there were approximately 36 holders of record of our Common Stock and 4,164,205 shares of Common Stock outstanding. We are unable
to estimate the total number of stockholders represented by these record holders, as many of our shares are held by brokers and other
institutions on behalf of our stockholders. We have never paid cash dividends on our capital stock and we do not anticipate paying any
regular cash dividends in the foreseeable future.
Securities
Authorized for Issuance under Equity Compensation Plans
Information
about our equity compensation plan is incorporated herein by reference to Item 12 of Part III of this Annual Report.
Item
6. [Reserved]
Item
7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
You
should read the following discussion and analysis of our financial condition and results of operations together with our audited consolidated
financial statements and related notes included elsewhere in this Annual Report. This discussion and other parts of this Annual Report
contain forward-looking statements that involve risk and uncertainties, such as statements of our plans, objectives, expectations and
intentions. As a result of many factors, including those factors set forth in the “Risk Factors” section of this Annual Report,
our actual results could differ materially from the results described in or implied by the forward-looking statements contained in the
following discussion and analysis.
References
to the “Company,” “we,” “us,” and “our” in this section generally refer to Tevogen Bio
Inc before the Business Combination and to Tevogen Bio Holdings Inc. and its subsidiary collectively from and after the Business Combination,
unless the context otherwise requires.
Overview
We
are a clinical-stage specialty immunotherapy company harnessing one of nature’s most powerful immunological weapons, CD8+ CTLs,
to develop off-the-shelf, precision T cell therapies for the treatment of infectious diseases, cancers, and other disorders, with the
aim of addressing the significant unmet needs of large patient populations. We believe the full potential of T cell therapies remains
largely untapped, and aspire to be the first biotechnology company offering commercially attractive, economically viable, and cost-effective
personalized T cell therapies.
We
believe our allogeneic, precision T cell technology, ExacTcell TM , has the potential to mainstream cell therapy with a new
class of off-the-shelf T cell therapies with diverse applications across virology, oncology, and other areas. ExacTcell is a set of processes
and methodologies to develop, enrich, and expand single human HLA restricted CTL therapies with proactively selected, precisely defined
targets. We are focused on using ExacTcell to develop therapeutics that are intended to be infused in patients other than the original
donor. ExacTcell is designed to maximize the immunologic specificity of our products in order to eliminate malignant and virally infected
cells while allowing healthy cells to remain intact. In addition, through our Tevogen.AI artificial intelligence initiative, we are exploring
ways to deploy artificial intelligence-powered target detection to further accelerate our product development pace.
The
first clinical product of ExacTcell, TVGN 489, is initially being developed to fill a critical gap in COVID-19 therapeutics for the immunocompromised
and the high-risk elderly, with potential applications in both treatment and prevention of Long COVID. We have completed a Phase 1 proof-of-concept
clinical trial of TVGN 489 for the treatment of ambulatory, high-risk adult COVID-19 patients. No dose-limiting toxicities or significant
treatment-related adverse events were observed in the treatment arm of the trial. Secondary endpoints showing a rapid reduction of viral
load and that infusion of TVGN 489 did not prevent development of the patients’ own T cell-related (cellular) or antibody-related
(humoral) anti-COVID-19 immunity were also met. None of the patients who participated in the trial reported progression of infection,
reinfection, or the development of Long COVID during the six-month follow-up period.
In
addition, through our Tevogen.AI artificial intelligence initiative, we are focused on harnessing the potential of AI to expedite drug
development, optimize laboratory processes and clinical trials, unravel complex biological data, improve patient outcomes, and pass on
related savings to patients.
82
Our
commercial success depends in part on our ability to obtain and maintain patent and other protection for our products and methods, preserve
the confidentiality of our trade secrets, operate without infringing, misappropriating, or otherwise violating the valid, enforceable
proprietary rights of others, and prevent others from infringing, misappropriating, or otherwise violating our proprietary rights. We
rely on a combination of patents, patent applications, trademarks, and trade secrets to establish and protect our intellectual property
rights. Our ability to stop third parties from making, using, selling, offering to sell, or importing our products without the right
to do so may depend on the extent to which we have rights under valid and enforceable patents, trademarks or trade secrets that cover
these activities.
We
continue to build our intellectual property portfolio and seek to protect our proprietary position by, among other things, filing patent
applications. Our patent estate includes patents and patent applications with claims relating to our product candidates, methods of use,
and methods of preparing the product candidates. To date, our U.S. intellectual property portfolio includes three U.S. patents relating
to TVGN 489 for the treatment of COVID-19, nine pending U.S. patent applications, including two patent applications relating to the treatment
of COVID-19, six relating to the treatment of other viruses or cancer, and one related to artificial intelligence-driven T cell target
identification and receptor engagement, as well as thirteen ex-U.S. patent applications, including applications in Australia, Canada,
Europe, Japan, Qatar, the United Arab Emirates, and the Patent Cooperation Treaty directed at viral specific T cells, methods of treating
and preventing viral infections, methods for developing CD3+CD+ cells against multiple viral epitopes for the treatment of viral infections,
and systems for predicting immunologically active peptides with machine learning models, which have anticipated expiration dates through
December 16, 2044.
In
the United States, our three issued utility patents, all of which will expire on December 9, 2040, are U.S. Patent No. 11,191,827 covering
methods of treating COVID-19 infection using COVID-19 peptide specific CTLs; U.S. Patent No. 11,207,401 covering COVID-19 peptide-specific
CTLs; and U.S. Patent No. 11,219,684 covering methods of manufacturing COVID-19 peptide specific CTLs. A pending utility patent application
in the United States directed at viral specific T cells and methods of treating and preventing viral infections has an anticipated expiration
of December 9, 2041. In addition, we own a registered trademark protection for “Tevogen Bio” (and design), and have applied
for registered trademark protection for “ExacTcell” and “Tevogen AI” with the United States Patent and Trademark
Office.
We
determine strategy for claim scope for our patent applications on a case-by-case basis, taking into account advice of counsel and our
business model and needs. We file patents containing claims for protection of useful applications of our proprietary technologies and
any product candidates, including new applications or uses we discover for existing technologies and product candidates, based on our
assessment of their strategic value. We continuously reassess the number and type of patent applications, as well as our pending and
issued patent claims, to ensure maximum coverage and value are obtained for our processes and compositions, given existing patent office
rules and regulations.
As
our patents were developed internally, historical expenditures related to their development were all expensed as incurred per GAAP. We
believe these patents have significant value as the basis of our product pipeline. Our continued investment in our pipeline highlights
our belief in future commercial viability of these products.
On
February 14, 2024 (the “Closing Date”), pursuant to the agreement and plan of merger dated June 28, 2023 (the “Merger
Agreement”) by and among Semper Paratus, Semper Merger Sub, Inc., a wholly owned subsidiary of Semper Paratus (“Merger Sub”),
SSVK Associates, LLC, Tevogen Bio, and Dr. Ryan Saadi, in his capacity as seller representative, Merger Sub merged with and into Tevogen
Bio, with Tevogen Bio being the surviving company and a wholly owned subsidiary of Semper Paratus (the “Merger,” and together
with the other transactions contemplated by the Merger Agreement, the “Business Combination”) and Semper Paratus was renamed
Tevogen Bio Holdings Inc. (the “Closing”). See Note 4 to our consolidated financial statements in this Annual Report for
additional information regarding the net assets acquired through the Merger. The Merger was accounted for as a reverse recapitalization
under GAAP because the Company was determined to be the accounting acquirer.
Since
commencing operations in June 2020, we have devoted substantially all our efforts and financial resources to establishing corporate governance,
recruiting essential staff, establishing research and development capability including securing laboratory space and equipment, conducting
scientific research, securing intellectual property rights to our inventions related to our product candidates and ExacTcell, carrying
out drug discovery including pre-clinical studies and our Phase 1 clinical trial of TVGN 489, raising capital, and pursuing the Business
Combination.
To
date, we have not generated any revenue. Our net loss for the years ended December 31, 2025 and 2024 was $26.3 million and $13.7 million,
respectively. Net loss for the year ended December 31, 2025 was primarily attributable to non-cash, stock-based compensation expense,
salaries and outside services. As of December 31, 2025, we had cash of $0.6 million.
On
February 14, 2024, we entered into a securities purchase agreement with The Patel Family, LLP (the “Patel Family”) pursuant
to which the Patel Family purchased 500 shares of our Series A Preferred Stock for an aggregate purchase price of $2.0 million. On March
27, 2024, we entered into an Amended and Restated Securities Purchase Agreement with the Patel Family pursuant to which we amended and
restated the original agreement and the Patel Family agreed to purchase 600 shares of our Series A-1 Preferred Stock for an aggregate
purchase price of $6.0 million, of which $3.0 million has been received through the date of this Annual Report. As of the date of this
Annual Report, a payment date for the
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.