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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 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, 2018

2021

OR

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

Commission File Number:
001-36577

ContraFect Corporation

(Exact name of registrant as specified in its charter)

Delaware
 
39-2072586

(State or other jurisdiction of

incorporation or organization)

 

(IRS Employer

Identification No.)

28 Wells Avenue, 3
rd
Floor

Yonkers, NY

 
10701
(Address of principal executive offices)
 
(Zip Code)

Registrant’s telephone number, including area code:

(914)
207-2300

Securities registered pursuant to Section 12(b) of the Act:

Title of Class

 

Trading Symbol(s)
Name of Exchange on Which Registered

Common Stock, Par Value $0.0001 per share
 
CFRX
Nasdaq
Capital Market

Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes  ☐    No  ☒

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.    Yes  ☐    No  ☒

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  ☒    No  ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation
S-T
232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  ☒    No  ☐

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of RegulationS-K is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form10-K or any amendment to this Form10-K.  ☒

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a
non-accelerated
filer, a smaller reporting company or 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. (Check one):

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.    ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule
12b-2
of the Act).    Yes  ☐    No  ☒

As of June 29, 2018,30, 2021, the last business day of the registrant’s most recently completed second fiscal quarter, the aggregate market value of the registrant’s common stock held by
non-affiliates
of the registrant was approximately $157.8$173.1 million, based on the closing price of the registrant’s common stock on the Nasdaq Capital Market on June 29, 201830, 2021 of $2.21$4.40 per share.

As of March 1
7 2019,
, 2022, there were 79,409,55639,332,721 shares of common stock, $0.0001 par value per share, outstanding.

DOCUMENTS INCORPORATED BY REFERENCE

Portions of the registrant’s definitive Proxy Statement relating to its 20192022 Annual Meeting of Stockholders to be filed with the Securities and Exchange Commission are incorporated by reference into Part III of this Annual Report on Form
10-K.

Auditor Firm Id: 00042
Auditor Name: Ernst & Young, LLP
Auditor Location: Hartford, Connecticut

Table of Contents

Table of Contents
      
Page
 
PART I

Item 1.

     1 

Item 1A.

     3437 

Item 1B.

     6474 

Item 2.

     6475 

Item 3.

     6475 

Item 4.

     6475 
PART II

Item 5.

     6576 

Item 6.

     6576 

Item 7.

     6676 

Item 7A.

8.
  Quantitative and Qualitative Disclosures about Market Risk77

Item 8.

   7789 

Item 9.

     7789 

Item 9A.

     7789 

Item 9B.

     7890
Item 9C.
90 
PART III

Item 10.

     7991 

Item 11.

     8396 

Item 12.

     8396 

Item 13.

     8396 

Item 14.

     8396 
PART IV

Item 15.

     8497 

Item 16.

     88100 

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References to ContraFect

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REFERENCES TO CONTRAFECT
Throughout this Annual Report on Form
10-K,
the “Company,” “ContraFect,” “we,” “us,” and “our,” except where the context requires otherwise, refer to ContraFect Corporation, and “our board of directors” refers to the board of directors of ContraFect Corporation.

All brand names or trademarks appearing in this Annual Report on Form
10-K
are the property of their respective holders.

Forward Looking Information

FORWARD LOOKING STATEMENTS
The information in this Annual Report on Form
10-K
contains forward-looking statements and information within the meaning of Section 27A of the Securities Act of 1933, as amended, or the Securities Act, and Section 21E of the Securities Exchange Act of 1934, as amended, or the Exchange Act, which are subject to the “safe harbor” created by those sections. These forward-looking statements include, but are not limited to, statements concerning our strategy, future operations, future financial position, future revenues, our ability to continue as a going concern, projected costs, prospects and plans and objectives of management. The words “anticipates”, “believes”, “estimates”, “expects”, “intends”, “targets”, “may”, “plans”, “projects”, “potential”, “will”, “would”, “could” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. All such forward-looking statements involve significant risks and uncertainties, including, but not limited to, statements regarding:

the success, cost, timing and potential indications of our product development activities and clinical trials;

our ability to advance into and through clinical development and ultimately obtain FDAU.S. Food and Drug Administration (“FDA”) approval for our product candidates;

our future marketingresearch and sales programs;

development plans and ability to bring forward additional product candidates into preclinical and clinical development;

our expectations regarding the impact of
COVID-19
on our business, operations and financial performance and position;
our contract with the Biomedical Advanced Research and Development Authority (“BARDA”) (the “BARDA Contract”) and any exercise of BARDA’s options to extend the BARDA Contract;
our grant awards from the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator
(“CARB-X”)
and the Military Infectious Diseases Research Program, United States Army Medical Research and Development Command (“USAMRDC”) and the respective options in each award for continued funding;
the rate and degree of market acceptance of our product candidates and our expectations regarding the size of the commercial markets for our product candidates;

our researchfuture marketing and development plans and ability to bring forward additional product candidates into preclinical and clinical development;

sales programs;

the effect of competition and proprietary rights of third parties;

our recurring losses from operations raise substantial doubt regarding our ability to continue as a going concern;
the availability of and our ability to obtain additional financing;

the effects of existing and future federal, state and foreign regulations;

the seeking of joint development, licensing or distribution and collaboration and marketing arrangements with third parties; and

the period of time for which our existing cash and cash equivalents will enable us to fund our operations.

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As more fully described under the heading “Risk Factors” contained elsewhere in this Annual Report on Form
10-K,
many important factors affect our ability to achieve our stated objectives and to develop and commercialize any product candidates. We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements and you should not place undue reliance on our forward-looking statements. These forward-looking statements involve risks and uncertainties that could cause our actual results to differ materially from those in the forward-looking statements, including, without limitation, the risks and uncertainties set forth in our filings with the SEC. You should read this Annual Report on Form
10-K
and the documents that we have filed as exhibits to this Annual Report on Form
10-K
completely and with the understanding that our actual results or events could differ materially from the plans, intentions and expectations

ii


disclosed in the forward-looking statements that we make. The forward-looking statements are applicable only as of the date on which they are made, and we do not assume any obligation to update any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by law.

RISK FACTOR SUMMARY
Our business is subject to numerous risks and uncertainties, including those described in Part I, Item 1A. “Risk Factors” in this Annual Report on Form
10-K.
You should carefully consider these risks and uncertainties when investing in our common stock. The principal risks and uncertainties affecting our business include the following:
We have incurred significant losses since our inception. We expect to incur losses for at least the next several years and may never achieve or maintain profitability.
Our recurring losses from operations raise substantial doubt regarding our ability to continue as a going concern.
We currently have no source of product revenue and have not yet generated any revenues from product sales.
We have a need for substantial additional funding. If we are unable to raise capital when needed, we could be forced to delay, reduce or eliminate our product development programs or commercialization efforts.
If BARDA were to eliminate, reduce, or delay funding for our BARDA Contract, we would experience a negative impact on our programs associated with such funding.
Raising additional capital may cause dilution to our stockholders, restrict our operations or require us to relinquish rights to our technologies or product candidates.
The timing of the milestone and royalty payments we are required to make to The Rockefeller University (“Rockefeller”) under certain agreements is uncertain and could adversely affect our cash flows and results of operations.
Our ability to utilize our net operating loss carryforwards and certain other tax attributes may be limited.
The
COVID-19
pandemic or another pandemic, epidemic or outbreak of an infectious disease may materially and adversely impact our business, including our preclinical studies and clinical trials.
We are heavily dependent on the success of our leading product candidate, exebacase. If we are ultimately unable to obtain regulatory approval for exebacase or any other product candidate our business will be substantially harmed.
If clinical trials of exebacase or any other product candidate that we develop fail to demonstrate safety and efficacy, or the manufacturing for the commercial supply of exebacase drug substance or drug product fails to demonstrate robustness, stability, purity and potency to the satisfaction of the FDA or
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similar international regulatory authorities or do not otherwise produce positive results, we may incur additional costs or experience delays in completing, or ultimately be unable to complete the development and commercialization of exebacase or any other product candidate.
We may be required to suspend or discontinue clinical trials due to adverse side effects or other safety risks that could preclude approval of exebacase or any other product candidates.
Delays in clinical trials are common and have many causes, and any such delays could result in increased costs to us and jeopardize, delay or prevent our ability to obtain regulatory approval and commence product sales as currently contemplated.
We are significantly dependent on our license agreements with Rockefeller that relate to exebacase.
We rely on Contract Research Organizations (“CROs”) to conduct our preclinical studies and clinical trials. If these third parties do not successfully carry out their contractual duties or meet expected deadlines, we may be delayed in obtaining, or may ultimately not be able to obtain, regulatory approval for commercialization of exebacase or any other product candidates.
We rely on contract manufacturing organizations (“CMOs”) to manufacture clinical and commercial supplies of our product candidates. In addition to the risks associated with the manufacture of our product candidates, which could include cost overruns, new impurities, difficulties in process or formulation development, scaling up or reproducing manufacturing processes and lack of timely availability of raw materials, if these third parties do not successfully carry out their contractual duties or meet expected deadlines, we may be delayed in obtaining, or may ultimately not be able to obtain, regulatory approval for commercialization of exebacase or any other product candidates.
Even if the FDA approves exebacase or any other product candidates, adverse effects discovered after approval could adversely affect our markets.
Any Breakthrough Therapy designation that we may receive from the FDA for our product candidates may not lead to a faster development or regulatory review or approval process, and it does not increase the likelihood that our product candidates will receive marketing approval.
Developments by competitors may render our products or technologies obsolete or
non-competitive.
The level of commercial success of exebacase or any other product candidates that we develop will depend upon significant market acceptance of these products among physicians and payors.
Coverage and reimbursement may not be available for exebacase or any other product candidates that we develop.
If we are unable to establish our own marketing and sales capabilities, or enter into agreements with third parties, to market and sell our products after they are approved, we may not be able to generate revenues.
Interim, “topline” and preliminary data from our clinical trials that we announce or publish from time to time may change as more patient data become available and are subject to audit and verification procedures that could result in material changes in the final data.
Risks related to regulatory approval of our product candidates and other legal and compliance matters.
Risks related to employee matters and managing growth.
Risks related to our intellectual property.
Risks related to our securities and organizational documents.
Security breaches, cybersecurity attacks, failure of our data and personal information protections and other disruptions could compromise our information and technology systems and expose us to liability, which would cause our business and reputation to suffer.
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Our collection, control, processing, sharing, disclosure and otherwise use of personal data could give rise to liabilities as a result of governmental regulation, conflicting legal requirements, and evolving laws concerning data privacy in the European Union (“EU”) and European Economic Area (“E.E.A.”).
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Item 1.

Business

We are a late clinical-stage biotechnology company focused on discovering novel, differentiated biologic therapeuticsthe discovery and developing themdevelopment of direct lytic agents (“DLAs”), including lysins and amurin peptides, as new medical modalities for the treatment of life-threatening, infectious diseases, including those caused by drug-resistant pathogens. Drug-resistant infections account for 2,000,000 illnessesantibiotic-resistant infections. We believe DLAs are fundamentally different than antibiotics and offer a potential paradigm shift in the United Statestreatment of antibiotic-resistant infections. According to one of the most recent and 700,000comprehensive reports on the global burden of bacterial antimicrobial resistance (“AMR”), there were an estimated 4.95 million deaths worldwide each year. We intendassociated with bacterial AMR in 2019, including 1.27 million deaths directly attributable to addressbacterial AMR. The six leading pathogens for deaths associated with resistance (
Escherichia coli (“E. coli”)
,
Staphylococcus aureus (“S. aureus”)
,
Klebsiella pneumoniae (“K. pneumoniae”)
,
Streptococcus pneumoniae
,
Acinetobacter baumannii (“A. baumannii”)
, and
Pseudomonas aeruginosa
(“
P. aeruginosa
”)) were responsible for 929,000 deaths. Only one pathogen–drug combination, methicillin-resistant
S. aureus
(“MRSA”), caused more than 100,000 deaths in 2019.
Our lead DLA product candidate, exebacase, was granted Breakthrough Therapy designation for the treatment of MRSA bloodstream infections (bacteremia), including right-sided endocarditis, when used in addition to
standard-of-care
(“SOC”) anti-staphylococcal antibiotics in adult patients, by the U.S. Food and Drug Administration (“FDA”) in February 2020 and is currently being studied in an ongoing Phase 3 superiority design study. In addition to bacteremia,
S. aureus
is also a common cause of pneumonia and osteomyelitis as well as biofilm-associated infections of heart valves (endocarditis), prosthetic joints, indwelling devices and catheters. These infections result in significant morbidity and mortality despite currently available antibiotic therapies.
Our next product candidate,
CF-370,
is designed to target a range of gram-negative bacteria including
P. aeruginosa
and has demonstrated potent
in vivo
activity against extensively drug-resistant infections using product candidates from our lysin platform. (“XDR”) strains.
P. aeruginosa
is a major cause of morbidity and mortality in patients with hospital-acquired or ventilator-associated pneumonia and a major medical challenge for cystic fibrosis patients with chronic lung infections.
CF-370
has also shown promising activity against
E. coli
,
K. pneumoniae
and
A. baumannii
in
in vitro
studies.
Lysins are recombinantly-produced enzymes, derived from naturally occurring bacteriophage, which are viruses that infect bacteria. When recombinantly produced and thenwhen applied to bacteria lysins cleave a key component of the target bacteria’s peptidoglycan cell wall, resulting in rapid bacterial cell death. Conventional antibiotics require bacterial cell division and metabolism to occur in order to exert their intended effect (i.e., cell death or cessation of growth). Based onin vitro tests, lysins, however, are fundamentally different in that they kill bacteria rapidly by enzymatic cleavage of the bacterial cell wall without need for bacterial growth and cell division. In addition to the speed of action and potent cidality, we believe lysins are differentiated by their other hallmark features, which include the demonstrated ability to eradicate biofilms and synergistically boost the efficacy of conventional antibiotics in animal models. Importantly, lysins alsoAmurin peptides are a new class of DLAs, discovered in our laboratories, which disrupt the outer membrane of gram-negative bacteria, resulting in rapid bacterial cell death, offering a distinct mechanism of action from lysins. Amurins have a “narrowpotent, broad spectrum” meaning they kill only specific of
in vitro
activity against a wide range of gram-negative pathogens, including deadly, drug-resistant
P. aeruginosa
,
K. pneumoniae, E. coli, A. baumannii
and
Enterobacter cloacae
bacteria species as well as difficult to treat pathogens such as
Stenotrophomonas,
Achromobacter
and some
Burkholderia
species. The highly differentiated properties of bacteria or closely related bacteria. As such, we believe that lysins targeting gram-positive pathogens will not have negative effects on the beneficial, normal human gastrointestinal (“GI”) microbiome, in contrast to conventional “broad spectrum” antibiotics which can kill the body’s normal, beneficial bacteria. We believe that the therapeutic profile of lysins is complementary to that of conventional antibiotics. As such, our approach includes theDLAs underscore their potential use of lysins in addition to conventional antibiotics with the goal of improving clinical outcomes compared to antibiotics alone. The development of DLAs involves a novel clinical and regulatory strategy, using superiority design clinical trials with the goal of delivering significantly improved clinical outcomes for the treatment ofpatients with serious, drug-resistantantibiotic-resistant bacterial infections, including biofilm-associated infections,infections. We believe this approach affords potential clinical benefits to achieve greater efficacy and improve clinical outcomes,patients as well as potentially protectingthe potential ability to mitigate against further development of antibiotic resistance.

We believe that

In December 2019, we initiated the propertiesPhase 3 DISRUPT (Direct Lysis of our lysins
S. aureus
Resistant Pathogen Trial) superiority design study of exebacase. The DISRUPT study is a randomized, double-blind, placebo-controlled Phase 3 clinical trial conducted in the U.S. alone to assess the efficacy and safety of exebacase in approximately 350 adult and adolescent patients with complicated
S. aureus
bacteremia, including right-sided endocarditis. Patients entering the study will make them suitable for targeting antibiotic-resistant organisms, such asStaphylococcus aureus (“Staph aureus”) andPseudomonas aeruginosa (“P. aeruginosa”), which can cause serious infections such as bacteremia, pneumonia and osteomyelitis. Beyond lysins, we continuebe randomized 2:1 to seek and identify novel antibacterial product candidates. We recently discovered a new class of novel lytic agents, called amurin peptides. Our preliminary characterization studies indicate that amurin peptides have potency across a wide range of resistant gram-negative pathogens, including species that are parteither exebacase or placebo, with all patients receiving SOC antistaphylococcal antibiotics. The primary efficacy endpoint of the ESKAPE pathogens (Enterococcus faecium,Staphylococcusstudy is clinical response at Day 14 in
1

patients with MRSA bacteremia, including right-sided endocarditis. Secondary endpoints include clinical response at Day 14 in the All
S. aureusKlebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,
patient group (MRSA andEnterobacter species methicillin-sensitive
S. aureus
(“MSSA”)), which are
30-day
all-cause
mortality in MRSA patients, and clinical response at later timepoints. We will also evaluate the leading causesimpact of treatment with exebacase on health resource utilization, including hospital acquired infections throughoutlength of stay, ICU length of stay and
30-day
readmission rates. We plan to conduct an interim futility analysis following the world. These pathogens are considered to be urgent or serious threats to global health byenrollment of approximately 60% of the MRSA population (the primary endpoint study population). We obtained feedback from the U.S. CenterFood and Drug Administration (“FDA”) regarding the Phase 3 study protocol at an
End-of-Phase
2 meeting with the FDA in September 2019, including the key design features of the study population, the endpoints and the size of the safety database that would be needed to support submission of a Biologics License Application (“BLA”) for Disease Control (“CDC”) and critical priorities by the World Health Organization (“WHO”). approval of exebacase.
We believe that the amurin peptides will be highly complementary to our pathogen-specific lysin platform in addressing these infections. We aim to improve outcomes in patient with these life-threatening bacterial infections through use of our differentiated biologic candidates developed from our novel lysin and amurin platforms.

Our most advanced program,CF-301 (“exebacase”), is an investigational novel lysin that targetsStaph aureus, including methicillin-resistant (“MRSA”) strains, which causes serious infections such as bacteremia, pneumonia and osteomyelitis.Staph aureus is also a common cause of biofilm-associated infections of heart valves (endocarditis), prosthetic joints, indwelling devices and catheters. These infections result in significant morbidity and mortality despite currently available antibiotic therapies. Exebacase is being studied incompleted a Phase 2 superiority design study to evaluateof exebacase that evaluated its safety, tolerability, efficacy and pharmacokinetics (“PK”) when used in addition to background standard of care (“SOC”)SOC antibiotics compared to SOC antibiotics alone for the treatment ofStaph

S. aureus
bacteremia, including endocarditis in adult patients.

We recently announced positive topline The results from thisfirst-in-patient Phase 2 superiority study of exebacase, which showed clinically meaningful improvement in clinical responder rates among patients treated with exebacase in addition to SOC antibiotics compared to SOC antibiotics alone. In the primary efficacy analysis population of 116 patients with documentedStaph

S. aureus
bacteremia, including endocarditis, who received a single intravenous (IV)(“IV”) infusion of blinded study drug, the clinical responder rate at Day 14 was 70.4% for

patients treated with exebacase and 60.0% for patients dosed with SOC antibiotics alone. alone (p=0.314).

In a
pre-specified
analysis of MRSA-infected patients, the clinical responder rate at Day 14 in patients treated with exebacase was 42.8%nearly
43-percentage
points higher than the clinical responder rate in patients treated with SOC antibiotics alone (74.1% for patients treated with exebacase compared to 31.3% for patients treated with SOC antibiotics alone (p=0.010)). TheIn addition to the higher rate of clinical response, MRSA-infected patients treated with exebacase showed a
21-percentage
point reduction in
30-day
all-cause
mortality (p=0.056), a four day lower mean length of hospital stay and meaningful reductions in hospital readmission rates. Additional
pre-specified
analyses showed a clinical responder rate at Day 14 in the subset of patients with bacteremia including right-sided endocarditis wasof 80.0% for patients treated with exebacase compared to 59.5% for patients treated with SOC antibiotics alone, an increase of 20.5% (p=0.028). In the subset of patients with bacteremia alone, the clinical responder rate at Day 14 was 81.8% for patients treated with exebacase compared to 61.5% for patients treated with SOC antibiotics alone, an increase of 20.3% (p=0.035).
Exebacase was well-tolerated and treatment emergent adverse events, including serious treatment-emergent serious adverse events (SAEs)(“SAEs”) were balanced between the treatment groups. There were no SAEs that we determined to be related to exebacase, there were no reports of hypersensitivity related to exebacase and no patients discontinued treatment with study drug in either treatment group.
We also performed a
post-hoc
Phase 3 simulation analysis using the Phase 2 data to evaluate the clinical outcomes for the Phase 2 patient population that would meet the Phase 3 inclusion criteria. In this simulated Phase 3 analysis population of 84 U.S. patients with documented
S. aureus
bacteremia, including right-sided endocarditis, who received a single IV infusion of blinded study drug, the clinical responder rate at Day 14 was 83.7% for patients treated with exebacase and 54.3% for patients dosed with SOC antibiotics alone, an improvement in the responder rate of over
29-percentage
points. The clinical responder rate at Day 14 in the subset of patients with MRSA bacteremia including right-sided endocarditis was 82.6% for patients treated with exebacase compared to 33.3% for patients treated with SOC antibiotics alone, an improvement in the responder rate of over
49-percentage
points. In the subset of patients with MSSA bacteremia including right-sided endocarditis, the clinical responder rate at Day 14 was 84.6% for patients treated with exebacase compared to 66.7% for patients treated with SOC antibiotics alone, an increase of nearly
18-percentage
points.
We believe these data establishestablished proof of concept for exebacase and for the lysin classDLAs as therapeutic agents,agents. In particular, the data for MRSA-infected patients treated with exebacase, which, in the Phase 2 superiority study, demonstrated superior outcomes in clinical response at Day 14 and will informin
30-day
all-cause
mortality as well as health
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economics benefits, provided the designbasis for the FDA to grant Breakthrough Therapy designation to exebacase for the treatment of Phase 3MRSA bloodstream infections (bacteremia), including right-sided endocarditis, when used in addition to SOC anti-staphylococcal antibiotics in adult patients. Breakthrough Therapy designation is a program designed by the FDA to expedite the development and review of medicines for exebacase.

We also continue to advance our preclinical portfolio of novel lysin programs. We have developed a novel, engineered variant of exebacase, knownserious or life-threatening diseases where preliminary clinical evidence suggests that the investigational therapy may demonstrate substantial improvement on at least one clinically significant endpoint over available therapies. The Breakthrough Therapy designation provides additional benefits, such asCF-296, which we believe provides expedited interactions with the opportunity for extension of our agents targetingStaph aureus through alternative dosing paradigms or drug product presentations. We are evaluatingFDA and the potential to developCF-296 as a targeted therapy for deep-seated, invasive biofilm-associatedStaph aureus infections such as prosthetic joint infections. We are conducting furtherpriority review, in vitro andin vivo characterization ofCF-296 to determine the profile and potential place in therapy for this compound. Our lysin research efforts are focused on a broad-based gram-negative discovery program which aims to identify, optimize and develop lysins that target deadly gram-negative pathogens. We have discovered and engineered lysins with potent activity against drug-resistantP. aeruginosabacteria, a major cause of morbidity and mortality in patients with hospital acquired pneumonia and a major medical challenge for patients with cystic fibrosis. We are initiating animal studies of our most promising anti-pseudomonal lysins with the goal of moving this programaddition to the clinic as soon as possible. We were awarded $1.0 millionFast Track designation granted to exebacase in funding fromCARB-X (Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) in 2017 to support these efforts andAugust 2015.

On March 10, 2021, we announced in January 2019 thatCARB-X awarded us an additional $2.3 million in the amount of funding to be received over the next two years.

Beyond our lysin programs, we continue our proprietary research to expand our pipeline of complementary, nontraditional antimicrobials to address high unmet medical needs. We have discoveredentered into a novel class of phage-derived lytic agents, known as amurin peptides, which have displayed potent activity againstcost-share contract (the “BARDA Contract”) with BARDA, a wide range of gram-negative pathogens in preclinical studies, including deadly, drug-resistantP. aeruginosa, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Enterobacter cloacaebacteria species. We are currently evaluating thein vitro profilesdivision of the amurins asU.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response. Under the BARDA Contract, we continuewill receive funding of up to an estimated $86.8 million to advance the program. We recently announced an award fromCARB-Xdevelopment of exebacase. The base period for the BARDA Contract includes government funding of up to $6.9$9.8 million to reimburse expenses for approximately one year to support the conduct of the ongoing Phase 3 clinical trial and futility analysis. Following successful completion of the base period, the BARDA Contract provides for approximately $77.0 million of additional BARDA funding for five option stages in support of the completion of the Phase 3 clinical trial of exebacase, further clinical and

non-clinical
studies, manufacturing, supply chain, clinical, regulatory and administrative activities. The contract
period-of-performance
(base period plus option exercises) is up to support these efforts.

Our Strategy

Our strategy isapproximately six years. The BARDA Contract contains terms and conditions that are customary for contracts with BARDA of this nature, including provisions giving the government the right to use our novel, highly differentiated therapeutic products, if approved, to achieve a leading market position interminate the treatment of life-threatening infectious diseases, including those caused by drug-resistant pathogens. We plan to pursue commercialization of therapeutic products through discovery, acquisition and development as follows:

Advance our lead product candidate, exebacase, through Phase 3 clinical development and demonstrate superiority of our therapeutic candidate used in addition to SOC antibiotics over SOC antibiotics alone for the treatment ofStaph aureus bacteremia, including endocarditis. If our Phase 3 clinical program confirms the results of the Phase 2 study, demonstrating the superiority of exebacase, used in addition to SOC antibiotics as compared to antibiotics alone, we would seek marketing authorization with a superiority claim which, if exebacase is approved, we believe would be highly differentiated from

contract at any time for its convenience.

conventional antibiotics and would lead to rapid uptake by providers, favorable reimbursements from payors and potential reductions in health care utilization and the overall cost of treatment per patient;

Advance additional product candidates from our portfolio, including lysins targeting gram-negative bacteria, to clinical development as rapidly as possible, and further advance our next-generation gram-positive lysins and amurin antimicrobial peptides;

Acquire additional foundation technologies that enable the efficient discovery of anti-infective agents;

Acquire clinical stage therapies that treat infectious diseases through unique mechanisms of action; and

Establish collaborations to further develop and commercialize our product candidates.

Our Portfolio

We intend to develop and commercialize novel therapeutic agents to treat life-threatening infections, including those caused by drug-resistantantibiotic-resistant pathogens. The increasing prevalence of antibiotic resistance among bacterial pathogens has been widely recognized as an urgent public health threat by the CDC,U.S. Center for Disease Control (“CDC”), the WHOWorld Health Organization (“WHO”) and the Infectious Disease Society of America (“IDSA”). Antibiotic resistance has limited the effectiveness of many conventional antibiotics and the discovery and development of new therapeutics to address resistance has not kept pace with the increasing incidence of thesedifficult-to-treat microbial infections. According to the IDSA, as of 2010 the estimated cost to the U.S. healthcare system of antibiotic-resistant infections was approximately $21 billion to $34 billion annually, a substantial portion of which is due to increased length of hospital stays necessary to treat these patients.

Antibiotic resistance has limited the effectiveness of many conventional antibiotics and the discovery and development of new therapeutics to address resistance has not kept pace with the increasing incidence of these

difficult-to-treat
microbial infections. As Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, has accordingly stated “never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent. Numerous initiatives are underway to reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”
We take this mandate very seriously and have focused our research and discovery efforts on those pathogens that are considered to be urgent or serious threats to global health by the CDC or considered critical priority by the WHO. In particular, species of bacteria that are part of the ESKAPE pathogens (
E
nterococcus faecium,
S
taphylococcus aureus,
K
lebsiella pneumoniae,
A
cinetobacter baumannii,
P
seudomonas aeruginosa,
and
E
nterobacter species
) are urgent or serious threats, and are also the leading causes of hospital acquired infections throughout the world. We believe that our DLA product candidates, if successfully developed and approved, will be highly complementary to conventional antibiotics in addressing these infections. We aim to improve outcomes in patient with these life-threatening bacterial infections through use of our DLA candidates developed from our novel lysin and amurin platforms.
We have made further advancements with our novel lytic agents across our portfolio. In addition to the ongoing Phase 3 DISRUPT study of exebacase, we initiated an expanded access program to provide exebacase for the treatment of persistent bacteremia caused by MRSA in patients with
COVID-19.
We have also continued the investigator-initiated access program for compassionate use of exebacase for individual named patients with
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chronic prosthetic joint infections (“PJIs”) under Temporary Authorizations for Use from the French National Agency for Medicines and Health Products Safety in collaboration with Dr. Tristan Ferry at the Hôpital de la Croix Rousse in Lyon, France. We have developed a novel, engineered variant of exebacase, known as
CF-296,
which we believe provides an additional opportunity to advance a potential targeted therapy for deep-seated, invasive biofilm-associated
S. aureus
infections. We are conducting further
in vitro
and
in vivo
characterization of
CF-296
to evaluate the full profile of this compound. In 2019, we were awarded up to $7.2 million of funding from USAMRDC over the course of three years to advance
CF-296
through Investigational New Drug application (“IND”)-enabling studies.
In July 2020, we were granted an award of up to $18.9 million in funding from
CARB-X,
including initial funding of $4.9 million, in support of the advancement of
CF-370
through
IND-enabling
activities. Any additional funding beyond the $4.9 million is at the discretion of
CARB-X
and based on factors such as available funding, achievement of project milestones and mutual agreement on future milestones. We expect
CF-370
to be our next DLA to enter clinical studies.
In addition, we have entered into two funding agreements with the Cystic Fibrosis Foundation to investigate the potential utility of DLAs against resistant gram-negative pathogens which afflict Cystic Fibrosis (“CF”) patients. The first agreement provided funding for the assessment of the
in vitro
activity of
CF-370
and amurin peptides against bacterial specimens obtained from CF patients at different stages of disease. The second agreement will provide funding for assessing the
in vitro
and
in vivo
activity of exebacase against
S. aureus
isolates obtained from CF patients. If we obtain supportive data, we plan to evaluate potential future clinical development of DLA product candidates for the treatment of exacerbations in CF lung disease.
Beyond our lysin programs, we continue our research to advance potential product candidates from our amurin peptide platform. We are evaluating our most promising amurins in preclinical animal studies with the goal of determining our next product candidate and moving this program towards clinical studies as soon as possible.
In summary, we now have three modalities within the DLA therapeutic umbrella, including (i) native lysins for gram-positive pathogens (ii) engineered lysins for gram-negative pathogens and (iii) amurins for a wide spectrum of gram-negative pathogens. Our current portfolio of programs is reflected below:

LOGO

Our Strategy
Our strategy is to use our novel, highly differentiated therapeutic DLAs, if approved, to achieve a leading market position in the treatment of life-threatening infectious diseases, including those caused by antibiotic-
4

resistant pathogens. We plan to pursue commercialization of therapeutic products through discovery, acquisition and development as follows:
Advance exebacase through Phase 3 clinical development and demonstrate superiority of our therapeutic candidate used in addition to SOC antibiotics over SOC antibiotics alone for the treatment of
S. aureus
bacteremia, including right-sided endocarditis. If our Phase 3 clinical program confirms the results of the Phase 2 study, demonstrating the superiority of exebacase, used in addition to SOC antibiotics as compared to antibiotics alone, we would seek marketing authorization with a superiority claim which, if exebacase is approved, we believe would be highly differentiated from conventional antibiotics and would lead to rapid uptake by providers, favorable reimbursements from payors and potential reductions in health care utilization and the overall cost of treatment per patient;
Evaluate exebacase for potential efficacy in additional proposed indications, including as a treatment for chronic PJIs;
Advance additional product candidates from our portfolio, including
CF-370
and other direct lytic agents targeting gram-negative bacteria, to clinical development as rapidly as possible;
Acquire additional technologies that enable the efficient discovery of anti-infective agents;
Acquire clinical stage therapies that treat infectious diseases through unique mechanisms of action; and
Establish collaborations to further develop and commercialize our product candidates.
Our Lead Program: Exebacase
(CF-301)

Medical Opportunity

Staph

S. aureus
bacteremia is a serious bacterial infection associated with high morbidity and mortality. In the U.S. alone, there are approximately 200,000 hospitalizations forStaph
S. aureus
bacteremia annually. Mortality rates from this bloodstream infection have been reported as ranging from
20-40%
despite conventional antibiotics. The last new agent forStaph
S. aureus
bacteremia and right-sided endocarditis, daptomycin, was approved over 13 years ago based on
non-inferiority
to vancomycin (approved in 1958) with clinical cure rates of less than 50% in the Phase 3 study that led to its approval.

Staph

S. aureus
bacteremia can lead to infectious endocarditis, a serious infection affecting the heart valves. The incidence of infective endocarditis in the U.S. has increased over the past decade with over 47,000 cases in 2011, and is likely due to the growth of the
at-risk
populations, such as older, diabetic and hemodialysis patients.Staph
S. aureus
endocarditis remains difficult to treat with current standard of care antibiotics. One reason for this is biofilm formation which prevents antibiotics from eradicating the bacteria, leading to the need for long courses of antibiotic therapy, which are often unsuccessful and necessitate surgery to eradicate bacteria from infected heart valves. Mortality attributed toStaph
S.
 aureus
bacteremia is higher when the infection is caused by MRSA as compared to methicillin-susceptible
S. aureus
(“MSSA”)Staph aureus. MRSA is considered a serious threat to global health by the CDC and a high priority threat by the WHO. Emerging resistance to conventional antibiotics such as vancomycin and daptomycin, which are used to treat MSSAandMSSA and MRSA, represents an additional serious threat which may have serious consequences in terms of increasing morbidity, mortality and health care utilization.

Exebacase Development

Exebacase is the first lysin to enter U.S. clinical trials and represents a
first-in-class
anti-bacterial therapeutic candidate. Exebacase has been granted both Breakthrough Therapy and Fast Track designationdesignations by the U.S. Food and Drug Administration (“FDA”) for the development of a parenteral formulationFDA for the treatment ofStaph aureusbacteremia, MRSA bloodstream infections (bacteremia), including right-sided endocarditis, caused by MRSA or MSSA.when used in addition to SOC anti-staphylococcal antibiotics in adult patients. If we are able to obtain regulatory approval of exebacase for this initial indication, we believe exebacase, and/or engineered variants, may be further developed for the treatment of other serious diseases caused byStaph
S. aureus
including biofilm-related infections in prosthetic joints and indwelling devices, as well as pneumonia and osteomyelitis.

5

Clinical Studies

Phase 23 DISRUPT Clinical Study

We are conducting a multi-center multi-national Phase 23 clinical study of exebacase for the treatment ofStaph
S. aureus
bacteremia, including right-sided endocarditis, caused by MRSA or MSSA. This randomized, double-blind, placebo-controlled study compares the efficacy, safety and tolerability of exebacase used in addition to SOC antibiotics to SOC antibiotics alone. The study is targeting enrollment of approximately 350 patients randomized 2:1 to receive either a single dose of exebacase administered as a
2-hour
IV infusion in addition to SOC antibiotics or placebo plus SOC antibiotics. The primary efficacy endpoint is clinical response at Day 14 in patients with MRSA bacteremia, including right-sided endocarditis. Secondary endpoints include clinical response at Day 14 in the All
S. aureus
patient group (MRSA and MSSA),
30-day
all-cause
mortality in MRSA patients, and clinical response at Day 30 and Day 60 in both the MRSA and the All
S. aureus
patient groups. A summary of the statistical parameters of the key efficacy endpoints is shown in Table 1 below.
Table 1
   
Primary Efficacy Endpoint:

Clinical Response at Day 14

(MRSA Patients)
  
Secondary Efficacy Endpoint:

Clinical Response at Day 14

(All
S. aureus
Patients)
  
Secondary Efficacy Endpoint:

Mortality

(MRSA Patients)
Target difference
  28% increase over
SOC antibiotics alone
  16% increase over
SOC antibiotics alone
  17% decrease from
SOC antibiotics alone
Power
  86%  83%  80%
Sample size
  135 patients  339 patients  135 patients
Clinical response is defined by objective clinical response criteria including (1) resolution of signs and symptoms attributable to
S. aureus
bacteremia/right-sided endocarditis (“SAB/RIE”) that were present at baseline, (2) no new signs and symptoms attributable to SAB/RIE, (3) no new complications of SAB/RIE (e.g. no development of a new foci of
S. aureus
infection after Day 7 and no septic emboli), (4) no changes in anti-staphylococcal antibiotics after treatment with study drug due to persistence, worsening or recurrence of signs or symptoms of SAB/RIE, (5) Blood culture(s) negative for
S. aureus
by Day 14 and (6) the patient is alive. Clinical response will be determined by an independent, blinded clinical adjudication committee.
We will evaluate the impact of treatment with exebacase on health resource utilization, including length of hospital stay, length of stay in the intensive care unit and
30-day
readmission rates for both
all-cause
and
S. aureus
infection readmissions. The independent Data Safety Monitoring Board (“DSMB”) will review data from an interim futility analysis after approximately 60% of the MRSA population (the primary endpoint study population) completes the Day 14 primary endpoint study visit.
Based on feedback from our
End-of-Phase
2 meeting with the FDA, including the advancement of exebacase under the streamlined development pathway, we believe that this single confirmatory Phase 3 clinical trial evaluating the superiority of exebacase used in addition to SOC antibiotics compared to SOC antibiotics alone for the treatment of
S. aureus
bacteremia, including right-sided endocarditis, if the results are positive, together with the full package of Phase 1 and Phase 2 clinical data, along with a robust
non-clinical
and PK/PD data package, will be sufficient to support a biologics license application (“BLA”) submission. If the Phase 3 study demonstrates superiority of exebacase, used in addition to SOC antibiotics as compared to antibiotics alone, we would seek inclusion of a superiority claim in the product labeling, which we believe would be highly differentiated from conventional antibiotics and would lead to rapid uptake by providers and favorable reimbursements from payors.
Phase 2 Clinical Study
We completed a multi-national Phase 2 clinical study of exebacase for the treatment of
S. aureus
bacteremia, including endocarditis, caused by MRSA or MSSA. This randomized, double-blind, placebo-
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controlled study compared the efficacy, safety and tolerability of exebacase used in addition to SOC antibiotics to SOC antibiotics alone. The study enrolled 121 patients randomized 3:2 to receive either a single dose of exebacase (0.25 mg/kg) administered as a 2 hour
2-hour
IV infusion in addition to SOC antibiotics or placebo plus SOC antibiotics. The primary efficacy analysis population (also known as the microbiological
intent-to-treat
population, or “mITT”) consisted of 116 patients with confirmedStaph
S. aureus
infection based on blood culture who received study drug, of which 71 patients received exebacase and 45 patients received placebo. All patients were treated with SOC antibiotics as prescribed by the study investigators, consisting of vancomycin or daptomycin for MRSA and a semi-synthetic penicillin or first-generation cephalosporin for MSSA, prescribed in accordance with treatment guidelines, accepted medical practice and the study protocol. The majority of patients were enrolled in the U.S. (79.3%) with the remainder of patient enrolled from sites in Europe, Latin America, Russia and Israel. A total of 38.8% of exebacase-treated and 35.5% of placebo patients, respectively, had a MRSA infection. The majority of patients in both treatment groups had bacteremia, 77.5% of the exebacase-treated group and 86.7% of the placebo group. Final diagnosis was determined by an independent, blinded clinical adjudication committee.

The primary efficacy endpoint of the study was clinical response at day 14. Clinical response was defined by objective clinical response criteria including (1) improvement or complete resolution of all attributable signs

and symptoms ofStaph aureus bacteremia that were present at baseline, (2) no new, worsening or persistent signs and symptoms attributable toStaph aureus bacteremia, (3) no development of a new foci ofStaph aureus infection after Day 7, (4) no further anti-staphylococcal therapy was needed, (5) no surgery or further medical intervention for the Staph aureus infection was necessary and (6) the patient is alive. Clinical response was also determined by the independent, blinded clinical adjudication committee.

Recently announced toplineTopline efficacy results from the core study demonstrated the clinical responder rate was 70.4% for patients treated with exebacase and 60.0% for patients treated with SOC antibiotics alone (p=0.314). In a

pre-specified
analysis of MRSA-infected patients, the clinical responder rate was 42.8%nearly
43-percentage
points higher in the exebacase group compared to the SOC antibiotics alone group (74.1% for patients treated with exebacase compared to 31.3% for patients dosed with SOC antibiotics alone (p=0.010)). In addition to the higher rate of clinical response, MRSA-infected patients treated with exebacase showed a
21-percentage
point reduction in
30-day
all-cause
mortality (p=0.056), a four day lower mean length of hospital stay and meaningful reductions in hospital readmission rates.
The clinical responder rate in the subset of patients with bacteremia, including right-sided endocarditis was 80.0% for patients treated with exebacase compared to 59.5% for patients treated with SOC antibiotics alone, an increase of 20.5% (p=0.028). Similarly, in the subset of patients with bacteremia alone, the clinical responder rate was 81.8% for patients treated with exebacase compared to 61.5% for patients treated with SOC antibiotics alone, an increase of 20.3% (p=0.035).

Based on these efficacy data, summarized in Table 12 below, treatment with exebacase in addition to SOC antibiotics resulted in clinically meaningful improvements in outcomes compared to antibiotic therapy alone.

Table 1

Clinical response at Day 14

  exebacase* antibiotics
alone
 p-value

Overall mITT population

  70.4% 60.0% 0.314
  

 

 

 

 

 

MRSA infection

  74.1% 31.3% 0.010
  

 

 

 

 

 

MSSA infection

  68.2% 73.3% 0.796
  

 

 

 

 

 

Bacteremia + right-sided endocarditis

  80.0% 59.5% 0.028
  

 

 

 

 

 

Bacteremia only

  81.8% 61.5% 0.035

2
Clinical response at Day 14
  
Exebacase*
 
Antibiotics

alone
 
p-value
Overall mITT population
  70.4% 60.0% 0.314
  
 
 
 
 
 
MRSA infection
  74.1% 31.3% 0.010
  
 
 
 
 
 
Bacteremia + right-sided endocarditis
  80.0% 59.5% 0.028
  
 
 
 
 
 
Bacteremia only
  81.8% 61.5% 0.035
Mortality
       
30-day
all-cause
mortality in MRSA patients
  3.7% 25.0% 0.056
*

used in addition to antibiotics

Another primary objective of the study was to describe the safety and tolerability of exebacase used in addition to SOC antibacterial therapy compared to SOC antibiotics alone in hospitalized patients withStaph
S. aureus
bacteremia, including endocarditis. An independent Data Safety Monitoring Board (DSMB)DSMB reviewed unblinded safety and pharmacokinetic data during the study. Treatment emergent adverse events (TEAEs)(“TEAEs”) were defined as an untoward medical event reported from the study drug administration until 28 days after last dose of standard of care antibiotics, regardless
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of whether or not the event was considered related to study drug. The incidence of TEAEs was balanced between the treatment groups (88.9% and 85.1% of the exebacase and SOC antibiotics alone groups, respectively), with incidence rates as expected for this population, given the severity of the disease under study and that patients had multiple
co-morbidities.
The incidence rates of TEAEs reported within approximately one week after administration of the single dose of study drug were also balanced between the treatment groups (66.7% and 66.0% in the exebacase and SOC antibiotics alone groups, respectively). The overall rate of serious treatment-emergent SAEs through day 180 was also similar between the treatment groups (47.2%(62.5% for the exebacase group and 51.1%59.5% for the SOC antibiotics alone group). Among all patients who received study drug, 19.4%23.6% of exebacase patients and 14.9%19.1% of placebo patients died.died through day 180. There were no SAEs, including deaths, that we determined to be related to study drug.exebacase. Exebacase was well-tolerated and there were no reports of hypersensitivity related to exebacase and no patients prematurely discontinued study drug in either treatment group.

Based on these safety and tolerability data, summarized in Table 23 below, we concluded that exebacase was well-tolerated in this study.

Table 2

   exebacase*  antibiotics
alone
   N=72
n (%)
  N=47
n (%)

TEAE

  64 (88.9)  40 (85.1)
  

 

  

 

TEAE through day 7

  48 (66.7)  31 (66.0)
  

 

  

 

TEAE leading to study drug interruption

  1 (1.4)  0
  

 

  

 

TEAE leading to study drug withdrawal

  0  0
  

 

  

 

TEAE related to study drug

  8 (11.1)  4 (8.5)
  

 

  

 

Serious TEAE

  34 (47.2)  24 (51.1)
  

 

  

 

Total deaths

  14 (19.4)  7 (14.9)

3
   
Exebacase*
  
Antibiotics

alone
   N=72
n (%)
  N=47
n (%)
TEAE
  64 (88.9)  40 (85.1)
  
 
  
 
TEAE through day 7
  48 (66.7)  31 (66.0)
  
 
  
 
TEAE leading to study drug withdrawal
  0  0
  
 
  
 
SAEs through day 180
  45 (62.5)  28 (59.5)
  
 
  
 
SAEs determined to be related to exebacase
  0  0
  
 
  
 
Total deaths through day 180
  17 (23.6)  9 (19.1)
*

used in addition to antibiotics

The Phase 2 study is still ongoingClinical Study Report, as patients are followed upwell as PK/PD modeling and any additional
in vitro
or
in vivo
studies were submitted and an
End-of-Phase
2 Meeting with FDA was conducted prior to 180 days after administration of study drug. We expect to complete the study and have the complete data set in the second quarter of 2019. We also expect to have additional data from the 180 day long-termfollow-up visit including additional safety, immunogenicity and PK data being assessed in the trial.

We expect to progress exebacaseadvancing into Phase 3 of clinical development. Based on previous feedback from the FDA, we believe that a single confirmatory Phase 3 clinical trial evaluating the superiority of exebacase used in addition to SOC antibiotics compared to SOC antibiotics alone for the treatment ofStaph aureus bacteremia, including right-sided endocarditis, together with the full package of Phase 1 and Phase 2 clinical data, along with a robustnon-clinical and PK/PD data package will be sufficient to support the biologics license application (“BLA”) submission. As such, the planned Phase 3 study is expected to be a multi-center, multi-national, randomized, double-blind, placebo-controlled superiority study comparing clinical responder rates of exebacase used in addition to SOC antibiotics to SOC antibiotics alone for the treatment ofStaph aureus bacteremia, including right-sided endocarditis. Specific parameters for Phase 3 will be informed by data from the Phase 2 study once it is completed, and relevant guidance from regulatory authorities. If the Phase 3 study confirms superiority of exebacase, used in addition to SOC antibiotics as compared to antibiotics alone, we would seek marketing authorization with a superiority claim, which we believe would be highly differentiated from conventional antibiotics and would lead to rapid uptake by providers and favorable reimbursements from payors.

3.

Phase 1 Clinical Study

In 2015, we concluded a Phase 1 single ascending dose study in healthy volunteers. This trial was a randomized, double-blind, placebo-controlled trial designed to evaluate the safety, tolerability and PK of four different intravenous doses of exebacase. Healthy normal subjects were randomized to receive a single IV dose of exebacase or placebo, each administered as a 2 hour
2-hour
IV infusion.

In this Phase 1 study, exebacase was generally well tolerated and there were no clinical adverse safety signals. No SAEs or hypersensitivity AEsadverse events (“AEs”) related to exebacase were reported, and no study stopping rules were met. A total of five
non-serious
AEs were reporting during the study as follows: two subjects who received exebacase reported a total of three
non-serious
AEs (headache, contact dermatitis, and allergic rhinitis); two subjects who received placebo reported a total of two
non-serious
AEs (viral upper respiratory tract infection and

viral infection). All of these events were mild in intensity and resolved. No patients withdrew from the study due to an AE. There were no clinically relevant changes in inflammatory markers (e.g., erythrocyte sedimentation rate, high sensitivity

c-reactive
protein, or complement factors including total hemolytic complement (CH50) associated with exebacase dosing.

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Nine out of 13 subjects dosed with exebacase developed anti-drug antibodies (“ADAs”) in the study. These ADAs were waning or absent by day 180, and were not correlated with mediators of allergic immune response. Exposure was generally linear, dose dependent and intra-subject variability was low. A pharmacometric analysis of the relationship between exebacase exposure and heart rate (“HR”), blood pressure and QT interval parameters showed no significant changes in systolic or diastolic blood pressure, HR or
HR-corrected
QT intervals with increases in exebacase plasma concentration at the doses tested in the Phase 1 study.

Estimated effective exposure of exebacase, based on
in vivo
pharmacology, PK/PD exposure target attainment analysis and PK/PD modeling was attained at the 0.25mg/kg dose in healthy subjects. The Phase 1 Clinical Study Report, as well as reports of the animal studies, PK/PD modeling and
in vitro
clinical microbiology studies were submitted to the regulatory authorities and an End of Phase
End-of-Phase
1 Meeting with FDA was conducted prior to advancing into Phase 2.

In vitro Microbiologic Studies and Animal Models Demonstrate the Therapeutic Potential of Exebacase

We believe exebacase is well differentiated from conventional antibiotics by itits spectrum of activity, including:

Eradication of biofilms. Exebacase has been shown to clear biofilmsin vitro studies and in animal models. Biofilm matrices associated with seriousStaph aureus infections form on human tissues (e.g., valve in endocarditis or bone in osteomyelitis) and/or on the abiotic surfaces (e.g., prosthetic joints, catheters and other devices) and protect bacteria from immune defenses. Biofilms pose significant therapeutic challenges by increasing antibiotic tolerance up to1,000-fold because conventional antibiotics are generally unable to clear or penetrate biofilms and kill dormantStaph aureus bacteria harbored within the biofilms. Hence, surgical removal of infected tissue, catheters, prosthetic joints and other indwelling devices containingStaph aureus biofilms is generally required to eradicate the infections.

Rapid, potent and selective bactericidal activity.In vitro, exebacase killsStaph aureus bacteria within seconds, thereby exerting a bactericidal effect, defined as a3-log (99.9%) drop in colony forming units (“CFU”) per mL, within about 30 minutes. Exebacase has exhibited potent antibacterial activity againstStaph aureus strains that are sensitive to methicillin as well as strains resistant to methicillin, vancomycin, daptomycin, or linezolid. Exebacase is highly targeted againststaphylococcaland some streptococcalspecies, with no demonstrable activity against gram negative organisms.We believe that this targeted effect will reduce the possible negative effects of exebacase on normal, healthy human bacterial flora, known as the microbiome, in the GI tract, in contrast to broad spectrum antibiotics which are widely known to have deleterious effects on the human GI microbiome.

Potentiation of the efficacy of conventional anti-staphylococcal antibiotics. We have demonstrated strong synergy between exebacase and a wide range of antibiotics in preclinical studies, which we believe may enable exebacase to potentiate the efficacy of current standards of care for the treatment ofStaph aureus bacteremia, including daptomycin, vancomycin and oxacillin. Because of this and the aforementioned features of exebacase which are also complementary to antibiotics, we believe the use of exebacase, in addition to conventional anti-staphylococcal antibiotics will provide significantly improved clinical cure rates, compared to antibiotics alone.

Low propensity for the development of resistance. In vitro models designed to induce the emergence of antibiotic resistance, such as 26 day serial passage studies, have shown a low propensity for bacteria to develop resistance to exebacase. In comparison, resistance to standard of care antibiotics such as

daptomycin can readily be induced in the same model. Importantly, the addition of exebacase to daptomycin or other antibiotics in the same model was observed to suppress the emergence of resistance to conventional antibiotics.

Eradication of biofilms.
Exebacase has been shown to clear biofilms
in vitro
studies and in animal models. Biofilm matrices associated with serious
S. aureus
infections form on human tissues (e.g., valve in endocarditis or bone in osteomyelitis) and/or on the abiotic surfaces (e.g., prosthetic joints, catheters and other devices) and protect bacteria from immune defenses. Biofilms pose significant therapeutic challenges by increasing antibiotic tolerance up to
1,000-fold
because conventional antibiotics are generally unable to clear or penetrate biofilms and kill dormant
S. aureus
bacteria harbored within the biofilms. Hence, surgical removal of infected tissue, catheters, prosthetic joints and other indwelling devices containing
S. aureus
biofilms is generally required to eradicate the infections.
Rapid, potent and selective bactericidal activity
.
In vitro
, exebacase kills
S. aureus
bacteria within seconds, thereby exerting a bactericidal effect, defined as a
3-log
(99.9%) drop in colony forming units (“CFU”) per mL, within about 30 minutes. Exebacase has exhibited potent antibacterial activity against
S. aureus
strains that are sensitive to methicillin as well as strains resistant to methicillin, vancomycin, daptomycin, or linezolid. Exebacase is highly targeted against
staphylococcal
and some
streptococcal
species, with no demonstrable activity against gram negative organisms
.
We believe that this targeted effect will reduce the possible negative effects of exebacase on normal, healthy human bacterial flora, known as the microbiome, in the GI tract, in contrast to broad spectrum antibiotics which are widely known to have deleterious effects on the human GI microbiome.
Potentiation of the efficacy of conventional anti-staphylococcal antibiotics.
We have demonstrated strong synergy between exebacase and a wide range of antibiotics in preclinical studies, which we believe may enable exebacase to potentiate the efficacy of current standards of care for the treatment of
S. aureus
bacteremia, including daptomycin, vancomycin and oxacillin. Because of this and the aforementioned features of exebacase which are also complementary to antibiotics, we believe the use of exebacase, in addition to conventional anti-staphylococcal antibiotics will provide significantly improved clinical cure rates, compared to antibiotics alone.
Low propensity for the development of resistance.
In vitro
models designed to induce the emergence of antibiotic resistance, such as
26-day
serial passage studies, have shown a low propensity for bacteria to develop resistance to exebacase. In comparison, resistance to standard of care antibiotics such as daptomycin can readily be induced in the same model. Importantly, the addition of exebacase to daptomycin or other antibiotics in the same model was observed to suppress the emergence of resistance to conventional antibiotics.
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We believe exebacase has other competitive advantages as well, including:

No direct competition. Vancomycin and daptomycin are the only two antibiotics with label indications in the U.S. for the treatment ofStaph aureus bacteremia, including endocarditis due to MSSA and MRSA. Daptomycin, the most recently FDA approved drug for this indication, was approved in 2005. Clinical cure rates at the test of cure visit in the Phase 3non-inferiority study which led to daptomycin’s approval were less than 50% for both daptomycin and the standard of care comparator. Exebacase has been shown to act synergistically with both daptomycin and vancomycin to improve eradication ofStaph aureus in animal studies ofStaph aureusendocarditis conducted in different species. As such exebacase is intended to be used in addition to, not as a replacement for, SOC antibiotics. No other agents have been shown to provide improved outcomes over SOC antibiotics.

Patent protection.Our issued patent with composition of matter claims and issued patent with method claims for killingStaph aureusstains both provide protection through 2032, our issued patent with method claims for disrupting or treating biofilm provides protection until 2033 and additional patents, if issued as we expect, could provide further protection beyond 2033.

No direct competition.
Vancomycin and daptomycin are the only two antibiotics with label indications in the U.S. for the treatment of MRSA bacteremia, including right-sided endocarditis. Daptomycin, the most recently FDA approved drug for this indication, was approved in 2005. Clinical cure rates at the test of cure visit in the Phase 3
non-inferiority
study which led to daptomycin’s approval were less than 50% for both daptomycin and the standard of care comparator. Exebacase has been shown to act synergistically with both daptomycin and vancomycin to improve eradication of
S. aureus
in animal studies of
S. aureus
endocarditis conducted in different species. As such exebacase is intended to be used in addition to, not as a replacement for, SOC antibiotics. No other agents have been shown to provide improved outcomes over SOC antibiotics.
Patent protection.
Our issued patent with composition of matter claims and issued patent with method claims for killing
S. aureus
stains both provide protection through 2032, our issued patent with method claims for disrupting or treating biofilm provides protection until 2033 and additional patents, if issued as we expect, could provide further protection beyond 2033.
Eradication of Antibiotic-Resistant Biofilms

Biofilm formation is a common characteristic of certain pathogenic bacteria such asStaph
S. aureus
and
P. aeruginosa
and represents a major therapeutic challenge. Biofilms are characterized by densely packed bacterial cells that grow in communities and are enclosed within a complex matrix of dead bacteria and excess cell wall components. Bacteria harbored within biofilms exhibit significant tolerance to conventional antibiotics and can be up to
1,000-fold
less susceptible than planktonic (or, free-floating) bacteria. Infected human tissues, such as the heart valve in endocarditis or bone in osteomyelitis, and the abiotic surfaces of indwelling medical devices, such as central venous catheters, prosthetic joints and cardiac devices are common sites for biofilm formation in the setting of systemicStaph
S. aureus
infections. Because conventional antibiotics are relatively ineffective at penetrating biofilms, long courses of antibiotics are generally required and are often unsuccessful, necessitating surgery (e.g., heart valve or prosthetic joint removal and replacement to eradicate the infection). There is a significant unmet medical need for novel treatment strategies to eradicate biofilms, as there are no medical products currently indicated for, or effective in, the eradication of biofilms.

Because exebacase disrupts the cell wall ofStaph
S. aureus
bacteria by enzymatic lysis, we expected exebacase to be highly active against biofilms and we have performed an extensive battery of studies to profile exebacase’s activity againstStaph
S. aureus
biofilms. These studies tested exebacase against biofilms formed on a range of surfaces, including polystyrene (i.e., microtiter plates), glass (i.e., chamber slides), and PVC (i.e., catheter tubing), as well as in human serum, plasma, blood and synovial fluid. The results of these studies as detailed and recently published in Antimicrobial Agents and Chemotherapy (Schuch, et al, AAC, July 2017), provide evidence that exebacase is a potent anti-staphylococcal biofilm agent.

We recently conducted a pilot study evaluating exebacase’s ability to eradicateStaph
S. aureus
biofilm from the inside of a hemodialysis catheter removed from an infected patient. The endpoint of the model was a reduction in the amount of bacteria (measured in CFUs). Segments of the catheter were assigned to one of three different treatment groups: exebacase, daptomycin (DAP) or exebacase + DAP at the clinically relevant concentration of 1 µg/mL. As shown in Figure 1 below, exebacase eradicated the biofilm at 1 µg/mL whereas daptomycin alone did not clear biofilm at 1 µg/mL. The addition of exebacase with daptomycin resulted in the same clearance of biofilm as exebacase alone. The catheter biofilm contained MRSA as well as other
Staph
species. We believe these data provide important translation of the previously reported potent efficacy of exebacase against biofilms formed in vitro and in animal models, to biofilms formed in the setting of human disease.

10

Figure 1: Sensitivity of MRSA Biofilms on Explanted Human Catheter to Exebacase
(CF-301)

LOGO

In view of the lack of efficacy of conventional antibiotics against biofilms, we believe exebacase, if approved, may provide an important new therapeutic option to address the biofilm components of invasiveStaph
S. aureus
infections and potentially forestall or eliminate the need for surgical intervention.

Rapid, potent and selective bactericidal activity

Lysins have demonstrated rapid bactericidal activity. We have performed timekill assays comparing the time it has taken exebacase to kill bacteria
in vitro
and exert a bactericidal effect to the time required for daptomycin or vancomycin to do the same. All drugs were administered at a concentration of 1x minimal inhibitory concentration (“MIC”). Exebacase reduced the number ofStaph
S. aureus
bacteria in tests on 62 strains (20 MSSA and 42 MRSA strains) by
3-logs within
30 minutes. In contrast, daptomycin required six hours to achieve the same level of cell killing, while vancomycin failed to achieve a
2-log,
or 99%, cell kill during the same
six-hour
test period. The rapid bactericidal activity of exebacase is one of the important reasons that we believe it could be a highly desirable therapeutic option, if approved, for the treatment ofStaph
S. aureus
infections.

Exebacase has beenbactericidalbeen
bactericidal against allStaph
S. aureus
isolates tested to date, regardless of their antibiotic-resistance profile. We have tested over 250 different drug sensitive and resistant isolates ofStaph
S. aureus
. The isolates tested can be classified by the particular drugs to which they are sensitive or resistant, including MSSA, MRSA, VRSA, linezolid-resistant (“LRSA”) and daptomycin-resistant (“DRSA”)Staph
S. aureus
. Exebacase was shown to be active against all the strains tested. Our Standard Bacteremia Model utilizes animals infected with 10 million (10
7
) CFU of MRSA and treated 3 hours later with various doses of therapy or buffer. In this model, exebacase produced a dose-dependent increase in survival rates, with mice receiving at least 0.5 mg/kg of exebacase having demonstrated at least 90% survival, whereas doses below 0.5 mg/kg resulted in lower survival.

Synergy with
Standard-of-Care
Antibiotics

Synergy is defined as the interaction of two or more agents so that their combined effect is greater than the sum of their individual effects. We identified a strong synergy between lysins and a wide range of anti-staphylococcal
11

Table of Contents
antibiotics, including daptomycin, vancomycin and oxacillin through
in vitro
synergy assays. In

these tests, synergy was assessed by checkerboard assay using the fractional inhibitory concentration index (“FICI”) for each combination. An FICI mean was derived from each checkerboard based on two consecutive FIC values along the growth/no growth interface. Synergy was defined as an FICI of£0.5; ≤0.5; strongly additive was

>0.5-<1;
indifference was 1 to <2; and antagonism was³2.

≥2.

To test and demonstrate this synergy
in vivo
, we developed the Drug Failure Bacteremia Model where exebacase could be tested in combination with a SOC antibiotic. The Drug Failure Bacteremia Model utilizes an extremely high infection burden of one billion (10
9
) CFU. This produces such an overwhelming infection in the animals such that SOC antibiotics used as monotherapies at their human equivalent doses failed to produce significant cure rates. We tested daptomycin, vancomycin and oxacillin in this model. We then adjusted the dose of exebacase so that monotherapy with exebacase would also fail to have significant cure rates under these intense infection conditions. To test and demonstrate whether the synergy that we had observed
in vitro
between exebacase and SOC antibiotics would lead to improved efficacy
in vivo
, we then treated groups of animals in the Drug Failure Bacteremia Model with the drugs as monotherapies and also in combination to evaluate if there was an improvement in efficacy.

In the Drug Failure Bacteremia Model, all control mice treated with buffer succumbed to bacterial infection within 12 hours. Administration of a clinical dose of daptomycin as a single agent resulted in clinical failure, as only 31% of mice survived. Similarly, when exebacase was dosed as a single agent at this chosen dose, only 18% of mice survived. In contrast, when mice received the exebacase
in addition to
daptomycin, 82% survived the bacterial challenge, demonstrating superiority of the combination therapy over either of the single-drug regimens, with a significantly higher survival rate than the sum of the results from the two monotherapies.

We have tested the combination of exebacase with daptomycin, vancomycin and oxacillin in multiple experiments with the Drug Failure Bacteremia Model. In each experiment, the combination therapy was shown to be superior to monotherapy with a single drug alone. We have also studied the combination of exebacase with other anti-staphylococcal agents, including linezolid, televancin, nafcillin, cefazolin, clindamycin and azithromycin,
in vitro
and found exebacase to be synergistic or strongly additive with each agent against both MSSA and MRSA strains.

To further explore the activity of exebacase in combination with SOC antibiotics for the treatment of life-threatening, drug-resistant infections, we engaged the LA Biomed Research Institute at Harbor-UCLA Medical Center (“UCLA”) to perform studies in their standard, well characterized rat and rabbit infective endocarditis models. The endpoint of the model is a reduction in the amount of bacteria (measured as CFUs) on the heart valve, in the kidney and in the spleen. The studies examined the activity of exebacase in combination with daptomycin, in UCLA’s prototypical high-burden biofilm-based model.

In this study, a single dose of exebacase used in addition to daptomycin resulted in an additional substantial reduction in CFUs, on top of the reduction in CFUs by daptomycin alone. This study is highly relevant to our understanding of the therapeutic potential of exebacase and the intended clinical application in a difficult to treat biofilm-based infection. This study demonstrated that a single dose of exebacase, when combined with four days of daptomycin treatment, resulted in a
3-log
drop in bacterial burden in the cardiac vegetations and
>2-log
drop in the kidney and spleen of infected animals relative to daptomycin treatment alone. Importantly, four out of nine animals treated with exebacase and daptomycin were found to have sterilized kidney, spleen and heart valve vegetations, whereas none of the animals treated with daptomycin alone had tissues that were sterilized.

We have subsequently conducted additional experiments at UCLA in the rabbit infective endocarditis model in order to both replicate the results of the rat study, but also to examine a range of exebacase doses used in addition to daptomycin as compared to both buffer and daptomycin alone. The results of a dose-ranging study, where a range of single doses of exebacase was assessed when administered in addition to four days of daptomycin treatment are shown in Figure 2 below. As seen in the rat studies, administration of daptomycin
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alone resulted in a
3-log
reduction in CFUs in the heart valve vegetations in these animals infected with MRSA.

The addition of a single dose of exebacase, resulted in an additional

~3-log
reduction in CFUs in the cardiac vegetations compared to daptomycin alone at all doses of exebacase tested (p
<
0.002). Using conventional allometric scaling, the 0.7 mg/kg dose of exebacase approximates the human clinical dose of 0.25mg/kg, which is the dose being studied in our Phase 2 clinical trial. This dose together with daptomycin resulted in a
6-log
reduction in CFUs compared to buffer (p
<
0.001). Of note, efficacy was maintained even at the lowest dose of exebacase tested (0.09 mg/kg) in this study (p
<
0.001).

Figure 2: Dose Ranging Study of Exebacase
(CF-301)
with Daptomycin in Rabbit Infective
Endocarditis Model

LOGO

Collectively, we believe these preclinical data provided significant support to the design of our ongoing Phase 2 study to evaluate the use of exebacase in addition to SOC antibiotics for the treatment ofStaph aureus bacteremia, including endocarditis.

clinical trials.

Non-Clinical
Activities

Chemistry, Manufacturing and Controls (“CMC”)

Exebacase is manufactured using a proprietary engineered
E. coli
strain that expresses the product in a recombinant manner during the fermentation process. This technology allows production of up to nine grams of exebacase per liter of fermentation broth. After fermentation, the broth containing exebacase is separated and purified through a process containing two chromatographic columns. The resulting product has greater than 99% purity.

We recently achieved concurrence with the FDA on our CMC plans for Phase 3 and BLA submission.registration. We intend tohave further optimizeoptimized the manufacturing process for increased purity and yield. Onceyield and completed we plan to begin a program tothe manufacture of Phase 3 material.materials. The process will then be scaled up from the current 100 liter fermentation and validated in a series of manufacturing batches to demonstrate consistency. In parallel to the validation, we intend to conduct a comparability program that demonstrates comparability between the final product used in Phase 3 and commercial manufacturing. We intend to include the results in the BLA that
13

Table of Contents
we

expect to submit to the FDA. Following submission, we expect that the FDA will conduct

pre-approval
inspections of all manufacturing facilities and determine whether it agrees that our commercial material is sufficiently comparable to our Phase 3 material.

Safety Pharmacology and Toxicology

We conducted
non-clinical
safety pharmacology and toxicology studies in connection with our Investigational New DrugIND application (“IND”) for exebacase. In these studies, exebacase was well-tolerated in rats for a single
two-hour
IV administration of doses up to 25mg/kg (determined by us to be the no observable adverse effect level, or “NOAEL”) and that a single dose of 2.5 mg/kg was not associated with any effects, adverse or not, and was therefore determined to be the no observable effect level (“NOEL”). Exebacase was well tolerated in these studies in both rats and dogs for seven consecutive days of once daily
two-hour
IV infusions of up to 2.5 mg/kg. In a
non-GLP
pilot study in rats, 1.0 mg/kg/day was well tolerated for up to seven consecutive days of once daily
two-hour
IV infusions or IV boluses.

Dose-dependent adverse effects were seen in both species at doses above 25 mg/kg/day for 1 day in the rat and above 2.5 mg/kg/day for seven-consecutive days in both the rat and the dog. The dose limiting toxicity observed was a localized microscopic histopathological change surrounding certain blood vessels. In accordance with industry practice, we intend to studyhave studied exebacase in clinical trials at doses much lower than those that caused adverse effects in animals, and we believe these doses to be within the efficacious range of the drug.

Upon first exposure to exebacase, no hypersensitivity reaction was observed in any of our animal studies. Upon administration of a second course of exebacase, given two weeks after completion of the first course, including
multiple-day
courses, hypersensitivity or hypersensitivity-like findings were observed in mice, rats and dogs. In a dedicated hypersensitivity study in rats, using a model intended to elicit hypersensitivity, findings consistent with hypersensitivity were observed after a two week
two-week
delayed
re-challenge
with a second course of exebacase and were not dose-dependent. In general, in humans, Type I hypersensitivity is an allergic anaphylaxis-like response (e.g., an immediate and potentially life-threatening allergic reaction) and Type III hypersensitivity is a serum sickness-like response (e.g., fever, joint pain, protein in urine, vascular changes). While the nature of hypersensitivity reactions in rats may not necessarily be predictive of hypersensitivity reactions that may occur in humans, we have also considered the risk of hypersensitivity occurring upon first administration of exebacase due to potential prior exposure to the active protein component of exebacase from the environment, as it is a naturally occurring protein. Testing for anti-drug antibodies was performed in Phase 1 subjects.subjects and Phase 2 patients. No clinical hypersensitivity related to exebacase was observed in subjects dosed in our Phase 1 or Phase 2 study. We are collecting additional information about the development of ADAs after dosing with exebacase in the Phase 2 study.

CF-296:
An Engineered ApproachLysin for Invasive
Staph aureus
Infections

We have engineered a lysin variant of exebacase which we believe may suitable for the potential treatment of the most challenging invasive infections caused byStaph
S. aureus
including biofilm-related infections in prosthetic joints and indwelling devices and osteomyelitis. Based on the safety pharmacology and toxicology profile of exebacase described above, our objectives for the program were to maintain the spectrum of activity of an anti-staphylococcal lysin while improving the
non-clinical
safety profile.

We are conducting further
in vitro
and
in vivo
preclinical studies of
CF-296
to further characterize this compound. In June 2019, we were awarded up to $7.2 million of funding from USAMRDC over the course of three years to advance
CF-296
through
IND-enabling
studies.
CF-370:
A Novel Engineered Lysin for
P. aeruginosa
Infections
Medical Opportunity
P. aeruginosa
is a gram-negative pathogen that is common in the environment and is an important and much-feared potential pathogen in hospitals.
P. aeruginosa
readily develops resistance to conventional
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Table of Contents
antibiotics resulting in the emergence of multidrug resistant (“MDR”) strains, which have become common in some hospitals and regions.
P. aeruginosa
is a major cause of hospital-acquired infections and is a particularly important cause of infections in immunocompromised hosts, and is also a major pathogen in burn and surgical wound infections.
P. aeruginosa
is also the most common pathogen isolated from adults with cystic fibrosis, the most common cause of respiratory failure in cystic fibrosis and responsible for the deaths of the majority of these patients.
Invasive
P. aeruginosa
infections, including ventilator associated pneumonia, blood stream infections, complicated urinary tract infections, and infections following surgery carry some of the highest risks of mortality among hospital acquired infections. More than 32,000
P. aeruginosa
infections are multidrug-resistant, with roughly 2,700 deaths per year attributed to these infections. Infections caused by multidrug resistant
P. aeruginosa
are associated with high
all-cause
mortality, hospital mortality and higher health-care related costs compared to infections caused by susceptible strains.
CF-370
Development
CF-370
is an investigational
first-in-class
anti-bacterial therapeutic candidate targeting a gram-negative pathogen.
CF-370
has been engineered to bypass the outer membrane of the bacteria and to enable potent activity in human serum. We believe this is a significant milestone for direct lytic agents as native lysins are typically unable to penetrate the outer membrane of gram-negative bacteria and consequently are unable to kill these pathogens.
CF-370
has exhibited the hallmark
in vitro
features of the lysin class, including rapid and potent bactericidal activity, synergy with a broad range of standard of care agents and the eradication of biofilms in preclinical studies.
We have studied the
in vivo
activity of
CF-370
against
P. aeruginosa
in a rabbit pneumonia model.
CF-370
was well-tolerated and conferred a survival advantage to animals with 100% of animals receiving
CF-370
surviving, compared to only 40% survival among vehicle control animals. In animals receiving either meropenem or
CF-370
alone, the mean bacterial lung counts decreased by
1.5-2log
10
CFU/g versus pretreatment or vehicle-treated controls (p ≤ 0.0016).
CF-370
(10 mg/kg) in addition to meropenem was synergistic, with bacterial counts in all target tissues decreasing by an additional 2log
10
CFU/g versus meropenem or
CF-370
alone (p ≤ 0.02).
We have also studied
CF-370
against
P. aeruginosa
in the rabbit infective endocarditis model.
CF-370
was well-tolerated and in the analysis of the right ventricle, the primary target organ of the study where cardiac vegetations and dense biofilms were present, three days of
CF-370
dosing at 10 mg/kg in addition to meropenem was synergistic, providing >2log
10
CFU/g reduction, as compared to meropenem alone. In further analysis of the kidney, spleen and lungs,
CF-370
showed additive activity when administered with meropenem, and reduced the mean bacterial lung counts by an additional
0.7-1.6log10
CFU/g versus meropenem alone.
We believe the results from these studies provide
in vivo
proof-of-concept
for
CF-370
as a potential treatment for
P. aeruginosa
infections and for lysins as a potential new modality to combat the threat of multidrug-resistant gram-negative pathogens. We continue to progress
CF-370
through
IND-enabling
activities and we expect it to be our next molecule in clinical studies. In July 2020, we were awarded up to $18.9 million in funding from
CARB-X
in support of the advancement of
CF-370
toward Phase 1 clinical trials.
Lysin Discovery Platform

The main objective of our lysin discovery platform has been to bring forth a portfolio of lysins that selectively target the largest threats of resistant bacteria, commonly referred to as the ESKAPE pathogens (
E
nterococcus faecium,
S
taphylococcus aureus,
K
lebsiella pneumoniae,
A
cinetobacter baumannii,
P
seudomonas aeruginosa, and
E
nterobacter species
), which are the leading causes of hospital acquired infections throughout the world.

Lysins

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Table of Contents
In nature, lysins are enzymes derived from naturally occurringpotent enzymatic killers of bacteria produced by bacteriophage, which are viruses that infect bacteria. When recombinantly produced from genetic sequences as purified proteins and then applied to bacteria, lysins cleave a key component of the target bacteria’s peptidoglycan cell wall, resulting in rapid bacterial cell death. Conventional antibiotics require bacterial cell division and metabolism to occur in order to exert their effect (i.e., cell death or cessation of growth). Based on
in vitro
tests, lysins, however, are fundamentally different in that they kill bacteria rapidly by enzymatic cleavage of the bacterial cell wall without need for bacterial growth and cell division. In addition to the speed of action and potent cidality, we believe lysins are differentiated by their other hallmark features which include the demonstrated ability to eradicate biofilms and synergistically boost the efficacy of conventional antibiotics in animal models. Importantly,Naturally occurring lysins alsotargeting gram-positive pathogens have a “narrow spectrum” meaning they kill only specific species of bacteria or closely related bacteria. As such, we believe that lysins targeting gram-positive pathogens willactivity and are not expected to have negative effects on the beneficial, normal human GI microbiome in contrast to conventional “broad spectrum” antibiotics which can kill the body’s normal, beneficial bacteria. We believe that the potential therapeutic profile of lysins is complementary to that of conventional antibiotics. As such, our approach includes the use of lysins in addition to conventional antibiotics for the treatment of serious, drug-resistant bacterial infections, including biofilm-associated infections, in an effort to achieve greater efficacy and improve clinical outcomes, as well as potentially protect against antibiotic resistance.

We employ bioinformatics and a series of metagenomic-based techniques to identify and clone bacteriophage lysins from bacterial, viral, and environmental sources. The field of metagenomics is based on the bulk extraction of DNA/RNA from environmental samples (e.g., soil, water, etc.) without prior isolation of individual microbial sources. This is useful when one considers that less than 1% of microbes are culturable under standard laboratory conditions. Once extracted, the metagenomic DNA can then be examined using sequence-based methods or by proprietary functional screens. These functional screens for bacteriophage lysin activity form the major component of our lysin discovery work. Once cloned, our scientists also employ a variety of techniques to further optimize and ‘engineer’ changes to the lysins to introduce specific characteristics which we believe may be favorable for potential therapeutic use.

For the functional metagenomic work that we perform, environmental genes are expressed in a recombinant format in a standard host organism (i.e.,
Escherichia coli
) and cells are monitored for the acquisition of a desired phenotype. We can vary both the source of environmental DNA and the way we monitor for desired phenotypes to focus only on environmental populations enriched for bacteriophage lysins that can actively kill a pathogen of interest. We sample various DNA sources including viral, prophage, and pathogen-amplified viral metagenomics. Multiple methods for both DNA library construction and for functional screening are used in parallel in order to maximize lysin identification.

The application of these methods enables the large scale identification of lysins, enabling the production of lysin banks specific for any particular pathogen. We believe the ability to rapidly identify lysins specific for any pathogen of interest, either by in vitro or in silico methods, will provide a steady pipeline of novel lysins for consideration as potential antimicrobial therapeutic candidates. Using this methodology, we have discovered lysins targeting gram-negative pathogens as part of our proprietary discovery program. These lysins were further characterized with funding fromCARB-X and will be further developed and tested inin vivo models as part of this program.

In addition to our proprietary lysin discovery program, we have an active collaborative research agreement through which we provide funding for the discovery of new lysins to Dr. Vincent Fischetti’s Laboratory of Bacterial Pathogenesis and Immunology at The Rockefeller University (“Rockefeller”). We have the first right to negotiate a license to all discoveries concerning lysins through October 2019. We hold worldwide exclusive license rights to patents for composition of matter for nine lysins from Rockefeller. Each lysin targets a specific species of gram-positive bacteria, including drug-sensitive and drug-resistant forms as shown in Table 3 below.

Table 3: Lysins Licensed From The Rockefeller University

Pathogen

CDC
Threat Level
WHO
Priority Level
Lysins

Staphylococcus aureus

SeriousHighCF-301, CF-302

Streptococcus pneumoniae

SeriousMediumCF-303,CF-309

Enterococcus faecalis

SeriousHighCF-304

Group Bstreptococcus

Concerning—  CF-307

Bacillus anthracis

—  —  CF-306,CF-308

The focus of our research and discovery efforts is on identifying lysins which selectively kill specific species of gram-negative bacteria that are considered to be urgent or serious threats to global health by the CDC or critical priorities by the WHO. Emerging strains of multi-drug resistant gram-negative pathogens that are resistant to all or nearly all available antibiotics are considered to be a major global health threat. We believe that lysins targeting gram-negative pathogens have the potential to be important therapeutics to combat antimicrobial resistance due to their novel mechanism of action and therapeutic profile, which is complementary to conventional antibiotics.

P. aeruginosa is the initial target of our gram-negative

We have discovered and engineered a novel lysin, discovery efforts.

P. aeruginosa is

CF-370,
an investigational
first-in-class
anti-bacterial therapeutic candidate targeting a gram-negative pathogen, which is common in
P. aeruginosa
.
CF-370
has been engineered to bypass the environment and is an important and much-feared potential pathogen in hospitals.P. aeruginosa readily develops resistance to conventional antibiotics resulting in the emergence of multidrug resistant (“MDR”) strains, which have become common in some hospitals and regions.P. aeruginosa is a major cause of hospital-acquired infections and is a particularly important cause of infections in immunocompromised hosts, and is also a major pathogen in burn and surgical wound infections. P. aeruginosa is also the most common pathogen isolated from adults with cystic fibrosis, the most common cause of respiratory failure in cystic fibrosis and responsible for the deathsouter membrane of the majority of these patients.

InvasiveP. aeruginosa infections, including ventilator associated pneumonia, blood stream infections, complicated urinary tract infections,bacteria and infections following surgery carry some of the highest risks of mortality among hospital acquired infections. An estimated 51,000 healthcare-associated P. aeruginosa infections occurto enable potent activity in the United States each year. More than 6,000 (13%) of these are multidrug-resistant, with roughly 400 deaths per year attributedhuman serum. We will continue to these infections. Infections caused by multidrug resistantP. aeruginosaare associated with highall-cause mortality, hospital mortality and higher health-care related costs compared to infections caused by susceptible strains.

The discovery and development ofpursue new lysins that targetP. aeruginosais a focus other gram-negative pathogens, such as the

Enterobacteriaceae
family of our research efforts. We developed a strategy for large scale cloningbacteria.
16

Table of lysins with potential specificity for the target pathogen. We then conducted functional screening in the context Contents
Enterobacteriaceae
The
Enterobacteriaceae
family
of both media and human serum to identify lysins with potent antimicrobial activity againstP. aeruginosa,including resistant strains.For all highly active clones, additional modifications were introduced to generate second and third generation molecules for furtherin vitroscreening. We have identified several lysins thatin vitroexhibit the hallmark features which differentiate the lysin class, including rapid and potent bactericidal activity, synergy with a broad range of standard of care agents and the eradication of biofilms.

Based on the results of these assays and the additional data we continue to generate in vitro, our gram-negative lysins represent a potential new therapeutic class of bactericidal agents to combat resistantP. aeruginosa. In 2017, we were awarded a grant fromCARB-X in support of this program. In January 2019, we announced an additional $2.3 million in the amount of funding to be received in further support of this effort as we move intoin vivo models of disease to further characterize these candidates.

bacteria

includes

Enterobacteriaceae

The Enterobacteriaceaefamilyof gram-negative bacteriaincludes

Klebsiella pneumoniae (“
(“
K. pneumoniae
”),
Enterobacter species
(“
Enterobacter”
e.g. Enterobacter cloacae) and
Escherichia coli (“
(“
E. coli
”), all of which can cause serious, life-threatening infections, and have demonstrated concerning resistance patterns.

K. pneumoniaeare common causes of serious, potentially life-threatening invasive infections (e.g. pneumonia, complicated urinary tract, intra-abdominal infections) in hospital settings, particularly in intensive care units and among vulnerable patients with impaired immune systems, diabetes oralcohol-use disorders. The mortality rates for hospital-acquired pneumonia due toK. pneumoniae can exceed 50% in vulnerable patients.

Enterobacter cloacaecan cause a wide range ofinvasive infections, and potentially contaminate intravenous fluids and medical devices as the source of deadly outbreaks in the hospital.

E. coliis the most frequent cause of community and hospital acquired urinary tract infections and a frequent cause of bloodstream infection. Patients in hospitals, nursing homes, and other healthcare settings whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for infection.

K. pneumoniae
are common causes of serious, potentially life-threatening invasive infections (e.g. pneumonia, complicated urinary tract, intra-abdominal infections) in hospital settings, particularly in intensive care units and among vulnerable patients with impaired immune systems, diabetes or
alcohol-use
disorders. The mortality rates for hospital-acquired pneumonia due to
K. pneumonia
e can exceed 50% in vulnerable patients.
Enterobacter cloacae
can cause a wide range of
invasive infections, and potentially contaminate intravenous fluids and medical devices as the source of deadly outbreaks in the hospital.
E. coli
is the most frequent cause of community and hospital acquired urinary tract infections and a frequent cause of bloodstream infection. Patients in hospitals, nursing homes, and other healthcare settings whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for infection.
The emergence and spread of antimicrobial resistance among
Enterobacteriaceae
are recognized public health threats which complicate the treatment of serious nosocomial infections.

Enterobacteriaceaecanproduce
can
produce enzymes (e.g., “extended-spectrum beta-lactamases (“ESBL”)) that confer resistance to most beta-lactam antibiotics, including penicillins, cephalosporins, and the monobactam aztreonam. Infections with ESBL-producing organisms have been associated with poor outcomes. Approximately 20% of
K. pneumoniae
infections and 31% of
Enterobacter
infections in intensive care units in the United States now involve strains which are not susceptible to third-generation cephalosporins. Community and hospital-acquired ESBL-producing
Enterobacteriaceae
are prevalent worldwide, and their prevalence may be underestimated because reliable identification of ESBL-producing organisms in clinical laboratories can be challenging.

Carbapenem antibiotics are considered to be the best currently available antimicrobial agent to treat infections caused by ESBL-producing Enterobacteriaceae. However, resistance to carbapenems is becoming increasingly prevalent, and the resulting Carbapenem-resistant
Enterobacteriaceae
(“CRE”), have high levels of resistance to antibiotics.
K. pneumoniae
and
E. coli
are a normal part of the human gut bacteria that can become carbapenem-resistant due to enzymes that breakdown carbapenem antibiotics and make them ineffective.
Klebsiella pneumoniae
carbapenemase (“KPC”) and New Delhi Metallo-beta-lactamase (“NDM”) are two such enzymes that break down carbapenems and make them ineffective. Both of these enzymes have also been reported in
P. aeruginosa
. CRE infections typically occur in hospitals, nursing homes, and other healthcare settings. Patients who require devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and/or patients who are taking long courses of certain antibiotics are most at risk for CRE infections. Some CRE bacteria have become resistant to most available antibiotics, are very difficult to treat, and can lead to death in up to 50% of patients who become infected.

We believe that lysins which target
K. pneumoniae
,
Enterobacter
and
E. coli
may be important therapeutic options for the treatment of serious, potentially life-threatening invasive infections caused by multidrug resistant pathogens. Because of the novel mechanism by which lysins kill bacterial, no cross resistance to conventional antibiotics, and as such, KPC, NDM and similar enzymes are not expected to have any effect on the activity of lysins. We believe that lysins may help to improve clinical outcomes of infections caused by these pathogens and thus we are also focusing research efforts to identify and develop lysins which target them.

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Gram-positive lysins
In addition to our proprietary lysin discovery program, we hold worldwide exclusive license rights to patents for composition of matter for nine lysins from The Rockefeller University (“Rockefeller”). The lysins each target a specific species of gram-positive bacteria, including drug-sensitive and drug-resistant forms as exemplified in Table 4 below.
Table 4: Lysins Licensed From The Rockefeller University
Pathogen
CDC

Threat Level
WHO

Priority Level
Lysins
Staphylococcus aureus
SeriousHigh
CF-301, CF-302
Streptococcus pneumoniae
SeriousMedium
CF-303,
CF-309
Enterococcus faecalis
SeriousHighCF-304
Group B
streptococcus
Concerning
CF-305,
CF-307
Bacillus anthracis
CF-306,
CF-308
Amurin Discovery Program

Amurin peptides are a class of novel, phage-derived lytic agents discovered in our laboratories. In preclinical studies, amurin peptides have shown some features common to lysins, including potent

bacteriocidality, including antibiotic-resistant strains, the ability to clear biofilms and synergize with conventional antibiotics. However, amurin peptides are further differentiated in their potential ability to exert these actions on the full range of gram-negative ESKAPE pathogens, as well as a range of additional, serious and difficult to treat gram-negative bacteria, includingBurkholdaria some strains of

Burkholderia
and
Stenotrophomonas
, in the context of human serum, without apparent ‘off target’ effects against gram-negatives. As such, amurin peptides have shown a highly differentiated spectrum of action, and we believe, if successfully developed, would be extremely well suited as potential treatments for patients suffering from polymicrobial gram-negative infections, such as cystic fibrosis, ventilator-associated pneumonia, intra-abdominal infections, and serious burns or certain chronic wound infections. Given their powerful
in vitro
activity against a broad range of resistant pathogens, as shown in Table 5 below, we believe that amurin peptides have the potential to become a powerful addition to our armamentarium against strains of gram-negative pathogens which have extreme- or
pan-
drug resistance to all or almost all currently available antibiotics.

Table 5:
In Vitro
Activity (minimal inhibitory concentrations) of Amurin
Candidates (AM1, AM2 and AM3) Observed Against Carbapenem-Resistant Pathogens*
Pathogen
  
AM1
  
AM2
  
AM3
  
Colistin
  
Meropenem
Escherichia coli
  0.5  0.25  0.625  0.5  >8
Enterobacter cloacae
  0.25  0.125  0.0625  1  >8
Klebsiella pneumoniae
  0.5  0.5  0.0625  >8  8
Acinetobacter baumannii
  1  1  0.25  >8  >8
*
strains listed are representative of >100 strains tested
Similar to the pilot study performed with exebacase, we evaluated the ability of one of our lead amurins, AM1, to eradicate
Stenotrophomonas maltophilia
biofilms from the inside of hemodialysis catheters removed from infected patients. The endpoint of the model was a reduction in the amount of bacteria (measured in CFUs) in sections of the catheters treated with amurin AM1 compared to a control group (sections with no treatment) and sections treated with clinically relevant concentrations of meropenem. Treatment with amurin AM1 resulted in the reduction in the amount of bacteria below the limit of detection, 0.7 log
10
CFU/g, while both the control
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groups and sections treated with meropenem had CFU counts >3.0 log
10
CFU/g. We believe these results provide important
ex vivo
translation of the
in vivo
activity to biofilms formed in the setting of human disease.
We plan to progress our amurin peptide program as quicklyrapidly as possible through preclinical profiling and into the clinic.clinical studies. We are currently evaluating the
in vitrovivo
profiles of the amurins as we continue to advance the program. We recently announced an award from CARB-X of up to $6.9 million of funding to support the development of amurin peptides as potential therapeutics to treat serious and potentially life-threatening infections, including those caused by antibiotic-resistant gram-negative ESKAPE pathogens.

CF-404: An Antibody Approach for Influenza

We intend to developCF-404, a combination of three human mAbs against influenza, as a potential treatment for seasonal and pandemic influenza infections, which kill as many as 49,000 people annually in the U.S. alone. Our preclinical studies to date have shown thatCF-404 may have the following attributes:

Broad activity against influenza in one formulation.CF-404 exhibits broad activity against influenza strains, including the three principal strains (H1, H3 and B). By targeting conserved regions on the virus, which are not subject to seasonal mutation, we believe that the efficacy ofCF-404 will be robust from season to season. The unique triple mAb formulation, allows (1) our mAbs to neutralize many different influenza strains; (2) for a single therapeutic covering all human seasonal and most pandemic influenza strains; and (3) for an immediate therapeutic effect.

Minimal resistance potential. Our mAbs target the principal hemagglutinin stalk on the surface of influenza which is a genetically conserved region of the virus, and hence, does not vary from one season to another.

Novel inhaled delivery.We intend to developCF-404 as an inhaled therapy. Inhaled therapy has demonstrated enhanced efficacy at lower doses than systemic administration in animal models. We believe that this delivery route will enableCF-404 to more directly target influenza potentially allowing for increased efficacy, even at low doses.

Preclinical studies

In preclinical studies,CF-404 was active against all seasonal strains of influenza, including the three principal strains (H1, H3 and B). These mAbs react with the principal protein, hemagglutinin, on the surface of influenza at a region referred to as the hemagglutinin stalk which is genetically stable and does not vary from one season to another.

We have tested our mAbs in standard mouse models which use weight changes to evaluate protection against lethal infection with different strains of influenza (H1N1, H3N2 or B). Control mice treated with buffer all succumbed to viral infection within7-9 days. By contrast, when we administered a single treatment ofCF-404 24 hours post-infection, the infected mice appeared healthy, with weight changes comparable to healthy mice.

We are developingCF-404 as an inhaled therapy. We believe that this novel delivery route allowsCF-404 to target the influenza virus more directly where it resides, in the respiratory system. We have demonstrated efficacy in animal models even when using low doses of our antibodies administered in an aerosolized form. In

our inhalation model, control mice treated with buffer all succumbed to viral infection within 10 days. By contrast, when we administered a single inhaled treatment ofCF-404 over a range of low doses 24 hours post-infection, the infected mice were protected and fared better with increasing dose (up to 0.82mg/kg) as compared to the 5mg/kg with a systemic dose.

We are continuing to develop a formulation ofCF-404 that would be suitable for human use. Ourin vivo data has shown that ouranti-H1(CF-401),anti-H3(CF-402) andanti-B(CF-403) mAbs have been able to protect animals from lethal challenge. Importantly, our studies also show that treatment with our mAbs appears to provide greatly enhanced potency compared to treatment with other mAbs. We believe our combination for the treatment of influenza is a novel approach addressing a high unmet medical need and would offer competitive advantages to the only product widely used on the market today if successfully developed and approved.

Intellectual Property

Our goal is to obtain, maintain and enforce patent protection for our products, formulations, processes, methods and other proprietary technologies, preserve our trade secrets, and operate without infringing on the valid proprietary rights of other parties, both in the United States and in other countries. Our policy is to actively seek to obtain, where appropriate, the broadest intellectual property protection possible for our product candidates, proprietary information and proprietary technology through a combination of contractual arrangements and patents, both in the United States and abroad. However, patent protection maydoes not always afford us with complete protection against competitors who seek to circumvent our patents.

We also depend upon the skills, knowledge, experience and
know-how
of our management and research and development personnel, as well as that of our advisors, consultants and other contractors. To help protect our proprietary
know-how,
which is not patentable, and for certain inventions, for which patents may be difficult to enforce,in accordance with our business strategies, we currently rely and will in the future rely on trade secret protection and confidentiality agreements to protect our interests. To this end, we will require all of our employees, consultants, and other contractors (including any consultants or contractors we may retain for purposes of any of our ad hoc Clinical Advisory Boards) to enter into confidentiality agreements that prohibit the disclosure of confidential information and, where applicable, require disclosure and assignment to us of the ideas, developments, discoveries and inventions important to our business.

Our lysinDLA portfolio consists of fifteen (15)twenty-seven (27) U.S. patents,thirty-one (31)
one-hundred
and
fifty-two
(152) issued foreign patents and onetwo hundred seventeen (117)and
thirty-six
(236) pending U.S. and international patent applications that we have licensed from Rockefeller and/or developed
in-house. These patents will expire between 2024 and 2033. The
Our patents and patent applications include those that are directed to compositions and methods for the treatment of infections caused by gram-positiveGram-positive bacteria (Group B
Streptococci, StaphS. aureus, Streptococcus pneumonia, Bacillus anthracis
(anthrax)
, Enterococcus faecalis
and
Enterococcus faecium
) and infections caused by gram-negativeGram-negative bacteria (
P. aeruginosa, K. pneumoniae
,
Enterobacter cloacae
and
E. coli)
. If patents are granted on our patent applications, which include thecertain patent applications related to exebacase,
CF-296
and the gram-negativeGram-negative lysins, they would expire between 2029 and 2039.

Our influenza patent portfolio consists of one (1) U.S. patent, eleven (11) foreign patents, andfifty-one (51) U.S. and foreign patent applications, which we have licensed from Trellis and/or developedin-house. The patent applications are directed to compositions relating to influenza antibodies as well as to pharmaceutical compositions for administration to patients and to methods for their use in conferring passive immunity against various influenza strains and clades. If patents are granted on these patent applications they would expire between 2031 and 2036.

2042.

The U.S. patent system permits the filing of provisional and
non-provisional
patent applications. A
non-provisional
patent application is examined by the United States Patent and Trademark Office (“USPTO”), and can issue as a patent once the USPTO determines that the claimed invention meets the various standards for

patentability. A provisional patent application is not examined or prosecuted, and automatically expires 12 months after its filing date if a

non-provisional
application is not filed based on the provisional application within that
12-month
period. Provisional applications are often used, among other things, to establish a priority filing date for the subsequently filed
non-provisional
patent application. The term of individual patents depends upon the legal term for patents in the countries in which they are filed. In most countries in which we file, the patent term is 20 years from the earliest filing date of a
non-provisional
patent application. In the United States, a patent’s term may be lengthened by patent term adjustment, which compensates a patentee for administrative delays by the USPTO in granting a patent. Alternatively, a patent’s term may be shortened if a patent is terminally disclaimed over another patent.

The term of a patent that covers an
FDA-approved
drug may also be eligible for patent term extension (“PTE”), which permits patent term restoration as compensation for the patent term lost during the FDA regulatory review process. The Drug Price Competition and Patent Term Restoration Act of 1984, or the Hatch-WaxmanHatch-
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Waxman Amendments, permits a PTE of up to five years beyond the expiration of the patent. The length of the PTE is related to the length of time the drug is under regulatory review. Patent extension cannot extend the remaining term of a patent beyond a total of 14 years from the date of product approval and only one patent applicable to an approved drug may be extended. Similar provisions are available in Europe and certain other foreign jurisdictions to extend the term of a patent that covers an approved drug. In the future, if and when our pharmaceutical product candidates receive FDA or other regulatory approval, we may be able to apply for or receive the benefit of PTEs on patents covering those products.

License Agreements—The Rockefeller University

We have entered into the following license agreements with Rockefeller:

On July 12, 2011, we entered into a license agreement for the worldwide, exclusive right to a provisional patent application, upon which a
non-provisional
patent application has since been filed, covering the composition of matter for the lysin PlySS2 for the treatment and prevention of diseases caused by gram-positive bacteria (the
“CF-301
License”). We rebranded PlySS2 as
CF-301,
or exebacase. This license gives us the right to exclusively develop, make, have made, use, import, lease, sell and offer for sale products that would fall within the scope of claims in the patent application or otherwise infringe a claim of this patent application orthe patent.

On June 1, 2011, we entered into a license agreement for the exclusive rights to Rockefeller’s interest in a joint patent application, which is presently pending,have granted patents covering the method of delivering antibodies through the cell wall of a gram-positive bacteria to the periplasmic space. This intellectual property was developed as a result of the sponsored research agreement between us and Rockefeller, and was jointly discovered and filed by the two parties.

On September 23, 2010, we entered into a license agreement for the worldwide, exclusive right to develop, make, have made, use, import, lease and sell, and offer for sale products that would otherwise infringe a claim of the suite of patents and patent applications covering the composition of matter for eight individual lysin molecules for the treatment and prevention of diseases caused by gram-positive bacteria. The lysins in this suite have activity against Group BStreptococci,Staph aureus,Streptococcus pneumonia,Bacillus anthracis,Enterococcus faecalis andEnterococcus faecium.

On September 23, 2010, we entered into a license agreement for the worldwide, exclusive right to develop, make, have made, use, import, lease and sell, and offer for sale products that would otherwise infringe or fall within the scope of a claim of the suite of patents and patent applications covering the composition of matter for eight individual lysin molecules for the treatment and prevention of diseases caused by gram-positive bacteria. The lysins in this suite have activity against Group B
Streptococci
,
S. aureus
,
Streptococcus pneumonia
,
Bacillus anthracis
,
Enterococcus faecalis
and
Enterococcus faecium
.
In consideration for the licenses, we paid Rockefeller license initiation fees in cash and stock and may be required to pay an annual maintenance fee, milestone payments and royalties on net sales from products to Rockefeller. We are allowed to grant sublicenses to third parties without prior approval, subject to certain conditions and the payment of a certain percentage of all payments we receive from sublicensees.

Each license agreement terminates upon the later of (i) the expiration or abandonment of the last licensed patent under the license agreement to expire or become abandoned, or (ii) 10 years after the first commercial sale

of the first licensed product. Rockefeller may terminate any license agreement in the event of a breach of such agreement by us or if we challenge the validity or enforceability of the underlying patent rights. We may terminate any license agreement at any time on 60 days’ notice.

License Agreement—Trellis Bioscience LLC

On January 29, 2014, we entered into a license agreement with Trellis that gives us exclusive rights to all Trellis mAbs in the field of influenza discovered from their CellSpot platform. Particularly, the license provides us with three fully human mAbs that bind, neutralize and protect animals from all strains of H1, H3 and B influenza, and that will also cross bind, neutralize and protect animals from other seasonal or pandemic influenza strains that may arise (including H5N1 and H7N9). We have selected our three lead mAbs for the H1, H3, and B influenzas and are currently producing these antibodies at scale using manufacturing-grade expression systems and performingIND-enabling studies.

In consideration for the license, we paid Trellis licensing fees in cash and stock and may be required to make specified development and regulatory milestone payments and make additional payments upon the achievement of future sales and a royalty on net sales from products to Trellis. We are allowed to grant sublicenses to third parties. The license agreement terminates upon the earlier of (i) our decision to terminate the agreement at will or for safety reasons, (ii) material breach by either party that is not cured within ninety (90) days, or (iii) either party’s insolvency.

On August 14, 2014, we amended the license agreement to include research conducted pursuant to a government grant.

Collaborative Research Agreements—The Rockefeller University

Beginning in October 2009, we entered into a research agreement with Rockefeller where we provided funding for research focused on producing and testing monoclonal antibodies against proteins ofStaph aureus, which is now expired On October 24, 2011, we entered into a second research agreement with Rockefeller, where we provided funding for the research primarily to identify lysins, enzymes or small molecules that will kill gram-negative bacteria, and to identify and characterize lysins fromClostridia difficile to be engineered into gut commensal bacteria. This agreement expired on October 25, 2016. On October 25, 2016, we entered into a third research agreement with Rockefeller, where we provide funding for the identification of novel lysin therapeutic candidates that target gram-negative pathogens. The research collaboration will focus on gram-negative pathogens such asP. aeruginosa, E. coli, andK. pneumoniae, including antibiotic-resistant strains.

Our current agreement runs through October 24, 2019. Either party may terminate the agreement upon breach of the agreement, following 30 days written notice and failure to cure such breach. Following the expiration or termination of the agreement, each party will have anon-exclusive license to use for internal research purposes all research results, including joint intellectual property. If Rockefeller or joint intellectual property develops from these programs, we will have theright-of-first refusal to negotiate to acquire a royalty-bearing license to utilize such intellectual property for commercial purposes.

Competition

The pharmaceutical and biotechnology industries are intensely competitive. While we believe that our technology and scientific knowledge provide us with competitive advantages, we face potential competition from many different sources, including major pharmaceutical, specialty pharmaceutical and biotechnology companies and academic and research organizations in developing therapies to treat diseases.

Exebacase is a potential
first-in-class
drug candidate and we believe it is the first lysin to enter human clinical trials in the U.S. We believe there is currently no clinical competitor to exebacase, which is highly

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differentiated from conventional antibiotics by at least six attributes that no single antibiotic possesses, including: (1) a novel mechanism of action, (2) specificity for a target bacteria (onlyStaph
S. aureus
), (3) rapid speed of action, (4) activity across all drug-sensitive and drug-resistant strains of the target bacteria (including MRSA, VRSA and DRSA), (5) the ability to eradicate biofilms, and (6) synergy with antibiotics.

Staph

S. aureus
bacteremia is typically treated with oxacillin or other semi-synthetic penicillin or first-generation cephalosporin, or for MRSA strains, daptomycin or vancomycin. We do not see market competition with these drugs, as our strategy is to administer exebacase in addition to these drugs with the goal of achieving clinical superiority over any one of those SOC antibiotics alone. We are aware of several other clinical trials currently being conducted or recently concluded in patients withStaph
S. aureus
bacteremia. Depending on the outcomesMost of those and future trials, exebacase may compete with productsthese agents are small molecules being studied in development from Genentech, Inc., iNtRon Biotechnology, Inc., (“iNtRon”) and XBiotech, Inc.
non-inferiority
trials. We believe that exebacase has demonstrated synergy
in vitro
with a broad range of conventional anti-staphylococcal agents of different classes and, in the event any of these
non-inferior
small molecules are approved, we believe that exebacase will also be synergistic and
non-competitive
with newer conventional antibiotics in these classes.

Wethem.

Based on recent data published by the WHO, there are not aware of anyonly five biologic agents, other lysinsthan ours, in clinical development underfor
S. aureus
infections from iNtRon Biotechnology, Inc., (“iNtRon”), Aridis Pharmaceuticals, Inc. (“Aridis”), MedImmune (a subsidiary of AstraZenenca plc), XBiotech, Inc (“XBiotech”) and Genentech, Inc. (“Genentech”). Aridis is studying
AR-301,
a monoclonal antibody, in
S. aureus
pneumonia, not bacteremia. MedImmune has been studying MEDI-4893, a monoclonal antibody, for the prevention of
S. aureus
pneumonia in a Phase 2 study since 2014. XBiotech is planning to study 514G3, a monoclonal antibody, for the prevention of
S. aureus
infection in hemodialysis patients. Genentech has been studying DSTA-4637S, an INDantibody-drug conjugate, in a Phase 1 study since 2017. Depending on the United States.outcomes of these and future trials, exebacase may compete with these products. We believe iNtRon, a biotechnology company located in South Korea, is currently conducting a human clinical trial in South Korea alone for
SAL-200,
an endolysin-based drug candidate, to evaluate it as a treatment forStaph
S. aureus
bacteremia. Additionally, in November 2018, iNtRon recently announced a licensing arrangement with Roivant Sciences with a stated purpose to pursue the global development and commercialization of its endolysin products, including
SAL-200.
We will continue to monitor the advancement of
SAL-200
as data and information become available.

CF-404 is intended We are not aware of

SAL-200
or any other anti-staphylococcal lysins having been applied for under an IND for clinical development in the treatment of potentially life-threatening seasonal and pandemic influenza infections. We believeCF-404 has competitive advantages in that it potentially addresses the short-comings of neuraminidase inhibitors and other products in development for the following reasons: (1) it may not be prone to drug-resistance due to targeting conserved regions of the influenza virus, (2) it may provide for an increased“time-to-treat” window compared to neuraminidase inhibitors, which are indicated to be used within 48 hours of symptom onset, and (3) it may provide complete coverage against all seasonal and most potential pandemic strains of human influenza without the need for annual reformulation, including influenza B.

CF-404 may directly or indirectly compete with other products already in development from F.Hoffmann-La Roche Ltd., Genentech, Inc., Johnson & Johnson, Inc., Theraclone Sciences, Inc., Toyama Chemical Co., Ltd., Romark Laboratories, L.C., Aviragen, Inc., Vectura Group plc, Far EastBio-Tec Co. Ltd, Visterra Inc., MedImmune LLC, Ansun Biopharma, Inc. and others with early stage product candidates.

United States.

Many of our competitors may have significantly greater financial resources and expertise in research and development, manufacturing, preclinical testing, conducting clinical trials, obtaining regulatory approvals and marketing approved medicines than we do. We compete with companies that have products on the market or in development for the same indications as our product candidates. Mergers and acquisitions in the pharmaceutical, biotechnology and diagnostic industries may result in even more resources being concentrated among a smaller number of our competitors. These competitors also compete with us in recruiting and retaining qualified scientific and management personnel and establishing clinical trial sites and patient registration for clinical trials. Smaller or early stageearly-stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large and established companies.

The key competitive factors affecting the success of all of our product candidates, if approved, are likely to be their efficacy, safety, convenience, price and the availability of reimbursement from government and other third-party payors. Our commercial opportunity could be reduced or eliminated if our competitors develop and commercialize medicines that are safer, more effective, have fewer or less severe side effects, are more convenient or are less expensive than any medicines that we may develop. Our competitors also may obtain FDA or other regulatory approval for their medicines more rapidly than we may obtain approval for ours, which could result in our competitors establishing a strong market position before we are able to enter the market.

Manufacturing

We do not own or operate, and currently have no plans to establish, any manufacturing facilities. We currently rely, and expect to continue to rely, on third parties for the manufacture of our product candidates for
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preclinical or clinical manufacturing, testing, as well as for commercial manufacture of any products that we may commercialize. We employPrior to 2021, we employed the services of Fujifilm Diosynth Biotechnologies UK LTD (“Fujifilm UK”) to supply the drug substance for exebacase. In the fourth quarter of 2020, we were notified by Fujifilm UK that they experienced equipment failures that would impact their manufacturing timelines. To mitigate this delay, Fujifilm UK has proposed the transition of the exebacase manufacturing process to Fujifilm Diosynth Biotechnologies USA Inc. (“Fujifilm USA”). We have successfully transferred the manufacturing process and expect to complete the process validation and initial commercial manufacturing of drug substance with Fujifilm USA in support of a potential BLA submission for exebacase. While steps have been and will continue to be taken to mitigate risks, we may still experience delays to the manufacturing timeline.
We do not yet have contracts to produce a commercial supply of the drug substance for exebacase; however, we intend to pursue agreements with Fujifilm UKUSA to do so. We employ the services of variousmultiple vendors to produce exebacase in its final vialed drug product form. We do not have contracts for the commercial supply of exebacase. We intend to pursue agreements with third party manufacturers regarding commercial supply of vialed drug product at an appropriate future time. We may choose to locate secondadditional fill finish third party manufacturers to supply other world regions such as the European Union (the “EU”)EU or Asia.

Sales, Marketing and Distribution

We do not currently have an organization for the sales, marketing and distribution of pharmaceutical products. We may rely on licensing and
co-promotion
agreements with strategic partners for the commercialization of our products in the United States and other territories. If we choose to build a commercial infrastructure to support marketing in the United States, such commercial infrastructure could be expected to include a targeted sales force supported by sales management, internal sales support, an internal marketing group and distribution support. To develop the appropriate commercial infrastructure internally, we would have to invest financial and management resources, some of which would have to be deployed prior to any confirmation that any of our other products will be approved.

Research

Government Regulation
The FDA and Development Expenses

other regulatory authorities at federal, state, and local levels, as well as in foreign countries, extensively regulate, among other things, the research, development, testing, manufacture, quality control, import, export, safety, effectiveness, labeling, packaging, storage, distribution, record keeping, approval, advertising, promotion, marketing, post-approval monitoring, and post-approval reporting of biologics such as those we are developing. We, have invested $22.4 million, $17.3 million,along with third-party contractors, will be required to navigate the various preclinical, clinical and $22.1 millioncommercial approval requirements of the governing regulatory agencies of the countries in researchwhich we wish to conduct studies or seek approval or licensure of our product candidates. The process of obtaining regulatory approvals and development expenses for the years ended December 31, 2018, 2017subsequent compliance with applicable federal, state, local and 2016, respectively.

Governmentforeign statutes and regulations require the expenditure of substantial time and financial resources.

U.S. Regulation

The production, distribution, of Drugs and marketing of products employing our research and intellectual property or that we may license from third parties are subject to extensive governmental regulation in the United States and in other countries. Biologics

In the United States, ourthe FDA regulates biological products will be regulated as biologics and subject tounder the Federal Food, Drug, and Cosmetic Act as amended (the “FDC Act”(“FDCA”), and the Public Health Service Act as amended (the “PHSA”(“PHSA”), and their implementing regulations, and biologics under the FDCA and the regulationsPublic Health Service Act (“PHSA”), and its implementing regulations. FDA approval is required before any new unapproved drug or dosage form, including a new use of a previously approved drug, can be marketed in the FDA, as well asUnited States. Drugs and biologics are also subject to other federal, state, and local statutes and regulations. These laws, and similar laws outside the United States, govern the research, development, clinical and preclinical testing, manufacture, safety, effectiveness, approval, labeling, distribution, sale, import, export, storage, record-keeping, reporting, advertising, and promotion and marketing of our products. Product development and approval within this regulatory framework, if successful, will require the expenditure of substantial resources and take years to achieve. Violations of regulatory requirements at any stage may result in various adverse consequences, including the FDA’s and other health authorities’ delay in approving or refusal to approve a product and may result in enforcement actions and administrative or judicial sanctions.

The following provides further information on certain legal and regulatory requirements that have the potential to affect our operations and the future marketing of our products.

FDA Approval Process

In the United States, pharmaceutical products are subject to extensive regulationprocess required by the FDA. The FDC Act and other federal and state statutes and regulations govern, among other things, the research, development, testing, manufacture, storage, recordkeeping, approval, labeling, promotion and marketing, distribution, post-

approval monitoring and reporting, sampling, and import and export of pharmaceutical products. In addition to regulation under the FDC Act, biological products used for the prevention, treatment, or cure of a disease or condition of a human being are subject to regulation under provisions of the PHSA, and FDA reviews applications for approval of a biologic pursuant to a BLA. FDA review applications for approval of drug products pursuant to a new drug application (“NDA”). Failure to comply with applicable U.S. requirementsbefore product candidates may subject a company to a variety of administrative or judicial sanctions, such as FDA refusal to approve pending NDAs or BLAs, warning or untitled letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, civil penalties, and criminal prosecution.

Pharmaceutical product development for a new product or certain changes to an approved productbe marketed in the United States typicallygenerally involves the following:

completion of extensive preclinical laboratory tests and preclinical animal tests, the studies, all performed in accordance with Good Laboratory Practices (“GLP”) regulations;
submission to the FDA of an IND, which must become effective before human clinical testingstudies may commence,begin and must be updated annually;
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approval by an independent institutional review board (“IRB”) or ethics committee representing each clinical site before each clinical study may be initiated;
performance of adequate and well-controlled human clinical trialsstudies in accordance with Good Clinical Practice (“GCP”), requirements to establish the safety and effectiveness ofefficacy, or with respect to biologics, the drug for each indication for which FDA approval is sought. Satisfaction of FDApre-market approval requirements typically takes many yearssafety, purity and the actual time required may vary substantially based upon the type, complexity, and noveltypotency of the product or disease.

Preclinical tests include laboratory evaluationcandidate for each proposed indication;

preparation of product chemistry, formulation, and toxicity, as well as animal trials to assess the characteristics and potential safety and efficacy of the product. The conduct of the preclinical tests must comply with federal regulations and requirements, including good laboratory practices. The results of preclinical testing are submittedsubmission to the FDA as partof a BLA after completion of all pivotal clinical studies;
a determination by the FDA within 60 days of its receipt of a BLA to file the application for review;
potential review of the product application by an FDA advisory committee, where appropriate and if applicable;
satisfactory completion of an FDA
pre-approval
inspection of the manufacturing facilities where the proposed product drug substance is produced to assess compliance with current Good Manufacturing Practices (“cGMP”), and audits of selected clinical trial sites to ensure compliance with GCP; and
FDA review and approval of an NDA or BLA prior to any commercial marketing or sale of a biological product in the United States.
An IND is a request for authorization from the FDA to administer an investigational new drug product to humans. The central focus of an IND along with other information, including information aboutsubmission is on the general investigational plan and the protocol or protocols for preclinical studies and clinical trials. The IND also includes results of animal and in vitro studies assessing the toxicology, pharmacokinetics, pharmacology and pharmacodynamic characteristics of the product, chemistry, manufacturing and controls (“CMC”) information, and aany available human data or literature to support the use of the investigational product. An IND must become effective before human clinical trials may begin. The IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA, within the
30-day
period, raises safety concerns or questions about the proposed clinical trial protocol. Long term preclinical tests,trial. In such as animal tests of reproductive toxicity and carcinogenicity, may continue aftera case, the IND is submitted.

A30-day waiting period aftermay be placed on clinical hold and the submission of each IND is required prior to the commencement of clinical testing in humans. Ifsponsor and the FDA has neither commented on nor questioned the IND within this30-day period,must resolve any outstanding concerns or questions before the clinical trial proposedcan begin. Submission of an IND therefore may or may not result in the IND may begin.

FDA authorization to begin a clinical trial.

Clinical trials involve the administration of the investigational new drug or biologicproduct to healthy volunteers or patientshuman subjects under the supervision of a qualified investigator.investigators in accordance with GCP, which includes the requirement that all research subjects provide their informed consent for their participation in any clinical study. Clinical trials must be conducted: (i) in compliance with federal regulations; (ii) in compliance with good clinical practice (“GCP”) regulations meant to protect the rights and health of healthy volunteers or patients and to define the roles of clinical trial sponsors, administrators, and monitors; as well as (iii)are conducted under protocols detailing, among other things, the objectives of the trial,study, the parameters to be used in monitoring safety and the effectiveness criteria to be evaluated. Each protocol involving testing on healthy volunteers or patients inA separate submission to the U.S.existing IND must be made for each successive clinical trial conducted during product development and for any subsequent protocol amendmentsamendments. While the IND is active, progress reports summarizing the results of the clinical trials and nonclinical studies performed since the last progress report, among other information, must be submitted at least annually to the FDA, and written IND safety reports must be submitted to the FDA as partand investigators for serious and unexpected suspected adverse events, findings from other studies suggesting a significant risk to humans exposed to the drug, findings from animal or in vitro testing suggesting a significant risk to humans exposed to the drug, and any clinically important increased rate of a serious suspected adverse reaction compared to that listed in the IND.

The FDAprotocol or investigator brochure.

Furthermore, an independent IRB for each site proposing to conduct the clinical trial must review and approve the plan for any clinical trial and its informed consent form before the clinical trial begins at that site, and must monitor the study until completed. Regulatory authorities, the IRB or the sponsor may order the temporary, or permanent, discontinuation ofsuspend a clinical trial at any time on various grounds, including a finding that the subjects are being exposed to an unacceptable health risk or impose other sanctions, if it believes that the trial is unlikely to meet its stated objectives. Some studies also include oversight by an independent group of qualified experts organized by the clinical study sponsor, known as a data safety monitoring board, which provides authorization for whether or not a study may move forward at designated check points based on access to certain data from the study and may halt the clinical trial eitherif it
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determines that there is not being conducted in accordance with FDA requirements or presents an unacceptable safety risk tofor subjects or other grounds, such as no demonstration of efficacy. There are also requirements governing the clinical trial patients. The study protocolreporting of ongoing preclinical studies and informed consent information for patients in clinical trials must also be submittedand clinical study results to an IRB for approval. An IRB may also require thepublic registries.
The clinical trial at the site to be halted, either temporarily or permanently, for failure to comply with the IRB’s requirements, or may impose other conditions.

Clinical trials to support NDAs or BLAs for marketing approval are typically conducted ininvestigation of a drug is generally divided into three sequential phases, butphases. Although the phases are usually conducted sequentially, they may overlap. In overlap or be combined.

Phase 1, the initial introduction of the drug or biologic1. The investigational product is initially introduced into healthy human subjects or patients with the target disease or condition. These studies are designed to test the safety, dosage tolerance, absorption, metabolism and distribution of the investigational product is tested to assess metabolism, pharmacokinetics, pharmacological actions,in humans, the side effects associated with increasing doses, and, if possible, to gain early evidence ofon effectiveness.
Phase 2 usually involves trials in2. The investigational product is administered to a limited patient population with a specified disease or condition to determineevaluate the effectiveness of the drug or biologic for a particular indication, dosage tolerance,preliminary efficacy, optimal dosages and optimum dosage,dosing schedule and to identify commonpossible adverse side effects and safety risks. If a compound demonstratesMultiple 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 effectiveness and an acceptable safety profile in Phase 2 evaluations, Phase 3 trials are undertaken to obtain the additional information about clinical efficacy and to further test for safety,

in a larger number of patients, typically generally at multiple geographically dispersed clinical trial sites,sites. These clinical trials are intended to permit the FDA to evaluateestablish the overall benefit-risk relationshiprisk/benefit ratio of the drug or biologicinvestigational product and to provide an adequate informationbasis for the labeling of the product. product approval.

In mostsome cases, the FDA may condition approval of a BLA for a product candidate on the sponsor’s agreement to conduct additional clinical studies after approval. In other cases, a sponsor may voluntarily conduct additional clinical studies after approval to gain more information about the drug. Such post-approval studies are typically requires two adequate and well-controlledreferred to as Phase 34 clinical studies. Concurrent with clinical trials, to demonstratecompanies may complete additional animal studies and develop additional information about the efficacybiological characteristics of the drug or biologic. A single Phase 3 trialproduct candidate, and must finalize a process for manufacturing the product in commercial quantities in accordance with other confirmatory evidence maycGMP requirements. The manufacturing process must be sufficient in some instances where the study is a large multicenter trial demonstrating internal consistency and a statistically very persuasive findingcapable of a clinically meaningful effect on mortality, irreversible morbidity or prevention of a disease with a potentially serious outcome and confirmationconsistently producing quality batches of the result in a second trial would be practicallyproduct candidate and, among other things, must develop methods for testing the identity, strength, quality and purity of the final product, or ethically impossible.

Afterfor biologics, the safety, purity and potency

BLA Review Process
Assuming successful completion of all required testing in accordance with all applicable regulatory requirements, the requiredresults of product development, nonclinical studies and clinical testing, an NDA or BLA is prepared andtrials are submitted to the FDA. FDA as part of a BLA requesting approval of the NDA or BLA is required before marketing ofto market the product may begin in the United States.for one or more indications. The NDA or BLA must include theall relevant data available from pertinent preclinical studies and clinical trials, including negative or ambiguous results of all preclinical, clinical, and other testing and a compilation of dataas well as positive findings, together with detailed information relating to the product’s pharmacology, chemistry, manufacture,CMC and controls. The costproposed labeling, among other things. Data can come from company-sponsored clinical studies intended to test the safety and effectiveness of preparingthe product, or from a number of alternative sources, including studies initiated and submitting an NDA or BLA is substantial.sponsored by investigators. The submission of most NDAs and BLAs is additionally subject toa BLA requires payment of a substantial application user fee. For fiscal year 2019,fee to the FDA, unless a waiver or exemption applies.
In addition, under the Pediatric Research Equity Act (“PREA”), a BLA or supplement to a BLA must contain data to assess the safety and effectiveness of the biological product candidate for the claimed indications in all relevant pediatric subpopulations and to support dosing and administration for each pediatric subpopulation for which the product is safe and effective. FDA requires that a sponsor who is planning to submit a marketing application for a drug or biological product that includes a new active ingredient, new indication, new dosage form, new dosing regimen or new route of administration submit an initial pediatric study plan within sixty days after an
end-of-Phase
2 meeting or as may be agreed between the sponsor and FDA. Unless otherwise required by regulation, PREA does not apply to any drug or biological product for an indication for which orphan designation has been granted.
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Within 60 days following submission of the application, user fee is $2,588,478. The manufacturer and/or sponsor under an approved NDA or BLA are also subject to annual program user fees, currently set at $309,915 per program. These fees are typically adjusted annually.

Thethe FDA has 60 days from its receipt of an NDA orreviews the submitted BLA to determine whetherif the application will be acceptedis substantially complete before the agency accepts it for filing based on the agency’s threshold determinationfiling. The FDA may refuse to file any BLA that it is sufficiently complete to permit substantive review.deems incomplete or not properly reviewable at the time of submission and may request additional information. In this event, the BLA must be resubmitted with the additional information. Once the submission isa BLA has been accepted for filing, the FDA begins anin-depth review. The FDA has agreed to certain performance goals in the review of NDAs and BLAs. The FDA aims to review applications for standard review drugs containing new molecular entities or original biologic products within ten months of the date the application was accepted for filing, and theFDA’s goal is to review standard applications within ten months after the filing date, or, if the application qualifies for priority review, drugs or biologics in six months ofafter the dateFDA accepts the application was accepted for filing. Priority review can be appliedThe FDA reviews a BLA to applications for drugs containing new molecular entitiesdetermine, among other things, whether a product is safe, pure and potent and the facility in which it is manufactured, processed, packed or biologics that are intendedheld meets standards designed to treat a serious disease or conditionassure the product’s continued safety, purity and that, if approved, would provide a significant improvement in safety or effectiveness. The review process forpotency. In both standard and priority reviews, the review process may also be extended by FDA requests for additional information or clarification. When reviewing a BLA, the FDA to consider certain late-submitted information, or information intended to clarify information already provided in the submission.

The FDA may also refer applications for novel drug or biologic products, or drug or biologic products that present difficult questions of safety or efficacy, toconvene an advisory committee—typically a panel that includes clinicians and other experts—forcommittee to provide clinical insight on application review evaluation, and a recommendation as to whether the application should be approved.questions. The FDA is not bound by the recommendationrecommendations of an advisory committee, but it generally followsconsiders such recommendations. recommendations carefully when making decisions.

Before approving a BLA, the FDA will typically inspect the facility or facilities where the product is manufactured. The FDA will not approve an NDA orapplication unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate to assure consistent production of the product within required specifications. Additionally, before approving a BLA, the FDA will typically inspect one or more clinical sites to assure compliance with GCP. Additionally, the FDA will inspect the facility or the facilities at which the drug is manufactured. The FDA will not approve the product unless compliance with current good manufacturing practices (“cGMPs”) is satisfactory and the BLA contains data that provide substantial evidence that the proposed biologic is safe, pure and potent for its intended use, and has an acceptable purity profile. In the case of an NDA, whether the drug is safe and effective for its intended use.

After the FDA evaluates the NDA or BLA and theconducts inspections of manufacturing facilities it issues eitherwhere the investigational product and/or its drug substance will be produced, the FDA may issue an approval letter or a complete response letter. A complete response letter generally outlines the deficiencies in the submission and may require substantial additional testing, or information, in order for the FDA to reconsider the application. If, or when, those deficiencies have been addressed to the FDA’s satisfaction in a resubmission of the NDA or BLA, the FDA will issue an approval letter. The FDA has committed to reviewing such resubmissions in two or six months depending on the type of information included.

Complete Response Letter (“CRL”). An approval letter authorizes commercial marketing of the drug or biologicproduct with specific prescribing information for specific indications. As a conditionA CRL will describe all of NDA orthe deficiencies that the FDA has identified in the BLA, except that where the FDA determines that the data supporting the application are inadequate to support approval, the FDA may issue the CRL without first conducting required inspections, testing submitted product lots and/or reviewing proposed labeling. In issuing the CRL, the FDA may recommend actions that the applicant might take to place the BLA in condition for approval, including requests for additional information or clarification. The FDA may delay or refuse approval of a BLA if applicable regulatory criteria are not satisfied, require additional testing or information and/or require post-marketing testing and surveillance to monitor safety or efficacy of a risk evaluationproduct.

If regulatory approval of a product is granted, such approval will be granted for particular indications and mitigation strategymay entail limitations on the indicated uses for which such product may be marketed. For example, the FDA may approve the BLA with a Risk Evaluation and Mitigation Strategy (“REMS”), to help ensure that the benefits of the drugproduct outweigh its risks. A REMS is a safety strategy to manage a known or biologic outweigh the potential risks. REMS canserious 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, for healthcare professionals, and

or elements to assure safe use, (“ETASU”). ETASU can include, but are not limitedsuch as restricted distribution methods, patient registries and other risk minimization tools. The FDA also may condition approval on, among other things, changes to special trainingproposed labeling or certification for prescribing or dispensing, dispensing only under certain circumstances, special monitoring,the development of adequate controls and specifications. Once approved, the use of patient registries. The requirement for a REMS can materially affectFDA may withdraw the potential market and profitability of the product. Moreover, product approval if compliance with

pre-
and post-marketing requirements is not maintained or if problems occur after the product reaches the marketplace. The FDA may require substantial post-approval testingone or more Phase 4 post-market studies and surveillance to further assess and monitor the product’s safety or efficacy. Once granted, product approvalsand effectiveness after commercialization, and may be withdrawn if compliance with regulatory standards is not maintained or problems are identified following initial marketing.

Changes to somelimit further marketing of the conditions established in an approved application, including changes in indications, labeling, or manufacturing processes or facilities, require submission and product based on the results of these post-marketing studies.

FDA approval of a new NDA or BLA or NDA or BLA supplement before the change can be implemented. An NDA or BLA supplement for a new indication typically requires clinical data similar to that in the original application, and the FDA uses the same procedures and actions in reviewing NDA or BLA supplements as it does in reviewing NDAs or BLAs.

Post-Approval Requirements

Once an NDA or BLA is approved, a product will be subject to certain post-approval requirements. For instance, the FDA closely regulates the post-approval marketing and promotion of drugs and biologics, including standards and regulations fordirect-to-consumer advertising,off-label promotion, industry-sponsored scientific and educational activities and promotional activities involving the internet. Drugs and biologics may be marketed only for the approved indications and in accordance with the provisions of the approved labeling.

Adverse event reporting and submission of periodic reports is required following FDA approval of an NDA or BLA. The FDA also may require post-marketing testing, known as Phase 4 testing, REMS, and surveillance to monitor the effects of an approved product, or the FDA may place conditions on an approval that could restrict the distribution or use of the product. In addition, quality control, drug manufacture, packaging, and labeling procedures must continue to conform to cGMPs after approval. Drug and biologic manufacturers and certain of their subcontractors are required to register their establishments with the FDA and certain state agencies. Registration with the FDA subjects entities to periodic unannounced inspections by the FDA, during which the agency inspects manufacturing facilities to assess compliance with cGMPs. Accordingly, manufacturers must continue to expend time, money, and effort in the areas of production and quality-control to maintain compliance with cGMPs. Regulatory authorities may withdraw product approvals or request product recalls if a company fails to comply with regulatory standards, if it encounters problems following initial marketing, or if previously unrecognized problems are subsequently discovered.

Fast Track Designation and Accelerated Approval

Expedited Review Programs

The FDA administers a number of programs to facilitate the development, and expedite the review, of drugs or biologics that are intended for the treatment of serious or life-threatening diseases or conditions. For instance, a sponsor may seekexample, the FDA’sfast track program is intended to expedite or facilitate the process for reviewing product candidates that meet certain criteria. Specifically, product candidates are eligible for fast track designation if they are intended to treat
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Table of its product candidate as a “fast track” product. Fast track products are those products intended for the treatment of Contents
a serious or life-threatening disease or condition and which demonstrate the potential to address unmet medical needs for suchthe disease or condition. Drugs that qualify as a qualified infectious diseaseFast track designation applies to the combination of the product or QIDP, undercandidate and the Generating Antibiotic Incentives Now, or GAIN Act, are also eligiblespecific indication for fast track designation. Biologics, such as lysins, are not currently eligible for QIDP designation.

Under the fast track program, thewhich it is being studied. The sponsor of a new drug or biologic candidate may request that the FDA designate the candidate for a specific indication as a fast track drug or biologic concurrent with, or after, the filing of the IND for the candidate. The FDA must determine if the drug or biologic candidate qualifies for fast track designation within 60 days of receipt of the sponsor’s request. If fast track designation is obtained, the FDA may initiate review of sections of the marketing application before the application is complete. This “rolling review” is available if the applicant provides and the FDA approves a schedule for the remaining information. However, the FDA’s time period goal for reviewing an application does not begin until the last section of the NDA or BLA is submitted. Additionally, the fast track designation may be withdrawn by the FDA if the FDA

believes that the designation is no longer supported by data emerging in the clinical trial process. In addition, a product candidate that receives fast track designation is eligiblehas opportunities for more frequent meetingsinteractions with the FDA to discussreview team during product development and, once a BLA is submitted, the product’s development plan and ensure collection of appropriate data needed to support approval and more frequent communications from FDA regarding such things as the design of the proposed clinical trials and use of biomarkers, as applicable. In August 2015, the FDA granted fast track designation to exebacase for the treatment ofStaph aureus bacteremia, including endocarditis.

In some cases, a product may be eligible for accelerated approval. Drug or biological productspriority review. A fast track product candidate may also be eligible for rolling review, where the FDA may consider for review sections of the BLA on a rolling basis before the complete application is submitted, if the sponsor provides a schedule for the submission of the sections of the BLA, the FDA agrees to accept sections of the BLA and determines that the schedule is acceptable, and the sponsor pays any required user fees upon submission of the first section of the BLA.

A product candidate 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. A product candidate can receive breakthrough therapy designation if preliminary clinical evidence indicates that the product, alone or in combination with one or more other drugs or biologics, may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. The designation includes all of the fast track program features, as well as more intensive FDA interaction and guidance beginning as early as Phase 1 and an organizational commitment to expedite the development and review of the product candidate, including involvement of senior managers.
Any marketing application for a drug or biologic submitted to the FDA for approval, including a product candidate with a fast track designation and/or breakthrough therapy designation, may be eligible for other types of FDA programs intended to expedite the FDA review and approval process, such as priority review and accelerated approval. A BLA is eligible for priority review if the product candidate has the potential to provide a significant improvement in the treatment, diagnosis or prevention of a serious disease or condition. For original BLAs, priority review designation means the FDA’s goal is to take action on the marketing application within six months of the
60-day
filing date (as compared to ten months under standard review).
Additionally, product candidates studied for their safety and effectiveness in treating serious or life-threatening diseases or conditions may be eligible forreceive accelerated approval upon a determination that the product candidate has an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit, or on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity, or prevalence of the condition and the availability or lack of alternative treatments. InAs a condition of accelerated approval, the FDA will generally require the sponsor to perform adequate and well-controlled post-marketing clinical trials, a surrogate endpoint is a measurement of laboratorystudies to verify and describe the anticipated effect on irreversible morbidity or mortality or other clinical signs of a disease or condition that substitutes for a direct measurement of how a patient feels, functions, or survives. Surrogate endpoints can oftenbenefit. Products receiving accelerated approval may be measured more easily or more rapidly than clinical endpoints.

A drug or biologic candidate approved on this basis is subject to rigorous post-marketing compliance requirements, includingexpedited withdrawal procedures if the completion of Phase 4 or post-approval clinical trials to confirm the effect on the clinical endpoint. Failuresponsor fails to conduct the required post-approvalpost-marketing studies or confirm aif such studies fail to verify the predicted clinical benefit during post-marketing studies, will allowbenefit. In addition, the FDA to withdraw the drug or biologic from the market on an expedited basis. Allcurrently requires as a condition for accelerated approval

pre-approval
of promotional materials, for drug candidates approved under accelerated regulations are subject to prior review bywhich could adversely impact the FDA. timing of the commercial launch of the product.
Fast track designation, breakthrough therapy designation, priority review, and accelerated approval do not change the standards for approval but may expedite the development or approval process.

Guidance Even if a product qualifies for Industry: “Antibacterial Therapiesone or more of these programs, the FDA may later decide that the product no longer meets the conditions for Patients With an Unmet Medical Needqualification or decide that the time period for FDA review or approval will not be shortened.

Post-Approval Requirements
Any products manufactured or distributed pursuant to FDA approvals are subject to pervasive and continuing regulation by the Treatment of Serious Bacterial Diseases” – Potential for Streamlined Development

The FDA, issued guidance for the industry in August 2017, whichincluding, among other things, discussesrequirements relating to record-keeping, reporting of adverse experiences, periodic reporting, product sampling and distribution, and advertising and promotion of the potential for antibacterial drug candidates intended to treat serious bacterial infections in patients who have few or no available therapies to be candidates for a streamlined development pathway. Accordingproduct. After approval, most changes to the guidance, candidatesapproved product, such as adding new indications or other labeling claims, are subject to prior FDA review and approval. There also are continuing user fee

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requirements, under which the FDA assesses an annual program fee for a streamlinedeach product identified in an approved BLA. Drug and biologic manufacturers and their subcontractors are required to register their establishments with the FDA and certain state agencies, and are subject to periodic unannounced inspections by the FDA and certain state agencies for compliance with cGMPs, which impose certain procedural and documentation requirements upon us and our third-party manufacturers. Changes to the manufacturing process would be likelyare strictly regulated, and, depending on the significance of the change, may require prior FDA approval before being implemented. FDA regulations also require investigation and correction of any deviations from cGMPs and impose reporting requirements upon us and any third-party manufacturers that we may decide to have (1) a new mechanism of action that preserves antibacterial activity against bacteria that have mechanisms of resistanceuse. Accordingly, manufacturers must continue to other available antibacterial drugs; (2) an added inhibitor that neutralizes a mechanism of resistance; (3) an alterationexpend time, money and effort in the structurearea of production and quality control to maintain compliance with cGMPs and other aspects of regulatory compliance.
The FDA may withdraw approval if compliance with regulatory requirements and standards is not maintained or if problems occur after the product reaches the market. Later discovery of previously unknown problems with 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-market studies or clinical studies to assess new safety risks; or imposition of distribution restrictions or other restrictions under a REMS program. Other potential consequences include, among other things:
restrictions on the marketing or manufacturing of the molecule that makes the drug candidate no longer susceptible to the mechanisms of resistance to existing drugs; or (4) some other characteristic that has a potential to lead to enhanced effectiveness.

Draft Guidance for Industry: “Limited Population Pathway for Antibacterial and Antifungal Drugs” (LPAD)

As partproduct, complete withdrawal of the 21st Century Cures Actproduct from the market or product recalls;

fines, warning letters, or untitled letters;
clinical holds on clinical studies;
refusal of 2016, LPADis intendedthe FDA to approve pending applications or supplements to approved applications, or suspension or revocation of product approvals;
product seizure or detention, or refusal to permit the approvalimport or export of new antibioticsproducts;
consent decrees, corporate integrity agreements, debarment or exclusion from federal healthcare programs;
mandated modification of promotional materials and labeling and the issuance of corrective information;
the issuance of safety alerts, Dear Healthcare Provider letters, press releases and other communications containing warnings or other safety information about the product; or
injunctions or the imposition of civil or criminal penalties.
The FDA closely regulates the marketing, labeling, advertising and promotion of biologics. A company can make only those claims relating to safety and efficacy, purity and potency that are approved by the FDA and in accordance with the provisions of the approved label. The FDA and other agencies actively enforce the laws and regulations prohibiting the promotion of
off-label
uses. Failure to comply with these requirements can result in, among other things, adverse publicity, warning letters, corrective advertising and potential civil and criminal penalties. Physicians may prescribe legally available products for uses that are not described in the product’s labeling and that differ from those tested by us and approved by the FDA. Such
off-label
uses are common across medical specialties. Physicians may believe that such
off-label
uses are the best treatment for many patients in varied circumstances. The FDA does not regulate the behavior of physicians in their choice of treatments. The FDA does, however, restrict manufacturer’s communications on the basissubject of relatively small
off-label
use of their products.
Biosimilars and Reference Product Exclusivity
The Biologics Price Competition and Innovation Act of 2009 (“BPCIA””), created an abbreviated approval pathway for biological products that are highly similar, or “biosimilar,” to or interchangeable with an
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FDA-approved reference
biological product. Biosimilarity, which requires that there be no clinically meaningful differences between the biological product and the reference product in terms of safety, purity, and potency, is generally shown through analytical studies, animal studies, and a clinical data setsstudying patients with rare, serious,study or life-threatening infectionsstudies. Interchangeability requires that a product is biosimilar to the reference product and the product must demonstrate that it can be expected to produce the same clinical results as the reference product in whomlarge-scale trials wouldany given patient and, for products that are administered multiple times to an individual, the biologic and the reference biologic may be infeasible. The FDA issued draft guidance foralternated or switched after one has been previously administered without increasing safety risks or risks of diminished efficacy relative to exclusive use of the industry regarding LPAD in June 2018 which defines the potential for antibacterial and antifungal drug candidatesreference biologic. A product shown to be approved under a limited population development pathway. According tobiosimilar or interchangeable with an
FDA-approved
reference biological product may rely in part on the draft guidance, candidates for this pathway are agents intended to treat a serious or life-threatening infection in a limited population with unmet needs, have substantial evidence of effectiveness for the drug’s intended use and sufficient information to conclude that the drug is safe for use under the conditions prescribed, recommended, or suggested in the proposed labeling which is expected to define the limited population for intended use. The FDA’s previous determination of safety and effectiveness must reflectfor the benefit-risk profilereference product for approval, which can potentially reduce the cost and time required to obtain approval to market the product.
Under the BPCIA, an application for a biosimilar product may not be submitted to the FDA until four years following the date that the reference product was first licensed by the FDA. In addition, the approval of a biosimilar product may not be made effective by the FDA until 12 years from the date on which the reference product was first licensed. During this
12-year
period of exclusivity, another company may still market a competing version of the antibiotic in the limited population and must take into account the severity, rarity, or prevalence of the infection the drug is intended to treat and the availability or lack of alternative treatments for that limited population.

Breakthrough Therapy Designation

The Food and Drug Administration Safety and Innovation Act established a category of drugs and biologics referred to as “breakthrough therapies” that may be eligible to receive breakthrough therapy designation. A sponsor may seek FDA designation of areference product candidate as a “breakthrough therapy” if the product is intended, alone or in combination with one or more other products, to treatFDA approves a serious or life-threatening disease or condition and preliminary clinical evidence indicates that the product may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. Under the breakthrough therapy program, the sponsor of a new drug candidate may request that the FDA designate the drug candidate for a specific indication as a breakthrough therapy concurrent with, or after, the filing of the INDfull BLA for the drug candidate.competing product containing that applicant’s own preclinical data and data from adequate and well-controlled clinical trials to demonstrate the safety, purity and potency of its product. The designation includes all of the fast track program features,BPCIA also created certain exclusivity periods for biosimilars approved as well as more intensive FDA interaction and guidance. The breakthrough therapy designationinterchangeable products. At this juncture, it is a distinct status from both accelerated approval and priority review, which can also be granted to the same drug if relevant criteria are met. If a product is designated as breakthrough therapy,unclear whether products deemed “interchangeable” by the FDA will, workin fact, be readily substituted by pharmacies, which are governed by state pharmacy law.

A biological product can also obtain pediatric market exclusivity in the United States. Pediatric exclusivity, if granted, adds six months to expediteexisting exclusivity periods and patent terms. This
six-month
exclusivity, which runs from the development and reviewend of other exclusivity protection or patent term, may be granted based on the voluntary completion of a pediatric study in accordance with an
FDA-issued
“Written Request” for such drug. The FDA may also rescind breakthrough therapy designation for a product candidate if the FDA determines the product candidate no longer meets the criteria for breakthrough therapy designation.

Pediatric Information

Under the Pediatric Research Equity Act (“PREA”), NDAs or BLAs or supplements to NDAs or BLAs must contain data to assess the safety and effectiveness of the drug for the claimed indications in all relevant pediatric subpopulations and to support dosing and administration for each pediatric subpopulation for which the drug is safe and effective. The FDA may grant full or partial waivers, or deferrals, for submission of data. Unless otherwise required by regulation, PREA does not apply to any drug for an indication for which orphan designation has been granted.

study.

Additional Controls for Biologics

To help reduce the increased risk of the introduction of adventitious agents, the PHSA emphasizes the importance of manufacturing controls for products whose attributes cannot be precisely defined. The PHSA also provides authority to the FDA to immediately suspend licenses in situations where there exists a danger to public health, to prepare or procure products in the event of shortages and critical public health needs, and to authorize the creation and enforcement of regulations to prevent the introduction or spread of communicable diseases in the United States and between states.

After a BLA is approved, the product may also be subject to official lot release as a condition of approval. As part of the manufacturing process, the manufacturer is required to perform certain tests on each lot of the product before it is released for distribution. If the product is subject to official release by the FDA, the manufacturer submits samples of each lot of product to the FDA together with a release protocol showing a summary of the history of manufacture of the lot and the results of all of the manufacturer’s tests performed on the lot. The FDA may also perform certain confirmatory tests on lots of some products, such as viral vaccines, before releasing the lots for distribution by the manufacturer. In addition, the FDA conducts laboratory research related to the regulatory standards on the safety, purity, potency, and effectiveness of biological products. As with drugs, after approval of biologics, manufacturers must address any safety issues that arise, are subject to recalls or a halt in manufacturing, and are subject to periodic inspection after approval.

Biosimilars

The Biologics Price Competition and Innovation Act of 2009 (“BPCIA”), created an abbreviated approval pathway for biological products shown to be highly similar to or interchangeable with anFDA-licensed reference biological product. Biosimilarity sufficient to reference a priorFDA-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 and the reference product in terms of safety, purity, and potency. Biosimilarity must be shown through analytical studies, animal studies, and at least one clinical study, absent a waiver by the Secretary. A biosimilar product 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 biologic 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. To date, few biosimilars have been licensed under the BPCIA, and no interchangeable products have been approved under the BPCIA to date. Complexities associated with the larger, and often more complex, structures of biological products, as well as the process by which such products are manufactured, pose significant hurdles to implementation which are still being evaluated by the FDA.

Under the BPCIA, an application for a biosimilar product may not be submitted to the FDA until four years following the date that the reference product was first licensed by the FDA. In addition, the approval of a biosimilar product may not be made effective by the FDA until 12 years from the date on which the reference product was first licensed. During this12-year period of exclusivity, another company may still market a competing version of the reference product if the FDA approves a full BLA for the competing product containing that company’s own preclinical and clinical data from adequate and well-controlled trials to demonstrate the safety, and efficacy of their product. The first biologic product submitted under the abbreviated approval pathway that is determined to be interchangeable with the reference product may also enjoy a period of exclusivity. At this juncture, it is unclear whether products deemed “interchangeable” by the FDA will, in fact, be readily substituted by pharmacies, which are governed by state pharmacy law.

Disclosure of Clinical Trial Information

Sponsors of clinical trials ofFDA-regulated products, including drugs, are required to register and disclose certain clinical trial information. Information related to the product, patient population, phase of investigation, study sites and investigators, and other aspects of the clinical trial is then made public as part of the registration. Sponsors are also obligated to discuss the results of their clinical trials after completion. Disclosure of the results of these trials can be delayed until the new product or new indication being studied has been approved. Competitors may use this publicly available information to gain knowledge regarding the progress of development programs.

Other DomesticU.S. Regulatory Requirements

In the United States, the research, manufacturing, distribution, sale, and promotion of drug and biological products are potentially subject to regulation by various federal, state, and local authorities in addition to the FDA, including the Centers for Medicare and Medicaid Services, other divisions of the United States Department
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of Health and Human Services (e.g., the Office of the Inspector General), the United States Department of Justice and individual United States Attorneys’ offices within the Department of Justice, and state and local governments. For example, sales, marketing, and scientific/educational grant programs must comply with the anti-fraud and abuse provisions of the Social Security Act and the False Claims Act, the privacy and security provisions of the Health Insurance Portability and Accountability Act, or “HIPAA”, as amended by the Health Information Technology and Clinical Health Act, or “HITECH”, and similar state laws, each as amended.Act. Pricing and rebate programs must comply with the Medicaid rebate requirements of the Omnibus Budget Reconciliation Act of 1990 and the Veterans Health Care Act of 1992, each as amended. If products are made available to authorized users of the Federal Supply Schedule of the General Services Administration, additional laws and requirements apply. All of these activities are also potentially subject to federal and state consumer protection, unfair competition, and other laws, and violations of these laws may result in imprisonment, criminal fines, civil monetary penalties and exclusion from participation in federal healthcare programs.

In addition to FDA restrictions on marketing of pharmaceutical products, several other types of state and federal laws have been applied to restrict certain marketing practices in the pharmaceutical industry in recent years. These laws include anti-kickback statutes and false claims statutes.

The federal healthcare program Anti-Kickback Statute prohibits, among other things, knowingly and willfully offering, paying, soliciting or receiving remuneration to induce or in return for purchasing, leasing, ordering or arranging for the purchase, lease or order of any healthcare item or service reimbursable under Medicare, Medicaid or other federally financed healthcare programs. This statute has been interpreted to apply to arrangements between pharmaceutical manufacturers on the one hand and prescribers, purchasers and formulary managers on the other. In addition, 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. Violations of the Anti-Kickback Statute are punishable by imprisonment, criminal fines, civil monetary penalties and exclusion from participation in federal healthcare programs. Although there are a number of statutory exemptions and regulatory safe harbors protecting certain common activities from prosecution or other regulatory sanctions, the exemptions and safe harbors are drawn narrowly, and practices that involve remuneration intended to induce prescribing, purchases or recommendations may be subject to scrutiny if they do not qualify for an exemption or safe harbor.

Federal false claims laws, including the False Claims Act, prohibit any person from knowingly presenting, or causing to be presented, a false claim for payment to the federal government, or knowingly making, or causing to be made, a false statement to have a false claim paid. Recently, several pharmaceutical and other healthcare companies have been prosecuted under these laws for allegedly inflating drug prices they report to pricing services, which in turn were used by the government to set Medicare and Medicaid reimbursement rates, and for allegedly providing free product to customers with the expectation that the customers would bill federal programs for the product. In addition, certain marketing practices, including
off-label
promotion, may also violate false claims laws. Moreover, the government may assert that a claim including items and services resulting from a violation of the U.S. federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the civil False Claims Act. The majority of states also have statutes or regulations similar to the federal anti-kickback law and false claims laws, which apply to items and services reimbursed under Medicaid and other state programs, or, in several states, apply regardless of the payor.

HIPAA also created new federal criminal statutes that prohibit among other actions, knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private third-party payors, knowingly and willfully embezzling or stealing from a healthcare benefit program, willfully obstructing a criminal investigation of a healthcare offense, and knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services. Similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation.

There has also been a recent trend of increased federal and state regulation of payments made to physicians and other healthcare providers. The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act or collectively,(collectively, the Affordable Care Act,“ACA”), among other things, imposes new reporting requirements on drug manufacturers for payments made by them to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors), certain
non-physician
practitioners (physician assistants, nurse practitioners, clinical nurse specialists, certified nurse anesthetists, anesthesiologist assistants and certified
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nurse midwives), and teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members. Failure to submit required information may result in significant civil monetary penalties of up to an aggregate of $165,786 per year (or up to an aggregate of $1,105,241 per yearand additional penalties for “knowing failures”), for all payments, transfers of value or ownership or investment interests that are not timely, accurately and completely reported in an annual submission. Drug manufacturers are required to submit reports to the government by the 90th day of each calendar year. Certain states also mandate implementation of compliance programs, impose restrictions on drug manufacturer marketing practices and/or require the tracking and reporting of gifts, compensation and other remuneration to physicians.

We

Violations of any of the laws described above or any other governmental regulations that apply to us may also be subject to data privacy and security regulation by both the federal government and the statesresult in which we conduct our business. HIPAA, HITECH, and their respective implementing regulations, impose specified requirements relating to the privacy, security and transmission of individually identifiable

health information. Among other things, HITECH makes HIPAA’s privacy and security standards directly applicable to “business associates,” defined as independent contractors or agents of covered entities that create, receive, maintain or transmit protected health information in connection with providing a service for or on behalf of a covered entity. HITECH also increased thesignificant administrative, civil and criminal penalties, that may be imposed against covered entities, business associatesdamages, fines, exclusion from participation in governmental health care programs, additional reporting obligations and possiblyoversight if we become subject to a corporate integrity agreement or other persons,agreement to resolve allegations of

non-compliance
with these laws, imprisonment, and gave state attorneys general new authority to file civil actions for damagesthe curtailment 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, state laws govern the privacy and securityrestructuring of health information in certain circumstances, many of which differ from each other in significant ways, thus complicating compliance efforts.

our operations.

Moreover, ContraFect is now, and in the future may become, subject to additional federal, state, and local laws, regulations, and policies relating to safe working conditions, laboratory practices, the experimental use of animals, and/or the use, storage, handling, transportation, and disposal of human tissue, waste, and hazardous substances, including radioactive and toxic materials and infectious disease agents used in conjunction with our research work.

Physician Drug Samples

As part of the sales and marketing process, pharmaceutical companies frequently provide samples of approved drugs to physicians. The Prescription Drug Marketing Act, or the PDMA, imposes requirements and limitations upon the provision of drug samples to physicians, as well as prohibits states from licensing distributors of prescription drugs unless the state licensing program meets certain federal guidelines that include minimum standards for storage, handling and record keeping. In addition, the PDMA sets forth civil and criminal penalties for violations.

New Legislation and Regulations

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 products regulated by the FDA. In addition to new legislation, FDA regulations and policies are often revised or interpreted by the agency in ways that may significantly affect our business and our products. It is impossible to predict whether further legislative changes will be enacted or whether FDA regulations, guidance, policies or interpretations changed or what the effect of such changes, if any, may be.

For example, in December 2016, the 21st Century Cures act, or Cures Act, was signed into law. The Cures Act, among other things, is intended to modernize the regulation of drugs and biologics and spur innovation, but its ultimate implementation remains unclear. Among other things, the Cures Act provides a new “limited population” approval pathway for antibacterial and antifungal drugs intended to treat serious or life-threatening infections.

Government Contracts and Regulation
We currently contract with the federal government. The BARDA Contract could result in payments to us of up to approximately $86.8 million and consists of a
one-year
base
period-of-performance
and a total contract
period-of-performance
(base period plus option exercises) of up to six years in support of the completion of the Phase 3 clinical trial of exebacase, further clinical and
non-clinical
studies, manufacturing, supply chain, clinical, regulatory and administrative activities. As a government contractor, we are subject to complex and wide-ranging
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federal and agency-specific regulations and contractual requirements that not only govern how we perform under the contract but also impose other requirements that affect our operations, including socio-economic obligations such as obligations related to affirmative action or maintaining a drug-free workplace. While some of our employees have been involved in government contracts previously, many of these government contracting requirements are new to us as a company. The costs of compliance with these requirements may be significant. Failure to comply with government contracting requirements could result in termination of our contract or the imposition of penalties.
Foreign Regulation

In addition to regulations in the United States, we may become subject to widely varying foreign regulations which may be quite different from those of the FDA, governing, among other things, clinical trials, manufacture, product registration and approval, and pharmaceutical sales. Whether or not FDA approval has been obtained, we must obtain a separate approval for a product by the comparable regulatory authorities of foreign countries prior to the commencement of clinical studies or marketing of the product marketing in these countries. The requirements and process governing the conduct of clinical studies, approval process, variesproduct licensing, pricing and reimbursement vary from country to country,country. Failure to comply with applicable foreign regulatory requirements, may be subject to, among other things, fines, suspension or withdrawal of regulatory approvals, product recalls, seizure of products, operating restrictions and criminal prosecution.
Non-clinical
studies and clinical trials
Similar to the United States, the various phases of
non-clinical
and clinical research in the European Union, or EU, are subject to significant regulatory controls.
Non-clinical
studies are performed to demonstrate the health or environmental safety of new chemical or biological substances.
Non-clinical
studies must be conducted in compliance with the principles of good laboratory practice, or GLP, as set forth in EU Directive 2004/10/EC. In particular,
non-clinical
studies, both in vitro and in vivo, must be planned, performed, monitored, recorded, reported and archived in accordance with the GLP principles, which define a set of rules and criteria for a quality system for the organizational process and the conditions for
non-clinical
studies. These GLP standards reflect the Organization for Economic
Co-operation
and Development requirements.
Clinical trials of medicinal products in the EU must be conducted in accordance with EU and national regulations and the International Conference on Harmonization (“ICH”) guidelines on GCP as well as the applicable regulatory requirements and the ethical principles that have their origin in the Declaration of Helsinki. If the sponsor of the clinical trial is not established within the EU, it must appoint an EU entity to act as its legal representative. The sponsor must take out a clinical trial insurance policy, and in most EU member states, the sponsor is liable to provide ‘no fault’ compensation to any study subject injured in the clinical trial.
The regulatory landscape related to clinical trials in the EU has been subject to recent changes. The EU Clinical Trials Regulation, or CTR, which was adopted in April 2014 and repeals the EU Clinical Trials Directive, became applicable on January 31, 2022. Unlike directives, the CTR is directly applicable in all EU member states without the need for member states to further implement it into national law. The CTR notably harmonizes the assessment and supervision processes for clinical trials throughout the EU via a Clinical Trials Information System, which contains a centralized EU portal and database.
While the Clinical Trials Directive required a separate clinical trial application, or CTA, to be submitted in each member state, to both the competent national health authority and an independent ethics committee, much like the FDA and IRB respectively, the CTR introduces a centralized process and only requires the submission of a single application to all member states concerned. The CTR allows sponsors to make a single submission to both the competent authority and an ethics committee in each member state, leading to a single decision per
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member state. The CTA must include, among other things, a copy of the trial protocol and an investigational medicinal product dossier containing information about the manufacture and quality of the medicinal product under investigation. The assessment procedure of the CTA has been harmonized as well, including a joint assessment by all member states concerned, and a separate assessment by each member state with respect to specific requirements related to its own territory, including ethics rules. Each member state’s decision is communicated to the sponsor via the centralized EU portal. Once the CTA is approved, clinical study development may proceed.
The CTR foresees a three-year transition period. The extent to which ongoing and new clinical trials will be governed by the CTR varies. For clinical trials whose CTA was made under the Clinical Trials Directive before January 31, 2022, the Clinical Trials Directive will continue to apply on a transitional basis for three years. Additionally, sponsors may still choose to submit a CTA under either the Clinical Trials Directive or the CTR until January 31, 2023 and, if authorized, those will be governed by the Clinical Trials Directive until January 31, 2025. By that date, all ongoing trials will become subject to the provisions of the CTR.
Medicines used in clinical trials must be manufactured in accordance with Good Manufacturing Practice, or GMP. Other national and
EU-wide
regulatory requirements may also apply.
Marketing Authorization
In order to market our future product candidates in the EU and many other foreign jurisdictions, we must obtain separate regulatory approvals. More concretely, in the EU, medicinal product candidates can only be commercialized after obtaining a marketing authorization, or MA. To obtain regulatory approval of an investigational medicinal product under EU regulatory systems, we must submit a marketing authorization application, or MAA. The process for doing this depends, among other things, on the nature of the medicinal product. There are two types of MAs:
“Centralized MAs” are issued by the European Commission through the centralized procedure based on the opinion of the Committee for Human Medicinal Products, or CHMP, of the European Medicines Agency, or EMA, and are valid throughout the EU. The centralized procedure is compulsory for certain types of product candidates such as: (i) medicinal products derived from biotechnology processes, such as genetic engineering, (ii) medicinal products containing a new active substance indicated for the treatment of certain diseases, such as HIV/AIDS, cancer, diabetes, neurodegenerative diseases, autoimmune and other immune dysfunctions and viral diseases, (iii) designated orphan medicines and (iv) advanced therapy medicinal products, or ATMPs, such as gene therapy, somatic cell therapy or tissue-engineered medicines. The centralized procedure may at the request of the applicant also be used in certain other cases and in particular for any other products containing new active substances not authorized in the EU or for product candidates which constitute a significant therapeutic, scientific, or technical innovation or for which the granting of authorization would be in the interests of public health in the EU.
“National MAs” are issued by the competent authorities of the EU member states, only cover their respective territory, and are available for products not falling within the mandatory scope of the centralized procedure. Where a product has already been authorized for marketing in an EU member state, this national MA can be recognized in another member state through the mutual recognition procedure. If the product has not received a national MA in any member state at the time of application, it can be approved simultaneously in various member states through the decentralized procedure. Under the decentralized procedure an identical dossier is submitted to the national competent authority of each of the member states in which the MA is sought, one of which is selected by the applicant as the reference member state.
Under the centralized procedure, the maximum timeframe for the evaluation of an MAA by the EMA is 210 days. In exceptional cases, the CHMP might perform an accelerated review of an MAA in no more than 150 days
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(not including clock stops). Innovative products that target an unmet medical need and are expected to be of major public health interest may be longer or shorter thaneligible for a number of expedited development and review programs, such as the PRIME scheme, which provides incentives similar to the breakthrough therapy designation in the U.S. PRIME is a voluntary scheme aimed at enhancing the EMA’s support for the development of medicines that requiredtarget unmet medical needs. It is based on increased interaction and early dialogue with companies developing promising medicines, to optimize their product development plans and speed up their evaluation to help them reach patients earlier. Many benefits accrue to sponsors of product candidates with PRIME designation, including but not limited to, early and proactive regulatory dialogue with the EMA, frequent discussions on clinical trial designs and other development program elements, and accelerated MAA assessment once a dossier has been submitted. Importantly, a dedicated contact and rapporteur from the CHMP is appointed early in the PRIME scheme facilitating increased understanding of the product at EMA’s committee level. An initial meeting initiates these relationships and includes a team of multidisciplinary experts at the EMA to provide guidance on the overall development and regulatory strategies.
MAs have an initial duration of five years. After these five years, the authorization may be renewed for FDA approval. In certain countries,an unlimited period on the basis of a reevaluation of the risk-benefit balance.
Data and Marketing Exclusivity
The EU also provides opportunities for market exclusivity. Upon receiving MA, reference products generally receive eight years of data exclusivity and an additional two years of market exclusivity. If granted, data exclusivity prevents regulatory authorities also establishin the EU from referencing the innovator’s data to assess a generic or biosimilar application. During the additional
two-year
period of market exclusivity, a generic or biosimilar MAA can be submitted, and the innovator’s data may be referenced, but no generic or biosimilar product can be marketed until the expiration of the market exclusivity. The overall
ten-year
market exclusivity period may be extended to a maximum of eleven years if, during the first eight years a new therapeutic indication with significant clinical benefit over existing therapies is approved. However, there is no guarantee that a product will be considered by the EU’s regulatory authorities to be a new chemical or biological entity, and products may not qualify for data exclusivity.
There is a special regime for biosimilars, or biological medicinal products that are similar to a reference medicinal product but that do not meet the definition of a generic medicinal product, for example, because of differences in raw materials or manufacturing processes. For such products, the results of appropriate preclinical or clinical trials must be provided, and guidelines from the EMA detail the type of quantity of supplementary data to be provided for different types of biological product. There are no such guidelines for complex biological products, such as gene or cell therapy medicinal products, and so it is unlikely that biosimilars of those products will currently be approved in the European Union. However, guidance from the EMA states that they will be considered in the future in light of the scientific knowledge and regulatory experience gained at the time.
Failure to comply with EU and member state laws that apply to the conduct of clinical trials, manufacturing approval, MA of medicinal products and marketing of such products, both before and after grant of the MA, manufacturing of pharmaceutical products, statutory health insurance, bribery and anti-corruption or with other applicable regulatory requirements may result in administrative, civil or criminal penalties. These penalties could include delays or refusal to authorize the conduct of clinical trials, or to grant MA, product withdrawals and recalls, product seizures, suspension, withdrawal or variation of the marketing authorization, total or partial suspension of production, distribution, manufacturing or clinical trials, operating restrictions, injunctions, suspension of licenses, fines and criminal penalties. The aforementioned EU rules are generally applicable in the European Economic Area, or EEA, which consists of the 27 EU member states plus Norway, Liechtenstein and Iceland.
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Brexit and the Regulatory Framework in the United Kingdom
The United Kingdom, or UK, left the EU on January 31, 2020, following which existing EU medicinal product legislation continued to apply in the UK during the transition period under the terms of the
EU-UK
Withdrawal Agreement. The transition period, which ended on December 31, 2020, maintained access to the EU single market and to the global trade deals negotiated by the EU on behalf of its members. The transition period provided time for the UK and EU to negotiate a framework for partnership for the future, which was then crystallized in the Trade and Cooperation Agreement, or TCA, and became effective on the January 1, 2021. The TCA includes specific provisions concerning pharmaceuticals, which include the mutual recognition of GMP inspections of manufacturing facilities for medicinal products and GMP documents issued, but does not foresee wholesale mutual recognition of UK and EU pharmaceutical regulations.
For other countries outside of Europe, such as countries in Latin America or Asia, the requirements governing the conduct of clinical trials, product licensing, pricing and reimbursement criteria.vary from country to country. In addition, under current United States law, thereall cases, again, the clinical studies are restrictions on the export of products not approved by the FDA, depending on the country involvedconducted in accordance with GCP and the statusapplicable regulatory requirements and the ethical principles that have their origin in the Declaration of the product in that country.

Helsinki.

European Medicines Agency (EMA) – Small and Medium Enterprise (SME)(“SME”) Designation

The SME designation was established by the EMA to promote innovation and the development of new medicinal products by smaller companies.companies established in the EEA. Companies with SME status are eligible to receive financial incentives as well as administrative and regulatory support through national and regional level programs. These benefits include access to dedicated EMA personnel during the clinical development process as well as reductions in fees associated with regulatory procedures such as Scientific Advice, Marketing Authorizations,scientific advice,
pre-
and post-authorization regulatory procedures, and inspections. Companies with SME status are also eligible for early application (prior to proof of concept) to the priority medicines (PRIME) scheme. PRIME provides enhanced supportcan apply for the PRIME scheme at an earlier stage of development of medicines that target an unmet medical need. In August 2016, the EMA granted SME designation to ContraFect. We continue to meet the requirementswhen they have compelling
non-clinical
data and tolerability data from initial clinical trials. They may also request a fee waiver for the designation and have maintained our SME status.

scientific advice.

Data Privacy and Security Laws

We are also subject

Numerous state, federal and foreign laws and regulations govern the collection, dissemination, use, access to, confidentiality and security of personal information, including health-related information. In the United States, numerous federal and state laws and regulations, including data breach notification laws, health information privacy and security laws, in jurisdictions outsideincluding the Health Insurance Portability and Accountability Act of 1996, as amended (“HIPAA”), and federal and state consumer protection laws and regulations (e.g., Section 5 of the U.S. For example, inFTC Act), that govern the collection, use, disclosure, and protection of health-related and other personal information could apply to our operations or the operations of our partners. In addition, certain state and
non-U.S.
laws, such as the California Consumer Privacy Act (“CCPA”), the California Privacy Rights Act (“CPRA”), the European Union General Data Protection Regulation (“E.U.”GDPR”) and the European Economic AreaUnited Kingdom GDPR (“E.E.A.”UK GDPR”) we are subject to Regulation (EU) 2016/679 (General Data Protection Regulation or GDPR) in relation to our collection, control, processing, sharing, disclosure, govern the privacy and other usesecurity of personal data (i.e. data relating to an identifiable living individual). The GDPR is directly applicable in each E.U. and E.E.A. Member State, however, it provides that E.U. and E.E.A. Member States may introduce further conditions,information, including limitations, which could limit our ability to collect, control, process, share, disclose and otherwise use personal data (including health and medical information), and/or could cause our compliance costs to increase, ultimately having an adverse impact on our business. The GDPR imposes a strict data protection compliance regime including: providing detailed disclosures about how personal data is collected and processed (in a concise, intelligible and easily accessible form); demonstrating that valid consent or another an appropriate legal basis is in place or otherwise exists to justify data processing activities; appointing data protection officershealth-related information in certain circumstances; granting new rights for data subjects in regard to their personal data (including the right to be “forgotten” and the right to data portability), as well as enhancing current rights (e.g., data subject access requests); introducing the obligation to notify data protection regulators or supervisory authorities (and in certain cases, affected individuals) of significant data breaches; imposing limitations on retention of personal data; maintaining a record of data processing; defining for the first time pseudonymized (i.e.,key-coded) data; and complying with principal of accountability and complying with the obligation to demonstrate compliance through policies, procedures, training and audit.

We are also subject to E.U. rules with respect to cross-border transfers of personal data out of the E.U. and E.E.A. These rules are under scrutiny from time to time. For example, there is ongoing litigation challenging the EU Commission approved model clauses (also called standard contractual clauses), which is a commonly used transfer mechanism under the GDPR. It is uncertain whether the model clauses will be invalidated by the European courts. In addition, Brexit will mean that atcircumstances, some point that the United Kingdom (“U.K.”) will become a “third party” for the purposes of data transfers under the GDPR.

We depend on a number of third parties in relation to the operation of our business (including clinical research organizations), a number of which process personal data on our behalf. There is no assurance that our own privacyare more stringent than HIPAA and security-related safeguards and/or any contractual measures that we enter intomany 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 providers will protect us from the risks associated with the third-party processing, storage and transmission of such information. Any violation of data or security laws, by our third party processors could have a material adverse effect on our business andwhere applicable, can result in the finesimposition of significant civil and/or criminal penalties and penalties outlined below.

Weprivate litigation. Privacy and security laws, regulations, and other obligations are subjectconstantly evolving, may conflict with each other to the supervision of local data protection authorities in those E.U.complicate compliance efforts, and E.E.A. jurisdictions where we are established or otherwise subject to the GDPR. Fines for certain breaches of the GDPR are significant: up to the greater of EUR 20 million or 4% of total global annual turnover. In addition to the foregoing, a breach of the GDPR couldcan result in regulatory investigations, reputational damage, ordersproceedings, or actions that lead to cease/ change our processing of oursignificant civil and/or criminal penalties and restrictions on data enforcement notices, assessment notices (for a compulsory audit), as well potential civil claims including class action type litigation where individuals suffer harm.

processing.

We are also subject to evolving E.U. privacy laws on cookies, ande-marketing. The E.U. is in the process of replacing thee-Privacy Directive with a new set of rules taking the form of a regulation. The drafte-Privacy Regulation imposes strictopt-in marketing rules with limited exceptions forbusiness-to-business communications, alters rules on third-party cookies, web beacons and similar technology and significantly increases fining powers to the same levels as the GDPR (i.e. the greater of 20 million Euros or 4% of total global annual revenue). While thee-Privacy Regulation was originally intended to be adopted on May 25 2018 (alongside the GDPR), it is still going through the European legislative process and commentators now expect it to be adopted during the second half of 2020 or during 2021 following a transition period. We are likely to be required to expend further capital and other resources to ensure compliance with these changing laws and regulations.

Pharmaceutical Coverage, Pricing and Reimbursement

Our ability to commercialize our product candidates successfully will depend in part on the extent to which the United States and foreign governmental authorities, private health insurers and other third-party payors establish appropriate coverage and reimbursement levels for our product candidates and related treatments. In
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many of the markets where we would commercialize a product following regulatory approval, the prices of pharmaceutical products are subject to direct price controls (by law) and to drug reimbursement programs with varying price control mechanisms. Public and private health care payors control costs and influence drug pricing through a variety of mechanisms, including through negotiating discounts with the manufacturers and through the use of tiered formularies and other mechanisms that provide preferential access to certain drugs over others within a therapeutic class. Payors also set other criteria to govern the uses of a drug that will be deemed medically appropriate and therefore reimbursed or otherwise covered. In particular, many public and private health care payors limit reimbursement and coverage to the uses of a drug that are either approved by the FDA or that are supported by other appropriate evidence (for example, published medical literature) and appear in a recognized drug compendium. Drug compendia are publications that summarize the available medical evidence for particular drug products and identify which uses of a drug are supported or not supported by the available evidence, whether or not such uses have been approved by the FDA.

Healthcare Reform

In the United States, there have been a number of legislative and regulatory changes to the healthcare system in ways that could affect our future revenues and profitability and the future revenues and profitability of our potential customers. For example, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the “MMA”) revised the payment methodologies for many drugs, which resulted in reduced reimbursement to providers. Additionally, the MMA created an outpatient prescription drug benefit which became effective on January 1, 2006. This benefit is administered by private pharmacy benefit managers and other managed care organizations and is putting increased pressure on the pharmaceutical industry to reduce prices.

In March 2010, the Affordable Care Act (“ACA”), was passed, which substantially changeschanged the way health care is financed by both governmental and private insurers, and significantly impactsimpacted the U.S. pharmaceutical industry. The Affordable Care Act,ACA, among other things, subjectssubjected biologic products to potential competition by lower-cost biosimilars, addressesaddressed a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, implanted or injected, increasesincreased the minimum Medicaid rebates owed by manufacturers under the Medicaid Drug Rebate Program and extendsextended the rebate program to individuals enrolled in Medicaid managed care organizations, establishesestablished annual fees and taxes on manufacturers of certain branded prescription drugs, and a new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer 50%70%

point-of-sale
discounts off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for the manufacturer’s outpatient drugs to be covered under Medicare Part D.

The current presidential administration and U.S. Congress have attempted to repeal or “repeal and replace” the Affordable Care Act. Although those efforts did not succeed, the presidential administration may continue to seek to modify, repeal, or otherwise invalidate all, or certain provisions of, the Affordable Care Act. There is still uncertainty with respect to the impact the President’s administration and the U.S. Congress may have, if any, on the Affordable Care Act, and any changes will likely take time to unfold. Additionally, since

Since its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the Affordable Care Act. For example, on December 14, 2018, aACA. On June 17, 2021, the U.S. DistrictSupreme Court Judge indismissed the Northern District of Texas, or Texas District Court Judge, ruled thatmost recent judicial challenge to the entire Affordable Care Act is invalid based primarilyACA brought by several states without specifically ruling on the factconstitutionality of the ACA. Prior to the Supreme Court’s decision, President Biden issued an executive order to initiate a special enrollment period for purposes of obtaining health insurance coverage through the ACA marketplace, which began on February 15, 2021 and remained open through August 15, 2021. The executive order also instructed certain governmental agencies to review and reconsider their existing policies and rules that limit access to healthcare, including among others, reexamining Medicaid demonstration projects and waiver programs that include work requirements, and policies that create unnecessary barriers to obtaining access to health insurance coverage through Medicaid or the Tax Cuts and Jobs Act of 2017 repealed thetax-based shared responsibility payment imposed by the Affordable Care Act, on certain individuals who fail to maintain qualifying health coverage for all or part of a year, which is commonly referred to as the “individual mandate”. While the Texas District Court Judge, as well as the current presidential administration and the Centers for Medicare and Medicaid Services, have stated that this ruling will have no immediate effect, itACA. It is unclear how this decision and subsequent appealsother healthcare reform measures of the Biden administration will impact the law and the effect such impact could have on coverage and reimbursement for healthcare items and services covered by plans that were authorized by the Affordable Care Act.

our business.

In addition, other legislative changes have been proposed and adopted in the United States since the Affordable Care Act was enacted. For example, the Budget Control Act of 2011 among other things, resulted in aggregate reductions of Medicare payments to providers of 2% per fiscal year, which went into effect in April 2013 and due to subsequent legislative amendments to the statute, will remain in effect through 20272030, with the exception of a temporary suspension from May 1, 2020 through March 31, 2022, unless additional Congressional action is taken. Further, on January 2, 2013, the American Taxpayer Relief Act of 2012 was signed into law, which, among other things, further reduced Medicare payments to several types of providers, including hospitals, imaging centers and cancer treatment centers, and increased the statute of limitations period for the government to recover overpayments to providers from three to five years. Recently there has also been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which has resulted in several Congressional inquiries and proposed and enacted legislation designed to, among other things,
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reform government program reimbursement methodologies. For example, the Cures Act changes the reimbursement methodology for infusion drugs and biologics furnished through durable medical equipment in an attempt to remedy over- and underpayment of certain drugs.

If additional state and federal healthcare reform measures are adopted in the future, any of which could limit the amounts that federal and state governments will pay for healthcare products and services, we could expect such measures to result in reduced demand for our product candidates or additional pricing pressures.

Segment Reporting

We are engaged solely in the discovery and development of therapeutic protein and antibody products for life-threatening, drug-resistant infectious diseases. Accordingly, we have determined that we operate in one operating segment.

Employees

Human Capital
As of March 7, 2019,17, 2022, we had 2038 full-time employees. We consider our staff relations to be good. Our company operates within an industry with a complex regulatory environment. The unique demands of our industry, together with the challenges of running a company focused on the discovery, development and manufacture of innovative therapeutics, require talent that is highly educated and/or has significant industry experience. Additionally, for certain key functions, we require specific scientific expertise to oversee and conduct these activities. To attract and retain a high-quality, experienced workforce, we offer a competitive mix of compensation and insurance benefits for our employees, as well as participation in our equity programs. Employees working 40 hours or more a week are eligible to participate in our medical, prescription, dental, vision, Flexible Spending Account and life insurance and disability plans. To assist employees with rising healthcare costs, we pay up to 100% of an employee’s costs to obtain the coverage and benefits of these plans. We also offer employees an annual bonus plan and a 401(k) retirement plan with a company match. All employees are awarded new hire equity option grants and are eligible to receive additional annual equity option grants. Accordingly, of our full-time employees, including 10 employees with advanced degrees. Of these full-time employees, 1128 employees are engaged in research and development activities.activities, and 21 employees have advanced degrees. None of our employees is represented by a labor union or covered by a collective bargaining agreement. We consider our relationship with our employees to be good.

Our Corporate Information

We were incorporated under the laws of the State of Delaware in March 2008. Our executive offices are located at 28 Wells Avenue, 3rd Floor, Yonkers, NY 10701, and our telephone number is
(914) 207-2300.
Our website address is www.contrafect.com. References to our website are inactive textual references only and the content of our website should not be deemed incorporated by reference into this Form
10-K.

Available Information

Our Annual Reports on Form
10-K,
Quarterly Reports on Form
10-Q,
Current Reports on Form
8-K
and any amendments to these reports filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended, are available free of charge on our website located at www.contrafect.com as soon as reasonably practicable after they are filed with or furnished to the Securities and Exchange Commission (the “SEC”). These reports are also available at the SEC’s Internet website at www.sec.gov.

A copy

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Table of our Corporate Governance Guidelines, Code of Business Conduct and Ethics, Whistleblower Policy and the charters of the Audit Committee, Compensation Committee and Nominating and Corporate Governance Committee are posted on our website, www.contrafect.com, under “Corporate Governance” and are available in print to any person who requests copies by contacting us by calling(914) 207-2300 or by writing to ContraFect Corporation, Attn: General Counsel, 28 Wells Avenue, 3rd Floor, Yonkers, NY 10701.

Contents

Item 1A.

Risk Factors

You should carefully consider the following risk factors, as well as the other information in this report, and in our other public filings. Our business, financial condition and operating results can be affected by a number of important factors, whether currently known or unknown, including but not limited to those described below, any one or more of which could, directly or indirectly, cause the Company’s actual results of operations and financial condition to vary materially from past, or from anticipated future, results of operations and financial condition. Any of these factors, in whole or in part, could materially and adversely affect the Company’s business, financial condition, results of operations and common stock price. Other factors may exist that we do not consider significant based on information that is currently available. In addition, new risks may emerge at any time, and we cannot predict those risks or estimate the extent to which they may affect us. Past financial performance should not be considered to be a reliable indicator of future performance, and investors should not use historical trends to anticipate results or trends in future periods.

Risks Related to Our Financial Position and Need for Additional Capital

We have incurred significant losses since our inception and do not expect to generate revenue for at least the next several years.inception. We expect to incur losses for at least the next several years and may never achieve or maintain profitability.

We are a clinical-stage biopharmaceutical company with no approved products, and we have not generated any revenue from product sales to date. To date, we have focused exclusively on developing our product candidates and have funded our operations primarily through the sale of common stock and warrants, convertible preferred stock and issuances of convertible debt to our investors.investors, and to a lesser extent, grant funding. We have not yet demonstrated an ability to overcome many of the risks and uncertainties frequently encountered by companies in the pharmaceutical industry, and you should analyze our company in light of such risks and uncertainties.

Since inception, we have incurred significant operating losses. Our net losses were $37.7 million, $15.5 million and $28.5 millionfrom operations for the years ended December 31, 2018, 20172021, 2020 and 2016,2019 were $47.3 million, $34.2 million and $27.9 million, respectively. We have devoted substantially all of our efforts to research and development. We expect to continue to incur significant expenses and increasing operating losses for at least the next several years. The net losses we incur may fluctuate significantly from quarter to quarter and year to year.

We anticipate that our expenses will increase substantially as clinical trials for any of our product candidates commence or progress. Our expenses will increase if and as we:

seek to discover or develop additional product candidates;

seek marketing approvals for any of our product candidates that successfully complete clinical trials;

in-license
or acquire other products and technologies;

maintain, expand and protect our intellectual property portfolio;

hire additional clinical, quality control and scientific personnel; and

add operational, financial and management information systems and personnel, including personnel to support our product development and planned future commercialization efforts.

Our recurring losses from operations raise substantial doubt regarding our ability to continue as a going concern.

We currently operate with limited resources. We have incurred significant losses since our inception and have never generated revenue or profit, and it is possible we will never generate revenue or profit. Based on our current operating plans, and without additional funding, we believe we will not have sufficient funds to meet our

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obligations within the next twelve months from the issuance of our audited consolidated financial statements that are included elsewhere in this Annual Report on Form
10-K.
These factors raise substantial doubt about our ability to continue as a going concern. We have relied on our ability to fund our operations primarily through public and private debt and equity financings, and, to a lesser extent, funding received from government contracts and granting organizations, but there can be no assurances that such financing or funding will continue to be available to us on satisfactory terms, or at all.

Securing additional financing may divert our management from our
day-to-day
activities, which may adversely affect our ability to develop and commercialize exebacase or any of our other product candidates. In addition, we cannot guarantee that future financing will be available in sufficient amounts or on terms acceptable to us, if at all. If we are unable to obtain funding, we would be forced to delay, reduce or eliminate our research and development programs, which would adversely affect our business prospects. In addition, if we are unable to raise capital, we will also need to implement cost reductions, and any failure to effectively do so will harm our business, results of operations and future prospects.

Substantial doubt about our ability to continue as a going concern may materially and adversely affect the price per share of our common stock, and it may be more difficult for us to obtain financing. If potential collaborators decline to do business with us or potential investors decline to participate in any future financings due to such concerns, our ability to increase our cash position may be limited. The perception that we may not be able to continue as a going concern may cause others to choose not to deal with us due to concerns about our ability to meet our contractual obligations.
We have prepared our consolidated financial statements on a going concern basis, which contemplates the realization of assets and the satisfaction of liabilities and commitments in the normal course of business. Our audited consolidated financial statements included in this Annual Report on Form 10-K do not include any adjustments to reflect the possible inability of the Company to continue as a going concern within one year after the issuance of such financial statements. If we are unable to continue as a going concern, you could lose all or part of your investment in our Company.

We currently have no source of product revenue and have not yet generated any revenues from product sales.

To date, we have not completed the development of any products and have not generated any revenues from product sales. Our ability to generate revenue from product sales and achieve profitability will depend upon our ability to successfully commercialize products, including any of our current product candidates, or other product candidates that we may
in-license
or acquire in the future. Even if we are able to successfully achieve regulatory approval for these product candidates, we may never generate revenues that are significant enough to achieve profitability. Our ability to generate revenue from product sales from our current or future product candidates also depends on a number of additional factors, including our ability to:

successfully complete development activities, including the necessary clinical trials;

complete and submit biologics license applications (“BLAs”)BLAs to the FDA, and obtain regulatory approval for indications for which there is a commercial market;

complete and submit applications to, and obtain approval from, foreign regulatory authorities;

set a commercially viable price for our products;

develop a commercial organization capable of sales, marketing and distribution for any products we intend to sell ourselves in the markets which we choose to commercialize on our own;

find suitable distribution partners to help us market, sell and distribute our products in other markets; and

obtain coverage and adequate reimbursement from third parties, including government and private payors.

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In addition, because of the numerous risks and uncertainties associated with product development, including that any of our product candidates may not advance through development or achieve the desired endpoints of applicable clinical trials, we are unable to predict the timing or amount of increased expenses, or when or if we will be able to achieve or maintain profitability. Even if we are able to complete the development and regulatory process for any product candidates, we anticipate incurring significant costs associated with commercializing these products.

Even if we are able to generate revenues from the sale of our products, we may not become profitable. 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 to 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 have a need for substantial additional funding. If we are unable to raise capital when needed, we could be forced to delay, reduce or eliminate our product development programs or commercialization efforts.

We expect our expenses to increase in connection with our ongoing activities, particularly as we continue the clinical development of exebacase and possibly acquire and develop new product candidates or technologies. Accordingly, we will need to obtain substantial additional funding in connection with our continuing operations. If we are unable to raise capital when needed or on attractive terms, we could be forced to delay, reduce or eliminate our research and development programs or any future commercialization efforts.

For example, the trading prices for our and other biopharmaceutical companies’ stock have been highly volatile as a result of the

COVID-19
pandemic and the current conflict between Russia and Ukraine. As a result, we may face difficulties raising capital through sales of our common stock and any such sales may be on unfavorable terms.
Our future capital requirements will depend on many factors, including:

the complexity, timing and results of our clinical trials of our product candidates;

the costs, timing and outcome of regulatory review of our product candidates;

the costs of developing our product candidates for additional indications;

the timing and amount of actual reimbursements under the BARDA Contract;
the continuation of funding under our
CARB-X
and USAMRDC grants;
our ability to establish scientific or business collaborations on favorable terms, if at all;

the costs of preparing, filing and prosecuting patent or other intellectual property applications, maintaining and protecting our intellectual property rights and defending against intellectual property-related claims;

the extent to which we
in-license
or acquire other product candidates or technologies; and

the scope, progress, results and costs of product development for our product candidates.

candidates;

the effects of the
COVID-19
pandemic on, among other things, our financial performance, business and operations.
Conducting clinical trials is a time-consuming, expensive and uncertain process that takes years to complete, and we may never generate the necessary data or results to obtain marketing approval and achieve product sales. In addition, if approved, exebacase or any other product candidate that we develop may not achieve commercial success. Accordingly, we may need to continue to rely on additional financing to achieve our business objectives.objectives and to continue as a going concern. In addition, we may seek additional capital due to favorable market conditions or strategic considerations, even if we believe that we have sufficient funds for our current or future operating plans. Adequate additional financing may not be available to us on acceptable terms, or at all.

39

Raising additional capital may cause dilution to our stockholders, restrict our operations or require us to relinquish rights to our technologies or product candidates.

Until such time, if ever, as we can generate substantial product revenues, we may finance our cash needs through a combination of equity offerings, debt financings, grants, collaborations, strategic alliances and marketing, distribution or licensing arrangements. We do not have any committed external source of funds. To the extent that we raise additional capital through the sale of equity or convertible debt securities, your ownership interest will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect your rights as a stockholder. Debt financing, if available, may involve agreements that include covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends.

If we raise additional funds through collaborations, strategic alliances or marketing, distribution or licensing arrangements with third parties, we may have to relinquish valuable rights to our technologies, future revenue streams or product candidates or grant licenses on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed, we may be required to delay, limit, reduce or terminate our product development or future commercialization efforts or grant rights to develop and market product candidates that we would otherwise prefer to develop and market ourselves.

Our short operating history may make it difficult for you to evaluate the success of our business to date and to assess our future viability.

We were incorporated in 2008 and commenced active research operations in 2010. Our operations to date have been limited to organizing and staffing our company, business planning, raising capital and acquiring and developing exebacase and other potential product candidates. We have not yet demonstrated our ability to successfully complete Phase 2 or Phase 3 clinical trials, obtain marketing approval, manufacture a commercial scale product, or arrange for a third-party to do so on our behalf, or conduct sales and marketing activities necessary for successful product commercialization. Consequently, any predictions you make about our future success or viability may not be as accurate as they could be if we had a longer operating history.

In addition, we may encounter unforeseen expenses, difficulties, complications, delays and other known and unknown factors. We will need to transition from a company with a product development focus to a company capable of supporting commercial activities. We may not be successful in such a transition.

The timing of the milestone and royalty payments we are required to make under certain agreements to Rockefeller is uncertain and could adversely affect our cash flows and results of operations.

We are party to certain agreements with Rockefeller pursuant to which we have acquired licenses to certain patents and patent applications and other intellectual property related to a series of compounds, including exebacase to develop and commercialize therapeutics. Under our agreements with Rockefeller, we have obligations to achieve diligence minimums and to make payments upon achievement of specified development and regulatory milestones. We will also make additional payments upon the achievement of future sales milestones and for royalties on future net sales.

The timing of milestone payments under our licenses and sponsored research agreements is subject to factors relating to the clinical and regulatory development and commercialization of products, many of which are beyond our control. We may become obligated to make a milestone payment when we do not have the cash on hand to make such payment, which could require us to delay our clinical trials, curtail our operations, scale back our commercialization and marketing efforts or seek funds to meet these obligations on terms unfavorable to us.

If BARDA were to eliminate, reduce, or delay funding for our BARDA Contract, we would experience a negative impact on our programs associated with such funding.
On March 10, 2021, we executed a cost-share contract from BARDA, part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services. Under the terms of the BARDA Contract, the Company will receive $9.8 million in initial funding during the base period. Following successful completion of the base period, the BARDA Contract provides for approximately $77.0 million of additional BARDA funding for five option stages in support of the completion of the Phase 3 clinical trial of exebacase, further clinical and
non-clinical
studies, manufacturing, supply chain, clinical, regulatory and administrative activities. The BARDA Contract contains terms and conditions that are customary for contracts with BARDA of this nature, including provisions giving the government the right to terminate the contract at any time for its convenience. If BARDA were to eliminate, reduce, or delay funding under the BARDA Contract or prohibit reimbursement of some of our incurred costs, we would have to seek additional funding to complete our ongoing Phase 3 DISRUPT superiority trial of exebacase or advance exebacase through FDA product approval and completion of post-approval commitments.
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The BARDA Contract includes special requirements, which subject us to the risk of a reduction or loss of funding.
Our BARDA Contract subjects us to various U.S. government contract requirements, including general clauses for a cost-reimbursement research and development contract, which may limit our reimbursement. In addition, if we are found to be in violation of the BARDA Contract, it could result in termination. If BARDA terminates the BARDA Contract with us for its convenience, or if we default by failing to perform in accordance with the contract schedule and terms, a significant negative impact on our cash flows and operations could result.
U.S. government contracts, such as our BARDA Contract, generally contain unfavorable termination provisions, which may subject us to additional risks as compared to our competitors that have not entered into such contracts. These risks include the ability of the U.S. government to unilaterally:
terminate or reduce the scope of our contract with or without cause;
interpret relevant regulations (federal acquisition regulation clauses);
require performance under circumstances that may not be favorable to us;
require an
in-process
review where the U.S. government will review the project and its options under the contract;
control the timing and amount of funding, which impacts the development progress of exebacase; and
audit and object to our contract-related costs and fees, including allocated indirect costs.
Our ability to utilize our net operating loss carryforwards and certain other tax attributes may be limited.

Under Section 382 and related provisions of the Internal Revenue Code of 1986, as amended (the “Code”), if a corporation undergoes an “ownership change” (generally defined as a greater than 50% change (by value) in its equity ownership over a three year period), the corporation’s ability to use its
pre-change
net operating loss carryforwards and other
pre-change
tax attributes to offset its post-change income may be limited. As a result of our past transactions, we may have experienced an “ownership change.” At this time, we have not completed a study to assess whether an ownership change under Section 382 of the Code has occurred, or whether there have been multiple ownership changes since our formation, due to the costs and complexities associated with such a study. We may also experience ownership changes in the future as a result of subsequent shifts in our stock ownership. Thus, our ability to utilize carryforwards of our net operating losses and other tax attributes to reduce future tax liabilities may be substantially restricted. Further, U.S. tax laws limit the time during which these carryforwards may be applied against future taxes. Therefore, we may not be able to take full advantage of these carryforwards for federal or state tax purposes. As of December 31, 2018,2021, we had federal and state net operating loss carryforwards of approximately $175.4$275.5 million and $189.0$293.9 million, respectively, and federal research and development credits of approximately $2.5$5.0 million, the use of which could be limited or eliminated by virtue of one or more “ownership changes.”

Risks Related to the Discovery, Development and Commercialization of Our Product Candidates

The
COVID-19
pandemic or other pandemics, epidemics or outbreaks of an infectious disease may materially and adversely impact our business, including our preclinical studies and clinical trials.
The measures taken in response to the ongoing
COVID-19
pandemic have had a significant impact on the economy and, to a lesser extent, both directly and indirectly, on our business. We adjusted our business operations, with a majority of our employees working remotely. Our Phase 3 DISRUPT clinical trial was also affected, as clinical sites experienced periodic delays in new patient enrollment.
The
COVID-19
pandemic worsened across the country earlier this year as new variants circulate and the number of
COVID-19
infections and hospitalizations increased rapidly. We are continuing to see effects of the pandemic on our trial with our patient enrollment rate slowed during certain months. Efforts we take to mitigate
41

slowed enrollment may not be effective and the progress of our study may continue to be adversely affected. If patient enrollment continues to be delayed during future months, our related corporate milestones, such as our planned interim futility analysis of the Phase 3 DISRUPT clinical trial, could be further delayed.
As a result of the
COVID-19
pandemic, the spread of variants of the virus or another pandemic, epidemic or outbreak of an infectious disease, we may experience disruptions that could severely impact our business, preclinical studies and clinical trials, including:
delays or difficulties in enrolling patients in our clinical trials;
delays or difficulties in clinical site initiation, including difficulties in recruiting clinical site investigators and staff;
increased rates of patients withdrawing from our clinical trials following enrollment as a result of contracting
COVID-19
or other health conditions or being forced to quarantine;
interruption of key clinical trial activities, such as clinical trial site data monitoring and efficacy and safety data collection, processing and analyses, due to limitations on travel imposed or recommended by federal, state or local governments, employers and others or interruption of clinical trial subject visits, which may impact the collection and integrity of subject data and clinical study endpoints;
interruption of, or delays in receiving, supplies of our products and product candidates from our contract manufacturing organizations due to staffing shortages, production slowdowns or stoppages and disruptions in supply or delivery systems;
delays in receiving authorization from local regulatory authorities to initiate our planned clinical trials;
changes in regulations as part of a response to the
COVID-19
pandemic which may require us to change the ways in which our clinical trials are conducted, which may result in unexpected costs, or to discontinue the clinical trials altogether;
delays in necessary interactions with regulators, ethics committees and other important agencies and contractors due to limitations in employee resources or forced furlough of government or contractor personnel;
diversion of healthcare resources away from the conduct of clinical trials, including the diversion of hospitals serving as our clinical trial sites and hospital staff supporting the conduct of our clinical trials;
delays in preclinical studies due to restricted or limited operations resulting from restrictions on our
on-site
activities;
interruption or delays of our sourced discovery and clinical activities; and
the ability of our contract research organizations (“CROs”), contract manufacturing organizations and suppliers to meet their contractual obligations in connection with the conduct of our clinical trial for our current product candidate and for any future product candidate.
The extent to which the pandemic further impacts our business, results of operations and financial condition, including expenses, research and development costs, procurement of raw materials for our supply chain, and clinical trial progress, will depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as the duration of the pandemic and future waves of infection, including the spread of variants of the virus, the availability, adoption and effectiveness of vaccines and treatments, travel restrictions and social distancing in the United States and other countries, business closures or business disruptions and the effectiveness of actions taken in the United States and other countries to contain and treat the disease. If we or any of the third parties with whom we engage were to experience shutdowns or other business disruptions, our ability to conduct our business in the manner and on the timelines presently planned could be materially and negatively impacted. Additionally, concerns over the economic impact of
COVID-19
pandemic have caused extreme volatility in financial and other capital markets which has and may continue to adversely impact our stock price and our ability to access capital markets.
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We are heavily dependent on the success of our leading product candidate, exebacase. The approval process of the FDA and comparable foreign regulatory authorities is lengthy, time consuming and inherently unpredictable, and if we are ultimately unable to obtain regulatory approval for exebacase or any other product candidate our business will be substantially harmed.

Our near-term business prospects are substantially dependent on our ability to develop and commercialize exebacase. We cannot market or sell exebacase or any other product candidate in the United States without FDA approval, but this approval, if ever issued, is at least several yearsmore than a year away. To commercialize exebacase or any other product candidate outside of the United States, we will need applicable foreign regulatory approvals. The clinical development of exebacase or any other product candidate is susceptible to the inherent risks of any drug development program, including a failure to achieve efficacy across a broad population of patients, the potential occurrence of severe adverse events and the risks that the FDA or any applicable foreign regulatory authority will determine that a drug product is not approvable.

The process required to obtain approval for commercialization from the FDA and similar foreign authorities is unpredictable, and typically takes many years even after the commencement of clinical trials, depending on numerous factors. In addition, approval policies, regulations, or the type and amount of clinical data necessary to obtain regulatory approval may change during the course of a product’s clinical development. development may vary among jurisdictions. We have not obtained regulatory approval for any product candidate and it is possible that any product candidates we may seek to develop in the future will never obtain regulatory approval. Neither we nor any future collaborator is permitted to market any of our product candidates in the United States until we receive regulatory approval of a BLA from the FDA or outside the United States, until we receive similar approval from foreign regulatory authorities.
Prior to obtaining approval to commercialize a product candidate in the United States or abroad, we or our collaborators must demonstrate with substantial evidence from well-controlled clinical trials, and to the satisfaction of the FDA or foreign regulatory agencies, that such product candidates are safe and effective, or in the case of biologics, safe, pure, and potent, for their intended uses. Results from nonclinical studies and clinical trials can be interpreted in different ways. Even if we believe the nonclinical or clinical data for our product candidates are promising, such data may not be sufficient to support approval by the FDA and other regulatory authorities. The FDA or other regulatory authorities also require us to conduct additional preclinical studies or clinical trials for our product candidates either prior to or post-approval, or it may object to elements of our clinical development program.
We may fail to obtain regulatory approval for exebacase or any other product candidate for many reasons, including the following:

we may not be able to demonstrate to the satisfaction of the FDA or comparable foreign regulatory authorities that exebacase or any other product candidate is safe and effective for any indication;

the results of clinical trials may not meet the level of clinical or statistical significance required for approval by the FDA or comparable foreign regulatory authorities;

the FDA or comparable foreign regulatory authorities may disagree with the design or implementation of our clinical trials;

we may not be able to demonstrate that exebacase or any other product candidate’s clinical and other benefits outweigh its safety risks;

the approval policies or regulations of the FDA or comparable foreign regulatory authorities may significantly change in a manner rendering our clinical data insufficient for approval;

the FDA or comparable foreign regulatory authorities may disagree with our interpretation of data from preclinical studies or clinical trials;

the FDA or comparable foreign regulatory authorities may identify deficiencies in data generated at our clinical trial sites;

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the FDA or comparable foreign regulatory authorities may identify deficiencies in the clinical practices of the third-party contract research organizations (“CROs”)CROs we use for clinical trials; and

the FDA or comparable foreign regulatory authorities may identify deficiencies in the manufacturing processes or facilities of third-party manufacturers with which we or our collaborators enter into agreements for clinical and commercial supplies.

This lengthy approval process as well as the unpredictability of future clinical trial results may prevent us from obtaining regulatory approval to market exebacase or any other product candidate, which would significantly harm our business.

In addition, disruptions caused by the
COVID-19

pandemic may increase the likelihood that we encounter such difficulties or delays in obtaining regulatory review and approval. Of the large number of drugs in development, only a small percentage successfully complete the FDA or foreign regulatory approval processes and are commercialized. The lengthy approval process as well as the unpredictability of future clinical trial results may result in our failing to obtain regulatory approval to market our product candidates, which would significantly harm our business, results of operations and prospects.

If clinical trials of exebacase or any other product candidate that we develop fail to demonstrate safety and efficacy, or the manufacturing for the commercial supply of exebacase drug substance or drug product fails to demonstrate robustness, stability, purity and potency to the satisfaction of the FDA or similar regulatory authorities outside the United States or do not otherwise produce positive results, we may incur additional costs or experience delays in completing, or ultimately be unable to complete, the development and commercialization of exebacase or any other product candidate.

Before obtaining marketing approval from regulatory authorities for the sale of exebacase or any other product candidate, we must complete preclinical development, perform extensive process validation and complete the manufacturing of our initial commercial supply of product to demonstrate robustness, stability, purity and potency of our drug product, and conduct extensive clinical trials to demonstrate the safety and efficacy of our product candidates in humans. Clinical testing is expensive, difficult to design and implement, can take many years to complete and is uncertain as to outcome. A failure of one or more clinical trials can occur at any stage of testing. The outcome of preclinical testing and early clinical trials may not be predictive of the success of later clinical trials, and interim results of a clinical trial do not necessarily predict final results. Moreover, preclinical and clinical data are often susceptible to varying interpretations and analyses, and many companies that have believed their product candidates performed satisfactorily in preclinical studies and clinical trials have nonetheless failed to obtain marketing approval of their products.

We may experience numerous unforeseen events during, or as a result of, clinical trials that could delay or prevent our ability to receive marketing approval or commercialize our product candidates, including:

clinical trials of our product candidates may produce negative or inconclusive results, or significant adverse side effects, and we may decide, or regulators may require us, to conduct additional clinical trials or abandon product development programs;

the number of patients required for clinical trials of our product candidates may be larger than we anticipate, enrollment in these clinical trials may be slower than we anticipate or participants may drop out of these clinical trials at a higher rate than we anticipate;

our third-party contractors may fail to comply with regulatory requirements or meet their contractual obligations to us in a timely manner, or at all;

regulators or institutional review boardsIRBs (or independent Ethics Committees (“IRBs”IECs”)) may not authorize us or our investigators to commence a clinical trial or conduct a clinical trial at a prospective trial site;

we may have delays in reaching or fail to reach agreement on acceptable clinical trial contracts or clinical trial protocols with prospective trial sites;

we may voluntarily suspend or terminate clinical trials of our product candidates for various reasons, including a finding that the participants are being exposed to unacceptable health risks;

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regulators or IRBs may require that we or our investigators suspend or terminate clinical research for various reasons, including noncompliance with regulatory requirements or a finding that the participants are being exposed to unacceptable health risks;

the cost of clinical trials of our product candidates may be greater than we anticipate;

the supply or quality of our product candidates or other materials necessary to conduct clinical trials of our product candidates may be insufficient or inadequate; and

our product candidates may have undesirable side effects or other unexpected characteristics, causing us or our investigators, regulators or IRBs (or IECs) to suspend or terminate the trials.

trials; or

the effects of the
COVID-19
pandemic.
If we are required to conduct additional clinical trials or other testing of exebacase or any other product candidate that we develop beyond those that we contemplate, if we are unable to successfully complete clinical trials of our product candidates or other testing, if the results of these trials or tests are not positive or are only modestly positive or if there are safety concerns, we may:

be delayed in obtaining marketing approval or sales revenues for our product candidates;

not obtain marketing approval at all;

obtain approval for indications or patient populations that are not as broad as intended or desired;

obtain approval with labeling that includes significant use or distribution restrictions or safety warnings, including boxed warnings;

be subject to additional post-marketing testing requirements; or

have the product removed from the market after obtaining marketing approval.

Our product development costs will also increase if we experience delays in testing or marketing approvals. We do not know whether any clinical trials will begin as planned, will need to be restructured or will be completed on schedule, or at all. Significant clinical trial delays also could shorten any periods during which we may have the exclusive right to commercialize our product candidates or may allow our competitors to bring products to market before we do and may impair our ability to successfully commercialize our product candidates and may harm our business and results of operations.

We

In addition, the FDA’s and other regulatory authorities’ policies with respect to clinical trials may change and additional government regulations may be requiredenacted. For instance, the regulatory landscape related to suspend or discontinue clinical trials duein the European Union, or EU, recently evolved. The EU Clinical Trials Regulation, or CTR, which was adopted in April 2014 and repeals the EU Clinical Trials Directive, became applicable on January 31, 2022. While the Clinical Trials Directive required a separate clinical trial application, or CTA to be submitted in each member state, to both the competent national health authority and an independent ethics committee, the CTR introduces a centralized process and only requires the submission of a single application to all member states concerned. The CTR allows sponsors to make a single submission to both the competent authority and an ethics committee in each member state, leading to a single decision per member state. The assessment procedure of the CTA has been harmonized as well, including a joint assessment by all member states concerned, and a separate assessment by each member state with respect to specific requirements related to its own territory, including ethics rules. Each member state’s decision is communicated to the sponsor via the centralized EU portal. Once the CTA is approved, clinical study development may proceed. The CTR foresees a three-year transition period. The extent to which ongoing and new clinical trials will be governed by the CTR varies. For clinical trials whose CTA was made under the Clinical Trials Directive before January 31, 2022, the Clinical Trials Directive will continue to apply on a transitional basis for three years. Additionally, sponsors may still choose to submit a CTA under either the Clinical Trials Directive or the CTR until January 31, 2023 and, if authorized, those will be governed by the Clinical Trials Directive until January 31, 2025. By that date, all ongoing trials will become subject to the provisions of the CTR. Compliance with the CTR requirements by us and our third-party service providers, such as CROs, may impact our developments plans.
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It is currently unclear to what extent the United Kingdom, or UK, will seek to align its regulations with the EU. The UK regulatory framework in relation to clinical trials is derived from existing EU legislation (as implemented into UK law, through secondary legislation). On January 17, 2022, the UK Medicines and Healthcare Regulatory Agency, or MHRA, launched an eight-week consultation on reframing the UK legislation for clinical trials. The consultation closes on March 14, 2022 and aims to streamline clinical trials approvals, enable innovation, enhance clinical trials transparency, enable greater risk proportionality, and promote patient and public involvement in clinical trials. The outcome of the consultation will be closely watched and will determine whether the UK chooses to align with the regulation or diverge from it to maintain regulatory flexibility. A decision by the UK not to closely align its regulations with the new approach that will be adopted in the EU may have an effect on the cost of conducting clinical trials in the UK as opposed to other countries and/or make it harder to seek a marketing authorization in the EU for our product candidates on the basis of clinical trials conducted in the UK.
If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies governing clinical trials, our development plans may also be impacted.
Our product candidates may be associated with serious adverse events, undesirable side effects or have other safety risksproperties that could precludehalt their clinical development, prevent their regulatory approval, of exebacaselimit their commercial potential or anyresult in significant negative consequences.
Adverse events or other undesirable side effects caused by our product candidates.

Ourcandidates could cause us or regulatory authorities to interrupt, delay or halt clinical trials mayand could result in a more restrictive label or the delay or denial of regulatory approval by the FDA or other comparable foreign regulatory authorities. During the conduct of clinical trials, patients report changes in their health, including illnesses, injuries, and discomforts, to their study doctor. Often, it is not possible to determine whether or not the product candidate being studied caused these conditions. It is possible that as we test our product candidates in larger, longer and more extensive clinical trials, or as use of these product candidates becomes more widespread if they receive regulatory approval, illnesses, injuries, discomforts and other adverse events that were observed in previous trials, as well as conditions that did not occur or went undetected in previous trials, will be suspended at any time forreported by patients. Many times, side effects are only detectable after investigational products are tested in large-scale clinical trials or, in some cases, after they are made available to patients on a number of reasons.commercial scale following approval. For example, it is possible that exposure to exebacase could result in adverse clinical events such as localized inflammation in the region surrounding blood vessels, or having a hypersensitivity reaction, such as serum sickness or anaphylaxis. A

If any serious adverse events occur, clinical trial may be prevented from commencingtrials or maycommercial distribution of any product candidates or products we develop could be suspended or terminated, byand our business could be seriously harmed. Treatment-related side effects could also affect patient recruitment and the ability of enrolled patients to complete the trial or result in potential liability claims. Regulatory authorities could order us our collaborators, IRBs, the FDA or other regulatory authorities due to the riskscease further development of, deny approval of, or occurrence of such adverse events, an unacceptable safety riskrequire us to participants, a failure to conduct the clinical trial in accordance with regulatory requirementscease selling any product candidates or our clinical protocols, presentation of unforeseen safety issuesproducts for any or adverse side effects, failure to demonstrate a benefit from using the investigational drug, changes in governmental regulations or administrative actions, lack of adequate funding to continue the clinical trial, or negative or equivocal findings of the data safety monitoring board or IRBs for a clinical trial. We may voluntarily suspend or terminate our clinical trials if at any time we believe that they present an unacceptable risk to participants.all targeted indications. If we elect or are forcedrequired to delay, suspend or terminate any clinical trial of any product candidates that we develop,or commercialization efforts, the commercial prospects of such product candidates willor products may be harmed, and our ability to generate product revenues if at all, from any of thesethem or other product candidates willthat we develop may be delayed or eliminated. Additionally, if one or more of our product candidates receives marketing approval and we or others later identify undesirable side effects or adverse events caused by such products, a number of potentially significant negative consequences could result, including but not limited to:
regulatory authorities may suspend, limit or withdraw approvals of such product, or seek an injunction against its manufacture or distribution;
regulatory authorities may require additional warnings on the label, including “boxed” warnings, or issue safety alerts, Dear Healthcare Provider letters, press releases or other communications containing warnings or other safety information about the product;
we may be required to change the way the product is administered or conduct additional clinical trials or post-approval studies;
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we may be required to create a REMS or similar risk management system, which could include a medication guide outlining the risks of such side effects for distribution to patients;
we may be subject to fines, injunctions or the imposition of criminal penalties;
we could be sued and held liable for harm caused to patients; and
our reputation may suffer.
Any of these occurrences may significantlyevents could prevent us from achieving or maintaining market acceptance of the particular product candidate, if approved, and could seriously harm our business.

Delays

We depend on enrollment of patients in our clinical trials are common and have many causes, and any such delays could result in increased costs to us and jeopardize, delay or prevent our ability to obtain regulatory approval and commence product sales as currently contemplated.

We may experience delays in clinical trials offor our product candidates. Our plannedIf we experience delays or difficulties enrolling in our clinical trials, might not begin on time, might need toour research and development efforts and business, financial condition, and results of operations could be redesigned, might notmaterially adversely affected.

Successful and timely completion of clinical trials will require that we enroll a sufficient number of patients or might notpatient candidates. These trials and other trials we conduct may be completed on schedule, if at all. Clinical trials can be delayedsubject to delays for a variety of reasons, including the following:

imposition of a clinical hold by the FDA or other regulatory authorities;

delays in reaching agreement on acceptable terms with prospective CROs and clinical trial sites;

delays in recruiting suitable patients to participate in a trial;

delays in having patients complete participation in a trial or return for post-treatmentfollow-up;

clinical sites dropping out of a trial to the detriment of enrollment;

adverse side effects in patient populations;

time required to add new sites;

delays resulting from negative or equivocal findings of the data safety monitoring board for a trial;

delays in completing, or as a result of findings from, preclinical studies;patient enrollment taking longer than anticipated, patient withdrawal or

adverse events. These types of developments could cause us to delay the trial or halt further development.

delays

Our clinical trials will compete with other clinical trials that are in developing adequate processes for manufacturethe same therapeutic areas as our product candidates, and this competition reduces the number and types of or formulations for, sufficient suppliespatients available to us, as 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. Because the number of qualified clinical investigators and clinical trial materials.

sites is limited, we expect to conduct some of our clinical trials at the same clinical trial sites that some of our competitors use, which will reduce the number of patients who are available for our clinical trials at such clinical trial sites. In addition, there may be limited patient pools from which to draw for clinical studies. In addition to the rarity of some diseases, the eligibility criteria of our clinical studies will further limit the pool of available study participants as we will require that patients have specific characteristics that we can measure or to assure their disease is either severe enough or not too advanced to include them in a study. Patient enrollment a significant factor in the timing of clinical trials, is affected bydepends on many factors, including including:

the size and nature of the patient population, population;
the severity of the disease under investigation;
eligibility criteria for the trial;
the proximity of patients to clinical sites, the eligibility criteria for the trial, sites;
the design of the clinical protocol;
the ability to obtain and maintain patient consents;
the ability to recruit clinical trial investigators with the appropriate competencies and experience;
the risk that patients enrolled in clinical trials will drop out of the trials before the administration of our product candidates or trial completion;
the availability of competing clinical trialstrials;
the availability of new drugs approved for the indication the clinical trial is investigating; and
clinicians’ and patients’ perceptions as to the potential advantages of the drug being studied in relation to other available therapies, including any new drugs thattherapies.
These factors may be approvedmake it difficult for the indications we are investigating. Any of these delays in completingus to enroll enough patients to complete our clinical trials in a timely and cost-effective manner. In addition, our Phase 3 DISRUPT clinical trial has experienced some delays in patient enrollment as a result of the
COVID-19
pandemic, as some clinical sites in high impact areas have
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delayed new patient enrollment as dictated by local conditions. We expect that such delays could adversely affect the expected timelines for our product development and approval process and may adversely affect our business, financial condition and results of operations. Delays in the completion of any clinical trial of our product candidates will increase our costs, slow down our product candidate development and approval process and delay or potentially jeopardize our ability to commence product sales and generate revenues.

revenue. In addition, some 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.

We are significantly dependent on our license agreements with Rockefeller that relate to exebacase.

Under our various license agreements with Rockefeller, we are obligated to use our diligent efforts to develop and commercialize licensed products, including exebacase. Rockefeller may terminate the agreement in the event of our breach of the terms of the license agreements. In the event of such termination, Rockefeller has the right to retain its license and other rights under the agreement, subject to continuing royalties and other obligations. Our breach of the agreement, including
non-payment
of any milestone payment, and Rockefeller’s subsequent termination of the agreement, could result in the loss of our rights to develop and commercialize exebacase, which would seriously harm our ability to generate revenues or achieve profitability.

We rely on CROs to conduct our preclinical studies and will rely on CROs to conduct our clinical trials. If these third parties do not successfully carry out their contractual duties or meet expected deadlines, we may be delayed in obtaining, or may ultimately not be able to obtain, regulatory approval for commercialization of exebacase or any other product candidates.

We have relied and will continue to rely on CROs for the execution of our preclinical and clinical studies and to recruit patients and monitor and manage data for our clinical programs for exebacase or any other product candidate. We control only certain aspects of our CROs’ activities, but we are responsible for ensuring that each of our studies is conducted in accordance with the applicable protocol and legal, regulatory and scientific standards. Our reliance on the CROs does not relieve us of these regulatory responsibilities. We and our CROs are required to comply with the FDA’s regulations and current good clinical practices (“GCPs”),GCPs requirements, which is an international guidelineare regulations and guidelines enforced by the FDA and comparable regulatory authorities meant to protect the rights and health of clinical trial subjects. The FDA enforces itsand comparable regulatory authorities enforce their regulations and GCPs through periodic inspections of trial sponsors, principal investigators and clinical trial sites. If we or our CROs fail to comply with applicable GCPs, the clinical data generated in our clinical trials may be deemed unreliable, and the FDA (or similar foreign authorities) may require us to perform additional clinical trials before approving our product candidates. We cannot assure you that, upon inspection, the FDA (or similar foreign authorities) will determine that any of our clinical trials comply with GCPs. In addition, to evaluate the safety and effectiveness of exebacase or any other product candidate to a statistically significant degree, our clinical trials will require an adequately large number of test subjects. Any clinical trial that a CRO conducts abroad on our behalf is subject to similar regulation. Accordingly, if our CROs fail to comply with these regulations or recruit a sufficient number of patients, we may have to repeat clinical trials, which would delay the regulatory approval process.

In addition, our CROs are not our employees and we cannot control whether or not they devote sufficient time and resources to our
non-clinical,
preclinical or clinical programs. Our CROs may also have relationships with other commercial entities, including our competitors, for whom they may also be conducting clinical studies or other drug development activities, which could impede their ability to devote appropriate time to our clinical programs. If our CROs do not successfully carry out their contractual duties or obligations or meet expected deadlines, if they need to be replaced, or if the quality or accuracy of the clinical data they obtain is compromised due to the failure to adhere to our clinical protocols or regulatory requirements, or for other reasons, our clinical

trials may be extended, delayed or terminated, and we may not be able to obtain regulatory approval for or successfully commercialize exebacase or any other product candidate that we seek to develop. As a result, our financial results and the commercial prospects for exebacase or any other product candidate that we seek to develop would be harmed, our costs could increase and our ability to generate revenues could be delayed or ended.

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If any of our relationships with these CROs change or terminate, we may not be able to enter into arrangements with alternative CROs or clinical study management organizations, or be able to do so on commercially reasonable terms. Switching or adding additional CROs or other clinical study management organizations involves additional cost and requires management time and focus. In addition, there is a natural transition period when a new CRO or clinical study management organization commences work. As a result, delays could occur, which could compromise our ability to meet our desired development timelines.
Any Breakthrough Therapy designation that we may receive from the FDA for our product candidates may not lead to a faster development or regulatory review or approval process, and it does not increase the likelihood that our product candidates will receive marketing approval.
We have no experiencereceived Breakthrough Therapy designation for exebacase for the treatment of for the treatment of MRSA bacteremia, including right-sided endocarditis, when used in addition to SOC anti-staphylococcal antibiotics in adult patients, and we may seek Breakthrough Therapy designation for our other product candidates. A Breakthrough Therapy is defined as a company in bringing a drug to regulatory approval.

As a company, we have never obtained regulatory approval for, or commercialized, a drug or biologic. Itbiologic that is possibleintended to treat a serious or life-threatening disease or condition, and preliminary clinical evidence indicates that the drug or biologic may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed in early clinical development. For drugs or biologics that have been designated as Breakthrough Therapies, interaction and communication between the FDA and the sponsor can help to identify the most efficient path for clinical development. Drugs or biologics designated as Breakthrough Therapies by the FDA are also eligible for rolling review of the associated marketing application, meaning that the agency may review portions of the marketing application before the sponsor submits the complete application, as well as priority review, if the relevant criteria are met.

Designation as a Breakthrough Therapy is within the discretion of the FDA. Accordingly, even if we believe one of our product candidates meets the criteria for designation as a Breakthrough Therapy, the FDA may refusedisagree and instead determine not to accept any or allmake such designation. The receipt of our planned BLAsa Breakthrough Therapy Designation for substantivea product candidate, including for exebacase, may not result in a faster development process, review or may conclude after reviewapproval compared to conventional FDA procedures and does not assure ultimate approval by the FDA. In addition, not all products designated as Breakthrough Therapies ultimately will be shown to have the substantial improvement over available therapies suggested by the preliminary clinical evidence at the time of our data that our application is insufficient to obtain regulatory approval ofdesignation. As a result, if the Breakthrough Therapy Designation for exebacase we have received or any other product candidate. Iffuture designation we receive is no longer supported by subsequent data, the FDA does not accept or approve any or all of our planned BLAs, it may require that we conduct additional preclinical,rescind the designation.
We rely on contract manufacturing organizations (“CMOs”) to manufacture clinical or manufacturing validation studies, which may be costly, and submit that data before it will reconsider our applications. Depending on the extent of these or any other FDA required studies, approval of any BLA or application that we submit may be significantly delayed, possibly for several years, or may require us to expend more resources than we have available. Any delay in obtaining, or an inability to obtain, regulatory approvals would prevent us from meeting our timelines for commercializing exebacase or any other product candidate, generating revenues and achieving and sustaining profitability.

Even if the FDA approves exebacase or any other product candidate, adverse effects discovered after approval could adversely affect our markets.

If we obtain regulatory approval for exebacase or any other product candidate that we develop, and we or others later discover that our products cause adverse effects, a number of potentially significant negative consequences could result, including:

regulatory authorities may withdraw their approval of the product;

regulatory authorities may require the addition of labeling statements, such as warnings or contraindications or imposition of a risk management strategy;

we may be required to change the way the product is administered, conduct additional clinical studies or restrict the distribution of the product;

we could be sued and held liable for harm caused to patients and our liability insurance may not adequately cover those claims; and

our reputation may suffer.

Any of these events could prevent us from maintaining market acceptance of the affected product candidate and could substantially increase the costs of, or prevent altogether, the commercializationcommercial supplies of our product candidates.

There are underlying In addition to the risks associated with the manufacture of our product candidates, which could include cost overruns, new impurities, difficulties in process or formulation development, scaling up or reproducing manufacturing processes and lack of timely availability of raw materials.

materials, if these third parties do not successfully carry out their contractual duties or meet expected deadlines, we may be delayed in obtaining, or may ultimately not be able to obtain, regulatory approval for commercialization of exebacase or any other product candidates.

We do not currently have nor do we plan to build the infrastructure or capability internally to manufacture exebacase or any other product candidates.

We rely, and expect to continue to rely, on third-party manufacturers for the production of our product candidates for preclinical studies and clinical trials under the guidance of members of our organization. For example, we employ the services of Fujifilm Diosynth Biotechnologies UK LTD (“Fujifilm UK”) to supply the active pharmaceutical ingredient for exebacase. We have not yet manufactured supplies for late phase human clinical trials, scaled upvalidated the process for manufacture of such supplies, validated themanufacturing processes or contractually secured our commercial supplies.

We employ the services of other vendors to produce exebacase in its final vialed drug product form. We do not currently have contractslong-term supply agreements. Furthermore, the raw materials for our product candidates are sourced, in some cases, from a single-source supplier. If we were to experience an unexpected loss of supply of any of our product candidates or any of our future product candidates for any reason, whether as a result of manufacturing, supply or storage issues or otherwise, we could experience delays, disruptions, suspensions or terminations of, or be required to restart or repeat, any pending or ongoing

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clinical trials. For example, on January 21, 2021, the President of the United States signed an executive order entitled “Executive Order on a Sustainable Public Health Supply Chain” (the “Executive Order”) which “directs immediate actions to secure supplies necessary for responding to the
COVID-19
pandemic, so that supplies are available, and remain available to the Federal Government and State, local, Tribal and territorial authorities, as well as to America’s health care workers, health systems, and patients. The DPA, which empowers the President to issue the Executive Order, allows him to direct private companies to prioritize orders from the federal government. The Executive Order directed the President’s administration to identify shortfalls in the supply of materials needed for the pandemic response, and to use the DPA to address them, if necessary. The extent to which the
COVID-19
pandemic and the invocation of the DPA impacts our ability to procure sufficient supplies for the development or manufacture of our products and product candidates will depend on the severity and duration of the spread of the virus, and any actions undertaken to contain
COVID-19
or treat its effects.
We expect to continue to rely on third-party manufacturers for the commercial supply of exebacase drug product.

any of our product candidates for which we obtain marketing approval. We intendmay be unable to pursuemaintain or establish required agreements with third-party manufacturers regarding commercial supply at an appropriate future time. We intendor to locate second fill finishdo so on acceptable terms. Even if we are able to establish agreements with third-party manufacturers, to supply other world regions such as reliance on third-party manufacturers entails additional risks, including:

the EU or Asia.

Late stage process development activities, including manufacturing process scale up and validationfailure of the bulk drug substance, pose inherent risks that may be greater for biological products than for small molecules. The process will undergo scale up from the current clinical process and then be repeated under protocol successfully three times for validation.

In addition, regulatory requirements could pose barriersthird-party to the manufacture of our active pharmaceutical ingredient and finished drug product for our product candidates. Our third-party manufacturers are required to comply with current good manufacturing practices (“cGMPs”). As a result, the manufacturing facilities and processes used by Fujifilm UK and any of our future manufacturers must pass inspection by the FDA as part of our BLA review and before approval of the applicable product candidate. Similar regulations apply to manufacturers of our products for use or sale in foreign countries. If our manufacturers cannot successfully manufacture material that conforms to our specifications and the strict regulatory requirements of the FDA and any applicable foreign(or similar regulatory authority, we will not be ableauthorities);

the failure of the third-party to secure the applicable approval for our product candidates. If these facilities are not deemed compliant with cGMPs for the commercial manufacture of our product candidates we may needaccording to find alternative manufacturing facilities, which would result in significant delaysour schedule, or at all, including if our third-party contractors give greater priority to the supply of up to several years in obtaining approval. In addition,other products over our manufacturers will be subject to ongoing periodic unannounced inspectionsproduct candidates;
the reduction or termination of production or deliveries by suppliers, or the raising of prices or renegotiation of terms;
the termination or nonrenewal of arrangements or agreements by our third-party contractors at a time that is costly or inconvenient for us;
the breach by the FDAthird-party contractors of our agreements with them or if the third-party otherwise does not satisfactorily perform according to the terms of the agreements between us and corresponding statethem;
the failure of third-party contractors to comply with applicable regulatory requirements;
the failure of the third party to manufacture our product candidates according to our specifications;
the mislabeling of clinical supplies, potentially resulting in the wrong dose amounts being supplied or study drug or placebo not being properly identified;
clinical supplies not being delivered to clinical sites on time, leading to clinical trial interruptions, or of drug supplies not being distributed to commercial vendors in a timely manner, resulting in lost sales; and foreign agencies
the misappropriation of our proprietary information, including our trade secrets and
know-how.
In the fourth quarter of 2020, we were notified by Fujifilm UK that they experienced equipment failures that would impact their manufacturing timelines. As a result, we successfully transferred manufacturing to Fujifilm USA and expect to complete the process validation and initial commercial manufacturing of drug substance with Fujifilm USA in support of a potential BLA submission for compliance with cGMPs and similar regulatory requirements.

exebacase. We may still experience delays to the manufacturing timeline.

If Fujifilm UK, Fujifilm USA, or any alternate supplier of an active pharmaceutical ingredient, or any supplier of finished drug product for our product candidates, experiences any significant difficulties in its respective manufacturing processes, does not comply with the terms of its agreement with us or does not devote
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sufficient time, energy and care to providing our manufacturing needs, we may experience delays. Moreover, as a result of the
COVID-19
pandemic, third-party manufacturers may be affected, which could disrupt their activities and, as a result, we could face difficulty sourcing key components necessary to produce supply of our product candidates. As a result, we could experience significant interruptions in the supply of our product candidates, which could impair our ability to supply our product candidates at the levels required for our clinical trials andor commercialization and prevent or delay its successful development andor commercialization. For example, a lot of the exebacase investigational drug product did not meet manufacturing release specifications, resulting in the delay of our Phase 2 study.

We do not have complete control over all aspects of the manufacturing process of, and are dependent on, our contract manufacturing partners, in particular Fujifilm UK and Fujifilm USA, for compliance with cGMP or similar regulations for manufacturing both active drug substances and finished drug products. Third-party manufacturers may not be able to comply with cGMP regulations or similar regulatory requirements outside of the United States. If our contract manufacturers cannot successfully manufacture material that conforms to our specifications and the strict regulatory requirements of the FDA or foreign regulatory authorities, they will not be able to secure and/or maintain marketing approval for their manufacturing facilities. In addition, we do not have control over the ability of our contract manufacturers to maintain adequate quality control, quality assurance and qualified personnel. If the FDA or a comparable foreign regulatory authority does not approve these facilities for the manufacture of our product candidates or if it withdraws any such approval in the future, we may need to find alternative manufacturing facilities, which would significantly impact our ability to develop, obtain marketing approval for or market our product candidates, if approved. Our failure, or the failure of our third-party manufacturers, to comply with applicable regulations could result in sanctions being imposed on us, including fines, injunctions, civil penalties, delays, suspension or withdrawal of approvals, license revocation, seizures or recalls of product candidates or drugs, operating restrictions and criminal prosecutions, any of which could significantly and adversely affect supplies of our product candidates or drugs and harm our business and results of operations.
Developments by competitors, many of which have greater financial and other resources than we do, may render our products or technologies obsolete or
non-competitive.

The pharmaceutical and biotechnology industries are intensely competitive. We compete directly and indirectly with other pharmaceutical companies, biotechnology companies and academic and research organizations in developing therapies to treat diseases. Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large, established companies. Many of our competitors have substantially greater financial, technical and other resources, such as larger research and development staff and experienced marketing and manufacturing organizations and well-established sales forces. We compete with companies that have products on the market or in development for the same indications as our product candidates. We may also compete with organizations that are developing similar technology platforms. Competitors may develop more effective, more affordable or more convenient products or may achieve earlier patent protection or commercialization of their products. These competing products may render our product candidates obsolete or limit our ability to generate revenue from our product candidates. Mergers and acquisitions in the biotechnology and pharmaceutical industries may result in even more resources being concentrated in our competitors. Competition may increase further as a result of advances in the commercial applicability of technologies and greater availability of capital for investment in these industries. Our competitors

may succeed in developing, acquiring or licensing, on an exclusive basis, drug products that are more effective or less costly than exebacase and our other product candidates.

The level of commercial success of exebacase or any other product candidates that we develop will depend upon attaining significant market acceptance of these products among physicians and payors.

Even if exebacase or any other product candidates that we develop is approved by the appropriate regulatory authorities for marketing and sale, physicians may not prescribe the approved product. Market acceptance of
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exebacase or any other product candidate that we develop by physicians, patients and payors will depend on a number of factors, many of which are beyond our control, including:

the indications for which the product is approved;

acceptance by physicians and payors of each product as a safe and effective treatment;

the availability, efficacy and cost of competitive drugs;

the effectiveness of our or any third-party partner’s sales force and marketing efforts;

the extent to which the product is approved for inclusion on formularies of hospitals and managed care organizations;

whether the product is designated under physician treatment guidelines as a first-line therapy or as a second- or third-line therapy for particular infections;

the availability of adequate reimbursement by third parties, such as insurance companies and other health care payors, and/or by government health care programs, including Medicare and Medicaid;

limitations or warnings contained in a product’s
FDA-approved labeling;
labeling (or similarly approved labeling by foreign authorities); and

prevalence and severity of adverse side effects.

Even if the medical community accepts that our product candidates are safe and efficacious for their approved indications, physicians may not immediately be receptive to the use or may be slow to adopt our product candidates as accepted treatments for their approved indications. While we believe our product candidates may demonstrate significant advantages in clinical studies, we cannot assure you that labeling approved by the FDA (or similar foreign authorities) will permit us to promote these advantages. In addition, our efforts to educate the medical community and third-party payors on the benefits of any product candidates that we develop may require significant resources and may never be successful.

Coverage and reimbursement may not be available for exebacase or any other product candidates that we develop, which could make it difficult for us to sell our products profitably.

Market acceptance and sales of exebacase or any other product candidate that we develop will depend on coverage and reimbursement policies and may be affected by health care reform measures. Government authorities and third-party payors, such as private health insurers and health maintenance organizations, decide which drugs they will pay for and establish reimbursement levels. We cannot be sure that reimbursement will be available for exebacase or any other product candidate that we develop. Also, we cannot be sure that the amount of reimbursement available, if any, will not reduce the demand for, or the price of, our products. If reimbursement is not available or is available only at limited levels, we may not be able to successfully commercialize exebacase or any other product candidate that we develop.

In both the United States and some foreign jurisdictions, there have been a number of legislative and regulatory proposals to change the health care system in ways that could affect our ability to sell our products profitably. In March 2010, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act (collectively, the “Affordable Care Act”),ACA became law in the United States. The

goal of the Affordable Care ActACA is to reduce the cost of health care and substantially change the way health care is financed by both governmental and private insurers. The Affordable Care Act,ACA, among other things, increased the minimum Medicaid rebates owed by manufacturers under the Medicaid Drug Rebate Program and extended the rebate program to individuals enrolled in Medicaid managed care organizations, established annual fees on manufacturers of certain branded prescription drugs, required manufacturers to participate in a discount program for certain outpatient drugs under Medicare Part D and promoted programs that increase the federal government’s comparative effectiveness research, which will impact existing government healthcare programs and will result in the development of new programs. An expansion in the government’s role in the United States healthcare industry may further lower rates of reimbursement for pharmaceutical products.

The current presidential administration and U.S. Congress attempted to repeal or “repeal and replace” the Affordable Care Act. Although those efforts did not succeed, the presidential administration may continue to seek to modify, repeal, or otherwise invalidate all, or certain provisions

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Table of the Affordable Care Act. There is still uncertainty with respect to the impact President Trump’s administration and the U.S. Congress may have on the Affordable Care Act, if any, and any changes will likely take time to unfold. Additionally, sinceContents
Since its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the Affordable Care Act. For example, on December 14, 2018, aACA. On June 17, 2021, the U.S. DistrictSupreme Court Judge indismissed the Northern District of Texas, or Texas District Court Judge, ruled thatmost recent judicial challenge to the entire Affordable Care Act is invalid based primarilyACA brought by several states without specifically ruling on the factconstitutionality of the ACA. Prior to the Supreme Court’s decision, President Biden issued an executive order to initiate a special enrollment period for purposes of obtaining health insurance coverage through the ACA marketplace, which began on February 15, 2021 and remained open through August 15, 2021. The executive order also instructed certain governmental agencies to review and reconsider their existing policies and rules that limit access to healthcare, including among others, reexamining Medicaid demonstration projects and waiver programs that include work requirements, and policies that create unnecessary barriers to obtaining access to health insurance coverage through Medicaid or the Tax Cuts and Jobs Act of 2017 repealed thetax-based shared responsibility payment imposed by the Affordable Care Act, on certain individuals who fail to maintain qualifying health coverage for all or part of a year, which is commonly referred to as the “individual mandate”. While the Texas District Court Judge, as well as the current presidential administration and the Centers for Medicare and Medicaid Services, have stated that this ruling will have no immediate effect, itACA. It is unclear how this decision and subsequent appealsother healthcare reform measures of the Biden administration will impact the law and the effect such impact could have on coverage and reimbursement for healthcare items and services covered by plans that were authorized by the Affordable Care Act. However, we cannot predict the ultimate content, timingour business or effect of any healthcare reform legislation or the impact of potential legislation on us.

financial condition.

Other legislative changes have been proposed and adopted in the United States since the Affordable Care Act was enacted. For example, the Budget Control Act of 2011, among other things, resulted in aggregate reductions of Medicare payments to providers of 2% per fiscal year, which went into effect in April 2013 and, due to subsequent legislative amendments to the statute, will remain in effect through 20272030, with the exception of a temporary suspension from May 1, 2020 through March 31, 2022, unless additional Congressional action is taken. Further, on January 2, 2013, the American Taxpayer Relief Act of 2012 was signed into law, or the ATRA, which, among other things, further reduced Medicare payments to several providers. Recently there has also been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which has resulted in several Congressional inquiries and proposed and enacted legislation designed to, among other things, reform government program reimbursement methodologies. For example, the Cures Act changes the reimbursement methodology for infusion drugs and biologics furnished through durable medical equipment in an attempt to remedy over- and underpayment of certain drugs.

More recently, on March 11, 2021, President Biden signed into law the American Rescue Plan Act of 2021, which eliminates the statutory cap on the Medicaid drug rebate, currently set at 100% of a drug’s average manufacturer price, beginning January 1, 2024.

While we cannot predict the impact these new laws will have in general or on our business specifically, they may result in downward pressure on pharmaceutical reimbursement, which could negatively affect market acceptance of exebacase or any future products.

We expect to experience pricing pressures in connection with the sale of exebacase or any other product candidate that we develop, due to the trend toward managed health care, the increasing influence of health maintenance organizations and additional legislative proposals. If we fail to successfully secure and maintain coverage and reimbursement for our products or are significantly delayed in doing so, we will have difficulty achieving market acceptance of our products and our business will be harmed.

Even if we obtain FDA approval of exebacase or any other product candidate, we may never obtain approval or commercialize our products outside of the United States, which would limit our ability to realize their full market potential.

In order to market exebacase or any other products outside of the United States, we must comply with numerous and varying regulatory requirements of other countries regarding safety and efficacy. Clinical trials conducted in one country may not be accepted by regulatory authorities in other countries, and regulatory approval in one country does not mean that regulatory approval will be obtained in any other country. Approval procedures vary among countries and can involve additional product testing and validation and additional administrative review periods. Seeking foreign regulatory approvals could result in significant delays, difficulties and costs for us and require additional preclinical studies or clinical trials which would be costly and time consuming. Regulatory requirements can vary widely from country to country and satisfying these and other regulatory requirements is costly, time consuming, uncertain and subject to unanticipated delays. In addition, our failure to obtain regulatory approval in the United States or any foreign country may delay or have negative effects on the process for regulatory approval in other countries. We do not have any product candidates approved for sale in the United States or any foreign country and we do not have experience as a company in obtaining regulatory approval in international markets.

We currently have no marketing and sales organization and have no experience in marketing drug products. If we are unable to establish our own marketing and sales capabilities, or enter into agreements with third parties, to market and sell our products after they are approved, we may not be able to generate revenues.

We do not have the capabilities to market, sell and distribute any of our drug products. In order to commercialize any products, we must develop these capabilities on our own or make arrangements with third parties for the marketing, sales and distribution of our products. The establishment and development of our own sales force would be expensive and time consuming and could delay any product launch, and we cannot be certain that we would be able to successfully develop this capability. As a result, we may seek one or more third parties to handle some or all of the sales, marketing or distribution for exebacase or any other product candidate in the United States or elsewhere. However, we may not be able to enter into arrangements with third parties to sell exebacase or any other product candidate on favorable terms or at all. In the event we are unable to develop our own marketing and sales force or collaborate with a third-party marketing and sales organization, we would not be able to commercialize exebacase or any other product candidate that we develop, which would negatively impact our ability to generate product revenues. Further, whether we commercialize products on our own or rely
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on a third party to do so, our ability to generate revenue will be dependent on the effectiveness of the sales force. In addition, to the extent we rely on third parties to commercialize our approved products, we may likely receive less revenues or profits than if we commercialized these products ourselves.

We may form or seek strategic alliances in the future, and we may not realize the benefits of such alliances.

We may form or seek strategic alliances, create 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 exebacase or any future product candidate that we may develop. 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. In addition, we face significant competition in seeking appropriate strategic alliances and the negotiation process is time-consuming and complex. Moreover, we may not be successful in our efforts to establish a strategic collaboration or other alternative arrangements for exebacase and any future product candidate because it may be deemed to be at too early of a stage of development for collaborative effort and third parties may not view exebacase or any future product candidate as having the requisite potential to demonstrate safety and efficacy. Any delays in entering into new strategic collaboration agreements could delay the development and commercialization of exebacase or any other product candidate that we develop, which would harm our business prospects, financial condition and results of operations.

Interim, “topline” and preliminary data from our clinical trials that we announce or publish from time to time may change as more patient data become available and are subject to audit and verification procedures that could result in material changes in the final data.
From time to time, we may publicly disclose interim, topline or preliminary data from our clinical trials, which is based on a preliminary analysis of then-available data, and the results and related findings and conclusions are subject to change following a more comprehensive review of the data related to the particular study or trial. We also make assumptions, estimations, calculations and conclusions as part of our analyses of data, and we may not have received or had the opportunity to fully and carefully evaluate all data. As a result, the topline or preliminary results that we report may differ from future results of the same studies, or different conclusions or considerations may qualify such results, once additional data have been received and fully evaluated. Topline or preliminary data also remain subject to audit and verification procedures that may result in the final data being materially different from the
top-line
or preliminary data we previously published. As a result, topline and preliminary data should be viewed with caution until the final data are available.
From time to time, we may also disclose interim data from our preclinical studies and clinical trials. Interim data from clinical trials that we may complete are subject to the risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient data become available. Adverse differences between interim data and final data could significantly harm our business prospects. Further, disclosure of interim data by us or by our competitors could result in volatility in the price of our common stock.
Further, others, including regulatory agencies, may not accept or agree with our assumptions, estimates, calculations, conclusions or analyses or may interpret or weigh the importance of data differently, which could impact the value of the particular program, the approvability or commercialization of the particular product candidate or product and our company in general. In addition, the information we choose to publicly disclose regarding a particular study or clinical trial is based on what is typically extensive information, and you or others may not agree with what we determine is material or otherwise appropriate information to include in our disclosure.
If the interim topline or preliminary data that we report differ from actual results, or if others, including regulatory authorities, disagree with the conclusions reached, our ability to obtain approval for, and commercialize, our product candidates may be harmed, which could harm our business, operating results, prospects or financial condition.
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Risks Related to Regulatory Approval of Our Product Candidates and Other Legal Compliance Matters

If we are not able to obtain, or if there are delays in obtaining, required regulatory approvals, we will not be able to commercialize, or will be delayed in commercializing, exebacase and any future product candidate, and our ability to generate revenue will be materially impaired.

Exebacase and any other product candidate that we develop and the activities associated with their development and commercialization, including their design, testing, manufacture, recordkeeping, labeling, storage, approval, advertising, promotion, sale, distribution, importation and exportation are subject to comprehensive regulation by the FDA and other regulatory agencies in the United States and by comparable authorities in other countries. Failure to obtain marketing approval for a product candidate will prevent us from commercializing the product candidate. We have not received approval to market any product from regulatory authorities in any jurisdiction. Securing regulatory approval requires the submission of extensive preclinical and clinical data and supporting information to the various regulatory authorities for each therapeutic indication to establish the product candidate’s safety and efficacy. Securing regulatory approval also requires the submission of information about the product manufacturing process to, and inspection of manufacturing facilities by, the relevant regulatory authority. Exebacase and any other product candidate that we develop may not be effective, may be only moderately effective or may prove to have undesirable or unintended side effects or other characteristics that may preclude our obtaining marketing approval or prevent or limit commercial use.

The process of obtaining marketing approvals, both in the United States and abroad, is expensive, may take many years, if approval is obtained at all, and can vary substantially based upon a variety of factors, including the type, complexity and novelty of the product candidates involved. Changes in marketing approval policies during the development period, changes in or the enactment of additional statutes or regulations, or changes in regulatory review for each submitted product application, may cause delays in the approval or rejection of an application. The FDA and comparable authorities in other countries have substantial discretion in the approval process and may refuse to accept any application or may decide that our data is insufficient for approval and require additional preclinical, clinical or other studies. If we experience delays in obtaining approvals or if we fail to obtain approval of our product candidates that we develop, our ability to generate revenues will be materially impaired.

We face extensive

Even if our product candidates receive regulatory approval, they will be subject to significant post- marketing regulatory requirements and our products may face future development and regulatory difficulties.

oversight.

Even if we obtain regulatory approval in (or outside) the United States, the FDA (or similar foreign authorities) may still impose significant restrictions on the indicated uses or marketing of the approved product, or impose ongoing requirements for potentially costly post-approval studies or post-market surveillance. The holder of an approved BLA is obligated to monitor and report adverse events and any failure of a product to meet the specifications in the BLA. The holder of an approved BLA must also submit new or supplemental applications and obtain FDA approval for certain changes to the approved product, product labeling or manufacturing process. Advertising and promotional materials must comply with FDA rules and are subject to FDA review, in addition to other potentially applicable federal and state laws.

Similar risks exist in foreign jurisdictions.

In addition, drug product manufacturers and their facilities are subject to payment of user fees and continual review and periodic inspections by the FDA and other regulatory authorities for compliance with cGMPs, or similar requirements outside the United States, and adherence to commitments made in the BLA. If we or a regulatory agency discovers 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 relative to that product or the manufacturing facility, including requiring recall or withdrawal of the product from the market or suspension of manufacturing.

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If the FDA or a comparable foreign regulatory authority approves any of our product candidates, the manufacturing processes, labeling, packaging, distribution, adverse event reporting, storage, advertising,

promotion and recordkeeping for the product will be subject to extensive and ongoing regulatory requirements. These requirements include submissions of safety and other post-marketing information and reports, registration requirements and continued compliance with cGMPs or similar requirements outside the United States and GCPs for any clinical trials that we conduct post-approval.

If we or our partners fail to comply with applicable regulatory requirements following approval of any of our future product candidates, a regulatory agency may:

issue a warning or untitled letter asserting that we are in violation of the law;

seek an injunction or impose civil or criminal penalties or monetary fines;

suspend or withdraw regulatory approval;

suspend any ongoing clinical trials;

refuse to approve a pending BLA or supplements to a BLA, or similar applications in foreign jurisdictions, submitted by us;

seize product; or

refuse to allow us to enter into supply contracts, including government contracts.

Any government investigation of alleged violations of law could require us to expend significant time and resources in response and could generate negative publicity. The occurrence of any event or penalty described above may inhibit our ability to commercialize our future products and generate revenues.

The FDA’s and other regulatory authorities’ policies may change and additional government regulations may be enacted that could prevent, limit or delay regulatory approval of our product candidates.
In addition, we cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or administrative or executive action, either in the United States or abroad. For example, certainWe also cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or administrative action, either in the United States or abroad. If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to maintain regulatory compliance, we may be subject to enforcement action and we may not achieve or sustain profitability.
The FDA and other regulatory agencies actively enforce the laws and regulations prohibiting the promotion of
off-label
uses.
If any of our product candidates are approved and we are found to have improperly promoted
off-label
uses of those products, we may become subject to significant liability. The FDA and other regulatory agencies strictly regulate the current presidential administrationpromotional claims that may impactbe made about prescription products, such as our product candidates, if approved. In particular, a product may not be promoted for uses that are not approved by the FDA or such other regulatory agencies as reflected in the product’s approved labeling. If we receive marketing approval for a product candidate, physicians may nevertheless prescribe it to their patients in a manner that is inconsistent with the approved label. If we are found to have promoted such
off-label
uses, we may become subject to significant liability. The U.S. federal government has levied large civil and criminal fines against companies for alleged improper promotion of
off-label
use and has enjoined several companies from engaging in
off-label
promotion. The FDA has also requested that companies enter into consent decrees or permanent injunctions under which specified promotional conduct is changed or curtailed. If we cannot successfully manage the promotion of our product candidates, if approved, we could become subject to significant liability, which would materially adversely affect our business and industry. Namely,financial condition.
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We have no experience as a company in bringing a drug to regulatory approval.
As a company, we have never obtained regulatory approval for, or commercialized, a drug or biologic. It is possible that the administration has taken several executive actions, including the issuanceFDA may refuse to accept any or all of a numberour planned BLAs for substantive review or may conclude after review of Executive Orders,our data that could impose significant burdens on, or otherwise materially delay, FDA’s abilityour application is insufficient to engage in routineobtain regulatory and oversight activities such as implementing statutes through rulemaking, issuance of guidance, and review and approval of marketingexebacase or any other product candidate. If the FDA does not accept or approve any or all of our planned BLAs, it may require that we conduct additional preclinical, clinical or manufacturing validation studies, which may be costly, and submit that data before it will reconsider our applications. It is difficult to predict how these executive actions, including the current Executive Orders, will be implemented, andDepending on the extent to which they will impact the FDA’s ability to exercise its regulatory authority. Ifof these executive actions impose constraints on FDA’s ability to engage in oversight and implementation activities in the normal course, our businessor any other FDA required studies, approval of any BLA or application that we submit may be negatively impacted.

Changessignificantly delayed, possibly for several years, or may require us to expend more resources than we have available. Any delay in fundingobtaining, or an inability to obtain, regulatory approvals would prevent us from meeting our timelines for commercializing exebacase or any other product candidate, generating revenues and achieving and sustaining profitability.

Disruptions at the FDA and other government agencies caused by funding shortages or global health concerns could hinder their ability to hire, and retain or deploy key leadership and other personnel, or otherwise prevent new or modified products and services from being developed, approved or commercialized in a timely manner or at all, which could negatively impact our business.

The ability of the FDA and foreign regulatory authorities to review and or approve new products can be affected by a variety of factors, including government budget and funding levels, statutory, regulatory, and policy changes, the FDA’s or foreign regulatory authorities’ ability to hire and retain key personnel and accept the payment of user fees, and statutory,other events that may otherwise affect the FDA’s or foreign regulatory and policy changes.authorities’ ability to perform routine functions. Average review times at the agencyFDA and foreign regulatory authorities have fluctuated in recent years as a result. In addition, government funding of other government agencies that fund research and development activities is subject to the political process, which is inherently fluid and unpredictable.

Disruptions at the FDA and other agencies, such as the EMA following its relocation to Amsterdam and resulting staff changes, may also slow the time necessary for new drugs and biologics or modifications to cleared or approved drugs/biologics to be reviewed and/or approved by necessary government agencies, which would adversely affect our business. For example, over the last several years, including for 35 days beginning on December 22, 2018, the U.S. government has shut down several times and certain regulatory agencies, such as the FDA, have had to furlough critical FDA employees and stop critical activities.
Separately, in response to the
COVID-19
pandemic, in March 2020, the FDA announced its intention to postpone most inspections of foreign manufacturing facilities, and on March 18, 2020, the FDA temporarily postponed routine surveillance inspections of domestic manufacturing facilities. Subsequently, in July 2020, the FDA resumed certain
on-site
inspections of domestic manufacturing facilities subject to a risk-based prioritization system. The FDA utilized this risk-based assessment system to assist in determining when and where it was safest to conduct prioritized domestic inspections. Additionally, on April 15, 2021, the FDA issued a guidance document in which the FDA described its plans to conduct voluntary remote interactive evaluations of certain drug manufacturing facilities and clinical research sites, among other facilities. According to the guidance, the FDA may request such remote interactive evaluations where the FDA determines that remote evaluation would be appropriate based on mission needs and travel limitations. In May 2021, the FDA outlined a detailed plan to move toward a more consistent state of inspectional operations, and in July 2021, the FDA resumed standard inspectional operations of domestic facilities and was continuing to maintain this level of operation as of September 2021. More recently, the FDA has continued to monitor and implement changes to its inspectional activities to ensure the safety of its employees and those of the firms it regulates as it adapts to the evolving
COVID-19
pandemic. Regulatory authorities outside the United States have adopted similar restrictions or other policy measures in response to the
COVID-19
pandemic. If a prolonged government shutdown occurs, or if global health concerns continue to prevent the FDA or other regulatory authorities from conducting their
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regular inspections, reviews, or other regulatory activities, it could significantly impact the ability of the FDA or other regulatory authorities to timely review and process our regulatory submissions, which could have a material adverse effect on our business.

If foreign approval for exebacase or any other product candidate is obtained, there are inherent risks in conducting business in international markets.

Commercialization of our product candidates in international markets is an element of our long-term strategy. If approved for commercialization in a foreign country, we intend to enter into agreements with third parties to market exebacase or any other product candidate whenever it may be approved and wherever we have the right to market it. Consequently, we expect that we will be subject to additional risks related to entering into international business relationships, including:

potentially reduced protection for intellectual property rights;

the potential for
so-called
parallel importing, which is what happens when a local seller, faced with high or higher local prices, opts to import goods from a foreign market (with low or lower prices) rather than buying them locally;

unexpected changes in tariffs, trade barriers and regulatory requirements;

economic weakness, including inflation, or political instability in particular foreign economies and markets;

compliance with laws for employees working and traveling abroad;

foreign taxes, including withholding of payroll taxes;

foreign currency fluctuations, which could result in increased operating expenses and reduced revenues;

workforce uncertainty in countries where labor unrest is more common than in the United States;

production shortages resulting from any events affecting active pharmaceutical ingredient and/or finished drug product supply or manufacturing capabilities abroad;

business interruptions resulting from
geo-political
actions, including war and terrorism, epidemics, including the
COVID-19
pandemic, or natural disasters including earthquakes, typhoons, floods and fires; and

failure to comply with the rules and regulations of the Office of Foreign Asset Control, the Foreign Corrupt Practices Act and other applicable anti-bribery rules and regulations in other jurisdictions.

These and other risks may materially adversely affect our ability to attain or sustain revenue from international markets and therefore materially adversely affect our business.

Product liability lawsuits against us could divert our resources, cause us to incur substantial liabilities and limit commercialization of any products that we may develop.

We face an inherent risk of product liability exposure related to the testing of exebacase and any other product candidate that we develop in human clinical trials and we will face higher degrees of this risk if we commercially sell any products that we develop. If we cannot successfully defend ourselves against claims that our product candidates or products caused injuries, we will incur substantial liabilities. Regardless of merit or eventual outcome, liability claims may result in:

distraction of our management or other internal resources from pursuing our business strategies;

decreased demand for any product candidates or products that we may develop;

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injury to our reputation and significant negative media attention;

withdrawal of clinical trial participants;

significant costs to defend the related litigation;

substantial monetary awards to trial participants or patients;

loss of revenue; and

the inability to commercialize any products that we may develop.

We maintain product liability insurance coverage in relation to our clinical trials. Such coverage may not be adequate to cover all liabilities that we may incur. Insurance coverage is increasingly expensive. 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.

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 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. From time to time and in the future, our operations may involve the use of hazardous and flammable materials, including chemicals and biological materials, and may also produce hazardous waste products. Even if we contract with third parties for the disposal of these materials and wastes, 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 for failure to comply with such laws and regulations.

Although we maintain workers’ compensation insurance to cover us for costs and expenses we may incur due to injuries to our employees resulting from the use of hazardous materials, this insurance may not provide adequate coverage against potential liabilities. We do not maintain insurance for environmental liability or toxic tort claims.

In addition, we may incur substantial costs in order to comply with current or future environmental, health and safety laws and regulations. These current or future laws and regulations may impair our research, development or production efforts. Failure to comply with these laws and regulations also may result in substantial fines, penalties or other sanctions.

Our product candidates may face competition sooner than anticipated.

The Affordable Care ActACA includes a subtitle called the Biologics Price Competition and Innovation Act of 2009, or BPCIA, which created an abbreviated approval pathway for biological products that are biosimilar to or interchangeable with an
FDA-licensed
reference biological product. Under the BPCIA, an application for a biosimilar product may not be submitted to the FDA until four years following the date that the reference product was first licensed by the FDA. In addition, the approval of a biosimilar product may not be made effective by the FDA until 12 years from the date on which the reference product was first licensed. During this
12-year
period of exclusivity, another company may still market a competing version of the reference product if the FDA approves a full BLA for the competing product containing the sponsor’s own preclinical data and data from adequate and well-controlled clinical trials to demonstrate the safety, purity and potency of their product. The law is complex and is still being interpreted and implemented by the FDA. As a result, its ultimate impact, implementation, and meaning are subject to uncertainty. While it is uncertain when such processes intended to implement BPCIA may be fully adopted by the FDA, any such processes could have a material adverse effect on the future commercial prospects for our biological products.

We believe that any of our product candidates approved 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 due to
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congressional action or otherwise, or that the FDA will not consider our product candidates to be reference products for competing products, potentially creating the opportunity for generic competition sooner than

anticipated. Other aspectsIn the EU, these exclusivity periods are even shorter. Upon receiving marketing authorization, new chemical or biological entities generally receive eight years of data exclusivity and an additional two years of market exclusivity. If granted, data exclusivity prevents regulatory authorities in the EU from referencing the innovator’s data to assess a generic/biosimilar application. During the additional

two-year
period of market exclusivity, a generic/biosimilar marketing authorization can be submitted, and the innovator’s data may be referenced, but no generic/biosimilar product can be marketed until the expiration of the BPCIA, some of which may impact the BPCIA exclusivity provisions, have also been the subject of recent litigation. market exclusivity.
Moreover, the extent to which a biosimilar, once approved, will be substituted for any one of our 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.

We may be subject, directly or indirectly, to foreign, federal and state healthcare laws, including applicable anti-kickback, fraud and abuse and other healthcare laws and regulations, which could expose us to criminal sanctions, civil penalties, contractual damages, reputational harm and diminished profits and future earnings.

Healthcare providers, physicians and third-party payors play a primary role in the recommendation and prescription of any product candidates for which we obtain marketing approval. Our business operations and current and future arrangements with third-party payors, healthcare providers and customers may expose us to broadly applicable fraud and abuse and other healthcare laws and regulations that may constrain the business or financial arrangements and relationships through which we research, develop, market, sell and distribute our products for which we obtain marketing approval. Restrictions under applicable federal and state healthcare laws and regulations include the following:

the federal healthcare Anti-Kickback Statute prohibits, among other things, persons from knowingly and willfully soliciting, offering, receiving or providing remuneration, directly or indirectly, in cash or in kind, to induce or reward either the referral of an individual for, or the purchase, order or recommendation of, any good or service, for which payment may be made under federal and state healthcare programs such as Medicare and Medicaid. A person or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or specific intent to violate it to have committed a violation; in addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the False Claims Act;

the federal False Claims Act imposes criminal and civil penalties, including through civil whistleblower or qui tam actions, against individuals or entities for knowingly presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent or making a false statement to avoid, decrease or conceal an obligation to pay money to the federal government;

government. In addition, the government may assert that a claim including items or services resulting from a violation of the federal Health Insurance Portability and Accountability ActAnti-Kickback Statute constitutes a false or fraudulent claim for purposes of 1996,the False Claims Act;

HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act, imposes criminal and civil liability for executing a scheme to defraud any healthcare benefit program and also imposes obligations, including mandatory contractual terms, with respect to safeguarding the privacy, security and transmission of individually identifiable health information;

program;

the federal false statements statute prohibits knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false statement in connection with the delivery of or payment for healthcare benefits, items or services. Similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it to have committed a violation;

the federal transparency requirements under the Affordable Care ActACA requires certain manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions) to report to the Department of Health and Human Services information related to physician payments and other transfers of value and ownership and investment interests held by physicians and their immediate family members and payments or other transfers
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ownership and investment interests held by physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors), certain
non-physician
practitioners (physician assistants, nurse practitioners, clinical nurse specialists, certified nurse anesthetists, anesthesiologist assistants and certified nurse midwives), and their immediate family members and payments or other transfers of value made to such physician owners;
analogous state laws and regulations, such as state anti-kickback and false claims laws, and transparency laws, may apply to sales or marketing arrangements and claims involving healthcare items or services reimbursed by
non-governmental
third-party payors, including private insurers, and

some state laws require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated by the federal government in addition to requiring drug manufacturers to report information related to payments to physicians and other health care providers or marketing expenditures and pricing information; and

some state laws require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated by the federal government in addition to requiring drug manufacturers to report information related to payments to physicians and other health care providers or marketing expenditures and pricing information; and

similar healthcare laws and regulations in the EU and other jurisdictions, including reporting requirements detailing interactions with and payments to healthcare providers and laws governing the privacy and security of certain personal data, including the General Data Protection Regulation (“GDPR”), which imposes obligations and restrictions on the collection and use of personal data relating to individuals located in the E.U. and E.E.A. (including with regard to health data).

providers.

Efforts to ensure that our business arrangements with third parties will comply with applicable healthcare laws and regulations will involve substantial costs. It is possible that governmental authorities will conclude that our business practices may not comply with current or future statutes, regulations or case law involving applicable fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of any of these laws or any other governmental regulations that may apply to us, we may be subject to significant civil, criminal and administrative penalties, damages, fines, exclusion from government funded healthcare programs, such as Medicare and Medicaid, additional reporting obligations and oversight if we become subject to a corporate integrity agreement or other agreement to resolve allegations of
non-compliance
with these laws, imprisonment and the curtailment or restructuring of our operations. Further, defending against any such actions, even if successful, can be costly, time-consuming and may require significant personnel resources. If any of the physicians or other providers or entities with whom we expect to do business are found to be not in compliance with applicable laws, they may be subject to criminal, civil or administrative sanctions, including exclusions from government funded healthcare programs.

The unfavorable consequences of any plaintiff attorney investigation or the adverse outcome of litigation or arbitration proceedings commenced by or against us could materially harm our business.

The unfavorable

Unfavorable consequences of anyfrom the most recent and prior investigations by a plaintiff attorneyattorneys could damage our reputation and disrupt our business. The adverse outcome of any litigation or arbitration proceedings commenced by or against us could have a material adverse effect on our business and impede the achievement of our development and commercialization objectives.

In the ordinary course of our operations, claims involving our actions, actions of third parties or agreements to which we are a party may be brought by and against us. The claims and charges can involve actual damages, as well as contractually agreed upon liquidated sums. These claims, if not resolved through negotiation, are often subject to lengthy and expensive litigation or arbitration proceedings.

The United Kingdom’s planned exitwithdrawal from the European Union may adversely impact our business.

In anon-binding referendum

The UK left the EU on the United Kingdom of Great Britain and Northern Ireland’s membershipJanuary 31, 2020, following which existing EU legislation continued to apply in the European Union in June 2016,UK during a majority of the United Kingdom’s electorate voted for the United Kingdom’s withdrawal from the European Union (“Brexit”). A process of negotiation will determine the future terms of the United Kingdom’s relationship with the European Union and its members. While Article 50 of the Lisbon Treaty was invoked by the United Kingdom on March 29, 2017, substantial uncertainty remains regarding the outcome of the negotiations, as well as the scope and duration of a transitionarytransition period if any, following the expiration of the Article 50 period on March 29, 2019. This uncertainty was exacerbated by the lack of a decisive majority following the United Kingdom general election in June 2017 and, following months of negotiation, the rejection by United Kingdom’s Parliament in January 2019 of a withdrawal agreement and related statement on future relations negotiated by representatives of the United Kingdom and the European Union.

Depending onunder the terms of Brexit, the United Kingdom could lose its present rights or terms of

EU-UK
Withdrawal Agreement. The transition period, which ended on December 31, 2020, maintained access to the EU single EU market and EU customs areas and to the global trade deals negotiated by the European UnionEU on

behalf of its members. The uncertainty regarding newtransition period provided time for the UK and EU to negotiate a framework for partnership for the future, which was then crystallized in the Trade and Cooperation Agreement, or modified arrangements, or initiallyTrade and Cooperation Agreement, which became effective on the absenceJanuary 1, 2021.

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Table of such arrangements,Contents
The long-term effects of Brexit on our business in the UK, the EU and worldwide will depend on the effects of the implementation and application of the Trade and Cooperation Agreement and any other relevant agreements between the United KingdomUK and the EU. EU laws which have been transposed into UK law through secondary legislation continue to be applicable as “retained EU law”. However, new legislation will not be applicable. The UK government has passed a new Medicines and Medical Devices Act 2021, which introduces delegated powers in favor of the Secretary of State or an ‘appropriate authority’ to amend or supplement existing regulations in the area of medical devices. This allows new rules to be introduced in the future by way of secondary legislation, which aims to allow flexibility in addressing regulatory gaps. There is a possibility that over time, national laws will be amended and that consequently the regulatory framework in Great Britain will diverge from that of the EU. As of January 1, 2021, the Medicines and Healthcare products Regulatory Agency, or MHRA, is the UK’s standalone medicines and medical devices regulator. As a result of the Northern Ireland protocol, different rules will apply in Northern Ireland than in England, Wales, and Scotland, together, Great Britain; broadly, Northern Ireland will continue to follow the EU regulatory regime, but its national competent authority will remain the MHRA.
Further, the UK’s withdrawal from the EU has resulted in the relocation of the EMA from the UK to the Netherlands. This relocation has caused, and may continue to cause, disruption in the administrative and medical scientific links between the EMA and the UK MHRA, including delays in granting clinical trial authorization or marketing authorization, disruption of importation and export of active substance and other countries following Brexit may have a material adverse effect on the movementcomponents of goods between the United Kingdomnew drug formulations, and membersdisruption of the European Unionsupply chain for clinical trial product and final authorized formulations. The cumulative effects of the United States, includingdisruption to the interruptionregulatory framework may add considerably to the development lead time to marketing authorization and commercialization of or delays in imports into the United Kingdom of goods originating within the European Union and exports from the United Kingdom of goods originating there. For example, shipments into the United Kingdom of drug substance manufactured for the Companyproducts in the European Union may be interrupted or delayed and thereby prevent or delay the manufacture in the United Kingdom of drug product. Similarly, shipments out of the United Kingdom of drug product to the United States EU and/or the European Union may be interrupted or delayed and thereby prevent or delay the delivery of drug product to clinical sites. Such a situation could hinder our ability to conduct current and planned clinical trials and have an adverse effect on our business.

UK.

Risks Related to Employee Matters and Managing Growth

Our future success depends on our ability to attract and retain qualified personnel, and changes in management may negatively affect our business.

We are dependent on the principal members of our management and scientific teams. Our success and the execution of our growth strategy depend largely on the continued service of these employees. Although we have formal employment agreements with our executive officers, these agreements do not prevent them from terminating their employment with us at any time. The loss of the services of any of these persons could be disruptive to our operations, impede our ability to raise additional funding or delay the achievement of our development and commercialization objectives. Additionally, we cannot be certain that changes in management will not lead to additional management departures or changes, affect our ability to hire or retain key personnel, or otherwise negatively affect our business. We do not maintain “key person” insurance for any of our executives or other employees.

Recruiting and retaining qualified scientific and clinical personnel is critical to our success. We may not be able to attract and retain these personnel on acceptable terms given the competition among numerous pharmaceutical and biotechnology companies for similar personnel. We also compete for the hiring of scientific and clinical personnel from universities and research institutions. In addition, we rely on consultants and advisors, including scientific and clinical advisors, to assist us in formulating our development and commercialization strategy. Our consultants and advisors may be employed by employers other than us and may have commitments under consulting or advisory contracts with other entities that may limit their availability to us.

For our Company to successfully develop and commercialize our product candidates, we may need to expand our development, regulatory and sales, marketing and distribution capabilities, and as a result, we may encounter difficulties in managing our growth, which could disrupt our operations.

In order to successfully develop and commercialize our product candidate, we may need to increase the number of our employees and expand the scope of our operations, particularly in the areas of drug discovery,
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drug development, regulatory affairs and commercialization. To manage our anticipated future growth, we would need to implement and improve our managerial, operational and financial systems, expand our facilities and continue to recruit and train additional qualified personnel. Due to our limited financial resources and the various levels of experience of our management team in managing a company with significant growth, we may not be able to effectively manage a significant expansion of our operations or recruit and train additional qualified personnel. The physical expansion of our operations may lead to significant costs and may divert our management and business development resources. Any inability to manage growth could delay the execution of our business plans or disrupt our operations.

Risks Related to Our Intellectual Property

If we or our licensors are unable to obtain and maintain patent protection for our owned or licensed technology and products, or if the scope of the patent protection is not sufficiently broad, our competitors could develop and commercialize technology and products similar or identical to ours, and our ability to successfully commercialize our technology and products may be adversely affected.

Our success depends in large part on our and our licensors’ ability to obtain and maintain patent protection in the United States and other countries with respect to our proprietary technology and products or technology or products that may have been licensed to us. Similar to our licensors, we seek to protect our proprietary position by filing patent applications in the United States and abroad related to our novel technologies and product candidates that are important to our business. This process is expensive and time-consuming, and we or our licensors may not be able to file and prosecute all necessary or desirable patent applications at a reasonable cost or in a timely manner. It is also possible that we or our licensors will fail to identify patentable aspects of either our or their research and development output before it is too late to obtain patent protection. Moreover, if we license technology or product candidates from third parties in the future, these license agreements may not permit us to control the preparation, filing and prosecution of patent applications, or to maintain the patents, covering this intellectual property. These agreements could also give our licensors the right to enforce the licensed patents without our involvement, or to decide not to enforce the patents without our consent. Therefore, in these circumstances, we could not be certain that these patents and applications would be prosecuted and enforced in a manner consistent with the best interests of our business.

The patent position of biotechnology and pharmaceutical companies generally is highly uncertain 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 and any patent rights we may license from a third party are highly uncertain. Our or our licensors’ pending and future patent applications may not result in issued patents that protect our technology or products, in whole or in part, or which effectively prevent others from commercializing competitive technologies and products. Changes in either the patent laws or interpretation of the patent laws in the United States and other countries may diminish the value of our or our licensors’ patents or narrow the scope of such patent protection.

The laws of foreign countries may not protect our rights to the same extent as the laws of the United States. For example, European patent law restricts the patentability of methods of treatment of the human body more than United States law does. Assuming the other requirements for patentability are met, historically, in the United States, the first to make the claimed invention was entitled to the patent, while outside the United States, the first to file a patent application is entitled to the patent. The United States currently uses a
first-inventor-to-file
system in which, assuming the other requirements for patentability are met, the first inventor to file a patent application will be entitled to the patent. Publications of discoveries in the scientific literature often lag behind the actual discoveries, and patent applications in the United States and other jurisdictions are typically not published until 18 months after filing, or in some cases not at all. Therefore, we cannot be certain that we were the first to make the inventions claimed in our patents or pending patent applications, or that we were the first to file for patent protection of such inventions. Moreover, we may be subject to a third party preissuance
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submission of prior art to the U.S. Patent and Trademark Office, or become involved in opposition, derivation, reexamination, litigation, inter partes review or interference proceedings, in the United States or elsewhere, challenging our patent rights or the patent rights of others. An adverse determination in any such submission, proceeding or litigation could reduce the scope of, or invalidate, our patent rights, allow third parties to commercialize our technology or products and compete directly with us, without payment to us, or result in our inability to manufacture or commercialize products without infringing third-party patent rights. In addition, if the breadth or strength of protection provided by our patents and patent applications is threatened, it could dissuade companies from collaborating with us to license, develop or commercialize current or future product candidates.

Even if our or our licensors’ patent applications issue as patents, they may not issue in a form that will provide us with any meaningful protection, prevent competitors from competing with us or otherwise provide us

with any competitive advantage. Our competitors may be able to circumvent our owned or licensed patents by developing similar or alternative technologies or products in a

non-infringing
manner.

The issuance of a patent is not conclusive as to its inventorship, scope, validity or enforceability, and our owned and licensed patents may be challenged in the courts or patent offices in the United States and abroad. Such challenges may result in loss of exclusivity or freedom to operate or in patent claims being narrowed, invalidated or held unenforceable, in whole or in part, which could limit our ability to prevent others from using or commercializing similar or identical technology and products, or limit the duration of the patent protection of our technology and products. Given the amount of time required for the development, testing and regulatory review of new product candidates, patents protecting such candidates might expire before or shortly after such candidates are commercialized and such patents may not be able to claim the benefits of any patent term extension laws or regulations. As a result, our patent portfolio may not provide us with sufficient rights to exclude others from commercializing products similar or identical to ours.

We may be subject to claims by third parties asserting that we or our employees have misappropriated their intellectual property, or claiming ownership of what we regard as our own intellectual property.
Many of our employees were previously employed at universities or other biotechnology or pharmaceutical companies, including our competitors or potential competitors. Although we use customary
non-disclosure
agreements and try to ensure that our employees do not use the proprietary information or
know-how
of others in their work for us, we may be subject to claims that we or these employees have used or disclosed intellectual property, including trade secrets or other proprietary information, of any such employee’s former employer. Litigation may be necessary to defend against these claims.
In addition, while we typically require our employees and contractors who may be involved in the development of intellectual property to execute agreements assigning such intellectual property to us, we may be unsuccessful in executing such an agreement with each party who in fact develops intellectual property that we regard as our own, or such agreements may be inadequately drafted at times thereby not ensuring assignment to us of all potential intellectual property rights. If we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or personnel. Even if we are successful in prosecuting or defending against such claims, litigation could result in substantial costs and be a distraction to management.
We have not yet registered our trademarks in all of our potential markets, and failure to secure those registrations could adversely affect our business.
Our future trademark applications may not be allowed for registration, and our registered trademarks may not be maintained or enforced. During trademark registration proceedings, we may receive rejections from the U.S. Patent and Trademark Office or other applicable foreign intellectual property offices. Although we are given an opportunity to respond to those rejections, we may be unable to overcome such rejections, or have to expend additional resources to secure registrations, such as commencing cancellation proceedings against third-party
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trademark registrations to remove them as obstacles to our trademark applications. In addition, in the U.S. Patent and Trademark Office and in comparable agencies in many foreign jurisdictions, third parties are given an opportunity to oppose pending trademark applications and to seek to cancel registered trademarks. Opposition or cancellation proceedings may be filed against our trademarks, and our trademarks may not survive such proceedings. If we do not secure registrations for our trademarks, we may encounter more difficulty in enforcing them against third parties than we otherwise would.
In addition, we have not yet proposed a proprietary name for our product candidates in any jurisdiction. Any proprietary name we propose to use with our product candidates in the United States must be approved by the FDA, regardless of whether we have registered it, or applied to register it, as a trademark. The FDA typically conducts a review of proposed product names, including an evaluation of potential for confusion with other product names. If the FDA objects to any of our proposed proprietary product names, we may be required to expend significant additional resources in an effort to identify a suitable proprietary product name that would qualify under applicable trademark laws, not infringe the existing rights of third parties and be acceptable to the FDA.
Risks Related to Our Securities
The price of our common stock may be volatile and you could lose all or part of your investment.
There has been significant volatility in the market price and trading volume of equity and derivative securities, which is unrelated to the financial performance of the companies issuing the securities, including due to the effects of the
COVID-19
pandemic. In addition, equity markets have experienced significant price and volume fluctuations that have affected the market prices for the securities of biotechnology and also newly public companies for a number of reasons, including reasons that may be unrelated to the business or operating performance of the companies. These broad market fluctuations may negatively affect the market price of our common stock.
The trading price of our securities has been and is likely to continue to be highly volatile and could be subject to wide fluctuations in response to various factors, some of which are beyond our control, including limited trading volume. In addition to the factors discussed in this “Risk Factors” section and elsewhere in this Annual Report, these factors include:
our ability to implement our preclinical, clinical and other development or operational plans;
adverse regulatory decisions;
strategic actions by us or our competitors, such as acquisitions or restructurings;
new laws or regulations, or new interpretations of existing laws or regulations, applicable to our business;
actual or anticipated fluctuations in our financial condition or annual or quarterly results of operations;
our cash position;
public reaction to our press releases, other public announcements and filings with the SEC;
changes in investor and financial analyst perceptions of the risks and condition of our business;
changes in, or our failure to meet, performance expectations of investors or financial analysts (including, without limitation, with respect to the status of development of our product candidates);
changes in market valuations of biotechnology companies;
changes in key personnel;
increased competition;
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sales of common stock by us or members of our management team;
trading volume of our common stock;
issuances of debt or equity securities;
the granting or exercise of employee stock options or other equity awards;
changes in accounting standards, policies, guidance, interpretations or principles;
ineffectiveness of our internal controls;
actions by institutional or other large stockholders;
significant lawsuits, including patent or stockholder litigation;
general political, market and economic conditions, including as a result of health pandemics; and
other events or factors, many of which are beyond our control.
In addition, the stock market in general, and the Nasdaq Capital Market and biotechnology companies in particular, have experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating performance of these companies. Broad market and industry factors may negatively affect the market price of our common stock, regardless of our actual operating performance. In the past, securities class action litigation has often been instituted against companies following periods of volatility in the market price of a company’s securities. This type of litigation, if instituted, could result in substantial costs and a diversion of management’s attention and resources, which would harm our business, operating results or financial condition.
Future sales of our common stock or warrants may cause the market price of our securities to decline.
Sales of substantial amounts of shares of our common stock or warrants in the public market, or the perception that these sales may occur, could adversely affect the price of our securities and impair our ability to raise capital through the sale of additional equity securities. As of March 17, 2022, we have approximately 39.3 million shares of common stock outstanding, of which approximately 37.4 million shares of our outstanding common stock are freely tradable, or may become freely tradable, without restriction, in the public market unless held by our “affiliates,” as defined under Rule 144 of the Securities Act of 1933, as amended (the “Securities Act”). Additionally, we have warrants to purchase approximately 10.9 million shares of our common stock outstanding as of March 17, 2022. Approximately 10.4 million shares of common stock underlying warrants will be freely tradable upon exercise unless held by our affiliates.
We have registered 4,031,200 shares of our common stock as of March 17, 2022 that we may issue under our employee benefit plans. These shares can be freely sold in the public market upon issuance, unless pursuant to their terms these stock awards have transfer restrictions attached to them. Additionally, pursuant to the 2014 Omnibus Incentive Plan (the “2014 Plan”), our management is authorized to grant stock options and other equity linked award to our employees, directors and consultants. The 2014 Plan provides that the number of shares available for future grant under our 2014 Plan will automatically increase on January 1st each year, from January 1, 2015 through January 1, 2024, by an amount equal to four percent of all shares of our capital stock outstanding as of December 31st of the preceding calendar year, subject to the ability of our board of directors to take action to reduce the size of such increase in any given year. Unless our board of directors elects not to increase the number of shares underlying our 2014 Plan each year, our stockholders may experience additional dilution, which could cause our stock price to decline.
Any failure to maintain effective internal control over financial reporting could have a significant adverse effect on our business and the price of our common stock.
Our management is required to report annually on the effectiveness of our internal control over financial reporting pursuant to Section 404 of the Sarbanes-Oxley Act, or Section 404. The rules governing the standards
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that must be met for our management to assess our internal control over financial reporting are complex and require significant documentation, testing and possible remediation. Because we are no longer an emerging growth company, our independent registered public accounting firm will be required to formally attest to the effectiveness of our internal control over financial reporting pursuant to Section 404 if we, in the future, no longer qualify under the SEC exemption for
low-revenue
“smaller reporting companies”, as defined in Rule
12b-2
of the Exchange Act. As such, our independent registered public accounting firm may in the future issue a report that is adverse in the event it is not satisfied with the level at which our controls are documented, designed or operating.
In the future, we may identify material weaknesses or significant deficiencies in our internal control over financial reporting, and we may not be able to remediate them in time to meet the deadline imposed by the Sarbanes-Oxley Act for compliance with the requirements of Section 404. In addition, we may encounter problems or delays in completing the implementation of any requested improvements and receiving a favorable attestation report from our independent registered public accounting firm, if such a report is required. We will be unable to issue securities in the public markets through the use of a shelf registration statement if we are not in compliance with Section 404. Furthermore, failure to achieve and maintain an effective internal control environment could materially adversely affect our business, reduce the market’s confidence in our common stock, adversely affect the price of our common stock and limit our ability to report our financial results accurately and timely.
We have no present intention to pay cash dividends and, even if we change that policy, we may be restricted from paying cash dividends on our common stock.
We do not intend to pay cash dividends for the foreseeable future. We currently expect to retain all future earnings, if any, for use in the development, operation and expansion of our business. Any determination to pay cash dividends in the future will depend upon, among other things, our results of operations, plans for expansion, tax considerations, available net profits and reserves, limitations under law, financial condition, capital requirements and other factors that our board of directors considers to be relevant.
Provisions in our corporate charter documents and under Delaware law could make an acquisition of us, which may be beneficial to our stockholders, more difficult and may prevent attempts by our stockholders to replace or remove our current management.
Provisions in our corporate charter and our bylaws may discourage, delay or prevent a merger, acquisition or other change in control of us that stockholders may consider favorable, including transactions in which you might otherwise receive a premium for your shares. These provisions could also limit the price that investors might be willing to pay in the future for our securities, thereby depressing the market prices of our securities. In addition, because our board of directors is responsible for appointing the members of our management team, these provisions may frustrate or prevent any attempts by our stockholders to replace or remove our current management by making it more difficult for stockholders to replace members of our board of directors. Among other things, these provisions:
allow the authorized number of our directors to be changed only by resolution of our board of directors;
establish advance notice requirements for stockholder proposals that can be acted on at stockholder meetings and nominations to our board of directors;
require that stockholder actions must be effected at a duly called stockholder meeting and prohibit actions by our stockholders by written consent;
limit who may call stockholder meetings;
authorize our board of directors to issue preferred stock without stockholder approval, which could be used to institute a stockholder rights plan, or
so-called
“poison pill,” that would work to dilute the stock ownership of a potential hostile acquirer, effectively preventing acquisitions that have not been approved by our board of directors; and
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require the approval of the holders of at least 75% of the votes that all our stockholders would be entitled to cast to amend or repeal certain provisions of our charter or bylaws.
Moreover, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware General Corporation Law, which prohibits a person who owns in excess of 15% of our outstanding voting stock from merging or combining with us for a period of three years after the date of the transaction in which the person acquired in excess of 15% of our outstanding voting stock, unless the merger or combination is approved in a prescribed manner.
Risks Related to Cybersecurity, Data Protection and Privacy
Security breaches and other disruptions could compromise our information and expose us to liability, which would cause our business and reputation to suffer.
In the ordinary course of our business, we store sensitive data, including intellectual property, proprietary business information and personally identifiable information, in our data centers and on our networks. The secure processing, maintenance and transmission of this information is critical to our operations and business strategy. Our information technology systems and those of our third-party service providers, strategic partners and other contractors or consultants are vulnerable to attack and damage or interruption from computer viruses and malware (e.g. ransomware), malicious code, natural disasters, terrorism, war, telecommunication and electrical failures, hacking, cyberattacks, phishing attacks and other social engineering schemes, employee theft or misuse, human error (e.g., social engineering, phishing), fraud, denial or degradation of service attacks, sophisticated nation-state and nation-state-supported actors or unauthorized access or use by persons inside our organization, or persons with access to systems inside our organization. Attacks upon information technology systems are increasing in their frequency, levels of persistence, sophistication and intensity, and are being conducted by sophisticated and organized groups and individuals with a wide range of motives and expertise. As a result of the
COVID-19
pandemic and the current conflict between Russia and Ukraine, we may also face increased cybersecurity risks due to our reliance on internet technology and the number of our employees who are working remotely, which may create additional opportunities for cybercriminals to exploit vulnerabilities. Furthermore, because the techniques used to obtain unauthorized access to, or to sabotage, systems change frequently and often are not recognized until launched against a target, we may be unable to anticipate these techniques or implement adequate preventative measures. We may also experience security breaches that may remain undetected for an extended period. Despite our security measures, our information technology and infrastructure may be vulnerable to attacks by hackers or breached due to employee error, malfeasance, or other disruptions. Even if identified, we may be unable to adequately investigate or remediate incidents or breaches due to attackers increasingly using tools and techniques that are designed to circumvent controls, to avoid detection, and to remove or obfuscate forensic evidence.
We and certain of our service providers are from time to time subject to cyberattacks and security incidents. While we do not believe that we have experienced any significant system failure, accident or security breach to date, any such breach could compromise our networks and the information stored there could be accessed, publicly disclosed, lost or stolen. Any such access, disclosure or other loss of information could result in significant costs to address and remediate the incident, lead to legal claims or proceedings, disrupt our operations, and damage our reputation.
We maintain cyber risk insurance, but this insurance may not be sufficient to cover all of our losses from any future breaches of our systems.
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Our collection, control, processing, sharing, disclosure and otherwise use of personal data could give rise to liabilities as a result of governmental regulation, conflicting legal requirements, and evolving laws concerning data privacy in the EU and EEA.
The global data protection landscape is rapidly evolving, and we are or may become subject to numerous state, federal and foreign laws, requirements and regulations governing the collection, use, disclosure, retention, and security of personal data, such as information that we may collect in connection with clinical trials in the U.S. and abroad. Implementation standards and enforcement practices are likely to remain uncertain for the foreseeable future, and we cannot yet determine the impact future laws, regulations, standards, or perception of their requirements may have on our business. This evolution may create uncertainty in our business, affect our ability to operate in certain jurisdictions or to collect, store, transfer use and share personal information, necessitate the acceptance of more onerous obligations in our contracts, result in liability or impose additional costs on us. The cost of compliance with these laws, regulations and standards is high and is likely to increase in the future. Any failure or perceived failure by us to comply with federal, state or foreign laws or regulation, our internal policies and procedures or our contracts governing our processing of personal information could result in negative publicity, government investigations and enforcement actions, claims by third parties and damage to our reputation, any of which could have a material adverse effect on our operations, financial performance and business.
As our operations and business grow, we may become subject to or affected by new or additional data protection laws and regulations and face increased scrutiny or attention from regulatory authorities. In the U.S., HIPAA imposes, among other things, certain standards relating to the privacy, security, transmission and breach reporting of individually identifiable health information. Certain states have also adopted comparable privacy and security laws and regulations, some of which may be more stringent than HIPAA. Such laws and regulations will be subject to interpretation by various courts and other governmental authorities, thus creating potentially complex compliance issues for us and our future customers and strategic partners. In addition, the CCPA went into effect on January 1, 2020. The CCPA creates individual privacy rights for California consumers and increases the privacy and security obligations of entities handling certain personal information. The CCPA provides for civil penalties for violations, as well as a private right of action for data breaches that is expected to increase data breach litigation. The CCPA may increase our compliance costs and potential liability, and many similar laws have been proposed at the federal level and in other states. Further, the CPRA recently passed in California. The CPRA will impose additional data protection obligations on covered businesses, including additional consumer rights processes, limitations on data uses, new audit requirements for higher risk data, and opt outs for certain uses of sensitive data. It will also create a new California data protection agency authorized to issue substantive regulations and could result in increased privacy and information security enforcement. The majority of the provisions will go into effect on January 1, 2023, and additional compliance investment and potential business process changes may be required. Similar laws have passed in Virginia and Colorado and have been proposed in other states and at the federal level, reflecting a trend toward more stringent privacy legislation in the United States. The enactment of such laws could have potentially conflicting requirements that would make compliance challenging. In the event that we are subject to or affected by HIPAA, the CCPA, the CPRA or other domestic privacy and data protection laws, any liability from failure to comply with the requirements of these laws could adversely affect our financial condition.
Our activities outside the United States impose additional compliance requirements and generate additional risks of enforcement for noncompliance. For example, the GDPR repealed the Data Protection Directive (95/46/EC) and is directly applicable in all E.E.A. countries (which consists of the 27 EU member states plus Norway, Liechtenstein and Iceland) since its effective date of May 25, 2018. The GDPR applies to companies established in the EEA, as well as companies that are not established in the EEA and which collect and use personal data in relation to offering goods or services to, or monitoring the behavior of, individuals located in the EEA, including, for example, through the conduct of clinical trials (whether the trials are conducted directly by the company itself or through a clinical vendor or collaborators). The GDPR permits EEA countries derogations for certain matters and, accordingly, we are also subject to national laws relating to the processing of certain data
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such as genetic data, biometric data and health data. It imposes a strict data protection compliance regime including: providing detailed disclosures about how personal data is collected and processed (in a concise, intelligible and easily accessible form); demonstrating that valid consent or another an appropriate legal basis is in place or otherwise exists to justify data processing activities; appointing data protection officers in certain circumstances; granting new rights for data subjects in regard to their personal data (including the right to be “forgotten” and the right to data portability), as well as enhancing current rights (e.g., data subject access requests); introducing the obligation to notify data protection regulators or supervisory authorities (and in certain cases, affected individuals) of significant data breaches; imposing limitations on retention of personal data; maintaining a record of data processing; defining for the first time pseudonymized (i.e.,
key-coded)
data; and complying with principal of accountability and complying with the obligation to demonstrate compliance through policies, procedures, training and audit.
We are also subject to EU rules with respect to cross-border transfers of personal data out of the E.E.A. These rules are under scrutiny from time to time. For example, in July 2020, the Court of Justice of the European Union (the “CJEU”) limited how organizations could lawfully transfer personal data from the EU/EEA to the United States by invalidating the
EU-U.S.
Privacy Shield for purposes of international transfers and imposing further restrictions on the use of standard contractual clauses (“SCCs”). Following the decision of the CJEU, the
EU-U.S.
Privacy Shield can no longer be used as a legal basis for transferring personal data from the European Union to the United States and the CJEU made clear that reliance on standard contractual clauses (SCCs) may not necessarily be a sufficient alternative. The European Commission issued revised SCCs on June 4, 2021 to account for the decision of the CJEU and recommendations made by the European Data Protection Board. The revised SCCs must be used for relevant new data transfers from September 27, 2021; existing standard contractual clauses arrangements must be migrated to the revised clauses by December 27, 2022. The new SCCs apply only to the transfer of personal data outside of the EEA and not the UK; the UK’s Information Commissioner’s Office launched a public consultation on its draft revised data transfers mechanisms in August 2021 and laid its proposal before Parliament, with the UK SCCs expected to come into force in March 2022, with a
two-year
grace period. There is some uncertainty around whether the revised clauses can be used for all types of data transfers, particularly whether they can be relied on for data transfers to
non-EEA
entities subject to the GDPR. As supervisory authorities issue further guidance on personal data export mechanisms, including circumstances where the standard contractual clauses cannot be used, and/or start taking enforcement action, we could suffer additional costs, complaints and/or regulatory investigations or fines, and/or if we are otherwise unable to transfer personal data between and among countries and regions in which we operate, it could affect the manner in which we provide our services, the geographical location or segregation of our relevant systems and operations, and could adversely affect our financial results. If we are otherwise unable to transfer personal data between and among countries and regions in which we operate, it could affect the manner in which we conduct our clinical trials and could adversely affect our business and financial results.
Further, we have had to comply with the GDPR and the GDPR as incorporated into United Kingdom national law, the latter regime having the ability to separately fine up to the greater of £17.5 million or 4% of global turnover. The European Commission has adopted an adequacy decision in favor of the UK, enabling data transfers from EU member states to the UK without additional safeguards. However, the UK adequacy decision will automatically expire in June 2025 unless the European Commission
re-assesses
and renews/ extends that decision and remains under review by the Commission during this period. The relationship between the UK and the EU in relation to certain aspects of data protection law remains unclear, and it is unclear how UK data protection laws and regulations will develop in the medium to longer term, and how data transfers to and from the UK will be regulated in the long term. These changes may lead to additional costs and increase our overall risk exposure.
We depend on a number of third parties in relation to the operation of our business (including clinical research organizations), a number of which process personal data on our behalf. There is no assurance that our own privacy and security-related safeguards and/or any contractual measures that we enter into with these providers will protect us from the risks associated with the third-party processing, storage and transmission of
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such information. Any violation of data or security laws by our third-party processors could have a material adverse effect on our business and result in the fines and penalties outlined below.
Fines for certain breaches of the GDPR are significant for companies: up to the greater of 4% of total annual worldwide turnover of the preceding financial year, or €20 million. In addition to the foregoing, a breach of the GDPR could result in regulatory investigations, reputational damage, orders to cease/ change our processing of our data, enforcement notices, assessment notices (for a compulsory audit), as well potential civil claims including class action type litigation where individuals suffer harm. Our actual or alleged failure to comply with the GDPR could result in enforcement actions and significant penalties against us (as outlined above), which could result in negative publicity, increase our operating, business and/or legal costs, subject us to claims or other remedies and have a material adverse effect on our clinical trials, business, financial condition, and operations.
We are also subject to evolving EU privacy laws on cookies, and
e-marketing.
The EU is in the process of replacing the
e-Privacy
Directive with a new set of rules taking the form of a regulation, which will be directly implemented to all EEA countries. The draft
E-Privacy
Regulation imposes strict
opt-in
marketing rules with limited exceptions for
business-to-business
communications, alters rules on third-party cookies, web beacons and similar technology and significantly increases fining powers to the same levels as the GDPR (i.e. the greater of 20 million Euros or 4% of total global annual revenue for certain breaches). While the
e-Privacy
Regulation was originally intended to be adopted on May 25, 2018 (alongside the GDPR), it is still going through the European legislative process and commentators now expect it to be adopted during 2021, after which a
two-year
transition period will follow before it is in force. We are likely to be required to expend further capital and other resources to ensure compliance with these changing laws and regulations.
Although we work to comply with applicable laws, regulations and standards, our contractual obligations and other legal obligations, these requirements are evolving and may be modified, interpreted and applied in an inconsistent manner from one jurisdiction to another, and may conflict with one another or other legal obligations with which we must comply. Any failure or perceived failure by us or our employees, representatives, contractors, consultants, collaborators, or other third parties to comply with such requirements or adequately address privacy and security concerns, even if unfounded, could result in additional cost and liability to us, damage our reputation, and adversely affect our business and results of operations.
General Risk Factors
We may become involved in lawsuits to protect or enforce our patents or other intellectual property, which could be expensive, time consuming and unsuccessful, and which could result in our patents or other intellectual property rights becoming invalidated.

Competitors may infringe our or our licensors’ patents, trademarks, copyrights or other intellectual property. To stop infringement or unauthorized use, we or our licensors may be required to file infringement claims, which can be expensive and time consuming. Any claims we or our licensors assert against perceived infringers could provoke these parties to assert counterclaims against us alleging that some or all of our patents or other intellectual property rights are not valid or that we or our licensors infringe their patents or other intellectual property rights. In addition, in a patent infringement proceeding, a court may decide that a patent of ours or our licensors is invalid or unenforceable, in whole or in part, construe the patent’s claims narrowly, or may refuse to stop the other party from using the technology at issue on the grounds that such patents do not cover the technology in question and therefore cannot be infringed. Similarly, if we assert trademark infringement claims, a court may determine that the marks we have asserted are invalid, unenforceable, or not infringed, or that the party against whom we have asserted trademark infringement claims has superior rights to the marks in question. In this case, we could ultimately be forced to cease use of such marks. In any infringement litigation, any award of monetary damages may be unlikely or very difficult to obtain, and any such award we may receive may not be commercially valuable. Furthermore, because of the substantial amount of discovery required in connection with
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intellectual property litigation, there is a risk that we could incur substantial litigation costs or that some of our confidential information could be compromised by disclosure during this type of litigation.

Third parties may initiate legal proceedings alleging that we or our licensors 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.

Our commercial success depends upon our ability to develop, manufacture, market, or sell our or our licensors’ product candidates and use our proprietary technologies without infringing the intellectual property and other proprietary rights of third parties. There is considerable intellectual property litigation in the biotechnology and pharmaceutical industries, and we may become party to, or threatened with, future adversarial proceedings or litigation regarding intellectual property rights with respect to our products and technology, including reexamination or interference proceedings before the U.S. Patent and Trademark Office. Third parties may assert infringement claims against us based on existing or future intellectual property rights.

If we or our licensors are found to infringe a third party’s intellectual property rights, we or our licensors could be enjoined from further using certain products and technology or may be required to obtain a license from such third party to continue developing and marketing such products 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 access to the same technologies licensed to us.

We could be forced, including by court order, to cease commercializing the infringing technology or product. 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 rights of a third party. A finding of infringement could prevent us from 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.

We may be subject to claims by third parties asserting that we or our employees have misappropriated their intellectual property, or claiming ownership of what we regard as our own intellectual property.

Many of our employees were previously employed at universities or other biotechnology or pharmaceutical companies, including our competitors or potential competitors. Although we use customarynon-disclosure agreements and try to ensure that our employees do not use the proprietary information orknow-how of others in their work for us, we may be subject to claims that we or these employees have used or disclosed intellectual property, including trade secrets or other proprietary information, of any such employee’s former employer. Litigation may be necessary to defend against these claims.

In addition, while we typically require our employees and contractors who may be involved in the development of intellectual property to execute agreements assigning such intellectual property to us, we may be unsuccessful in executing such an agreement with each party who in fact develops intellectual property that we regard as our own, or such agreements may be inadequately drafted at times thereby not ensuring assignment to us of all potential intellectual property rights. If we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or personnel. Even if we are successful in prosecuting or defending against such claims, litigation could result in substantial costs and be a distraction to management.

Intellectual property litigation could cause us to spend substantial resources and could distract our personnel from their normal responsibilities.

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, sales, marketing or distribution activities. We may not have sufficient financial or other resources to adequately conduct or defend 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. 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.

In addition to seeking patents for some of our technology and products, we also rely on trade secrets, including unpatented
know-how,
technology and other proprietary information, to maintain our competitive position. We seek to protect these trade secrets, in part, by entering into
non-disclosure
and confidentiality agreements with parties who have access to them, such as our employees, corporate collaborators, outside scientific collaborators, contract manufacturers, consultants, advisors and other third parties. However, we cannot guarantee that we have executed these agreements with each party that may have or have had access to our trade secrets, nor can we guarantee that such agreements will always be adequately drafted so as to be enforceable. If we are unable to protect the confidentiality of our trade secrets, our business and competitive position would be harmed.

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Enforcing a claim that a party illegally disclosed or misappropriated a trade secret is difficult, expensive and time-consuming, and the outcome is unpredictable. In addition, because of potential differences in laws in

different jurisdictions, some courts inside and outside the United States are less willing or unwilling to protect trade secrets. If any of our trade secrets were to be lawfully obtained or independently developed by a competitor, we would have no right to prevent them, or those to whom they communicate it, from using that technology or information to compete with us. If any of our trade secrets were to be disclosed to or independently developed by a competitor, our competitive position would be harmed.

We have not yet registered our trademarks in all of our potential markets, and failure to secure those registrations could adversely affect our business.

Our future trademark applications may not be allowed for registration, and our registered trademarks may not be maintained or enforced. During trademark registration proceedings, we may receive rejections from the U.S. Patent and Trademark Office or other applicable foreign intellectual property offices. Although we are given an opportunity to respond to those rejections, we may be unable to overcome such rejections, or have to expend additional resources to secure registrations, such as commencing cancellation proceedings against third-party trademark registrations to remove them as obstacles to our trademark applications. In addition, in the U.S. Patent and Trademark Office and in comparable agencies in many foreign jurisdictions, third parties are given an opportunity to oppose pending trademark applications and to seek to cancel registered trademarks. Opposition or cancellation proceedings may be filed against our trademarks, and our trademarks may not survive such proceedings. If we do not secure registrations for our trademarks, we may encounter more difficulty in enforcing them against third parties than we otherwise would.

In addition, we have not yet proposed a proprietary name for our product candidates in any jurisdiction. Any proprietary name we propose to use with our product candidates in the United States must be approved by the FDA, regardless of whether we have registered it, or applied to register it, as a trademark. The FDA typically conducts a review of proposed product names, including an evaluation of potential for confusion with other product names. If the FDA objects to any of our proposed proprietary product names, we may be required to expend significant additional resources in an effort to identify a suitable proprietary product name that would qualify under applicable trademark laws, not infringe the existing rights of third parties and be acceptable to the FDA.

Risks Related to Our Securities

The price of our common stock may be volatile and you could lose all or part of your investment.

There has been significant volatility in the market price and trading volume of equity and derivative securities, which is unrelated to the financial performance of the companies issuing the securities. In addition, equity markets have experienced significant price and volume fluctuations that have affected the market prices for the securities of biotechnology and also newly public companies for a number of reasons, including reasons that may be unrelated to the business or operating performance of the companies. These broad market fluctuations may negatively affect the market price of our common stock.

Prior to our initial public offering, there was no public market for our common stock. The trading price of our securities has been and is likely to continue to be highly volatile and could be subject to wide fluctuations in response to various factors, some of which are beyond our control, including limited trading volume. In addition to the factors discussed in this “Risk Factors” section and elsewhere in this Annual Report, these factors include:

our ability to implement our preclinical, clinical and other development or operational plans;

adverse regulatory decisions;

strategic actions by us or our competitors, such as acquisitions or restructurings;

new laws or regulations, or new interpretations of existing laws or regulations, applicable to our business;

actual or anticipated fluctuations in our financial condition or annual or quarterly results of operations;

our cash position;

public reaction to our press releases, other public announcements and filings with the SEC;

changes in investor and financial analyst perceptions of the risks and condition of our business;

changes in, or our failure to meet, performance expectations of investors or financial analysts (including, without limitation, with respect to the status of development of our product candidates);

changes in market valuations of biotechnology companies;

changes in key personnel;

increased competition;

sales of common stock by us or members of our management team;

trading volume of our common stock;

issuances of debt or equity securities;

the granting or exercise of employee stock options or other equity awards;

changes in accounting standards, policies, guidance, interpretations or principles;

ineffectiveness of our internal controls;

actions by institutional or other large shareholders;

significant lawsuits, including patent or stockholder litigation;

general political, market and economic conditions; and

other events or factors, many of which are beyond our control.

In addition, the stock market in general, and the Nasdaq Capital Market and biotechnology companies in particular, have experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating performance of these companies. Broad market and industry factors may negatively affect the market price of our common stock, regardless of our actual operating performance. In the past, securities class action litigation has often been instituted against companies following periods of volatility in the market price of a company’s securities. This type of litigation, if instituted, could result in substantial costs and a diversion of management’s attention and resources, which would harm our business, operating results or financial condition.

We are required to meet the Nasdaq Capital Market’s continued listing requirements and other Nasdaq rules, or we may risk delisting. Delisting could negatively affect the price of our common stock, which could make it more difficult for us to sell securities in a future financing or for you to sell our common stock.

We are required to meet the continued listing requirements of the Nasdaq Capital Market and other Nasdaq rules, including those regarding director independence and independent committee requirements, minimum stockholders’ equity, minimum share price and certain other corporate governance requirements. In particular, we are required to maintain a minimum bid price for our listed common stock of $1.00 per share. If we do not meet these continued listing requirements, our common stock could be delisted. On February 20, 2019, we received a letter from The Nasdaq Stock Market LLC (“Nasdaq”) indicating that, for the last thirty consecutive business days, the bid price for our common stock had closed below the minimum $1.00 per share requirement for continued listing on The Nasdaq Capital Market under Nasdaq Listing Rule 5550(a)(2). In accordance with Nasdaq Listing Rule 5810(c)(3)(A), we have been provided an initial period of 180 calendar days, or until

August 19, 2019, to regain compliance. The letter states that the Nasdaq staff will provide written notification that we have achieved compliance with Rule 5550(a)(2) if at any time before August 19, 2019, the bid price of our common stock closes at $1.00 per share or more for a minimum of ten consecutive business days. The letter has no immediate effect on the listing or trading of our common stock. Delisting from the Nasdaq Capital Market would cause us to pursue eligibility for trading of these securities on other markets or exchanges, or on the “pink sheets.” In such case, our stockholders’ ability to trade, or obtain quotations of the market value of our common stock would be severely limited because of lower trading volumes and transaction delays. These factors could contribute to lower prices and larger spreads in the bid and ask prices of these securities. There can be no assurance that our securities, if delisted from the Nasdaq Capital Market in the future, would be listed on a national securities exchange, a national quotation service, theover-the-counter markets or the pink sheets. Delisting from the Nasdaq Capital Market, or even the issuance of a notice of potential delisting, would also result in negative publicity, make it more difficult for us to raise additional capital, adversely affect the market liquidity of our securities, decrease securities analysts’ coverage of us or diminish investor, supplier and employee confidence.

We may issue additional shares of common stock, warrants or other securities to finance our growth.

We may finance the development of our product pipeline or generate additional working capital through additional equity financing. Therefore, subject to the rules of the Nasdaq, we may issue additional shares of our common stock, warrants and other equity securities of equal or senior rank, with or without shareholderstockholder approval, in a number of circumstances from time to time. The issuance by us of shares of our common stock, warrants or other equity securities of equal or senior rank will have the following effects:

the proportionate ownership interest in us held by our existing shareholdersstockholders will decrease;

the relative voting strength of each previously outstanding share of common stock may be diminished; and

the market price of our common stock may decline.

In addition, if we issue shares of our common stock and/or warrants in a future offering (or, in the case of our common stock, the exercise of outstanding warrants to purchase our common stock), it could be dilutive to our security holders.

Future sales of our common stock or warrants may cause the market price of our securities to decline.

Sales of substantial amounts of shares of our common stock or warrants in the public market, or the perception that these sales may occur, could adversely affect the price of our securities and impair our ability to raise capital through the sale of additional equity securities. As of March 7, 2019, we have approximately 79.4 million shares of common stock outstanding, of which approximately 77.1 million shares of our outstanding common stock are freely tradable, or may become freely tradable, without restriction, in the public market unless held by our “affiliates,” as defined under Rule 144 of the Securities Act of 1933, as amended (the “Securities Act”). Additionally, we have warrants to purchase approximately 31.3 million shares of our common stock outstanding as of March 7, 2019. Approximately 30.9 million shares of common stock underlying the Warrants will be freely tradable upon exercise unless held by our affiliates.

We have registered 9,878,747 shares of our common stock as of March 7, 2019 that we may issue under our employee benefit plans. These shares can be freely sold in the public market upon issuance, unless pursuant to their terms these stock awards have transfer restrictions attached to them. Additionally, pursuant to the 2014 Omnibus Incentive Plan (the “2014 Plan”), our management is authorized to grant stock options and other equity linked award to our employees, directors and consultants. The 2014 Plan provides that the number of shares available for future grant under our 2014 Plan will automatically increase on January 1st each year, from January 1, 2015 through January 1, 2024, by an amount equal to four percent of all shares of our capital stock

outstanding as of December 31st of the preceding calendar year, subject to the ability of our board of directors to take action to reduce the size of such increase in any given year. Unless our board of directors elects not to increase the number of shares underlying our 2014 Plan each year, our stockholders may experience additional dilution, which could cause our stock price to decline.

If shares of our common stock become subject to the penny stock rules, it would become more difficult to trade them.

The SEC has adopted regulations which generally define a “penny stock” to be an equity security that has a market price of less than $5.00 per share or an exercise price of less than $5.00 per share, subject to specific exemptions, including an exemption for any securities listed on a national securities exchange. The rules impose additional sales practice requirements on broker-dealers for transactions involving “penny stock”, with some exceptions. If shares of our common stock were delisted from the Nasdaq Capital Market and determined to be “penny stock”, broker-dealers may find it more difficult to trade such securities and investors may find it more difficult to acquire or dispose of such securities on the secondary market.

There can be no assurance that we will ever provide liquidity to our investors through a sale of our company.

company.

While acquisitions of pharmaceutical companies like ours are not uncommon, potential investors are cautioned that no assurances can be given that any form of merger, combination, or sale of our company will take place, or that any merger, combination, or sale, even if consummated, would provide liquidity or a profit for our investors. You should not invest in our company with the expectation that we will be able to sell the business in order to provide liquidity or a profit for our investors.

We incur significant costs as a result of operating as a public company and our management is required to devote substantial time to complying with public company regulations.

We completed an initial public offering on August 1, 2014.

As a public company, we incur significant legal, accounting and other expenses, including costs associated with our public company reporting requirements under the Securities Exchange Act of 1934, as amended (the “Exchange Act”). We must also follow the rules, regulations and requirements subsequently adopted by the SEC and the Nasdaq and any failure by us to comply with such rules and requirements could negatively affect investor
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confidence in us and cause the market price of our common stock to decline. Our executive officers and other personnel also need to devote substantial time and financial resources to comply with these rules, regulations and requirements.

The rules and regulations applicable to public companies have substantially increased our legal and financial compliance costs and made some activities more time-consuming and costly. If these requirements divert the attention of our management and personnel from other business concerns, they could have a material adverse effect on our business, financial condition and results of operations. The increased costs decrease our net income or increase our net loss, and may require us to reduce costs in other areas of our business. For example, we expect these rules and regulations to make it more difficult and more expensive for us to obtain director and officer liability insurance and we may be required to incur substantial costs to maintain the same or similar coverage. We cannot predict or estimate the amount or timing of additional costs we may incur to respond to these requirements. The impact of these requirements could also make it more difficult for us to attract and retain qualified persons to serve on our board of directors, our board committees or as executive officers.

Any failure to maintain effective internal control over financial reporting could have a significant adverse effect on our business and the price of our common stock.

Our management is required to report annually on the effectiveness of our internal control over financial reporting pursuant to Section 404 of the Sarbanes-Oxley Act, or Section 404. The rules governing the standards that must be met for our management to assess our internal control over financial reporting are complex and require significant documentation, testing and possible remediation.

In the future, we may identify material weaknesses or significant deficiencies in our internal control over financial reporting, and we may not be able to remediate them in time to meet the deadline imposed by the Sarbanes-Oxley Act for compliance with the requirements of Section 404. In addition, we may encounter problems or delays in completing the implementation of any requested improvements and receiving a favorable attestation report from our independent registered public accounting firm, if such a report is required. We will be unable to issue securities in the public markets through the use of a shelf registration statement if we are not in compliance with Section 404. Furthermore, failure to achieve and maintain an effective internal control environment could materially adversely affect our business, reduce the market’s confidence in our common stock, adversely affect the price of our common stock and limit our ability to report our financial results accurately and timely.

Reports published by analysts, including projections in those reports that exceed our actual results, could adversely affect the price and trading volume of our common stock.

The projections of securities research analysts may vary widely and may not accurately predict the results we actually achieve. The price of our common stock may decline if our actual results do not match the projections of these securities research analysts. Similarly, if one or more of the analysts who write reports on us downgrades our stock or publishes inaccurate or unfavorable research about our business, the price of our common stock could decline. If one or more of these analysts ceases coverage of us or fails to publish reports on us regularly, the price or trading volume of our common stock could decline.

If securities or industry analysts do not publish research or reports about our business, the prices of our securities and trading volume could decline.

The trading market for our securities depends, in part, on the research and reports that securities or industry analysts publish about us or our business. We do not have any control over these analysts. If no securities or industry analysts commence coverage of our company, the trading prices for our securities may be negatively impacted.

We have broad discretion in the use of the net proceeds from our public offerings and private placement and may not use them effectively.

Our management has broad discretion in the application of the net proceeds from our public offerings and private placement and could spend the proceeds in ways that do not enhance the value of our common stock. Because of the number and variability of factors that will determine our use of the net proceeds from our completed offerings, their ultimate use may vary substantially from their currently intended use. The failure by our management to apply these funds effectively could delay the development of our product candidates or have a material adverse effect on our business. Pending their use, we may invest the net proceeds from the offerings in a manner that does not produce income or that loses value. If we do not apply or invest the net proceeds from the offerings in ways that enhance stockholder value, we may fail to achieve expected financial results, which could cause the price of our securities to decline.

We are an “emerging growth company,” and the reduced disclosure requirements applicable to emerging growth companies may make our common stock less attractive to investors.

We are an “emerging growth company,” as defined in the JOBS Act, and will remain an emerging growth company through the year ended December 31, 2018. For so long as we remain an emerging growth company, we are permitted and intend to rely on exemptions from certain disclosure requirements that are applicable to other public companies that are not emerging growth companies. These exemptions include:

not being required to comply with the auditor attestation requirements in the assessment

Item 1B.
Unresolved Staff Comments
None
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Table of our internal control over financial reporting;

Contents

not being required to comply with any requirement that may be adopted by the Public Company Accounting Oversight Board regarding mandatory audit firm rotation or a supplement to the auditor’s report providing additional information about the audit and the financial statements;

reduced disclosure obligations regarding executive compensation; and

exemptions from the requirements of holding a nonbinding advisory vote on executive compensation and shareholder approval of any golden parachute payments not previously approved.

We have taken advantage of certain reduced reporting burdens. We cannot predict whether investors will find our securities less attractive if we rely on these exemptions. If some investors find our securities less attractive as a result, there may be a less active trading market for our common stock, and the prices for our securities may be more volatile.

We have no present intention to pay cash dividends and, even if we change that policy, we may be restricted from paying cash dividends on our common stock.

We do not intend to pay cash dividends for the foreseeable future. We currently expect to retain all future earnings, if any, for use in the development, operation and expansion of our business. Any determination to pay cash dividends in the future will depend upon, among other things, our results of operations, plans for expansion, tax considerations, available net profits and reserves, limitations under law, financial condition, capital requirements and other factors that our board of directors considers to be relevant.

Provisions in our corporate charter documents and under Delaware law could make an acquisition of us, which may be beneficial to our stockholders, more difficult and may prevent attempts by our stockholders to replace or remove our current management.

Provisions in our corporate charter and our bylaws may discourage, delay or prevent a merger, acquisition or other change in control of us that stockholders may consider favorable, including transactions in which you might otherwise receive a premium for your shares. These provisions could also limit the price that investors might be willing to pay in the future for our securities, thereby depressing the market prices of our securities. In addition, because our board of directors is responsible for appointing the members of our management team, these provisions may frustrate or prevent any attempts by our stockholders to replace or remove our current management by making it more difficult for stockholders to replace members of our board of directors. Among other things, these provisions:

allow the authorized number of our directors to be changed only by resolution of our board of directors;

establish advance notice requirements for stockholder proposals that can be acted on at stockholder meetings and nominations to our board of directors;

require that stockholder actions must be effected at a duly called stockholder meeting and prohibit actions by our stockholders by written consent;

limit who may call stockholder meetings;

authorize our board of directors to issue preferred stock without stockholder approval, which could be used to institute a shareholder rights plan, orso-called “poison pill,” that would work to dilute the stock ownership of a potential hostile acquirer, effectively preventing acquisitions that have not been approved by our board of directors; and

require the approval of the holders of at least 75% of the votes that all our stockholders would be entitled to cast to amend or repeal certain provisions of our charter or bylaws.

Moreover, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware General Corporation Law, which prohibits a person who owns in excess of 15% of our outstanding

voting stock from merging or combining with us for a period of three years after the date of the transaction in which the person acquired in excess of 15% of our outstanding voting stock, unless the merger or combination is approved in a prescribed manner.

Risks Related to Cybersecurity, Data Protection and Privacy

Security breaches and other disruptions could compromise our information and expose us to liability, which would cause our business and reputation to suffer.

In the ordinary course of our business, we store sensitive data, including intellectual property, proprietary business information and personally identifiable information, in our data centers and on our networks. The secure processing, maintenance and transmission of this information is critical to our operations and business strategy. Despite our security measures, our information technology and infrastructure may be vulnerable to attacks by hackers or breached due to employee error, malfeasance, or other disruptions. Any such breach could compromise our networks and the information stored there could be accessed, publicly disclosed, lost or stolen. Any such access, disclosure or other loss of information could result in significant costs to address and remediate the incident, lead to legal claims or proceedings, disrupt our operations, and damage our reputation.

We maintain cyber risk insurance, but this insurance may not be sufficient to cover all of our losses from any future breaches of our systems.

Our collection, control, processing, sharing, disclosure and otherwise use of personal data could give rise to liabilities as a result of governmental regulation, conflicting legal requirements, and evolving laws concerning data privacy in the E.U. and E.E.A.

The regulatory environment with regard to privacy and data protection issues is increasingly challenging. For example, the GDPR repealed the Data Protection Directive (95/46/EC) and is directly applicable in all E.U. and E.E.A. Member States since its effective date of May 25, 2018. The GDPR applies to companies established in the E.U. or E.E.A., as well as companies that are not established in the E.U. or E.E.A. and which collect and use personal data in relation to offering goods or services to, or monitoring the behavior of, individuals located in the E.U. or E.E.A., including, for example, through the conduct of clinical trials (whether the trials are conducted directly by the company itself or through a clinical vendor or collaborators). The GDPR permits E.U. and E.E.A. Member State derogations for certain matters and, accordingly, we are also subject to EU national laws relating to the processing of certain data such as genetic data, biometric data and health data. It imposes a strict data protection compliance regime including: providing detailed disclosures about how personal data is collected and processed (in a concise, intelligible and easily accessible form); demonstrating that valid consent or another an appropriate legal basis is in place or otherwise exists to justify data processing activities; appointing data protection officers in certain circumstances; granting new rights for data subjects in regard to their personal data (including the right to be “forgotten” and the right to data portability), as well as enhancing current rights (e.g., data subject access requests); introducing the obligation to notify data protection regulators or supervisory authorities (and in certain cases, affected individuals) of significant data breaches; imposing limitations on retention of personal data; maintaining a record of data processing; defining for the first time pseudonymized (i.e.,key-coded) data; and complying with principal of accountability and complying with the obligation to demonstrate compliance through policies, procedures, training and audit.

We are also subject to E.U. rules with respect to cross-border transfers of personal data out of the E.U. and E.E.A. These rules are under scrutiny from time to time. For example, there is ongoing litigation challenging the EU Commission approved model clauses (also called standard contractual clauses), which is a commonly used transfer mechanism under the GDPR. It is uncertain whether the model clauses will be invalidated by the European courts. In addition, Brexit will mean that at some point that the United Kingdom (“U.K.”) will become a “third party” for the purposes of data transfers under the GDPR.

We depend on a number of third parties in relation to the operation of our business (including clinical research organizations), a number of which process personal data on our behalf. There is no assurance that our own privacy and security-related safeguards and/or any contractual measures that we enter into with these providers will protect us from the risks associated with the third-party processing, storage and transmission of such information. Any violation of data or security laws by our third party processors could have a material adverse effect on our business and result in the fines and penalties outlined below.

Fines for certain breaches of the GDPR are significant: up to the greater of 4% of total worldwide turnover, or €20 million. In addition to the foregoing, a breach of the GDPR could result in regulatory investigations, reputational damage, orders to cease/ change our processing of our data, enforcement notices, assessment notices (for a compulsory audit), as well potential civil claims including class action type litigation where individuals suffer harm. Our actual or alleged failure to comply with the GDPR could result in enforcement actions and significant penalties against us (as outlined above), which could result in negative publicity, increase our operating, business and/or legal costs, subject us to claims or other remedies and have a material adverse effect on our clinical trials, business, financial condition, and operations.

We are also subject to evolving E.U. privacy laws on cookies, ande-marketing. The E.U. is in the process of replacing thee-Privacy Directive with a new set of rules taking the form of a regulation. The draftE-Privacy Regulation imposes strictopt-in marketing rules with limited exceptions forbusiness-to-business communications, alters rules on third-party cookies, web beacons and similar technology and significantly increases fining powers to the same levels as the GDPR (i.e. the greater of 20 million Euros or 4% of total global annual revenue). While thee-Privacy Regulation was originally intended to be adopted on May 25 2018 (alongside the GDPR), it is still going through the European legislative process and commentators now expect it to be adopted during the second half of 2020 or during 2021 following a transition period. We are likely to be required to expend further capital and other resources to ensure compliance with these changing laws and regulations.

Item 1B. Unresolved Staff Comments

None

Item 2. Properties

In the second quarter of 2011, we opened our

Our corporate headquarters and laboratory is located in Yonkers, New York. This 15,000 sq. ft. mixed use office, laboratory space consists of open laboratory and suites for molecular biology, microbiology, tissue culture, microscopy, a vivarium, and a robotics suite. This facility is leased through December 31, 2027.

Item 3. Legal Proceedings

None

Item 4. Mine Safety Disclosures

None

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PART II

Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

Market Information

Our common stock is publicly traded on the Nasdaq Capital Market under the symbol “CFRX”.

Holders

On March 7, 2019,17, 2022, the last reported sale price for our common stock on the Nasdaq Capital Market was $0.40$3.48 per share. As of March 7, 2019,17, 2022, there were approximately 1,6131,600 holders of record of our common stock. This number does not include beneficial owners whose shares are held by nominees in street name.

Dividends

We have not declared or paid any cash dividends on our capital stock since our inception. We intend to retain future earnings, if any, to finance the operation and expansion of our business and do not anticipate paying any cash dividends to holders of common stock in the foreseeable future.

Recent

Unregistered Sales of Unregistered Securities; Equity Securities
None
Purchases of Equity Securities by the Issuer or Affiliated Purchaser

We did not repurchase any of our equity securities or issue any securities that were not registered under Securities Act during the quarter ended December 31, 2018.

2021.

Item 6. Selected Financial Data

The following selected financial data should be read in conjunction with Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations”, the financial statements and the notes thereto and other financial information included elsewhere in this Annual Report on Form10-K.

We derived the financial data for the years ended December 31, 2018, 2017 and 2016 and as of December 31, 2018 and 2017 from our audited financial statements, which are included elsewhere in this Annual Report on Form10-K. We derived the financial data for the years ended December 31, 2015 and 2014 and as of December 31, 2016, 2015 and 2014 from our audited financial statements that are not included elsewhere in this Annual Report on Form10-K. The selected financial data in this section are not intended to replace our financial statements and related notes. Our historical results are not necessarily indicative of our future results.

   Year Ended December 31, 

Statement of Operations Data

  2018  2017  2016  2015  2014 

Loss from operations

  $(31,124,425 $(26,563,757 $(33,532,246 $(25,065,336 $(16,935,911

Net loss attributable to common stockholders

  $(37,668,424 $(15,517,658 $(28,538,399 $(25,120,964 $(34,617,536

Net loss per share of common stock, basic and diluted

  $(0.50 $(0.28 $(0.85 $(1.08 $(3.86
   As of December 31, 

Balance Sheet Data

  2018  2017  2016  2015  2014 

Cash, cash equivalents and marketable securities

  $30,452,253  $46,853,910  $35,161,154  $32,921,653  $27,393,059 

Total assets

   32,872,571   50,189,479   37,624,470   35,861,137   30,053,622 

Long-term liabilities

   21,533,592   14,575,366   13,693,419   1,416,443   1,249,046 

Total stockholders’ equity

   5,541,960   31,193,445   19,512,854   30,675,510   25,581,507 
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 financial statements and the related notes and other financial information included elsewhere in this Annual Report on Form
10-K.
Some of the information contained in this discussion and analysis or set forth elsewhere in this Annual Report on Form
10-K,
including information with respect to our plans and strategy for our business, includes forward-looking statements that involve risks and uncertainties. You should review the “Risk factors” section of this Annual Report on Form
10-K
for a discussion of important factors that could cause actual results to differ materially from the results described in or implied by the forward-looking statements contained in the following discussion and analysis.

Overview

We are a late clinical-stage biotechnology company focused on discovering novel, differentiated biologic therapeuticsthe discovery and developing themdevelopment of direct lytic agents (“DLAs”), including lysins and amurin peptides, as new medical modalities for the treatment of life-threatening, infectious diseases, including those caused by drug-resistant pathogens. Drug-resistant infections account for 2,000,000 illnessesantibiotic-resistant infections. We believe DLAs are fundamentally different than antibiotics and offer a potential paradigm shift in the United Statestreatment of antibiotic-resistant infections. According to one of the most recent and 700,000comprehensive reports on the global burden of bacterial antimicrobial resistance (“AMR”), there were an estimated 4.95 million deaths worldwide each year. We intendassociated with bacterial AMR in 2019, including 1.27 million deaths directly attributable to address drug-resistant infections using product candidates from our lysin platform. bacterial AMR. The six leading pathogens for deaths associated with resistance (
Escherichia coli (“E. coli”)
,
Staphylococcus aureus (“S. aureus”)
,
Klebsiella pneumoniae (“K. pneumoniae”)
,
Streptococcus
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pneumoniae
,
Acinetobacter baumannii (“A. baumannii”)
, and
Pseudomonas aeruginosa
(“
P. aeruginosa
”)) were responsible for 929,000 deaths. Only one pathogen–drug combination, methicillin-resistant
S. aureus
(“MRSA”), caused more than 100,000 deaths in 2019.
Lysins are recombinantly-produced enzymes, derived from naturally occurring bacteriophage, which are viruses that infect bacteria. When recombinantly produced and thenwhen applied to bacteria lysins cleave a key component of the target bacteria’s peptidoglycan cell wall, resulting in rapid bacterial cell death. Conventional antibiotics require bacterial cell division and metabolism to occur in order to exert their intended effect (i.e., cell death or cessation of growth). Based onin vitro tests, lysins, however, are fundamentally different in that they kill bacteria rapidly by enzymatic cleavage of the bacterial cell wall without need for bacterial growth and cell division. In addition to the speed of action and potent cidality, we believe lysins are differentiated by their other hallmark features, which include the demonstrated ability to eradicate biofilms and synergistically boost the efficacy of conventional antibiotics in animal models. Importantly, lysins alsoAmurin peptides are a new class of DLAs, discovered in our laboratories, which disrupt the outer membrane of gram-negative bacteria, resulting in rapid bacterial cell death, offering a distinct mechanism of action from lysins. Amurins have a “narrowpotent, broad spectrum” meaning they kill only specific of
in vitro
activity against a wide range of gram-negative pathogens, including deadly, drug-resistant
P. aeruginosa
,
K. pneumoniae, E. coli, A. baumannii
and
Enterobacter cloacae
bacteria species as well as difficult to treat pathogens such as
Stenotrophomonas,
Achromobacter
and some
Burkholderia
species. The highly differentiated properties of bacteria or closely related bacteria. As such, we believe that lysins targeting gram-positive pathogens will not have negative effects on the beneficial, normal human GI microbiome, in contrast to conventional “broad spectrum” antibiotics which can kill the body’s normal, beneficial bacteria. We believe that the therapeutic profile of lysins is complimentary to that of conventional antibiotics. As such, our approach includes theDLAs underscore their potential use of lysins in addition to conventional antibiotics with the goal of improving clinical outcomes compared to antibiotics alone. The development of DLAs involves a novel clinical and regulatory strategy, using superiority design clinical trials with the goal of delivering significantly improved clinical outcomes for the treatment ofpatients with serious, drug-resistantantibiotic-resistant bacterial infections, including biofilm-associated infections,infections. We believe this approach affords potential clinical benefits to achieve greater efficacy and improve clinical outcomes,patients as well as potentially protectingthe potential ability to mitigate against further development of antibiotic resistance.

We believe that the properties of our lysins will make them suitable for targeting antibiotic-resistant organisms, such asStaphylococcus aureus (“Staph aureus”) andPseudomonas aeruginosa (“P.aeruginosa”), which cause serious infections such as bacteremia, pneumonia and osteomyelitis. Beyond lysins, we continue to seek and identify novel antibacterial product candidates. We recently discovered a new class of novel lytic agents, called amurin peptides. Our preliminary characterization studies indicate that amurin peptides have potency across a wide range of resistant gram-negative pathogens, including species that are part of the ESKAPE pathogens (Enterococcus faecium,Staphylococcus aureus,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,andEnterobacter species), which are the leading causes of hospital acquired infections throughout the world. These pathogens are considered to be urgent or serious threats to global health by the U.S. Center for Disease Control (“CDC”) and critical priorities by the World Health Organization (“WHO”). We believe that the amurin peptides will be highly complementary to our pathogen-specific lysin platform in addressing these infections. We aim to improve outcomes in patient with these life-threatening bacterial infections through use of our differentiated biologic candidates developed from our new classes of molecules.

We have not generated any revenues and, to date, have funded our operations primarily through our IPO,initial public offering (“IPO”), our
follow-on
public offerings, private placements of convertible preferred stock and convertible debt to our investors,securities, and grant funding received. In our most recent financing in July and August 2018,On March 22, 2021, we soldcompleted an

aggregate underwritten public offering of 5,750,00011,500,000 shares of our common stock, including shares sold pursuant to the fully exercised overallotment option granted to the underwriters in connection with the offering, at a public offering price of $2.00$5.00 per share of common stock, resulting in an underwrittenfollow-on offering, generatingestimated net proceeds of approximately $10.4$53.8 million after underwriting discounts and commissions and offering expenses payable by us.

On May 27, 2020, we completed an underwritten public offering of 11,797,752 shares of our common stock and warrants to purchase an additional 8,848,314 shares of our common stock at an exercise price of $4.90 per share. The public offering price was $4.45 for one share of common stock and an accompanying warrant to purchase 0.75 shares of common stock, resulting in net proceeds of approximately $48.9 million after underwriting discounts and commissions and offering expenses payable by us. We also completed a concurrent private placement to Pfizer Inc. (“Pfizer”) of 674,156 shares of common stock and an accompanying warrant to purchase an additional 505,617 shares of our common stock at an exercise price of $4.90 per share. The offering price for the warrant was $4.45 for one share of common stock and an accompanying warrant to purchase 0.75 shares of common stock, resulting in net proceeds of approximately $3.0 million. This was the second investment by Pfizer, for a total of $6.0 million invested into the Company.
On March 10, 2021, we executed a cost-share contract (the “BARDA Contract”) with the Biomedical Advanced Research and Development Authority (“BARDA”) and any exercise of BARDA’s options to extend such contract, part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services. Under the terms of the BARDA Contract, the Company will receive $9.8 million in initial funding and up to an additional $77.0 million. The initial funding will be used to support our ongoing pivotal Phase 3 DISRUPT superiority trial of exebacase. Under the terms of the agreement, and if supported by Phase 3 DISRUPT study data, BARDA may provide the Company with additional funding upon achievement of key milestones to continue the advancement of exebacase through FDA product approval and completion of post-approval commitments. The BARDA Contract contains terms and conditions that are customary for contracts with BARDA of this nature, including provisions giving the government the right to terminate the contract at any time for its convenience. As a government contractor, we are subject to complex and wide-ranging federal and
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agency-specific regulations and contractual requirements. The costs of compliance with these requirements may be significant. Failure to comply with government contracting requirements could result in termination of our contract or the imposition of penalties.
We have never been profitable and our net operating losses were $37.7$47.3 million, $15.5$34.2 million, and $28.5$27.9 million for the years ended December 31, 2018, 20172021, 2020 and 2016,2019, respectively. As of December 31, 2021, we had an accumulated deficit of $260.7 million and we had approximately $54.3 million in cash, cash equivalents and marketable securities. We expect to incur significant expenses and increasing operating losses for the foreseeable future. We expect our expenses to increase in connection with our ongoing activities, particularly as we advance our product candidates through preclinical activities and clinical trials to seek regulatory approval and, if approved, commercialize such product candidates. Accordingly, we will need additional financing to support our continuing operations.operations and to continue as a going concern. We expect to seek to fund our operations through public or private equity, debt financings, equity-linked financings, collaborations, strategic alliances, licensing arrangements, research grants or other sources. Adequate additional financing may not be available to us on acceptable terms, or at all. Our failure to raise capital as and when needed would have a negative impact on our financial condition and our ability to pursue our business strategy. Without additional funding, the Company believes it will not have sufficient funds to meet its obligations within the next twelve months from the date of issuance of these consolidated financial statements. These factors raise substantial doubt about the Company’s ability to continue as a going concern. Substantial doubt about our ability to continue as a going concern may materially and adversely affect the price per share of our common stock, and it may be more difficult for us to obtain financing. If potential collaborators decline to do business with us or potential investors decline to participate in any future financings due to such concerns, our ability to increase our cash position may be limited. We will need to generate significant revenues to achieve profitability, and we may never do so.

Financial Operations Overview

Revenue

We have not generated any revenues to date. In the future, we may generate revenues from product sales. In addition, to the extent we enter into licensing or collaboration arrangements, we may have additional sources of revenue. We expect that any revenue we generate will fluctuate from quarter to quarter as a result of the amount and timing of payments that we may recognize upon the sale of our products, to the extent that any products are successfully commercialized, and the amount and timing of fees, reimbursements, milestone and other payments received under any future licensing or collaboration arrangements. If we fail to complete the development of our product candidates in a timely manner or obtain regulatory approval for them, our ability to generate future revenue, and our results of operations and financial position, would be materially adversely affected.

Research and development expenses

Research and development expenses consist primarily of costs incurred for our research activities, including our drug discovery efforts, and the development of our product candidates, which include:

employee-related expenses, including salaries, performance bonuses, benefits, travel and
non-cash share-based
stock-based compensation expense;

external research and development expenses incurred under arrangements with third parties such as contract research organizations, or CROs, contract manufacturers, consultants and academic institutions; and

facilities and laboratory and other supplies.

We expense research and development costs to operations as incurred. We account for
non-refundable
advance payments for goods and services that will be used in future research and development activities as expenses when the service has been performed or when the goods have been received, rather than when the payment is made.

The following summarizes our most advanced current research and development programs.

78

Exebacase

Exebacase is an investigational novel lysin that targetsStaph aureus

Our lead DLA product candidate, exebacase, was granted Breakthrough Therapy designation for the treatment of MRSA bloodstream infections (bacteremia), including MRSA strains, which causes serious infections such asright-sided endocarditis, when used in addition to
standard-of-care
(“SOC”) anti-staphylococcal antibiotics in adult patients, by the U.S. Food and Drug Administration (“FDA”) in February 2020 and is currently being studied in an ongoing Phase 3 superiority design study. In addition to bacteremia, pneumonia and osteomyelitis.Staph
S. aureus
is also a frequent sourcecommon cause of

biofilm-dependent pneumonia and osteomyelitis as well as biofilm-associated infections of heart valves (endocarditis), prosthetic joints, indwelling devices and catheters. These infections result in significant morbidity and mortality despite currently available antibiotic therapies. Exebacase

In December 2019, we initiated the Phase 3 DISRUPT (Direct Lysis of
S. aureus
Resistant Pathogen Trial) superiority design study of exebacase. The DISRUPT study is being studieda randomized, double-blind, placebo-controlled Phase 3 clinical trial conducted in the U.S. alone to assess the efficacy and safety of exebacase in approximately 350 adult and adolescent patients with complicated
S. aureus
bacteremia, including right-sided endocarditis. Patients entering the study will be randomized 2:1 to either exebacase or placebo, with all patients receiving SOC antistaphylococcal antibiotics. The primary efficacy endpoint of the study is clinical response at Day 14 in patients with MRSA bacteremia, including right-sided endocarditis. Secondary endpoints include clinical response at Day 14 in the All
S. aureus
patient group (MRSA and methicillin-sensitive
S. aureus
(“MSSA”)),
30-day
all-cause
mortality in MRSA patients, and clinical response at later timepoints. We will also evaluate the impact of treatment with exebacase on health resource utilization, including hospital length of stay, ICU length of stay and
30-day
readmission rates. We plan to conduct an interim futility analysis after approximately 60% of the MRSA population (the primary endpoint study population) completes the Day 14 primary endpoint study visit. We obtained concurrence with the FDA on the Phase 3 study protocol at an
End-of-Phase
2 meeting with the FDA in September 2019, including the key design features of the study population, the endpoints and the size of the safety database that would be needed to support a Biologics License Application (“BLA”) for approval of exebacase, under the FDA’s “streamlined development” paradigm for agents to treat bacterial infections associated with high unmet medical need.
We completed a Phase 2 superiority design study to evaluateof exebacase that evaluated its safety, tolerability, efficacy and PKpharmacokinetics (“PK”) when used in addition to background SOC antibacterial therapyantibiotics compared to SOC antibiotics alone for the treatment ofStaph
S. aureus
bacteremia, including endocarditis in adult patients.

We recently announced positive topline The results from thisfirst-in-patient Phase 2 superiority study of exebacase which showed clinically meaningful improvement in clinical responder rates among patients treated with exebacase in addition to SOC antibiotics compared to SOC antibiotics alone. In the primary efficacy analysis population of 116 patients with documentedStaph

S. aureus
bacteremia, including endocarditis, who received a single intravenous (IV)(“IV”) infusion of blinded study drug, the clinical responder rate at Day 14 was 70.4% for patients treated with exebacase and 60.0% for patients dosed with SOC antibiotics alone. alone (p=0.314).
In a
pre-specified
analysis of MRSA-infected patients, the clinical responder rate at Day 14 in patients treated with exebacase was 42.8%nearly
43-percentage
points higher than the clinical responder rate in patients treated with SOC antibiotics alone (74.1% for patients treated with exebacase compared to 31.3% for patients treated with SOC antibiotics alone (p=0.010)). TheIn addition to the higher rate of clinical response, MRSA-infected patients treated with exebacase showed a
21-percentage
point reduction in
30-day
all-cause
mortality (p=0.056), a four day lower mean length of hospital stay and meaningful reductions in hospital readmission rates. Additional
pre-specified
analyses showed a clinical responder rate at Day 14 in the subset of patients with bacteremia including right-sided endocarditis wasof 80.0% for patients treated with exebacase compared to 59.5% for patients treated with SOC antibiotics alone, an increase of 20.5% (p=0.028). In the subset of patients with bacteremia alone, the clinical responder rate at Day 14 was 81.8% for patients treated with exebacase compared to 61.5% for patients treated with SOC antibiotics alone, an increase of 20.3% (p=0.035).
Exebacase was well-tolerated and treatment emergent adverse events, including serious treatment-emergent SAEsserious adverse events (“SAEs”) were balanced between the treatment groups. There were no SAEs that we
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determined to be related to exebacase, there were no reports of hypersensitivity related to exebacase and no patients discontinued treatment with study drug in either treatment group.
We also performed a
post-hoc
Phase 3 simulation analysis using the Phase 2 data to evaluate the clinical outcomes for the Phase 2 patient population that would meet the Phase 3 inclusion criteria. In this simulated Phase 3 analysis population of 84 U.S. patients with documented
S. aureus
bacteremia, including right-sided endocarditis, who received a single IV infusion of blinded study drug, the clinical responder rate at Day 14 was 83.7% for patients treated with exebacase and 54.3% for patients dosed with SOC antibiotics alone, an improvement in the responder rate of over
29-percentage
points. The clinical responder rate at Day 14 in the subset of patients with MRSA bacteremia including right-sided endocarditis was 82.6% for patients treated with exebacase compared to 33.3% for patients treated with SOC antibiotics alone, an improvement in the responder rate of over
49-percentage
points. In the subset of patients with MSSA bacteremia including right-sided endocarditis, the clinical responder rate at Day 14 was 84.6% for patients treated with exebacase compared to 66.7% for patients treated with SOC antibiotics alone, an increase of nearly
18-percentage
points.
We believe these data establishestablished proof of concept for exebacase and for the lysin classDLAs as therapeutic agents,agents. In particular, the data for MRSA-infected patients treated with exebacase, which, in the Phase 2 superiority study, demonstrated superior outcomes in clinical response at Day 14 and will informin
30-day
all-cause
mortality as well as health economics benefits, provided the design of Phase 3basis for exebacase.

Other programs

We continuethe FDA to explore variants ofgrant Breakthrough Therapy designation to exebacase to expand our portfolio of lysins targeting biofilm-dependentStaph aureus infections. We have engineered a novel mutant variant,CF-296, which we believe has properties which may make it particularly useful for the treatment of prosthetic joint infections. WeMRSA bloodstream infections (bacteremia), including right-sided endocarditis, when used in addition to SOC anti-staphylococcal antibiotics in adult patients. Breakthrough Therapy designation is a program designed by the FDA to expedite the development and review of medicines for serious or life-threatening diseases where preliminary clinical evidence suggests that the investigational therapy may demonstrate substantial improvement on at least one clinically significant endpoint over available therapies. The Breakthrough Therapy designation provides additional benefits, such as expedited interactions with the FDA and the potential for priority review, in addition to the Fast Track designation granted to exebacase in August 2015.

On March 10, 2021, we entered into a cost-share contract (the “BARDA Contract”) with BARDA, a division of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response. Under the BARDA Contract, we will receive funding of up to an estimated $86.8 million to advance the development of exebacase. The base period for the BARDA Contract includes government funding of up to $9.8 million to reimburse expenses for approximately one year to support the conduct of the ongoing Phase 3 clinical trial and futility analysis. Following successful completion of the base period, the BARDA Contract provides for approximately $77.0 million of additional BARDA funding for five option stages in support of the completion of the Phase 3 clinical trial of exebacase, further clinical and
non-clinical
studies, manufacturing, supply chain, clinical, regulatory and administrative activities. The contract
period-of-performance
(base period plus option exercises) is up to approximately six years. The BARDA Contract contains terms and conditions that are evaluatingCF-296customary for contracts with BARDA of this nature, including provisions giving the government the right to terminate the contract at any time for its convenience.
Other programs
Our next product candidate,
CF-370,
is designed to target a range of gram-negative bacteria including
P. aeruginosa
and has demonstrated potent
in animal models to further characterize this compound.

Our lysin research efforts are focused on a broad-based gram-negative discovery program which aims to identify, optimize and develop lysins that target deadly gram-negative pathogens. We have discovered and engineered lysins with potent vivo

activity against extensively drug-resistant (“XDR”) strains.
P. aeruginosabacteria in preclinical studies,
is a major cause of morbidity and mortality often related to hospital acquiredin patients with hospital-acquired or ventilator-associated pneumonia and a major medical challenge particularly for cystic fibrosis patients with cystic fibrosis.chronic lung infections.
CF-370
has also shown promising activity against
E. coli
,
K. pneumoniae
and
A. baumannii
in
in vitro
studies.
In July 2020, we were granted an award of up to $18.9 million in funding from
CARB-X,
including initial funding of $4.9 million, in support of the advancement of
CF-370
through
IND-enabling
activities. Any additional funding beyond the $4.9 million is at the discretion of
CARB-X
and based on factors such as available funding, achievement of project milestones and mutual agreement on future milestones. We expect
CF-370
to be our next DLA to enter clinical studies.
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In addition, we have entered into two funding agreements with the Cystic Fibrosis Foundation to investigate the potential utility of DLAs against resistant gram-negative pathogens which afflict Cystic Fibrosis (“CF”) patients. The first agreement provided funding for the assessment of the
in vitro
activity of
CF-370
and amurin peptides against bacterial specimens obtained from CF patients at different stages of disease. The second agreement will provide funding for assessing the
in vitro
and
in vivo
activity of exebacase against
S. aureus
isolates obtained from CF patients. If we obtain supportive data, we plan to evaluate potential future clinical development of DLA product candidates for the treatment of exacerbations in CF lung disease.
We have developed a novel, engineered variant of exebacase, known as
CF-296,
which we believe provides an additional opportunity to advance a potential targeted therapy for deep-seated, invasive biofilm-associated
S. aureus
infections. We are initiating animal studiesconducting further
in vitro
and
in vivo
characterization of our most promising anti-pseudomonal lysins with
CF-296
to evaluate the goalfull profile of moving this programcompound. We have been awarded up to $7.2 million of funding from the clinic as soon as possible.

Military Infectious Diseases Research Program, United States Army Medical Research and Development Command (“USAMRDC”) over the course of three years to advance

CF-296
through Investigational New Drug application (“IND”)-enabling studies.
Beyond our lysin programs, we continue our proprietary research to expandadvance potential product candidates from our pipeline of complimentary, nontraditional antimicrobials to address unmet medical needs.amurin peptide platform. We are continuing to progressCF-404, which is an aerosolized treatment for life-threatening human influenza composed of three human mAbs which target all seasonal andevaluating our most pandemic strains of influenza. We have discovered a novel class of phage-derived lytic agents, known as amurin peptides, which display potent bacteriocidal activity against a wide range of gram-negative pathogenspromising amurins in preclinical animal studies including deadly, drug-resistantP. aeruginosa, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumanniiwith the goals of determining our next product candidate and Enterobacter cloacaebacteria species. We are currently evaluating thein vitro andin vivo profiles of the amurin peptidesmoving this program towards clinical studies as we continue to advance the program.

soon as possible.

To date, a large portion of our research and development work has related to the establishment of our lysin platform technologies, the advancement of our research projects to discovery of clinical candidates, manufacturing and preclinical testing of our clinical candidates and clinical testing of exebacase. We currently expect to focus the majority of our resources on the exebacase program. In the future,As our pipeline progresses, we intendare able to further

leverage our employee and infrastructure resources across multiple development programs well as research projects. InWe recorded approximately $35.5 million, $22.6 million, and $18.1 million of research and development expenses for the years ended December 31, 2018, 20172021, 2020 and 2016, we recorded approximately $22.4 million, $17.3 million and $22.1 million, respectively, of research and development expenses.2019, respectively. A breakdown of our research and development expenses by category is shown below. We do not currently utilize a formal time or laboratory project expense allocation system to allocate employee-related expenses, laboratory costs or depreciation to any particular project. Accordingly, we do not allocate these expenses to individual projects or product candidates. However, we do allocate some portions of our research and development expenses in the product development, external research and licensing and professional fees categories by project, includingto exebacase andCF-404, as shown below.

The following table summarizes our research and development expenses by category for the years ended December 31, 2018, 20172021, 2020 and 2016:

   Year Ended December 31, 
   2018   2017   2016 

Product development

  $14,307,715   $10,219,826   $10,331,021 

Personnel related

   3,064,872    3,387,749    4,357,177 

Professional fees

   2,467,000    1,760,608    3,170,364 

Laboratory costs

   1,266,780    1,011,766    2,065,064 

External research and licensing costs

   684,281    482,803    1,590,668 

Share-based compensation

   626,003    451,334    587,426 
  

 

 

   

 

 

   

 

 

 

Total research and development expense

  $22,416,651   $17,314,086   $22,101,720 
  

 

 

   

 

 

   

 

 

 

2019:

   
Year Ended December 31,
 
   
2021
   
2020
   
2019
 
Product development
  $29,813   $15,502   $10,401 
Personnel related
   8,404    4,703    3,402 
Professional fees
   3,618    3,605    2,912 
External research and licensing costs
   1,651    952    2,487 
Laboratory costs
   1,638    1,418    2,021 
Stock-based compensation
   933    655    469 
Expenses reimbursed through grant agreements and government contracts
   (10,549   (4,221   (3,635
  
 
 
   
 
 
   
 
 
 
Total research and development expense
  $35,508   $22,614   $18,057 
  
 
 
   
 
 
   
 
 
 
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The following table summarizes our research and development expenses by program for the years ended December 31, 2018, 20172021, 2020 and 2016:

   Year Ended December 31, 
   2018   2017   2016 

Exebacase

  $16,218,315   $10,974,804   $8,092,280 

CF-404

   5,600    797,726    5,639,474 

Other research and development

   2,501,861    1,707,473    3,425,363 

Personnel related and share-based compensation

   3,690,875    3,839,083    4,944,603 
  

 

 

   

 

 

   

 

 

 

Total research and development expense

  $22,416,651   $17,314,086   $22,101,720 
  

 

 

   

 

 

   

 

 

 

2019:

   
Year Ended December 31,
 
   
2021
   
2020
   
2019
 
Exebacase
  $25,460   $15,094   $11,370 
CF-370
   4,077    1,325    —   
Other research and development
   7,184    5,058    6,451 
Personnel related and stock-based compensation
   9,336    5,358    3,871 
Expenses reimbursed through grant agreements and government contracts
   (10,549   (4,221   (3,635
  
 
 
   
 
 
   
 
 
 
Total research and development expense
  $35,508   $22,614   $18,057 
  
 
 
   
 
 
   
 
 
 
We anticipate that our research and development expenses will increase substantially in connection with the commencement of additional clinical trials for our product candidates. However, the successful development of
future product candidates is highly uncertain. This is due to the numerous risks and uncertainties associated with developing drugs, including the uncertainty of:

the scope, rate of progress and expense of our research and development activities;

clinical trial results;

the terms and timing of regulatory approvals;

our ability to market, commercialize and achieve market acceptance for our product candidates in the future; and

the expense, filing, prosecuting, defending and enforcing of patent claims and other intellectual property rights.

A change in the outcome of any of these variables with respect to the development of exebacase or any other product candidate that we may develop could mean a significant change in the costs and timing associated with the development of exebacase or any such product candidate. For example, if the FDA or other regulatory authority were to require us to conduct clinical trials beyond those which we currently anticipate will be required for the completion of clinical development of exebacase or if we experience significant delays in enrollment in any clinical trials of exebacase, we could be required to expend significant additional financial resources and time on the completion of the clinical development of exebacase.

General and Administrative Expenses

General and administrative expenses consist primarily of salaries and related costs for personnel, including
non-cash share-based
stock-based compensation expense, in our executive, finance, legal, human resource and business development functions. Other general and administrative expenses include facility costs, insurance expenses and professional fees for legal, consulting and accounting services.

We anticipate that our general and administrative expenses will increase in future periods to support increases in our research and development activities and as a result of increased headcount, expanded infrastructure, increased legal, compliance, accounting and investor and public relations expenses associated with being a public company and increased insurance premiums, among other factors.

Interest Income

Interest income consists of interest earned on our cash and cash equivalents and
available-for-sale
securities.

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Critical Accounting Policies and Significant Judgments and Estimates

Our management’s discussion and analysis of our financial condition and results of operations is based on our financial statements, which we have prepared in accordance with U.S. generally accepted accounting principles. The preparation of these financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities and expenses and the disclosure of contingent assets and liabilities in our financial statements. On an ongoing basis, we evaluate our estimates and judgments. We base our estimates on our limited historical experience, known trends and events and various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.

While our significant accounting policies are described in more detail in the notes to our financial statements included elsewhere in this Annual Report on Form
10-K,
we believe that the following accounting policies are the most critical to aid you in fully understanding and evaluating our financial condition and results of operations.

Fair Value of Warrant Liability

In accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 820,
Fair Value Measurements and Disclosures (“
(“ASC 820”), we classify and account for our warrant liability as a level 3 financial instrument. The valuation of a level 3 financial instrument requires inputs that reflect our own assumptions that are both significant to the fair value measurement and unobservable. We calculate the fair value estimate of our warrant liability on a recurring basis at each measurement date, based on relevant market information.

We use the Black-Scholes option pricing model to estimate the fair value of our warrant liability using various assumptions that require management to apply judgment and make estimates, including:

the expected term of the warrant, which we estimate to be the remaining contractual life;

the expected volatility of the underlying common stock, which we estimate based on the historical volatility of a representative peer group of publicly traded biopharmaceutical companies with similarities to us, including stage of drug development, area of therapeutic focus, number of employees and market capitalization;

our own common shares;

the risk-free interest rate, which we based on the yield curve of U.S. Treasury securities with periods commensurate with the expected term; and

the expected dividend yield, which we estimate to be zero based on the fact that we have never paid cash dividends and have no present intention to pay cash dividends.

These estimates may be subjective in nature and involve uncertainties and matters of significant judgment and therefore cannot be determined with precision. If factors change and different assumptions are used, our warrant liability could be materially different in the future.

Accrued research and development expenses

As part of the process of preparing our financial statements, we are required to estimate our accrued expenses. This process involves reviewing quotations and contracts, identifying services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the actual cost. The majority of our service providers invoice us monthly in arrears for services performed or when contractual milestones are met. We make estimates of our accrued expenses as of each balance sheet date in our financial statements based on facts and circumstances known to us at that time. We periodically confirm the accuracy of our estimates with the service providers and make adjustments if necessary. The significant estimates in our accrued research and development expenses are related to fees paid to CMOs and CROs in connection with research and development activities for which we have not yet been invoiced.

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We base our expenses related to CMOs and CROs on our estimates of the services received and efforts expended pursuant to quotes and contracts with CROs thatfor the conduct of manufacturing or research and development on our behalf. The financial terms of these agreements are subject to negotiation, vary from contract to contract and may result in uneven payment flows. There may be instances in which payments made to our vendors will exceed the level of services provided and result in a prepayment of the research and development expense. In accruing service fees, we estimate the time period over which services will be performed and the level of effort to be expended in each period. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrual or prepayment expense accordingly. Although we do not expect our estimates to be materially different from amounts actually incurred, our understanding of the status and timing of services performed relative to the actual status and timing of services performed may vary and could result in us reporting amounts that are too high or too low in any particular period. Differences between our estimates and amounts actually incurred to date, and any resulting adjustments, have not been material.

Stock-based compensation

We account for stock-based compensation in accordance with Financial Accounting Standards Board Accounting Standards CodificationFASB ASC Topic 718,
Compensation-Stock Compensation
, which we refer to as ASC 718. ASC 718 requires the measurement and recognition of compensation expense for all stock-based payment awards made to employees, andnon-employeedirectors, and
non-employees,
including employee stock options. Compensation expense based on the grant date fair value is generally amortized over the requisite service period of the award on a straight-line basis.

We account for stock options granted tonon-employees, which primarily consists of consultants, using the

The fair value method. Stockof options granted tonon-employees are subject to periodic revaluation over their vesting terms and stock-based compensation expense may be recognizedis calculated using an accelerated recognition model.

We use the Black-Scholes option pricing model. The Black-Scholes option pricing model to estimate the fair value of stock option awards usinguses various assumptions that require management to apply judgment and make estimates, including:

the expected term of the stock option award, which fornon-employees we use the remaining contractual term, but for employees we calculate using the simplified method, as prescribed by the Securities and Exchange Commission Staff Accounting Bulletin No. 107, Share-Based Payment, as we have insufficient historical information regarding our stock options to provide a basis for an estimate;

the expected term of the stock option award, which for
non-employees
we use the remaining contractual term, but for employees we calculate using the simplified method, as prescribed by the Securities and Exchange Commission Staff Accounting Bulletin No. 107,
Share-Based Payment,
as we have insufficient historical information regarding our stock options to provide a basis for an estimate;
the expected volatility of the underlying common stock, which depending on the related expected term, we estimate based on either (i) the historical volatility of a representative peer group of publicly traded biopharmaceutical companies with similarities to us, including stage of drug development, area of therapeutic focus, number of employees and market capitalization or (ii) the historical volatility of our own common shares;

the risk-free interest rate, which we based on the yield curve of U.S. Treasury securities with periods commensurate with the expected term of the options being valued;

the expected dividend yield, which we estimate to be zero based on the fact that we have never paid cash dividends and have no present intention to pay cash dividends; and

the fair value of our common stock on the date of grant.

If factors change and different assumptions are used, our stock-based compensation expense could be materially different in the future.

Recent Accounting Pronouncements

See Note 2—Summary of Significant Accounting Policies, of the Notes to Financial Statements, for a discussion of the impact of new accounting standards on our Financial Statements.

Results of Operations

For a discussion of our results of operations for the year ended December 31, 2020, including a
year-to-year
comparison between 2020 and 2019, refer to Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our Annual Report on Form
10-K
for the year ended December 31, 2020.
84

Comparison of years ended December 31, 20182021 and 2017

2020

The following table summarizes our results of operations for the years ended December 31, 20182021 and 2017:

   Year Ended December 31,         
   2018   2017   Dollar Change   % Change 

Operating expenses:

    

Research and development

  $22,416,651   $17,314,086   $5,102,565    29

General and administrative

  $8,707,774   $9,249,671   $(541,897   (6)% 

Other (expense) income

  $(6,559,999  $11,046,099   $(17,606,098   (163)% 

2020 (in thousands):

   
Year Ended December 31,
         
   
2021
   
2020
   
Dollar Change
   
% Change
 
Operating expenses:
    
Research and development
  $35,508   $22,614   $12,894    57
General and administrative
  $11,757   $11,625   $132    1
Other income
  $26,983   $6,084   $20,899    344
Research and Development Expenses

Research and development expense was $22.4$35.5 million for the year ended December 31, 2018,2021, compared with $17.3$22.6 million for the year ended December 31, 2017,2020, an increase of $5.1$12.9 million. This increase was primarily attributable to a $4.5$5.6 million increase in expenditures on our product candidates as we completed enrollment in and delivery of topline data for the Phase 23 DISRUPT study of exebacase as we increased patient enrollment and expanded the number of clinical trialsites. We also increased expenditures by $4.9 million on
non-clinical
studies of exebacase that will support a potential BLA submission and
CF-370
that will support a potential IND submission and by $4.5 million on manufacturing costs related to the process transfer, validation and manufacturing of exebacase that will also support a potential BLA submission, in addition to process development and manufacturing for
CF-370.
Finally, we increased expenditures to expand our internal research and development team and our external consultants by $4.0 million. These increases were partially offset by a continued reduction in expenditures onCF-404 activities. The increase was also due to an overall $0.6$6.3 million increase primarily in other research and developmentour expenses including laboratory and external research costs in support ofthat are reimbursable under our grants compared to the discovery and study of additional product candidates.

prior year period.

General and Administrative Expenses

General and administrative expense was $8.7$11.8 million for the year ended December 31, 2018,2021, compared with $9.2$11.6 million for the year ended December 31, 2017, a decrease2020, an increase of $0.5$0.1 million. This decreaseincrease was primarily attributable to decreasedincreases in internal compensation costs including severanceand external professional fees of $0.6 million and insurance costs of $0.8 million, which$0.4 million. These increases were partially offset by a $0.5$0.9 million increasereduction in payroll taxes due to a refundable payroll tax credit realized in the year ended December 31, 2017.

our external legal costs.

Other (expense) income

Other expenseincome was $6.6$27.0 million for the year ended December 31, 20182021 compared with other income of $11.0$6.1 million for the year ended December 31, 2017, a decrease2020, an increase of $17.6$20.9 million. In 2018, we hadThis increase was primarily attributable to the increase in the
non-cash expense of $7.2 million
gain related to the change in fair value of our warrant liability which was partially offset by interest income of $0.6$18.8 million. In 2017, we hadnon-cash income of $11.5 million relatedaddition, the prior year period has a charge to the change in fair value of our warrant liability and $0.4 million of interest income. These income items were partially offset byother expense of $0.9$2.2 million for issuance costs allocated to the warrants issued with the offering of our securities in July 2017.

Comparison of years ended December 31, 2017 and 2016

The following table summarizes our results of operations for the years ended December 31, 2017 and 2016:

   Year Ended December 31,         
   2017   2016   Dollar Change   % Change 

Operating expenses:

    

Research and development

  $17,314,086   $22,101,720   $(4,787,634   (22)% 

General and administrative

  $9,249,671   $11,430,526   $(2,180,855   (19)% 

Other income

  $11,046,099   $4,993,847   $6,052,252    121

Research and Development Expenses

Research and development expense was $17.3 million for the year ended December 31, 2017, compared with $22.1 million for the year ended December 31, 2016, a decrease of $4.8 million. This decrease was primarily attributable to a $3.3 million decrease in expenses related to our research headcount, which included a reduction in research and development expense of $1.2 million reflecting grant funding received for salaries, benefits and laboratory costs in support of the discovery and study of additional product candidates and a $1.5 million decrease in external professional and consulting fees.

General and Administrative Expenses

General and administrative expense was $9.2 million for the year ended December 31, 2017, compared with $11.4 million for the year ended December 31, 2016, a decrease of $2.2 million. This decrease was primarily attributable to decreases in severance related costs of $1.1 million, a decrease in external professional, consulting and legal fees of $0.5 million, a decrease of $0.4 million in expenses related to our administrative personnel and a $0.2 million decrease in the administrative portion of the expenditure on our office and laboratory facility and related operating expenses from the reduction of the square footage of our leased premises.

Other income

Other income was $11.0 million for the year ended December 31, 2017 compared with $5.0 million for the year ended December 31, 2016, an increase of $6.0 million. This increase was primarily attributable to an increase innon-cash income of $5.2 million related to the change in fair value of our warrant liability, a decrease of $0.6 million in issuance costs allocated to warrants, issuedfor which there was no such expense in ourfollow-on offerings and an increase in interest income of $0.2 million.

2021.

Liquidity and Capital Resources

Sources of Liquidity

We have financed our operations to date primarily through proceeds from sales of common stock, common stock and warrants, convertible preferred stock and convertible debt and, to a lesser extent, grant funding.funding received from government contracts and granting organizations. To date, we have not generated any revenue from the sale of products. We have incurred losses and generated negative cash flows from operations since inception.

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Since the date of our initial public offering,IPO, we have funded our operations through the sale of registered securities for gross proceeds of $127.8$257.8 million, $9.6 million from the exercise of the Class B Warrants issued in our IPO, and $20.0$26.0 million from the sale of securities in private placements and the receipt of $16.7 million of funding from grant agreements and government contracts.
On August 14, 2020, we filed a private placement.

shelf registration statement on Form

S-3
(the “Form
S-3”)
with the SEC. The Form
S-3
was declared effective by the SEC on August 31, 2020. The Form
S-3
allows us to offer and sell from
time-to-time
up to $150.0 million of common stock, preferred stock, debt securities, warrants or units comprised of any combination of these securities. On March 22, 2021, we completed an underwritten public offering of 11,500,000 shares of our common stock, including shares sold pursuant to the fully exercised overallotment option granted to the underwriters in connection with the offering, at a public offering price of $5.00 per share of common stock, resulting in estimated net proceeds of approximately $53.8 million after underwriting discounts and commissions and offering expenses payable by us. The terms of any future offerings under the shelf registration statement will be established at the time of such offering and will be described in a prospectus supplement filed with the SEC prior to the completion of any such offering.
As of December 31, 2018,2021, we had approximately $30.5$54.3 million in cash, cash equivalents and marketable securities which we do not believe will not be sufficient to meet our obligations within the next twelve months from the date of issuance of our audited consolidated financial statements that are included elsewhere in this Annual Report on Form 10-K. Combined with our accumulated deficit and our forecasted cash expenditures, these factors raise substantial doubt about our ability to continue as a going concern. We have relied on our ability to fund our operations primarily through public and private debt and equity financings, but there can be no assurances that such financing will continue to be available to us on satisfactory terms, or at all.
As such, under the requirements of ASCAccounting Standard Codification (“ASC”)
205-40,
we may not consider the potential for future capital raises in our assessment of our ability to meet our obligations for the next twelve months. We plan to continue to fund our operations through public or private debt and equity financings, but there can be no assurances that such financing will continue to be available to us on acceptable terms, or at all, and the terms of any public or private offerings of stock could be significantly dilutive to existing stockholders. If we are unable to obtain funding, we would be forced to delay, reduce or eliminate our research and development programs, which could adversely affect our business prospects, or we may be unable to continue operations. In accordance with the requirements of ASC
205-40,
we have concluded that substantial doubt exists about our ability to continue as a going concern for twelve months from the date of issuance of our audited consolidated financial statements that are included elsewhere in this Annual Report on Form
10-K.

In the past, we have obtained grants to supplement our financings with
non-dilutive
funding, including grants from
CARB-X,
USAMRDC and our cost-sharing contract with BARDA. We may continue to pursue further
non-dilutive
funding opportunities. In addition, there can be no assurances that either BARDA,
CARB-X
or USAMRDC will provide the maximum potential funding to the Company.
Cash flows

The following table shows a summary of our cash flows for the years ended December 31, 2018, 20172021 and 2016:

   Year Ended December 31, 
   2018   2017   2016 

Net cash provided by (used in):

      

Operating activities

  $(26,258,849  $(24,528,993  $(29,300,340

Investing activities

  $17,151,224   $(9,359,641  $(8,968,567

Financing activities

  $10,432,896   $37,076,696   $32,103,109 

2020:

   
Year Ended December 31,
 
   
2021
   
2020
 
Net cash (used in) provided by:
    
Operating activities
  $ (41,125)   $(33,187) 
Investing activities
  $(11,613  $(27,404
Financing activities
  $53,907   $51,892 
Net cash used in operating activities

Net cash used in operating activities resulted primarily from our net losses adjusted for
non-cash
charges and changes in the components of working capital. Net cash used in operating activities increased $1.7$7.9 million in
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for the year ended December 31, 20182021 as compared to the comparable period in 2017.2020. This increase was primarily attributable to the increased expenditure on exebacase as we continued to executeexpenditures for the Phase 2 study3 DISRUPT trial of exebacase in order to completionenroll more patients and expand the number of enrollmentactive investigator sites, process transfer, validation and deliverymanufacturing of topline data.Netexebacase, process development and manufacturing of
CF-370,
and an increased number of personnel and related compensation costs.
Net cash used in operatinginvesting activities
Net cash used in investing activities for the year ended December 31, 2017 decreased by $4.8 million as compared2021 was attributable to the comparable period in 2016. This was primarily attributable to our decrease in expenditures ofCF-404 as we completed drug substance manufacturing in 2016 and focused our development efforts on advancing exebacase into a Phase 2 clinical study.

Net cash provided by (used in) investing activities

Net cash provided by investing activities in the year ended December 31, 2018 resulted from the excess of the proceeds received from the maturities of marketable securities compared toless the purchases of marketable securities.securities subsequent to the equity offering completed on March 22, 2021. Net cash used in investing activities infor the yearsyear ended December 31, 2017 and 2016 resulted2020 was attributable to the proceeds received from the investmentmaturities of our cash balances into marketable securities less proceeds from any maturitiesthe purchases of those securities.

marketable securities subsequent to the equity offerings completed on May 27, 2020.

Net cash provided by financing activities

Net cash provided by financing activities infor the year ended December 31, 20182021 resulted primarily from the completion of anour equity offering of our common stock to institutional investors in August 2018,on March 22, 2021, resulting in net proceeds of $10.4 million.$53.8 million, net of offering costs. Net cash provided by financing activities infor the year ended December 31, 2017

resulted from the completion of a registered offering of our securities to institutional investors in July 2017, resulting in net proceeds of $37.1 million. Net cash provided by financing activities in the year ended December 31, 20162020 resulted primarily from the completion of a registered offering of our securities to institutional investors in July 2016,equity offerings on May 27, 2020, resulting in net proceeds of $32.0 million.

$51.9 million, net of offering costs.

Funding requirements

All of our product candidates are in early clinical or preclinical development. We expect to continue to incur significant expenses and increasing operating losses for the foreseeable future. We anticipate that our expenses will increase substantially if and as we:

continue our ongoing clinical trials, and initiate the planned clinical trials of our product candidates;

continue our ongoing preclinical studies, and initiate additional preclinical studies, of our product candidates;

continue the research and development of our other product candidates and our platform technology;

seek

add operational, financial and management information systems and personnel, including personnel to identify additionalsupport our product candidates;

acquire orin-license other productsdevelopment and technologies;

future commercialization efforts;

seek marketing approvals for our product candidates that successfully complete clinical trials;

establish, either on our own or with strategic partners, a sales, marketing and distribution infrastructure to commercialize any products for which we may obtain marketing approval;

seek to identify additional product candidates;
acquire or
in-license
other products and technologies;
maintain, leverage and expand our intellectual property portfolio; and

add operational,

For a description of our contractual obligations, see Note 8, “Commitments and Contingencies” to the notes to our consolidated financial and management information systems and personnel, including personnel to support our product development and future commercialization efforts.

statements included elsewhere in this Annual Report on Form
10-K.

Without additional funding, we believe we will not have sufficient funds to meet our obligations within the next twelve months from the date of issuance of our audited consolidated financial statements that are included elsewhere in this Annual Report on Form
10-K. We
If we are unable to obtain funding, we would be forced to delay, reduce or eliminate our research and development programs, which could adversely affect our business
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prospects, or we may be unable to continue operations. In accordance with the requirements of ASC
205-40,
we have based this estimate on assumptionsconcluded that may provesubstantial doubt exists about our ability to be wrong, and we could use our available capital resources sooner than we currently expect.continue as a going concern. Because of the numerous risks and uncertainties associated with the development and commercialization of our product candidates, and the extent to which we may enter into collaborations with third parties for development and commercialization of our product candidates, we are unable to estimate the amounts of increased capital outlays and operating expenses associated with completing the development of our current product candidates. We plan to continue to fund our operations through public or private debt and equity financings, but there can be no assurances that such financing will be available to us on satisfactory terms, or at all. We plan to continue to supplement our financings with
non-dilutive
funding, including grants from
CARB-X
and USAMRDC and our cost-sharing contract with BARDA, but there can be no assurances that either BARDA,
CARB-X
or USAMRDC will provide the maximum potential funding to the Company.
Our future capital requirements will depend on many factors, including:

the progress and results of the clinical trials of our lead product candidates;

the scope, progress, results and costs of compound discovery, preclinical development, laboratory testing and clinical trials for our other product candidates;

the extent to which we acquire or
in-license
other products and technologies;

the timing and amount of actual reimbursements under the BARDA Contract;
the costs, timing and outcome of regulatory review of our product candidates;

the costs of future commercialization activities, including product sales, marketing, manufacturing and distribution, for any of our product candidates for which we receive marketing approval;

revenue, if any, received from commercial sales of our product candidates, should any of our product candidates receive marketing approval;

the costs of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and defending intellectual property-related claims; and

our ability to establish any future collaboration arrangements on favorable terms, if at all.

Until such time, if ever, as we can generate substantial product revenues, we expect to finance our cash needs through a combination of equity and debt offerings, collaborations, grants, government contracts, strategic alliances and licensing arrangements. We do not have any committed external source of funds. To the extent that we raise additional capital through the sale of equity or other securities, the ownership interest of our stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect your rights as a common stockholder. Debt financing, if available, may involve agreements that include covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we raise additional funds through collaborations, strategic alliances or licensing arrangements with third parties, we may have to relinquish valuable rights to our technologies, future revenue streams, research programs or product candidates or grant licenses on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed, we may be required to delay, limit, reduce or terminate our product development or future commercialization efforts or grant rights to develop and market product candidates that we would otherwise prefer to develop and market ourselves.

We incur significant costs as a public company, including, but not limited to, increased personnel costs, increased directors fees, increased directors and officers insurance premiums, audit and legal fees, investor relations and external communications fees, expenses for compliance with the Sarbanes-Oxley Act and rules implemented by the SEC and Nasdaq and various other costs and expenses.

Contractual Obligations and Commitments

The following table summarizes our contractual obligations at December 31, 2018 and the effect such obligations are expected to have on our liquidity and cash flows in future periods:

   Payments due by period 

Contractual obligations

  Total   Less than
1 year
   1 - 3 years   4 - 5 years   More than
5 years
 

Operating lease commitments(1)

  $6,372,936   $653,324   $1,346,110   $1,400,492   $2,973,010 

License and sponsored research agreements(2)

   1,449,750    449,749    400,000    400,000    200,000 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total contractual obligations

  $7,822,686   $1,103,073   $1,746,110   $1,800,492   $3,173,010 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

(1)

Represents future minimum lease payments undernon-cancelable operating leases for our principal facilities in Yonkers, New York which expire in 2027. The minimum lease payments above do not include certain utility costs, common area maintenance charges or real estate taxes.

(2)

Represents certain amounts payable under our licenses and sponsored research agreements with The Rockefeller University and Trellis Bioscience LLC.

We enter into contracts in the normal course

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Table of business with contract research organizations, or CROs, for clinical trials, clinical supply manufacturing,non-clinical and preclinical studies and for other services and products for operating purposes. These contracts generally provide for termination on notice, and therefore are cancelable contracts and not included in the table of contractual obligations.

The contractual obligations table also does not include any potential contingent payments upon the achievement by us of specified clinical, regulatory and commercial events, as applicable, or royalty payments we may be required to make under license agreements we have entered into with The Rockefeller University and Trellis Bioscience LLC. The occurrence and timing of these events are difficult to predict and subject to significant uncertainty. Since we are unable to reliably estimate the timing and amounts of such milestone and royalty payments, or whether they will occur at all, these contingent payments have been excluded from the table above. See “Note 8—Commitments and Contingencies” on PageF-18 of this Annual Report for additional information.

Contents

Effects of Inflation

We do not believe that inflation or changing prices had a significant impact on our results of operations for any periods presented herein.

Off-Balance Sheet Arrangements

We did not have duringcontinue to monitor the periods presented,impact of inflationary pressures on purchases and we are currently not party to, anyoff-balance sheet arrangements.

new contractual commitments.
Item 7A.

Quantitative and Qualitative Disclosures about Market Risk

Our primary exposure to market risk is interest income sensitivity, which is affected by changes in the general level of U.S. interest rates. As of December 31, 2018, we had cash, cash equivalents and marketable securities of $30.5 million. Because of the short-term maturities of our cash equivalents and marketable securities, we do not believe that an increase in market rates would have any significant impact on the fair value of our cash equivalents or marketable securities. If a 10% change in interest rates were to have immediately occurred on December 31, 2018, this change would not have had a material effect on the fair value of our investment portfolio as of that date.

While we believe our cash, cash equivalents and marketable securities do not contain excessive credit or liquidity risk, we cannot provide absolute assurance that in the future our investments will not be subject to adverse changes in market value. In addition, we maintain significant amounts of cash and cash equivalents at one or more financial institutions that are in excess of federally insured limits.

We do not own any derivative financial instruments. Accordingly, we do not believe that there is any material market risk exposure with respect to derivative, foreign currency or other financial instruments that would require disclosure under this item.

Item 8.

Financial Statements and Supplementary Data

The financial statements required to be filed pursuant to this Item 8 are appended to this report. An index of those financial statements is found in Item 15 of Part IV of this Annual Report on Form
10-K.

Item 9.

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

None

Item 9A.

Controls and Procedures

Limitations on Effectiveness of Controls and Procedures

In designing and evaluating our disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and procedures must reflect the fact that there are resource constraints and that management is required to apply judgment in evaluating the benefits of possible controls and procedures relative to their costs.

Evaluation of Disclosure Controls and Procedures

As required by Rule
13a-15(b)
and Rule
15d-15(b)
of the Exchange Act, our management, including our principal executive officer and our principal financial officer, conducted an evaluation as of the end of the period

covered by this Annual Report on Form

10-K
of the effectiveness of our disclosure controls and procedures (as defined in Rule
13a-15(e)
and Rule
15d-15(e)
of the Exchange Act). Based on that evaluation, our principal executive officer and principal financial officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of December 31, 2018.

2021.

Management’s Annual Report on Internal Control Over Financial Reporting

Management is responsible for establishing and maintaining adequate internal control over financial reporting, as such term is defined in Rule
13a-15(f)
under the Securities Exchange Act of 1934, as amended.

Our management conducted an assessment of the effectiveness of our internal control over financial reporting based on the criteria set forth in “Internal Control-Integrated Framework (2013)” issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on this assessment, management concluded that, as of December 31, 2018,2021, our internal control over financial reporting was effective.

This annual report does not include an attestation report of our registered public accounting firm on internal control over financial reporting due to an exemption established bybecause we qualify as a “smaller reporting company”, as defined in Rule
12b-2
of the JOBS Act for “emerging growth companies”.

Exchange Act.

Changes in Internal Control Over Financial Reporting

As required by Rule13a-15(d) and Rule15d-15(d) of the Exchange Act, our management, including our principal executive officer and our principal financial officer, conducted an

In connection with management’s evaluation of our internal control over financial reporting to determine whether any changes occurred during the quarter endedas of December 31, 2018 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting. Based on that evaluation,2021, our principal executive officer and principal financial officer concluded that there were no changes to our internal control over financial reporting during the quarter ended December 31, 20182021 that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

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Item 9B.

Other Information

None

Item 9C.
Disclosure Regarding Foreign Jurisdictions That Prevent Inspections
Not applicable.
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PART III

Item 10.

Directors, Executive Officers and Corporate Governance

Director Biographical Information

Biographical information concerning each of our directors is set forth below:

Name
  

Age

 
Position
Steven C. Gilman, Ph.D.
Roger J. Pomerantz, M.D., F.A.C.P
  6665 

President, Chief Executive Officer, Director, Chairman of the Board

Roger J. Pomerantz, M.D., F.A.C.P.
Steven C. Gilman, Ph.D
  6269 
Director, Vice Chairman of the Board
Sol J. Barer, Ph.D.Ph.D
  7174 
Director, Lead Independent Director
Isaac Blech
Lishan Aklog, M.D
  6956 
Director
Jane F. Barlow, M.D
61
Director
David N. Low, Jr.Jr
  6063 
Director
Michael J. Otto, Ph.D.Ph.D
73
Director
Cary W. Sucoff, J.D
 70 Director
Cary W. Sucoff, J.D.67
Director

Steven C. Gilman, Ph.D.

Roger J. Pomerantz, M.D., F.A.C.P.
Dr. GilmanPomerantz has served as Chairman of our board of directors since May 2015. In March 2016, he was appointed Interimand our Chief Executive Officer of the Company and in July 2016since April 2019. Prior to that, he was appointed Chief Executive Officer of the Company. Until 2015, hehad served as the Executive Vice President, Research & Development and Chief Scientific Officer at Cubist Pharmaceuticals, a biopharmaceutical company, until its acquisition by Merck & Co. Prior to joining Cubist in 2008, he served as Chairman of the Board of Directors and Chief Executive Officer of ActivBiotics, a privately held biopharmaceutical company. Previously, he worked at Millennium Pharmaceuticals, Inc., where he held a number of senior leadership roles including Vice President and General Manager of the Inflammation franchise responsible for all aspects of the Inflammation business from early gene discovery to product commercialization. Prior to Millennium, he was Group Director at Pfizer Global Research and Development, where he was responsible for drug discovery of novel antibacterial agents as well as several other therapeutic areas. Dr. Gilman has also held scientific, business, and academic appointments at Wyeth, Cytogen Corporation, Temple Medical School, and Connecticut College. He currently serves on the board of directors of publicly traded companies Keryx Biopharmaceuticals, Inc., Momenta Pharmaceuticals, Inc., SCYNEXIS Inc., and Vericel Corporation. Dr. Gilman received his Ph.D. and M.S. degrees in microbiology from Pennsylvania State University, his post-doctoral training at Scripps Clinic and Research Foundation, and received a B.A. in microbiology from Miami University of Ohio. He has authored over 60 publications and is an inventor on 7 patents. We believe that Dr. Gilman’s significant scientific, executive and board leadership experience in the pharmaceutical and biotechnology industries qualifies him to serve as a member of our board of directors.

Roger J. Pomerantz, M.D., F.A.C.P. Dr. Pomerantz has served as a member of our board of directors since April 2014 and was appointed Vice Chairman in May 2014. SinceFrom November 2013 to December 2019, Dr. Pomerantz has served as Chairman of the board of directors of Seres Therapeutics, Inc., a biotechnology company, and as its President and Chief Executive Officer of Seres sincefrom June 2014.2014 to January 2019. From 2011 to 2013, he was formerly Worldwide Head of Licensing & Acquisitions, Senior Vice President at Merck & Co., Inc. where he oversaw all licensing and acquisitions at Merck Research Laboratories. Previously, he served as Senior Vice President and Global Franchise Head of Infectious Diseases at Merck. Prior to joining Merck, Dr. Pomerantz was Global Head of Infectious Diseases for Johnson & Johnson Pharmaceuticals. He joined Johnson & Johnson in 2005 as President of Tibotec Pharmaceuticals, Inc.

Dr. Pomerantz serves as Chairman of the board of directors of the public companies Collplant Biotechnologies, Inc. since 2021, Indaptus Therapeutics since 2021 and Viracta Therapeutics since 2020. He also serves as Chairman of the board of directors of the private company Silicon Therapeutics Inc. since 2019, and a member of the board of the private companies
X-VAX
Technology, Inc. since 2019 and VerImmune since 2020. Previously, Dr. Pomerantz served on the board of directors of public companies Rubius Therapeutics from 2014 to 2019 and Evelo Therapeutics from 2015 to 2016. Dr. Pomerantz received his B.A. in Biochemistry at the Johns Hopkins University and his M.D. at the Johns Hopkins School of Medicine. He received post-graduate training at the Massachusetts General Hospital, Harvard Medical School and M.I.T. Dr. Pomerantz is Board Certified in both Internal Medicine and Infectious Diseases. He was Professor of Medicine, Biochemistry and Molecular Pharmacology, Chief of Infectious Diseases, and the Founding Director and Chair of the Institute for Human Virology and Biodefense at the Thomas Jefferson University and Medical School. He has developed nine drugs approved world-wide in important diseases, including HIV, HCV, and tuberculosis. We believe that Dr. Pomerantz’s significant

scientific, executive and board leadership experience in drug development and in the pharmaceutical industry qualifies him to serve as a member of our board of directors.

Steven C. Gilman, Ph.D.
Dr. Gilman has served as Vice Chairman of our board of directors since April 2019. Prior to that, he had served as our Chairman since May 2015, Interim Chief Executive Officer from March 2016 to July 2016 and Chief Executive Officer since July 2016. Until 2015, he served as the Executive Vice President, Research & Development and Chief Scientific Officer at Cubist Pharmaceuticals, a biopharmaceutical company, until its acquisition by Merck & Co. Prior to joining Cubist in 2008, he served as Chairman of the Board of Directors and Chief Executive Officer of ActivBiotics, a privately held biopharmaceutical company. Previously, he worked at Millennium Pharmaceuticals, Inc., where he held a number of senior leadership roles including Vice President and General Manager of the Inflammation franchise responsible for all aspects of the
91

Inflammation business from early gene discovery to product commercialization. Prior to Millennium, he was Group Director at Pfizer Global Research and Development, where he was responsible for drug discovery of novel antibacterial agents as well as several other therapeutic areas. Dr. Gilman has also held scientific, business, and academic appointments at Wyeth, Cytogen Corporation, Temple Medical School, and Connecticut College. He currently serves on the board of directors of publicly traded companies Akebia Therapeutics, SCYNEXIS Inc., and Vericel Corporation, and previously served on the board of directors of Momenta Pharmaceuticals, Inc. Dr. Gilman also serves as a director of the
non-profit
organization Lakes Environmental Association of Bridgeton, Maine and is a Trustee at the Atrium School in Watertown, MA. He received his Ph.D. and M.S. degrees in microbiology from Pennsylvania State University, his post-doctoral training at Scripps Clinic and Research Foundation, and received a B.A. in microbiology from Miami University of Ohio. He has authored over 60 publications and is an inventor on 7 patents. We believe that Dr. Gilman’s significant scientific, executive and board leadership experience in the pharmaceutical and biotechnology industries qualifies him to serve as a member of our board of directors.
Sol J. Barer, Ph.D
. Dr. Barer has served as a member of our board of directors since April 2011. Dr. Barer served as our Chairman of the board of directors from February 2012 to May 2015. He was appointed Lead Independent Director in May 2015. Dr. Barer spent most of his professional career with the Celgene Corporation.Corporation, a pharmaceutical company. He was Chairman from January 2011 until June 2011, Executive Chairman from June 2010 until January 2011, and Chairman and Chief Executive Officer from May 2006 until June 2010. Before assuming the CEO position, he was appointed Chief Operating Officer in 1994 and President in 1993. Dr. Barer was the founder of the biotechnology group at the Celanese Research Company which was subsequently spun out to form Celgene. Dr. Barer serves as Chairman of the board of directors of the public companies Aevi Genomic Medicine, and Teva Pharmaceutical Industries and Neximmune and the private company Centrexion.Centrexion and as a board member of the private companies 3DBio Therapeutics and Zephyr AI. He is anthe Founding Chair of the Hackensack Meridian Health Center for Discovery and Innovation, and Founder of Mendham Investment Group. He is a venture advisor to biotechnology/medical companies, the Israel Biotech Fund and not for profit organizations.as well as an advisor to biopharma companies. In 2011, Dr. Barer was Chairman of the University of Medicine and Dentistry of New Jersey Governor’s Advisory Committee which resulted in sweeping changes in the structure of New Jersey’s medical schools and public research universities. He previously served as a Commissioner of the NJ Commission on Science and Technology. He was a member of the Board of Trustees of Rutgers University and served two terms as Chair of the Board of Trustees of BioNJ, the New Jersey biotechnology organization. Dr. Barer received a Ph.D. in Organic Chemistry in 1974 from Rutgers University where he was an NDEA Graduate Fellow and a B.S. in 1968 from Brooklyn College (City University of New York) where he was an NSF Undergraduate Fellow and Regents Scholar. He received an LL.D. (Honorary) from the Rabbinical College of America in 2018. We believe that Dr. Barer’s significant scientific, executive and board leadership experience in the pharmaceutical and biotechnology industries qualifies him to serve as a member of our board of directors.

Isaac Blech

Lishan Aklog, M.D
. Mr. BlechDr. Aklog has served as a member of our board of directors since August 2010. Mr. BlechJune 2020. He is
Co-Founder,
Chairman and Chief Executive Officer of PAVmed Inc. since 2014, a publicly traded commercial-stage diversified medical technology company, and Chairman and Chief Executive Officer of its subsidiary, Lucid Diagnostics, a publicly traded commercial-stage cancer prevention diagnostics company since its IPO in October, 2021 and as Executive Chairman since its inception in 2018. He also serves as a
co-founding
Partner of both Pavilion Holdings Group LLC (“PHG”), a medical device holding company, since its inception in 2007, and Pavilion Medical Innovations LLC, a venture-backed medical device incubator, since its inception in 2009. Prior to entering the medical device industry full-time in 2012, Dr. Aklog was an academic cardiac surgeon serving, from 2006 to 2012, as Associate Professor of Surgery, Chief of Cardiovascular Surgery and Chair of The Cardiovascular Center at St. Joseph’s Hospital and Medical Center’s Heart and Lung Institute in Phoenix, Arizona; from 2002 to 2006, as Assistant Professor of Cardiothoracic Surgery, Associate Chief of Cardiac Surgery and Director of Minimally Invasive Cardiac Surgery at Mount Sinai Medical Center in New York; and as Assistant Professor of Surgery at Harvard Medical School, Director of theco-founder Cardiac Surgery Research Laboratory, and an attending cardiac surgeon at Brigham and Women’s Hospital in Boston, from 1999 to 2002. Dr. Aklog received his clinical training in general and cardiothoracic surgery at Brigham and Women’s Hospital
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and Boston Children’s Hospital, during which he spent two years as the Medtronic Research Fellow at Harvard Medical School’s Cardiac Surgery Research Laboratory. He was then awarded the American Association of Thoracic Surgery Traveling Fellowship pursuant to which he received advanced training in heart valve surgery under renowned cardiac surgeons Sir Magdi Yacoub at Harefield Hospital in London and Professor Alain Carpentier at L’Hopital Broussais in Paris. Dr. Aklog has served as Chairman of the Boston ECG Project Charitable Foundation since 2018, and as a director on the International Board of Directors since 2019, the New York Executive Committee of Human Rights Watch since 2015 and the Advanced Medical Technology Association since 2021. He previously served on the board of directors of Viveon Health Acquisition Corp. from 2020 to 2021, as Chairman and Chief Technology Officer of Vortex Medical Inc., from its inception in 2008 until its acquisition in October 2012 by Angiodynamics, as a board member of the International Society for Minimally Invasive Cardiothoracic Surgery from 2006 to 2009 and as President of the 21st Century Cardiothoracic Surgery Society in 2011. He is a member of numerous professional societies and has been elected to the American Association of Thoracic Surgery. Dr. Aklog has served as a consultant and on the advisory boards of many major medical device companies as well as innovative startups. Dr. Aklog is an inventor on 35 issued patents and over 45 patent applications, including the core patents of Vortex Medical’s AngioVac
®
system and the patents for a majority of PAVmed Inc.’s products. He has also a
co-author
of 38 peer-reviewed articles and 10 book chapters and has served as Vice Chairmanon the Editorial Board of Sapience Therapeutics Inc.the Journal of Cardiothoracic Surgery since November 2015. Mr. Blech2006. Dr. Aklog received his A.B., magna cum laude, in Physics from Harvard University, where he was theco-founder and Vice Chairman of Elucida Oncology Inc. since 2013. Mr. Blech was theco-founder and Vice Chairman of Centrexion Therapeutics Corp. since 2011. Mr. Blech was also theco-founder and Vice Chairman of Cerecor Inc. since 2011. Mr. Blech is the Vice Chairman of Aridis Pharmaceuticals since December 2015. Mr. Blech currently serves as a Director for Adheara Therapeutics, Inc.elected to Phi Beta Kappa. He received his M.D., Edge Therapeutics Inc., SpendSmart Networks Inc., X4 Pharmaceuticals Inc., andX-VAX Technology, Inc. Mr. Blech is a successful founder and investor in the biotechnology industry. Over the past 35 years, he has established multiple successful biotechnology companies. These include Celgene Corporation, ICOS Corporation, Nova Pharmaceutical Corporation, Pathogenesis Corporation and Genetics Systems Corporation. Mr. Blech earned a B.A.cum laude, from Baruch College in 1975.Harvard Medical School. We believe that Mr. Blech’s businessDr. Aklog’s significant scientific, medical, executive and board leadership experience and ties to the investment community qualifyqualifies him to serve as a member of our board of directors.

Jane F. Barlow, M.D.
Dr. Barlow has served as a member of our board of directors since February 2021. She is currently the Chief Executive Officer of Jane Barlow & Associates, LLC, a consulting firm focused on value-based health care services, since January 2017 and Executive Vice President and Chief Clinical Officer at Real Endpoints, a data, analytics, and advisory firm, since January 2017. She is a senior advisor to MIT’s Center for Biomedical Innovation and serves on the Biotech Advisory Board of Pictet Asset Management. Prior to her current roles, she was Associate Chief Medical Officer at CVS Health and Chief Medical Officer of CVS Health’s Government Services arm where she successfully implemented industry-leading clinical strategies supporting drug purchasing, distribution, and utilization management. Formerly, she served as Vice President of Clinical Innovation at Medco Health Solutions, leading the adoption of cutting-edge therapeutic programs through all aspects of pharmacy. Dr. Barlow previously served on the public company boards of Momenta Pharmaceuticals, Inc. (prior to and during its sale to Johnson and Johnson), Therapeutics MD Inc., and SilverScript Insurance Company. Dr. Barlow received her medical degree from Creighton University School of Medicine and subsequently completed her residency in occupational and environmental medicine at The Johns Hopkins University, where she also earned her M.P.H. She is a distinguished graduate of the United States Air Force School of Aerospace Medicine and served as Chief of Flight Medicine at the Beale and Maxwell Air Force Bases. Additionally, she holds an M.B.A. from the University of Alabama. She is board-certified in occupational medicine and a fellow of the American College of Occupational and Environmental Medicine and the American College of Preventive Medicine. She is a diplomat of the American College of Physician Executives and a member of the American Medical Association. We believe that Dr. Barlow’s extensive experience in steering pharmaceutical development by strategically weighing the value and economic costs that drug candidates bring to the healthcare ecosystem at large qualifies her to serve as a member of our board of directors.
David N. Low, Jr.
Mr. Low has served as a member of our board of directors since April 2014. Mr. Low has worked as an investment banker since 1987, with broad investment and advisory experience in the life sciences, biotechnology and medical technology sectors. Since June 2017, Mr. Low has served as a partner at MTS Health Partners, a healthcare investment banking boutique. From 2002 to April 2017, Mr. Low was a member of Lazard’s Life Sciences Group as a Managing Director and Senior Advisor. Mr. Low has advised on major M&A transactions in the life sciences, biotechnology and medical technology sectors, and has worked with private and public companies to raise capital, including emerging growth companies. Prior to joining Lazard, Mr. Low was a Managing Director at JP Morgan Chase & Co. and a Senior Vice President at Lehman Brothers. Mr. Low serves on the board of directors of the Philharmonia Baroque Orchestra.Orchestra as President since 2020 and as a board member
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since 2012, and as a Trustee of the Ellen Battell Stoeckel Trust since 2021. Mr. Low holds an A.B. from Harvard College, where he graduated cum laude, an M.A. from the Johns Hopkins University School of Advanced International Studies and an M.B.A. from Yale University. We believe that Mr. Low’s significant investment and financial advisory experience qualifies him to serve as a member of our board of directors.

Michael J. Otto, Ph.D
. Dr. Otto has served as a member of our board of directors since April 2014. Dr. Otto served as Chief Scientific Officer of Pharmasset, a pharmaceutical company, from October 1999 until February 2012, when the company was

acquired by Gilead Sciences. He led the research team responsible for the discovery of sofosbuvir for the treatment of HCV infections. In previous capacities, he has served as Associate Director ofAnti-Infectives Clinical Research at

Rhône-Poulenc
Rorer, Vice President for Research and Development at Avid Therapeutics, Inc., Research Manager at DuPont Pharmaceuticals and DupontDuPont Merck Pharmaceuticals and as Group Leader in the Virology Dept. at Sterling Drug in Rensselaer, NY. Prior to joining Sterling Drug, Dr. Otto was Research Assistant Professor at Yale University School of Medicine, Dept. of Pharmacology. Dr. Otto also served as the US editor for Antiviral Chemistry & Chemotherapy from 1989 until 2012. Dr. Otto holds a B.S. degree from Loyola University of Chicago and a Ph.D. degree in medical microbiology from The Medical College of Wisconsin. He is the author or coauthor of over 100 research papers and book chapters and named inventor on several patents and patent applications. We believe that Dr. Otto’s substantial scientific and executive leadership experience in the pharmaceutical industry qualifies him to serve as a member of our board of directors.

Cary W. Sucoff.Sucoff, J.D.
Mr. Sucoff has served on our board of directors since May 2010. Mr. Sucoff has more than 3040 years of legal and securities industry experience encompassing supervisory, banking and sales responsibilities. He has participated in the financing of more than 100 public and private biotech companies.experience. Since 2011, Mr. Sucoff has owned and operated Equity Source Partners LLC, an advisory and consulting firm. In addition to ContraFect,He has participated in the financing of more than 100 public and private biotech companies. Mr. Sucoff currently serveshas served on the board of directors of Legacy Education Alliancethe public company IMAC Holdings, Inc. since 2020 and the private companies First Wave Technologies, Inc. since 2016, Galimedix Therapeutics since 2018 and Jupiter Unmanned since 2021. In addition, Mr. Sucoff currently serves as a consultant to Sapience Therapeutics, LB Pharmaceuticals, Kinetic Power Systems and Galimedix PharmaceuticalsGreen Hygienics Holdings Inc. He previously served as a director of Legacy Education Alliance, Inc. (LEAI) from 2015 to 2021. Mr. Sucoff, a former New York City prosecutor, is the past President of New England Law/Boston and has been a member of the Board of Trustees for over 25 years and is the currentyears. He has been Chairman of the Endowment Committee.Committee for over ten years. Mr. Sucoff received a B.A. from SUNY Binghamton in 1974 and a J.D. from New England School of Law in 1977, where he was managing editorthe Managing Editor of the Law Review and graduated magna cum laude. He has been a member of the Bar of the State of New York since 1978. We believe that Mr. Sucoff’s broad financial and legal experience qualifies him to serve as a member of our board of directors.

Executive Officers of the Registrant

Biographical information concerning each of our executive officers is set forth below. Information concerning Steven C. Gilman, Ph.D.Roger J. Pomerantz, M.D., F.A.C.P., our Chief Executive Officer, may be found above in the section entitled “Director Biographical Information.”

Natalie Bogdanos, J.D.
Ms. Bogdanos, age 50,53, has served as our General Counsel and Corporate Secretary since August 2014, and served as a member of the Interim Office of the Chief Executive Officer from March 2017 to June 2017. Ms. Bogdanos has also served as our Data Protection Officer since July 2018. She has over 20 years of experience in the legal field, almost 14at least 15 of which were serving as the chief legal officer of a publicly traded biotechnology company.companies. Prior to joining ContraFect in 2014, Ms. Bogdanos served as a full timefull-time legal consultant for Ferring Pharmaceuticals, Inc. from January 2014 to August 2014. Prior to that, Ms. Bogdanos served as Associate General Counsel at Memorial Sloan-Kettering Cancer Center (“MSKCC”), a cancer treatment and research institution, where she held a joint appointment with the Office of the General Counsel and the Office of Technology Development (“OTD”) from 2012 to 2013. At MSKCC, she provided legal counsel and guidance to various departments throughout the institution while having sole responsibility for the legal oversight of the OTD. Prior to MSKCC, she was General Counsel at Enzo Biochem, Inc. (“Enzo”), a publicly traded
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international biotechnology and life science company, from 2003 to 2012. At Enzo, she was responsible for leading the legal department, ensuring SEC and regulatory compliance, overseeing litigation and managing Enzo’s portfolio of 500+ patents and patent applications and negotiating complex business development agreements as well as other contracts. Previously, Ms. Bogdanos was an associate at Amster, Rothstein & Ebenstein from 1999 to 2003 where her practice focused on all intellectual property matters including related litigation. Ms. Bogdanos was a faculty member at the Practising Law Institute. Prior to attending law school, she was a research technician at the Public Health Research Institute where her work focused on
Staphylococcus aureus.aureus
. Ms. Bogdanos is an attorney and admitted to practice law in New York, the United States District Court, Southern and Eastern District of New York and the United States Court of Appeals for the Federal Circuit. She is also licensed to practice before the United States Patent and Trademark Office. Ms. Bogdanos received her J.D.

from New York Law School and her Bachelor of Arts in Biology, with honors, from Queens College of the City University of New York.

Cara M. Cassino, M.D.
Dr. Cassino, age 57,60, has served as our Chief Medical Officer since September 2015, also as Executive Vice President of Research and Development since August 2016, and served as a member of the Interim Office of the Chief Executive Officer from March 2017 to June 2017. Dr. Cassino has over 20 years of experience as a clinician and executive in healthcare, including over 15 years of experience in pharmaceutical product development with over 20 successful regulatory submissions in the United States and globally. Prior to joining ContraFect, Dr. Cassino served as an independent consultant to various pharmaceutical and biotechnology companies, including Scynexis,SCYNEXIS Inc., from December 2014 to September 2015. Prior to that, she served as Senior Vice President at Forest Laboratories, Inc., a biopharmaceutical company (acquired by Actavis plc, now Allergan plc), where she oversaw Global Clinical Development from 2013 to 2014. While at Forest, she was responsible for
pre-
and post-marketingpost- marketing clinical activities for a portfolio of 35 compounds, and also clinical due diligence for M&A activity, including the $2.9 billion acquisition of Aptalis Pharma and the $1.1 billion acquisition of Furiex Pharmaceuticals. From 2008 to 2013, Dr. Cassino held a number of senior positions at Pfizer, including Global Medical Team Leader of Pfizer’s antibacterial franchise which included Zyvox (linezolid) and Medicines Development Group VP for Pulmonary Vascular Disease and Rare Diseases. Prior to joining Pfizer, Dr. Cassino also served as Executive Medical Director for the late stagelate-stage U.S. respiratory franchise atBoehringer-Ingelheim Pharmaceuticals, Inc. and was a member of the academic faculty of the Division of Pulmonary and Critical Care Medicine at New York University (NYU) School of Medicine for eight years prior to joining industry. Dr. Cassino received her B.A., summa cum laude, in Chemistry and Fine Arts from NYU where she was elected Phi Beta Kappa, followed by an M.D. from NYU School of Medicine. She completed her internship and residency in Internal Medicine at NYU/Bellevue Hospital and a fellowship in Pulmonary/Critical Care Medicine at NYU and Mount Sinai Medical Centers. Dr. Cassino is Board Certified in both internal medicine and pulmonary medicine.

Michael Messinger, CPA
. Mr. Messinger, age 44,47, has served as our Chief Financial Officer since November 2018. He has more than 1820 years of experience in finance, accounting and forecasting for clinical development. Prior to joining ContraFect in November 2012 as our Vice President, Finance, and later serving as our Senior Vice President, Finance beginning in August 2016, he served as Director of Finance at Lexicon Pharmaceuticals, Inc. (“Lexicon”) for eight years and also held the position of Controller for three years. Prior to working at Lexicon, Mr. Messinger served as Controller of Coelacanth Corporation (which was acquired by Lexicon) for two years. While at Lexicon, Mr. Messinger was responsible for the financial management of Lexicon’s partnership with Symphony Capital, LLC, in addition to coordinating fiscal and program management concerning Lexicon’s development programs. Mr. Messinger received his B.B.A. degree in accounting from the University of Michigan. He started his career as an auditor at Ernst & Young LLP.

Nancy Dong. Ms. Dong, age 53, has served as our Vice President, Finance and Administration since March 2017 She has more than 20 years of experience in accounting, strategic planning, budgeting and forecasting, organizational development, financial systems and controls and human resources. Prior to joining ContraFect in 2010 as Vice President, Controller, she served as controller at XL Marketing, a direct marketing firm, from 2009 to 2010 and at Alley Corp, a company that provides strategic advice to companies within its network, from 2007 to 2009. She also served as Vice President of Finance and Administration at DCM, atele-services firm supporting the performing arts, from 2002 to 2007. Ms. Dong also held the positions of COO and CFO at Semaphore, a project management software development firm. Ms. Dong received her B.A. degree from Yale University and a MPPM degree from The Wharton School at the University of Pennsylvania. She started her career as a management consultant at Ernst & Young LLP.

Our board of directors has adopted a Code of Ethics and Business Conduct and Ethics applicable to all officers, directors and employees, which is available on our website at http://ir.contrafect.com/governance-docs. We intend to satisfy the disclosure requirement under Item 5.05 of Form
8-K
regarding amendment to, or waiver from, a provision of our Code of Ethics and Business Conduct, and Ethics, as well as Nasdaq’s requirement to disclose

waivers with respect to directors and executive officers, by posting such information on our website at the address and location specified above.

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The remaining information required by this Item 10 will be contained under the headings “Sectionheading “Corporate Governance,” “Delinquent Section 16(a) Beneficial Ownership Reporting Compliance,Reports” and “Executive Compensation – Compensation Committee Interlocks and Insider Participation,and “Corporate Governance – Committees of the Board of Directors”if applicable, in our definitive proxy statement to be filed with the SEC with respect to our 20192022 Annual Meeting of Stockholders and is incorporated herein by reference.

Item 11. Executive Compensation

Item 11.
Executive Compensation
The information required by this Item 11 will be contained under the heading “Executive Compensation” in our definitive proxy statement to be filed with the SEC with respect to our 20192022 Annual Meeting of Stockholders and is incorporated herein by reference.

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

Item 12.
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
The information required by this Item 12 will be contained under the headings “Executive Compensation – Equity Compensation Plan Information” and “Security Ownership of Certain Beneficial Owners and Management” in our definitive proxy statement to be filed with the SEC with respect to our 20192022 Annual Meeting of Stockholders and is incorporated herein by reference.

Item 13. Certain Relationships and Related Transactions, and Director Independence

Item 13.
Certain Relationships and Related Transactions, and Director Independence
The information required by this Item 13 will be contained under the headings “Certain Relationships and Related Transactions” and “Corporate Governance – Director Independence” in our definitive proxy statement to be filed with the SEC with respect to our 20192022 Annual Meeting of Stockholders and is incorporated herein by reference.

Item 14. Principal Accountant Fees and Services

Item 14.
Principal Accountant Fees and Services
The information required by this Item 14 will be contained under the heading “Ratification of Appointment of Independent Registered Public Accounting Firm” in our definitive proxy statement to be filed with the SEC with respect to our 20192022 Annual Meeting of Stockholders and is incorporated herein by reference.

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PART IV

Item 15.

Exhibits and Financial Statement Schedules

(a) The following documents are filed as part of this Annual Report on Form
10-K:

(1) Index list to Consolidated Financial Statements

The following documents are included on pages
F-1
throughF-27
F-28
attached hereto and are filed as part of this Annual Report on Form
10-K.

   F-2 

Audited Consolidated Financial Statements:

  

F-3

Consolidated Statements of Operations

   F-4 

   F-5 

   F-6 

   F-7 

   F-8 
F-9

(2) Financial Statement Schedules

Schedules have been omitted since they are either not required or not applicable or the information is otherwise included herein.

(3) Exhibits

Exhibit Index

      Incorporated by Reference   

Exhibit

    No.    

  

Description

  Form  File No.  Exhibit  

Filing Date

  

Filed/Furnished
Herewith

    3.1  Amended and Restated Certificate of Incorporation of ContraFect Corporation, dated August  1, 2014, and Certificate of Amendment, dated May 9, 2016 and Certificate of Amendment dated May 2, 2017  8-K  001-36577  3.1  May 3, 2017  
    3.2  Amended and Restated Bylaws of ContraFect Corporation  8-K  001-36577  3.2  May 10, 2016  
    4.1  Form of Common Stock Certificate  S-1/A  333-195378  4.1  July 3, 2014  
    4.2  Representative’s Warrant, dated August 27, 2014  8-K  001-36577  4.14  October 29, 2015  
    4.3  Form of Noteholder Warrant  S-1/A  333-195378  4.7  July 3, 2014  
    4.4  Specimen Unit Certificate  S-1/A  333-195378  4.8  July 1, 2014  
    4.5  Form of Indenture  S-3  333-206786  4.1  September 4, 2015  
    4.6  Form of Investor Warrant  8-K  001-36577  4.1  June 12, 2015  

      Incorporated by Reference   

Exhibit

    No.    

  

Description

  Form  File No.  Exhibit  

Filing Date

  

Filed/Furnished
Herewith

    4.7  Form of Placement Agent Warrant  8-K  001-36577  4.2  June 12, 2015  
    4.8  Form of Warrant Agreement by and between ContraFect Corporation and the American Stock Transfer  & Trust Company, LLC, dated July 27, 2016  8-K  001-36577  4.1  July 27, 2016  
    4.9  Form of Warrant Certificate  8-K  001-36577  4.2  July 27, 2016  
    4.10  Form of Warrant Agreement by and between ContraFect Corporation and the American Stock Transfer  & Trust Company, LLC, dated July 25, 2017  8-K  001-36577  4.1  July 25, 2017  
    4.11  Form of Warrant Certificate  8-K  001-36577  4.2  July 25, 2017  
  10.1  License Agreement, between The Rockefeller University and ContraFect Corporation, dated July 12, 2011  S-1  333-195378  10.1  April 18, 2014  
  10.2  Lease Agreement, between Hudson View Building #3 LLC and ContraFect Corporation, dated December 1, 2010  S-1  333-195378  10.2  April 18, 2014  
  10.3  Lease Agreement, between Hudson View Building #3 LLC and ContraFect Corporation, dated January 1, 2012  S-1  333-195378  10.3  April 18, 2014  
  10.4#  Form of Indemnification Agreement  S-1/A  333-195378  10.4  July 1, 2014  
  10.5#  ContraFect Corporation Amended and Restated 2008 Equity Incentive Plan  S-1  333-195378  10.11  April 18, 2014  
  10.6#  ContraFect Corporation Form of Stock Option Agreement  S-1  333-195378  10.12  April 18, 2014  
  10.7#  ContraFect Corporation 2008 Equity Incentive Plan  S-1  333-195378  10.13  April 18, 2014  
  10.8#  ContraFect Corporation 2014 Omnibus Incentive Plan  S-1/A  333-195378  10.14  July 1, 2014  
  10.9  License Agreement, between Trellis Bioscience LLC and ContraFect Corporation, dated January 29, 2014  S-1/A  333-195378  10.15  July 1, 2014  
  10.10  Amendment to the Trellis License Agreement, dated June 15, 2014  S-1/A  333-195378  10.16  July 1, 2014  

      
Incorporated by Reference
   
Exhibit

No.
  
Description
  
Form
  
File No.
  
Exhibit
  
Filing Date
  
Filed/
Furnished

Herewith
    3.1  Amended and Restated Certificate of Incorporation of ContraFect Corporation, dated August 1, 2014, and Certificate of Amendment, dated May 9, 2016, Certificate of Amendment dated May 2, 2017, Certificate of Amendment dated February 3, 2020, and Certificate of Amendment dated February 24, 2022  10-K  001-36577  3.1  March 18, 2020  
    3.2  Amended and Restated Bylaws of ContraFect Corporation  10-Q  001-36577  3.2  November 13, 2020  
    4.1  Form of Common Stock Certificate  S-1/A  333-195378  4.1  July 3, 2014  
    4.2  Form of Warrant Agreement by and between ContraFect Corporation and the American Stock Transfer & Trust Company, LLC, dated July 27, 2016  8-K  001-36577  4.1  July 27, 2016  
    4.3  Form of Warrant Certificate  8-K  001-36577  4.2  July 27, 2016  
      Incorporated by Reference   

Exhibit

No.

  

Description

  Form  File No.  Exhibit  

Filing Date

  

Filed/Furnished
Herewith

  10.11  Form of Securities Purchase Agreement between the Company and Benjamin Small, Birchview Fund, LLC, Broadfin Healthcare Master Fund, Ltd., Cormorant Global Healthcare Master Fund, LP, Jack W. Schuler, Matthew W. Strobeck, Oracle Institutional Partners, LP, Oracle Partners, LP, and Richard B. McCormick, dated June 11, 2015  8-K  001-36577  10.1  June 12, 2015  
  10.12  Form of Registration Rights Agreement among the Company, Benjamin Small, Birchview Fund, LLC, Broadfin Healthcare Master Fund, Ltd., Cormorant Global Healthcare Master Fund, LP, Jack W. Schuler, Matthew W. Strobeck, Oracle Institutional Partners, LP, Oracle Partners, LP, and Richard B. McCormick and Brookline Group LLC, dated June 11, 2015  8-K  001-36577  10.2  June 12, 2015  
  10.13#  Letter Agreement, dated July 21, 2016, between ContraFect Corporation and Steven C. Gilman, Ph.D.  8-K  001-36577  10.1  July 21, 2016  
  10.14#  Separation and Consulting Agreement by and between ContraFect Corporation and Michael Wittekind, Ph.D., dated October 3, 2016  10-Q  001-36577  10.1  November 9, 2016  
  10.15#  Letter Agreement, dated March 13, 2017, between ContraFect Corporation and Steven C. Gilman, Ph.D.  8-K  001-36577  10.1  March 13, 2017  
  10.16#  Amendment No. 1 to Offer Letter, dated May 29, 2018, between ContraFect Corporation and Steven C. Gilman, Ph.D.  8-K  001-36577  10.1  May 30, 2018  
  10.17#  Offer Letter, dated June 26, 2014, between ContraFect Corporation and Natalie Bogdanos, as amended by Amendment No.  1, dated November 2, 2015  10-K  001-36577  10.27  March 15, 2017  

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Incorporated by Reference
   
Exhibit

No.
 
Description
  
Form
  
File No.
  
Exhibit
  
Filing Date
  
Filed/
Furnished

Herewith
    4.4 Form of Warrant Agreement by and between ContraFect Corporation and the American Stock Transfer & Trust Company, LLC, dated July 25, 2017  8-K  001-36577  4.1  July 25, 2017  
    4.5 Form of Warrant Certificate  8-K  001-36577  4.2  July 25, 2017  
    4.6 Description of ContraFect Corporation Securities  10-K  001-36577  4.12  March 18, 2020  
  10.1 License Agreement, between The Rockefeller University and ContraFect Corporation, dated July 12, 2011  S-1  333-195378  10.1  April 18, 2014  
  10.2 Lease Agreement, between Hudson View Building #3 LLC and ContraFect Corporation, dated December 1, 2010  S-1  333-195378  10.2  April 18, 2014  
  10.3 Lease Agreement, between Hudson View Building #3 LLC and ContraFect Corporation, dated January 1, 2012  S-1  333-195378  10.3  April 18, 2014  
  10.4# Form of Indemnification Agreement  S-1/A  333-195378  10.4  July 1, 2014  
  10.5# ContraFect Corporation Amended and Restated 2008 Equity Incentive Plan  S-1  333-195378  10.11  April 18, 2014  
  10.6# ContraFect Corporation Form of Stock Option Agreement  S-1  333-195378  10.12  April 18, 2014  
  10.7# ContraFect Corporation 2008 Equity Incentive Plan  S-1  333-195378  10.13  April 18, 2014  
  10.8# ContraFect Corporation 2014 Omnibus Incentive Plan  S-1/A  333-195378  10.14  July 1, 2014  
  10.9 License Agreement, between Trellis Bioscience LLC and ContraFect Corporation, dated January 29, 2014  S-1/A  333-195378  10.15  July 1, 2014  
  10.10 Amendment to the Trellis License Agreement, dated June 15, 2014  S-1/A  333-195378  10.16  July 1, 2014  
  10.11# Offer Letter, dated June 26, 2014, between ContraFect Corporation and Natalie Bogdanos, as amended by Amendment No. 1, dated November 2, 2015  10-K  001-36577  10.27  March 15, 2017  
  10.12# Offer Letter, dated August 24, 2015, between ContraFect Corporation and Cara Cassino, M.D.  10-K  001-36577  10.28  March 15, 2017  
  10.13# Amendment No. 1 to Offer Letter, dated March 15, 2017, between ContraFect Corporation and Cara Cassino, M.D.  10-K  001-36577  10.29  March 15, 2017  
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Incorporated by Reference
   
Exhibit

No.
 
Description
  
Form
  
File No.
  
Exhibit
  
Filing Date
  
Filed/
Furnished

Herewith
  10.14# Employment Agreement, dated as of April 2, 2019, by and between ContraFect Corporation and Roger J. Pomerantz  8-K  001-36577  10.1  April 2, 2019  
  10.15 Stock Purchase Agreement, dated December 9, 2019, by and between ContraFect Corporation and Pfizer Inc.  8-K  001-36577  10.1  December 12, 2019  
  10.16# Employment Agreement, dated November 5, 2012, by and between ContraFect Corporation and Michael Messinger  10-K  001-36577  10.16  March 30, 2021  
  10.17# Non-Employee Director Compensation Program  10-K  001-36577  10.17  March 30, 2021  
  10.18 Cost-Sharing Agreement by and between ContraFect Corporation and the Biomedical Advanced Research and Development Authority, dated March 15, 2021  8-K  001-36577  10.1  March 12, 2021  
  23.1 Consent of Ernst & Young LLP, Independent Registered Public Accounting Firm          *
  31.1 Certification of Chief Executive Officer pursuant to Rule 13a-14(a) and Section 302 of the Sarbanes-Oxley Act of 2002          *
  31.2 Certification of Principal Financial Officer pursuant to Rule 13a-14(a) and Section 302 of the Sarbanes-Oxley Act of 2002          *
  32.1 Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002          **
  32.2 Certification of Principal Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002          **
101.INS Inline eXtensible Business Reporting Language (XBRL) Instance Document – the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document          *
��
99

Table of Contents
      
Incorporated by Reference
   

Exhibit


No.

  

Description

  
Form
  
File
No.
  
Exhibit
  

Filing
Date

  

Filed/
Furnished

Herewith

  10.18#Offer Letter, dated August 24, 2015, between ContraFect Corporation and Cara Cassino, M.D.10-K001-3657710.28March 15, 2017
  10.19#Amendment No. 1 to Offer Letter, dated March 15, 2017, between ContraFect Corporation and Cara Cassino, M.D.10-K001-3657710.29March 15, 2017
  23.1Consent of Ernst & Young LLP, Independent Registered Public Accounting Firm*
  31.1Certification of Chief Executive Officer pursuant to Rule13a-14(a) and Section 302 of the Sarbanes-Oxley Act of 2002*
  31.2Certification of Principal Financial Officer pursuant to Rule13a-14(a) and Section 302 of the Sarbanes-Oxley Act of 2002*
  32.1Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002**
  32.2Certification of Principal Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002**
101.INSXBRL Instance Document*
101.SCH  Inline XBRL Taxonomy Extension Schema Document          *
101.CAL  Inline XBRL Taxonomy Extension Calculation Linkbase Document          *
101.DEF  Inline XBRL Taxonomy Extension Definition Linkbase Document          *
101.LAB  Inline XBRL Taxonomy Extension Label Linkbase Document          *
101.PRE  Inline XBRL Taxonomy Extension Presentation Linkbase Document          *
104Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)*

*

Filed herewith.

**

Furnished herewith.

#

Indicates management contract or compensatory plan.

Item 16.

Form
10-K
Summary

None

100

Table of Contents

F-1

Report of Independent Registered Public Accounting Firm

To the Stockholders and the Board of Directors of ContraFect Corporation

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of ContraFect Corporation (the Company) as of December 31, 20182021 and 2017,2020, the related consolidated statements of operations, comprehensive loss, stockholders’ equity and cash flows for each of the three years in the period ended December 31, 2018,2021, and the related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company at December 31, 20182021 and 2017,2020, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2018,2021, in conformity with U.S. generally accepted accounting principles.

The Company’s Ability to Continue as a Going Concern

The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going concern. As discussed in Note 1 to the consolidated financial statements, the Company has an accumulated deficit, has incurred recurring losses and used significant cash flowscashflows in operations, expects continuing future losses and has stated that substantial doubt exists about the Company’s ability to continue as a going concern. Management’s evaluation of the events and conditions and management’s plans regarding these matters are also described in Note 1. The consolidated financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.
Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.

Critical Audit Matter
The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was communicated or required to be communicated to the audit committee and that: (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging,
F-2

Table of Contents
subjective or complex judgments. The communication of the critical audit matter does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.
Accrued and Prepaid Research and Development Costs
Description of
the Matter
As discussed in Note 2 of the Company’s consolidated financial statements, costs for certain development activities, such as clinical trials, are recognized based on an evaluation of the progress to completion of specific tasks using data such as patient enrollment, clinical site activations or information provided to the Company by its vendors. Payments for these activities are based on the terms of the individual arrangements, which may differ from the pattern of costs incurred. The Company’s estimates are highly dependent upon the timeliness and accuracy of the data provided by third parties regarding the status of their contracted activity. As of December 31, 2021, total accrued liabilities and prepaid expenses were $9.1 million and $4.4 million, respectively, including estimated amounts for research and clinical development service costs either incurred and unpaid or paid in advance as of that date.
Auditing management’s accrued and prepaid research and development costs is especially challenging and judgmental due to the estimation required by management to determine the cost incurred for the services rendered on or prior to the balance sheet date for enrolling, dosing and monitoring patients, activating trial sites and conducting manufacturing activities. The Company has contracts with multiple clinical research organizations (“CROs”) that conduct and manage clinical studies on its behalf, as well as, contract manufacturing organizations (“CMOs”) that perform manufacturing activities. The financial terms of these agreements are subject to negotiation, vary from contract to contract and may result in uneven payments during the period.
How We Addressed the Matter in Our Audit
To test the estimated accrued and prepaid research and development costs, we performed audit procedures that included, among others, assessing the methodologies and testing the significant assumptions applied, such as the number of patient visits and trial sites and the amount of manufacturing activity. We also tested the underlying data used by management and assessed the historical accuracy of management’s estimates. We performed inquiries of management regarding the status of significant trials and manufacturing activities to understand the impact of recent developments on the accounting for the studies and requested confirmation of costs incurred as of period end that were invoiced or remained unbilled from a sample of CROs and CMOs. Additionally, we compared significant cash payments to the contractual terms. To evaluate the completeness of the accrued research and development costs we also examined invoices received from vendors and cash disbursements made subsequent to December 31, 2021.
/s/ Ernst & Young LLP

We have served as the Company’s auditor since 2013.

Hartford, Connecticut

March 14, 2019

24, 2022

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Table of Contents
CONTRAFECT CORPORATION

Consolidated Balance Sheets

   December 31, 
   2018  2017 

Assets

   

Current assets:

   

Cash and cash equivalents

  $8,320,317  $6,995,046 

Marketable securities

   22,131,936   39,858,864 

Prepaid expenses and other current assets

   988,799   1,848,063 
  

 

 

  

 

 

 

Total current assets

   31,441,052   48,701,973 

Property and equipment, net

   1,076,099   1,093,903 

Other assets

   355,420   393,603 
  

 

 

  

 

 

 

Total assets

  $32,872,571  $50,189,479 
  

 

 

  

 

 

 

Liabilities and stockholders’ equity

   

Current liabilities:

   

Accounts payable

  $1,427,287  $1,302,431 

Accrued liabilities

   4,369,732   3,118,237 
  

 

 

  

 

 

 

Total current liabilities

   5,797,019   4,420,668 

Deferred rent

   679,182   704,240 

Warrant liabilities

   20,781,663   13,549,437 

Other liabilities

   72,747   321,689 
  

 

 

  

 

 

 

Total liabilities

   27,330,611   18,996,034 

Commitments and contingencies (Note 8)

   —     —   

Stockholders’ equity:

   

Preferred stock, $0.0001 par value, 25,000,000 shares authorized and none outstanding at December 31, 2018 and 2017

   —     —   

Common stock, $0.0001 par value, 200,000,000 shares authorized, 79,406,556 shares issued and outstanding at December 31, 2018; 200,000,000 shares authorized, 73,656,006 shares issued and outstanding at December 31, 2017

   7,941   7,366 

Additionalpaid-in capital

   204,884,211   192,896,367 

Accumulated other comprehensive loss

   (30,300  (74,820

Accumulated deficit

   (199,319,892  (161,635,468
  

 

 

  

 

 

 

Total stockholders’ equity

   5,541,960   31,193,445 
  

 

 

  

 

 

 

Total liabilities and stockholders’ equity

  $32,872,571  $50,189,479 
  

 

 

  

 

 

 

(in thousands, except share data)
   
December 31,
 
   
2021
  
2020
 
Assets
         
Current assets:
         
Cash and cash equivalents
  $16,654  $15,485 
Marketable securities
   37,631   27,005 
Prepaid expenses
   4,439   3,084 
Other current assets
   4,140   1,081 
   
 
 
  
 
 
 
Total current assets
   62,864   46,655 
Property and equipment, net
   741   910 
Operating lease
right-of-use
assets
   2,544   2,811 
Other assets
   613   740 
   
 
 
  
 
 
 
Total assets
  $66,762  $51,116 
   
 
 
  
 
 
 
Liabilities and stockholders’ equity
         
Current liabilities:
         
Accounts payable
  $2,389  $1,806 
Accrued liabilities
   9,128   3,610 
Current portion of lease liabilities
   657   644 
   
 
 
  
 
 
 
Total current liabilities
   12,174   6,060 
Warrant liabilities
   2,530   29,404 
Long-term portion of lease liabilities
   2,609   2,959 
Other liabilities
   73   73 
   
 
 
  
 
 
 
Total liabilities
   17,386   38,496 
Commitments and contingencies (Note 8)
   0—     0—   
Stockholders’ equity:
         
Preferred stock, $0.0001 par value, 25,000,000 shares authorized and NaN issued or outstanding at December 31, 2021 and 2020
   0—     —   
Common stock, $0.0001 par value, 125,000,000 shares authorized; 39,332,721 and 27,810,161 shares issued and outstanding at December 31, 2021 and 2020
   4   3 
Additional
paid-in
capital
   310,008   252,908 
Accumulated other comprehensive loss
   (84  (21
Accumulated deficit
   (260,552  (240,270
   
 
 
  
 
 
 
Total stockholders’ equity
   49,376   12,620 
   
 
 
  
 
 
 
Total liabilities and stockholders’ equity
  $66,762  $51,116 
   
 
 
  
 
 
 
See accompanying notes.

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Table of Contents
CONTRAFECT CORPORATION

Consolidated Statements of Operations

   Year Ended December 31, 
   2018  2017  2016 

Operating expenses:

   

Research and development, including stock-based compensation of $626,002, $451,334 and $587,426, respectively

  $22,416,651  $17,314,086  $22,101,720 

General and administrative, including stock-based compensation of $929,521, $1,171,794 and $1,644,456, respectively

   8,707,774   9,249,671   11,430,526 
  

 

 

  

 

 

  

 

 

 

Total operating expenses

   31,124,425   26,563,757   33,532,246 
  

 

 

  

 

 

  

 

 

 

Loss from operations

   (31,124,425  (26,563,757  (33,532,246

Other (expense) income:

    

Interest income

   672,227   418,135   216,616 

Other expense

   —     (905,014  (1,569,341

Change in fair value of warrant liabilities

   (7,232,226  11,532,978   6,346,572 
  

 

 

  

 

 

  

 

 

 

Total other (expense) income

   (6,559,999  11,046,099   4,993,847 
  

 

 

  

 

 

  

 

 

 

Net loss

  $(37,684,424 $(15,517,658 $(28,538,399
  

 

 

  

 

 

  

 

 

 

Per share information:

    

Net loss per share of common stock, basic and diluted

  $(0.50 $(0.28 $(0.85
  

 

 

  

 

 

  

 

 

 

Basic and diluted weighted average shares outstanding

   76,062,664   55,595,732   33,539,465 
  

 

 

  

 

 

  

 

 

 

(in thousands, except share and
per-share
data)
   
Year Ended December 31,
 
   
2021
  
2020
  
2019
 
Operating expenses:
         
Research and development, including stock-based compensation of $933, $655 and $469, respectively
  $35,508  $22,614  $18,057 
General and administrative, including stock-based compensation of $2,261, $1,921 and $977, respectively
   11,757   11,625   9,809 
   
 
 
  
 
 
  
 
 
 
Total operating expenses
   47,265   34,239   27,866 
   
 
 
  
 
 
  
 
 
 
Loss from operations
   (47,265  (34,239  (27,866
Other income (expense):
             
Interest income
   109   192   359 
Other expense
   0     (2,165  —   
Change in fair value of warrant liabilities
   26,874   8,056   14,713 
   
 
 
  
 
 
  
 
 
 
Total other income
   26,983   6,083   15,072 
   
 
 
  
 
 
  
 
 
 
Net loss
  $(20,282 $(28,156 $(12,794
   
 
 
  
 
 
  
 
 
 
Per share information:
             
Net loss per share of common stock, basic and diluted
  $(0.55 $(1.24 $(1.54
   
 
 
  
 
 
  
 
 
 
Basic and diluted weighted average shares outstanding
   36,775,950   22,763,528   8,283,509 
   
 
 
  
 
 
  
 
 
 
See accompanying notes.

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Table of Contents
CONTRAFECT CORPORATION

Consolidated Statements of Comprehensive Loss

   Year Ended December 31, 
   2018  2017  2016 

Net loss

  $(37,684,424 $(15,517,658 $(28,538,399

Other comprehensive gain (loss):

    

Unrealized gain (loss) onavailable-for-sale securities

   44,520   (23,154  (21,293
  

 

 

  

 

 

  

 

 

 

Comprehensive loss

  $(37,639,904 $(15,540,812 $(28,559,692
  

 

 

  

 

 

  

 

 

 

(in thousands)
   
Year Ended December 31,
 
   
2021
  
2020
  
2019
 
Net loss
  $(20,282 $(28,156 $(12,794
Other comprehensive (loss) gain:
             
Unrealized (loss) gain on
available-for-sale
securities
   (63  (21  30 
   
 
 
  
 
 
  
 
 
 
Comprehensive loss
  $(20,345 $(28,177 $(12,764
   
 
 
  
 
 
  
 
 
 
See accompanying notes.

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Table of Contents
CONTRAFECT CORPORATION

Consolidated Statements of Stockholders’ Equity

  Common Stock  Additional
Paid-In
Capital
  Accumulated
Other
Comprehensive
Loss
  Accumulated
Deficit
  Stockholders’
Equity
 
  Shares  Amount             

Balance, December 31, 2015

  27,482,692  $2,748  $148,282,546  $(30,373 $(117,579,411 $30,675,510 

Issuance of common stock for services

  31,206   3   93,927   —     —     93,930 

Issuance of securities in registered offering

  14,000,000   1,400   16,397,372   —     —     16,398,772 

Financing cost of sale of securities

  —     —     (1,383,548  —     —     (1,383,548

Issuance of common stock for exercise of options

  2,850   1   —     —     —     1 

Issuance of common stock for exercise of warrants

  139,258   14   55,984   —     —     55,998 

Share-based compensation

  —     —     2,231,883   —     —     2,231,883 

Unrealized loss on marketable securities

  —     —     —     (21,293  —     (21,293

Net loss

  —     —     —     —     (28,538,399  (28,538,399
 

 

 

  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

Balance, December 31, 2016

  41,656,006  $4,166  $165,678,164  $(51,666 $(146,117,810 $19,512,854 

Issuance of securities in registered offering

  32,000,000   3,200   27,613,365   —     —     27,616,565 

Financing cost of sale of securities

  —     —     (2,018,290  —     —     (2,018,290

Share-based compensation

  —     —     1,623,128   —     —     1,623,128 

Unrealized loss on marketable securities

  —     —     —     (23,154  —     (23,154

Net loss

  —     —     —     —     (15,517,658  (15,517,658
 

 

 

  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

Balance, December 31, 2017

  73,656,006  $7,366  $192,896,367  $(74,820 $(161,635,468 $31,193,445 

Issuance of common stock in registered offering

  5,750,000   575   11,499,425   —     —     11,500,000 

Financing cost of sale of securities

  —     —     (1,072,607  —     —     (1,072,607

Issuance of common stock for exercise of warrants

  3,550   —     5,503   —     —     5,503 

Share-based compensation

  —     —     1,555,523   —     —     1,555,523 

Unrealized gain on marketable securities

  —     —     —     44,520   —     44,520 

Net loss

  —     —     —     —     (37,684,424  (37,684,424
 

 

 

  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

Balance, December 31, 2018

  79,409,556  $7,941  $204,884,211  $(30,300 $(199,319,892 $5,541,960 
 

 

 

  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

(in thousands, except share data)
   
Common Stock
   
Additional

Paid-In

Capital
  
Accumulated

Other

Comprehensive

Loss
  
Accumulated

Deficit
  
Stockholders’

Equity
 
   
Shares
   
Amount
   
 
  
 
  
 
  
 
 
Balance, December 31, 2018
   7,940,931   $1   $204,891  $(30 $(199,320 $5,542 
Issuance of securities in registered offerings
   6,280,000    1    20,033   —     —     20,034 
Issuance of securities in private placement
   1,111,111    —      3,000   —     —     3,000 
Financing cost of sale of securities
   —      —      (1,713  —     —     (1,713
Stock-based compensation
   —      —      1,447   —     —     1,447 
Unrealized gain on marketable securities
   —      —      —     30   —     30 
Net loss
   —      —      —     —     (12,794  (12,794
   
 
 
   
 
 
   
 
 
  
 
 
  
 
 
  
 
 
 
Balance, December 31, 2019
   15,332,042   $2   $227,658  $
 

  
  $(212,114 $15,546 
Issuance of securities in registered offerings
   11,797,752    1    21,107   —     —     21,108 
Issuance of securities in private placement
   674,156    —      3,000   —     —     3,000 
Financing cost of sale of securities
   —      —      (1,462  —     —     (1,462
Issuance of common stock for exercise of warrants
   5,850    —      29   —     —     29 
Issuance of common stock for exercise of options
   361    —      —     —     —     —   
Stock-based compensation
   —      —      2,576   —     —     2,576 
Unrealized loss on marketable securities
   —      —      —     (21  —     (21
Net loss
   —      —      —     —     (28,156  (28,156
   
 
 
   
 
 
   
 
 
  
 
 
  
 
 
  
 
 
 
Balance, December 31, 2020
   27,810,161   $3   $252,908  $(21 $(240,270 $12,620 
Issuance of securities in registered offering
   11,500,000    1    57,499   —     —     57,500 
Financing cost of sale of securities
   —      —      (3,703  —     —     (3,703
Issuance of common stock for exercise of warrants
   22,560    —      110   —     —     110 
Stock-based compensation
   —      —      3,194   —     —     3,194 
Unrealized loss on marketable securities
   —      —      —     (63  —     (63
Net loss
   —      —      —     —     (20,282  (20,282
   
 
 
   
 
 
   
 
 
  
 
 
  
 
 
  
 
 
 
Balance, December 31, 2021
   39,332,721   $4   $310,008  $(84 $(260,552 $49,376 
   
 
 
   
 
 
   
 
 
  
 
 
  
 
 
  
 
 
 
See accompanying notes.

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Table of Contents
CONTRAFECT CORPORATION

Statements of Cash Flows

   Year Ended December 31, 
   2018  2017  2016 

Cash flows from operating activities

    

Net loss

  $(37,684,424 $(15,517,658 $(28,538,399

Adjustments to reconcile net loss to net cash used in operating activities:

    

Depreciation

   151,292   187,249   451,008 

Stock-based compensation expense

   1,555,523   1,623,128   2,231,883 

Issuance of common stock in exchange for services

   —     —     93,930 

Issuance costs allocated to warrants

   —     905,014   1,569,341 

Change in fair value of warrant and embedded derivative liabilities

   7,232,226   (11,532,978  (6,346,572

(Decrease) increase in deferred rent

   (25,058  (290,199  22,320 

Net amortization of premium paid on marketable securities

   486,736   831,793   428,783 

Changes in operating assets and liabilities:

    

Decrease (increase) in prepaid expenses and other current andnon-current assets

   897,447   (1,059,502  138,352 

Increase in accounts payable and accrued liabilities

   1,127,409   324,160   649,014 
  

 

 

  

 

 

  

 

 

 

Net cash used in operating activities

   (26,258,849  (24,528,993  (29,300,340

Cash flows from investing activities

    

Purchases of marketable securities

   (23,846,176  (53,162,598  (36,459,405

Proceeds from maturities of marketable securities

   41,130,888   43,802,957   27,604,030 

Purchases of property and equipment

   (133,488  —     (113,192
  

 

 

  

 

 

  

 

 

 

Net cash provided by (used in) investing activities

   17,151,224   (9,359,641  (8,968,567

Cash flows from financing activities

    

Proceeds from issuance of equity securities

   11,500,000   40,000,000   35,000,000 

Payment of financing costs of securities sold

   (1,072,607  (2,923,304  (2,952,889

Proceeds from exercise of warrants

   5,503   —     55,998 
  

 

 

  

 

 

  

 

 

 

Net cash provided by financing activities

   10,432,896   37,076,696   32,103,109 
  

 

 

  

 

 

  

 

 

 

Net increase (decrease) in cash and cash equivalents

   1,325,271  ��3,188,062   (6,165,798

Cash and cash equivalents at beginning of period

   6,995,046   3,806,984   9,972,781 
  

 

 

  

 

 

  

 

 

 

Cash and cash equivalents at end of period

  $8,320,317  $6,995,046  $3,806,984 
  

 

 

  

 

 

  

 

 

 

Supplemental disclosures of cash flow information andnon-cash investing and financing activities

    

Issuance of common stock for services

  $—   $—   $93,930 

Issuance of warrants to purchase common stock

  $—   $12,383,435  $18,601,228 

(in thousands)
   
Year Ended December 31,
 
   
2021
  
2020
  
2019
 
Cash flows from operating activities
             
Net loss
  $(20,282 $(28,156 $(12,794
Adjustments to reconcile net loss to net cash used in operating activities:
             
Depreciation
   148   168   169 
Stock-based compensation expense
   3,194   2,576   1,447 
Issuance costs allocated to warrants
   —     2,175   —   
Change in fair value of warrant liabilities
   (26,874  (8,056  (14,713
Net amortization of premium paid on marketable securities
   924   378   171 
Changes in operating assets and liabilities:
             
(Increase) decrease in prepaid expenses and other current and
non-current
assets
   (4,336  1,738   (1,263
Increase (decrease) in accounts payable, accrued liabilities and other liabilities
   6,101   (4,010  (445
   
 
 
  
 
 
  
 
 
 
Net cash used in operating activities
   (41,125  (33,187  (27,428
Cash flows from investing activities
             
Purchases of marketable securities
   (48,698  (47,555  —   
Proceeds from maturities of marketable securities
   37,085   20,151   21,991 
Purchases of property and equipment
   —     —     (20
   
 
 
  
 
 
  
 
 
 
Net cash (used in) provided by investing activities
   (11,613  (27,404  21,971 
Cash flows from financing activities
             
Proceeds from issuance of equity securities
   57,500   55,500   23,034 
Payment of financing costs of securities sold
   (3,703  (3,637  (1,713
Proceeds from exercise of warrants
   110   29   —   
   
 
 
  
 
 
  
 
 
 
Net cash provided by financing activities
   53,907   51,892   21,321 
   
 
 
  
 
 
  
 
 
 
Net increase (decrease) in cash and cash equivalents
   1,169   (8,699  15,864 
Cash and cash equivalents at beginning of period
   15,485   24,184   8,320 
   
 
 
  
 
 
  
 
 
 
Cash and cash equivalents at end of period
  $16,654  $15,485  $24,184 
   
 
 
  
 
 
  
 
 
 
Supplemental disclosures of cash flow information
             
Prepaid expenses in accrued liabilities
  $—    $—    $4,097 
Right-of-use
assets obtained in exchange for lease obligations
  $—    $—    $4,149 
Leasehold improvement obtained in exchange for lease incentive obligations
  $—    $—    $189 
Issuance of warrants to purchase common stock
  $—    $31,391  $—   
See accompanying notes.

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Table of Contents
ContraFect Corporation

Notes to Financial Statements

December 31, 2018

2021

1. Organization and Description of Business

Organization and Business

ContraFect Corporation (the “Company”) is a clinical-stage biotechnology company focused on biologic therapeutic productsthe discovery and development of direct lytic agents (“DLAs”), including lysins and amurin peptides, as new medical modalities for the treatment of life-threatening, infectious diseases, particularly those treated in hospital-based settings.antibiotic-resistant infections. The Company intends to address multi-drug resistantantibiotic-resistant infections using its therapeutic product candidates from itsour lysin platform.and amurin peptide platforms. DLAs are fundamentally different than antibiotics and offer a potential paradigm shift in the treatment of antibiotic-resistant infections. The Company’s most advanced product candidate is exebacase, a lysin which targetsStaph
S. aureus
, including methicillin-resistant strains, which causes serious infections such as bacteremia, pneumonia and osteomyelitis.Staph
S. aureus
is also a frequent source of biofilm-dependent infections of heart valves (endocarditis), prosthetic joints, indwelling devices and catheters. These infections result in significant morbidity and mortality despite current antibiotic therapy. Exebacase is being studied in a pivotal Phase 23 superiority study to evaluate its safety, tolerability, efficacy and pharmacokinetics when used in addition to background standard of care antibacterial therapy for the treatment ofStaph
S. aureus
bacteremia, including right-sided endocarditis in adult patients.

The Company has incurred recurring losses from operations since inception as a research and development organization and has an accumulated deficit of $199.3$260.6 million as of December 31, 2018.2021. For the year ended December 31, 2018,2021, the Company used $26.3$41.1 million of cash in operations. The Company has relied on its ability to fund its operations through public and private debt and equity financings, and, to a lesser extent, grant funding. The Company expects operating losses and negative cash flows to continue at significant levels in the future as it continues its clinical trials. WithoutAs of December 31, 2021, the Company had approximately $54.3 
million in cash, cash equivalents and marketable securities, which, without additional funding, the Company believes it will not havebe sufficient funds to meet its obligations within the next twelve months from the date of issuance of these consolidated financial statements. These factors raise substantial doubt about the Company’s ability to continue as a going concern. The Company plans to continue to fund its operations through public or private debt and equity financings, but there can be no assurances that such financing will continue to be available to the Company on satisfactory terms, or at all. As such, under the requirements of ASCAccounting Standard Codification (“ASC”)
205-40,
management may not consider the potential for future capital raises in its assessment of the Company’s ability to meet its obligations for the next twelve months.months, and substantial doubt exists about the Company’s ability to continue as a going concern for twelve months from the date the financial statements were issued. If the Company is unable to obtain funding, the Company would be forced to delay, reduce or eliminate its research and development programs, which could adversely affect its business prospects, or the Company may be unable to continue operations.

operations or continue as a going concern.

The consolidated financial statements have been prepared assuming that the Company will continue as a going concern, which contemplates continuity of operations, the realization of assets and the satisfaction of liabilities and commitments in the normal course of business.

On July 27, 2016,August 14, 2020, the Company filed a shelf registration statement on Form
S-3
(the “Form
S-3”)
with the SEC. The Form
S-3
was declared effective by the SEC on August 31, 2020. The Form
S-3
allows the Company to offer and sell from
time-to-time
up to $150.0 million of common stock, preferred stock, debt securities, warrants or units comprised of any combination of these securities.
On March 22, 2021, the Company completed an underwritten public offering under the Form
S-3
of 14,000,000 shares of its common stock and warrants to purchase an additional 14,000,000 shares of its common stock at an exercise price of $3.00 per share (the “2016 Offering”). The public offering price was $2.50 per share of common stock and accompanying warrant, resulting in net proceeds to the Company of approximately $32.0 million after underwriting discounts and commissions and offering expenses payable by the Company.

On July 25, 2017, the Company completed an underwritten public offering of 32,000,000 shares of its common stock and warrants to purchase an additional 16,000,000 shares of its common stock at an exercise price of $1.55 per share (the “2017 Offering”). The public offering price was $1.25 per share of common stock and accompanying warrant, resulting in net proceeds to the Company of approximately $37.1 million after underwriting discounts and commissions and offering expenses payable by the Company.

On August 3, 2018, the Company completed an underwritten public offering of 5,750,00011,500,000 shares of its common stock, including shares sold pursuant to the fully exercised overallotment option granted to the underwriters in connection with the offering, at a public offering price of $2.00$5.00 per share, resulting in estimated net proceeds to the Company of approximately $10.4$53.8 million after underwriting discounts and commissions and offering expenses payable by the Company.

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Table of Contents
On March 10, 2021, the Company entered into a cost-share contract (the “BARDA Contract”) with BARDA, a division of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response. Under the BARDA Contract, the Company will receive funding of up to an estimated $86.8 million to advance the development of exebacase. The base period for the BARDA Contract includes government funding of up to $9.8 million to reimburse expenses for to support the conduct of the ongoing Phase 3 clinical trial and futility analysis. Following successful completion of the base period, the BARDA Contract provides for approximately $77.0 million of additional BARDA funding for five option stages in support of the completion of the Phase 3 clinical trial of exebacase, further clinical and
non-clinical
studies, manufacturing, supply chain, clinical, regulatory and administrative activities. The contract
period-of-performance
(base period plus option exercises) is up to approximately six years.
On May 27, 2020, the Company completed an underwritten public offering of 11,797,752 shares of its common stock and warrants to purchase an additional 8,848,314 shares of its common stock at an exercise price of $4.90 per share (the “2020 Offering”). The public offering price was $4.45 for one share of common stock and an accompanying warrant to purchase 0.75 shares of common stock, resulting in net proceeds to the Company of approximately $48.9 million after underwriting discounts and commissions and offering expenses payable by the Company. The Company completed a concurrent private placement to Pfizer Inc. (“Pfizer”) of 674,156 shares of common stock and an accompanying warrant to purchase an additional 505,617 shares of its common stock at an exercise price of $4.90 per share (the “Pfizer Warrant”). The offering price for one share of common stock and an accompanying warrant to purchase 0.75 shares of common stock was at a price of $4.45 per share of common stock, resulting in net proceeds to the Company of approximately $3.0 million.
On December 18, 2019, the Company completed an underwritten public offering of 2,565,000 shares of its common stock at a public offering price of $3.90 per share, resulting in gross proceeds to the Company of approximately $10.0 million. On December 12, 2019, the Company completed an underwritten public offering of 3,715,000 shares of its common stock at a public offering price of $2.70 per share and a concurrent private placement of 1,111,111 shares of common stock to Pfizer Inc. at a price of $2.70 per share, resulting in gross proceeds to the Company of approximately $13.0 million. The combined net proceeds of both public offerings together with the private placement was $21.3 million after underwriting discounts and commissions and offering expenses payable by the Company.
The significant increases in common stock outstanding are expected to impact the year-over-year comparability of the Company’s net loss per share calculations.

2. Summary of Significant Accounting Policies

significant accounting policies

Basis of Presentation

The accompanying financial information has been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”).

Principles of Consolidation

The Company has a wholly-owned subsidiary, ContraFect International Limited, in Scotland that establishes legal status for interactions with the European Economic Area. This subsidiary is dormant or is otherwise
non-operative.
Any inter-company accounts have been eliminated in consolidation.

Segment and Geographic Information

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker, or decision makingdecision-making group, in making decisions on how to allocate resources and assess performance. The Company’s chief operating decision maker is the chief executive officer. The Company and the chief decision maker view the Company’s operations and manage its business as one1 operating segment. The Company operates in only one1 geographic segment.

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Table of Contents
Significant Risks and Uncertainties

The Company’s operations are subject to a number of factors that can affect its operating results and financial condition. Such factors include, but are not limited to: the results of clinical testing and trial activities of the Company’s products, the Company’s ability to obtain regulatory approval to market its products, and, if approved, the price of, and demand for, the Company’s products, competition from products manufactured and sold or being developed by other companies, the price of, and demand for, the Company’s products, the Company’s ability to negotiate favorable licensing or other manufacturing and marketingother agreements for its products and the Company’s ability to raise capital.

The Company currently relies on a single manufacturer of exebacase drug substance and drug product, located in the United Kingdom, and there is no long-term supply agreement in place. A sustained disruption in the operations of this manufacturer or in the event the Company would need to change to a new supplier, could result in a significant delay in the ability of the Company to complete the activities needed to support a Biologics License Application for, and, if approved, commercialization of exebacase.
Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of expenses during the reporting period. The Company bases estimates and assumptions on historical experience when available and on various factors that it believes to be reasonable under the circumstances. On an ongoing basis, the Company evaluates its estimates and assumptions, including those related to research and development prepaid expenses and accruals, fair value measurements, stock-based compensation, warrant valuation and realization of net deferred income tax assets. The Company’s actual results may differ from these estimates under different assumptions or conditions. There have been no significant changes from the Company’s original estimates in any periods presented.

Concentrations of Credit Risk

Financial instruments which potentially subject the Company to credit risk consist primarily of cash, cash equivalents and marketable securities. The Company holds these investments in highly rated financial institutions, and, by policy, limits the amounts of credit exposure to any one financial institution. These amounts at times may exceed federally insured limits. The Company has not experienced any credit losses in such accounts and does not believe it is exposed to any significant credit risk on these funds. The Company has no
off-balance
sheet concentrations of credit risk, such as foreign currency exchange contracts, option contracts or other hedging arrangements.

Cash and Cash Equivalents

The Company considers all highly liquid investments with maturities at the date of purchase of three months or less to be cash equivalents. Cash and cash equivalents include bank demand deposits, marketable securities with maturities of three months or less at purchase, and money market funds that invest primarily in certificates of deposit, commercial paper and U.S. government and U.S. government agency obligations. Cash equivalents are reported at fair value.

Marketable Securities

Marketable securities consistconsists of investments in corporate debt and U.S. Treasury securities. Management determines the appropriate classification of the securities at the time they are acquired and evaluates the appropriateness of such classifications at each balance sheet date. The Company classifies its marketable securities as
available-for-sale
pursuant to ASC 320,
Investments – Debt and Equity Securities
. The Company classifies marketable securities available to fund current operations as current assets on its consolidated balance sheets. Marketable securities are
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classified aslong-term assets on the consolidated balance sheets if (i) the Company has the intent and ability to hold the investments for a period of at least one year and (ii) the contractual maturity date of the investments is greater than one year. Marketable securities are recorded at fair value, with unrealized gains and losses included as a component of accumulated other comprehensive loss in stockholders’ equity and a component of total comprehensive loss in the consolidated statements of comprehensive loss, until realized. The fair value of these securities is based on quoted prices for identical or similar assets. Realized gains and losses are included in interest income in the consolidated statement of operations and comprehensive loss on a specific-identification basis.Therebasis.
There were no0 realized gains or losses on sales of marketable securities for the yearsyear ended December 31, 2018, 2017 or 2016.2021. There were no$9,609 of realized gains on sales of marketable securities for the year ended December 31, 2020. There were 0 marketable securities that had been in an unrealized loss position for more than 12 months as of December 31, 20182021 or 2017.

2020.

The Company reviews marketable securities for other-than-temporary impairment whenever the fair value of a marketable security is less than the amortized cost and evidence indicates that a marketable security’s carrying amount is not recoverable within a reasonable period of time. Other-than-temporary impairments of investments are recognized in the consolidated statements of operations if the Company has experienced a credit loss, has the intent to sell the marketable security, or if it is more likely than not that the Company will be required to sell the marketable security before recovery of the amortized cost basis. Evidence considered in this assessment includes reasons for the impairment, compliance with the Company’s investment policy, the severity and the duration of the impairment and changes in value subsequent to the end of the period.

Fair Value of Financial Instruments

The Company’s financial instruments consist of cash and cash equivalents, marketable securities, accounts payable, accrued liabilities and warrant liabilities. Fair value estimates of these instruments are made at a specific point in time, based on relevant market information. These estimates may be subjective in nature and involve uncertainties and matters of significant judgment and therefore cannot be determined with precision. The fair value of the Company’s warrant liabilities are
is
based upon unobservable inputs, as described further below.

The Company is required to disclose information on all assets and liabilities reported at fair value that enables an assessment of the inputs used in determining the reported fair values. FASB ASC Topic 820,
Fair Value Measurements and Disclosures (ASC 820)
(“ASC 820”), establishes a hierarchy of inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the observable inputs be used when available. Observable inputs are inputs that market participants would use in pricing the asset or liability based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the inputs that market participants would use in pricing the asset or liability, and are developed based on the best information available in the circumstances. The fair value hierarchy applies only to the valuation inputs used in determining the reported fair

value of the investments and is not a measure of the investment credit quality. The three levels of the fair value hierarchy are described below:

Level 1—Valuations based on unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.

Level 2—Valuations based on quoted prices for similar assets or liabilities in markets that are not active or for which all significant inputs are observable, either directly or indirectly.

Level 3—Valuations that require inputs that reflect the Company’s own assumptions that are both significant to the fair value measurement and unobservable.

To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in Level 3. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement.

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The Company had no0 liabilities classified as Level 1 or Level 2. The carrying amounts reported in the accompanying financial statements for accounts payable and accrued expenses approximate their respective fair values due to their short-term maturities. The fair value of the warrant and embedded derivative liabilities are
is
discussed in Note 4, “Fair Value Measurements.”

Property, Office Equipment, and Leasehold Improvements

Property and equipment are recorded at cost less accumulated depreciation. Depreciation of property and equipment is provided by the straight-line method over their estimated useful lives, ranging from three to five years.

Leasehold improvements are amortized on a straight linestraight-line basis over the useful life
of
the
improvement or the initial lease term, whichever is shorter. Costs for normal repair and maintenance are charged to expense as incurred.

Impairment of Long-lived Assets

In accordance with ASC 360,
Property, Plant, and Equipment
, the Company’s policy is to review long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. An impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of the asset and its eventual disposition is less than its carrying amount. As of December 31, 20182021 and 2017, no2020, 0 impairment of long-lived assets has occurred.

Deferred Rent

The Company has an operating lease for office and laboratory space. Rent expense is recorded on a straight-line basis over the initial lease term. The difference between the actual cash paid and the straight-line rent expense is recorded as deferred rent.

Research and Development Costs

Research and development costs are charged to expense as incurred and are typically made up of salaries and benefits, clinical trial activities, drug development and manufacturing costs, and third-party service fees, including for clinical research organizations and investigative sites. Costs for certain development activities, such as clinical trials, are recognized based on an evaluation of the progress to completion of specific tasks using data

such as patient enrollment, clinical site activations, or information provided by vendors on their actual costs incurred. Payments for these activities are based on the terms of the individual arrangements, which may differ from the pattern of costs incurred, and are reflected in the financial statements as prepaid expenses or accrued expenses.

Share-basedliabilities.

Stock-based Compensation

The Company accounts for stock-based compensation in accordance with ASC 718,
Compensation—Stock Compensation,
which requires the measurement and recognition of compensation expense for all stock-based payment awards made to employees, andnon-employeedirectors, and
non-employees,
including employee stock options. Compensation expense based on the grant date fair value is generally amortized over the requisite service period of the award on a straight-line basis.

The fair value of options is calculated using the Black-Scholes option pricing model on the date of grant based on key assumptions such as stock price, risk free interest rates, expected volatility, expected term, and expected term.dividend yield. The Company’s estimates of these assumptions are primarily based on historical data, peer company data and judgment regarding future trends and factors.

Income Taxes

The Company uses the asset and liability method to calculate deferred tax assets and liabilities. Deferred taxes are recognized based on the differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases using enacted tax rates expected to apply to taxable income in the
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years in which those differences are expected to be recovered or settled. The Company records a valuation allowance against a deferred tax asset when it is
more-likely-than-not
that the deferred tax asset will not be realized.

The Company is subject to federal, state and local taxes and follows a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The Company recognizes tax benefits or expenses of uncertain tax positions in the year such determination is made when the position is “more likely than not” to be sustained assuming examination by tax authorities. Management has reviewed the Company’s tax positions for all open tax years (tax years ended December 31, 20082010 through December 31, 2018)2021) and concluded that no0 provision for unrecognized tax benefits or expense is required in these financial statements. There are no income tax audits in progress as of December 31, 2018.

Grants

2021.

Government Contracts and Grant Agreements
The Company recognizes a receivable, which is included in other current assets on its consolidated balance sheet, and the related reduction in its research and development expenses when the actual reimbursable costs have been incurred and there is reasonable assurance that the Company has complied with the conditions of the grantsapplicable government contract or grant agreement and the amounts will be received. For the years ended December 31, 2018 and 2017, theThe Company recognized a reduction to its research and development expense in the amount of approximately $1,222,000
$10.5 million, $4.2 million and $1,176,000,$3.6 million for the years ended December 31, 2021, 2020 and 2019 respectively. The receivable for grantsgovernment contracts and grant agreements as of December 31, 20182021 and 2020 was approximately $202,000$4.1 million and $
1.1
million, respectively, and is included in prepaid expenses and other current assets.assets on the
consolidated
balance sheet. The Company has approximately $482,000
$7.7 million of approvedcommitted government contract and grant awardagreement funding remaining as of December 31, 2018.

2021.

Net Loss per Share Applicable to Common Stockholders

Basic net loss per share applicable to common stockholders is calculated by dividing net loss applicable to common stockholders by the weighted average shares outstanding during the period, without consideration for common stock equivalents. Diluted net loss per share applicable to common stockholders is calculated by adjusting weighted average shares outstanding for the dilutive effect of common stock equivalents outstanding for the period, determined using the treasury-stock method. For purposes of the dilutive net loss per share

applicable to common stockholdersstockholders’ calculation, stock options and warrantwarrants are considered to be common stock equivalents but are excluded from the calculation of diluted net loss per share applicable to common stockholders, as their effect would be anti-dilutive; therefore, basic and diluted net loss per share applicable to common stockholders were the same for all periods presented.

Comprehensive Loss

Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions, and other events and circumstances from
non-owner
sources, and currently consists of net loss and changes in unrealized gains and losses on
available-for-sale
securities.

Recently Adopted Accounting Pronouncements

In

Fair Value Measurements
On January 2016,1, 2020, the FASB issued a newCompany adopted Accounting Standards UpdateRecognition No.
2018-13-
Fair Value Measurement (Topic 820).
Topic 820 eliminates, adds and Measurement of Financial Assets and Financial Liabilities (ASU2016-01)
. ASU2016-01 amends the guidance in U.S. GAAP on the classification and measurement of financial instruments. Although the ASU retains many current requirements, it significantly revises an entity’s accounting related to (1) the classification and measurement of investments in equity securities and (2) the presentation of certain fair value changes for financial liabilities measured at fair value. The ASU also amendsmodifies certain disclosure requirements associated with thefor fair value measurements. The adoption of the new guidance did not affect the Company’s consolidated financial instruments. The new standard is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2017, with early adoption permitted for certain changes. Thestatements.
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Table of Contents
Income Taxes
On January 1, 2021, the Company adopted ASU2016-01 asAccounting Standards Update
No. 2019-12,
Income Taxes (Topic 740)
, which simplified the accounting for income taxes. The adoption of January 1, 2018 and there was no impact tothe new guidance did not affect the Company’s consolidated financial statements and related disclosures.

In August 2016, the FASB issued Accounting Standards UpdateNo. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments (ASU2016-15), which amended the existing accounting standards for the statement of cash flows by providing guidance on eight classification issues related to the statement of cash flows. ASU2016-15 is effective in fiscal years beginning after December 15, 2017, including interim periods within those fiscal years, and early adoption is permitted. The amendments should be applied retrospectively to all periods presented. For issues that are impracticable to apply retrospectively, the amendments may be applied prospectively as of the earliest date practicable. The Company adopted ASUNo. 2016-15 as of January 1, 2018 and there was no impact to the Company’s financial statements and related disclosures.

In November 2016, the FASB issued Accounting Standards UpdateNo. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash (ASU2016-18), which amended the existing accounting standards for the statement of cash flows by requiring restricted cash to be included with cash and cash equivalents when reconciling thebeginning-of-period andend-of-period total amounts shown on the statement of cash flows. ASU2016-18 is effective in fiscal years beginning after December 15, 2017, including interim periods within those fiscal years, and early adoption is permitted. The amendments should be applied retrospectively to all periods presented. The Company adopted ASUNo. 2016-18 as of January 1, 2018 and there was no impact to the Company’s financial statements and related disclosures.

In May 2017, the FASB issued Accounting Standards Update2017-09,Compensation – Stock Compensation (Topic 718): Scope of Modification Accounting (ASU2017-09). This new standard provides guidance about which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting in Topic 718. ASU2017-09 allows for prospective application and is effective for fiscal years beginning after December 15, 2017, and interim periods therein with early adoption permitted for interim or annual periods. The Company adopted ASUNo. 2017-09 as of January 1, 2018 and there was no impact to the Company’s financial statements and related disclosures.

statements.

Recent

Recently Issued Accounting Pronouncements Not Yet Adopted

In February 2016, the FASB issued a new Accounting Standards Update,Leases (ASU2016-02). ASU2016-02 is aimed at making leasing activities more transparent and comparable and requires most leases be recognized by lessees on the balance sheet as an asset and a corresponding lease liability, regardless of whether they are classified as finance (previously referred to as capital leases) or operating leases. The new standard is effective for annual reporting periods beginning after December 15, 2018, including interim periods within that reporting period, with early adoption permitted. We will adopt the new standard effective January 1, 2019.

This guidance will be effective on a modified retrospective basis and we will apply the optional transition method. The Company is currently evaluating the potential impact ASU2016-02 may have on its financial position, results of operations, and related footnotes. The Company expects it will elect to utilize the available package of practical expedients permitted under the transition guidance within the new standard, which does not require the reassessment of the following: i) whether existing or expired arrangements are or contain a lease, ii) the lease classification of existing or expired leases, and iii) whether previous initial direct costs would qualify for capitalization under the new lease standard. Additionally, the Company expects it will make an accounting policy election to keep leases with an initial term of 12 months or less off of its balance sheet. The Company currently expects the lease of its corporate headquarters at 28 Wells Avenue in Yonkers, New York, as disclosed in Note 8— Commitments and Contingencies in our Annual Report on Form10-K filed with the SEC on March 15, 2018, will be subject to the new standard and recognize as aright-of-use asset and operating lease liability upon its adoption of ASU2016-02. The Company has begun its implementation which will increase the total assets and total liabilities that the Company reports relative to such amounts prior to adoption and continues to assess the impact that this standard has on its other contracts, if any. We expect to complete our assessment of the full financial impact of ASC 842 during the first quarter of 2019, and will include all required presentation and disclosures under ASC 842 in our Form10-Q for the three months ending March 31, 2019.

In June 2016, the FASB issued a new Accounting Standards Update,
Financial Instruments-Credit Losses (ASU
2016-13).
ASU
2016-13
amends the guidance for measuring and recording credit losses on financial assets measured at amortized cost by replacing the “incurred loss” model with an “expected loss” model. Accordingly, these financial assets will be presented at the net amount expected to be collected. This new standard also requires that credit losses related to
available-for-sale
debt securities be recorded through an allowance for such losses rather than reducing the carrying amount under the current, other-than-temporary-impairment model. The new standard is effective for interim and annual periods beginning after December 15, 2019.2022. The Company is currently evaluating the impact that this new standard will have on its consolidated financial statements and related disclosures.

In June 2018,November 2021, the FASB issued a new Accounting Standards Update,Compensation-Stock Compensation
Disclosure by Business Entities about Government Assistance (ASU2018-07), which simplifies 2021-10)
. ASU 2021-10 improves the transparency of government assistance received by certain business entities by requiring the disclosure of (1) the types of government assistance received, (2) the accounting for share-based payments granted to nonemployees by aligningsuch assistance, and (3) the accounting witheffect of the requirements for employee share-based compensation.assistance on the business entity’s financial statements. The new guidancestandard is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years,2021, with early adoption permitted. The Company is assessingcurrently evaluating the impact of the adoption ofthat this guidancenew standard will have on its consolidated financial statements and whether or not to adopt early.

In August 2018, the FASB issued Accounting Standards Update,Fair Value Measurement: Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement, (ASU2018-13).The new standard removes certain disclosures, modifies certain disclosures and adds additional disclosures related to fair value measurement. The new standard will be effective beginning January 1, 2020 and early adoption is permitted. The Company is currently evaluating the potential impact ASU2018-13 may have on its disclosures upon adoption.

In August 2018, the SEC adopted the final rule under SEC ReleaseNo. 33-10532, Disclosure Update and Simplification, amending certain disclosure requirements that were redundant, duplicative, overlapping, outdated

disclosures.

or superseded. In addition, the amendments expanded the disclosure requirements on the analysis of stockholders’ equity for interim financial statements. Under the amendments, an analysis of changes in each caption of stockholders’ equity presented in the balance sheet must be provided in a note or separate statement. The analysis should present a reconciliation of the beginning balance to the ending balance of each period for which a statement of comprehensive income is required to be filed. The Company anticipates its first presentation of changes in stockholders’ equity as required under the new SEC guidance will be included in its Form10-Q for the quarter ended March 31, 2019.

3. Marketable Securities

Marketable securities at December 31, 20182021 consisted of the following:

Marketable Securities

  Amortized Cost   Unrealized
Gains
   Unrealized
Losses
   Fair Value 

Current:

        

Corporate debt

  $19,179,530   $314   $(31,160  $19,148,684 

U.S. Treasury securities

   2,982,706    546    —      2,983,252 
  

 

 

   

 

 

   

 

 

   

 

 

 
  $22,162,236   $860   $(31,160  $22,131,936 
  

 

 

   

 

 

   

 

 

   

 

 

 

following (in thousands):

Marketable Securities
  
Amortized Cost
   
Unrealized

Gains
   
Unrealized

Losses
   
Fair
Value
 
Current:
                    
Corporate debt
  $37,715   $0     $(84  $37,631 
Marketable securities at December 31, 20172020 consisted of the following:

Marketable Securities

  Amortized Cost   Unrealized
Gains
   Unrealized
Losses
   Fair Value 

Current:

        

Corporate debt

  $39,933,684   $—     $(74,820  $39,858,864 

U.S. Treasury securities include government debt instruments issued by the U.S. Department of the Treasury. following (in thousands):

Marketable Securities
  
Amortized Cost
   
Unrealized

Gains
   
Unrealized

Losses
   
Fair
Value
 
Current:
                    
Corporate debt
  $27,026   $6   $(27  $27,005 
Corporate debt includes obligations issued by investment-grade corporations, and may include issues that have been guaranteed by governments and government agencies.corporations. At December 31, 2018,2021, the Company held only investments that have maturities of less than one year.

At December 31, 20182021 and December 31, 2017,2020, the Company held 22
 23
and 3215 debt securities, respectively, that individually and in total were in an immaterial unrealized loss position for 
less than one year.year
. The aggregate fair value of debt securities in an unrealized loss position at December 31, 20182021 and December 31, 20172020 was $19,544,246
$37,631
and $39,858,864,$18,116, respectively. The Company evaluated its securities for other-than-temporary impairment and considered the decline in market value for the securities to be primarily attributable to current economic and market conditions. It iswas not more likely than not that the Company will bewould have been required to sell the securities prior to the recovery of the amortized cost basis. Based on this analysis, these marketable securities
were not 0t
considered to be other-than-temporarily impaired as of December 31, 20182021 and 2017.

December 3

1
, 2020.
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4. Fair Value Measurements

The following fair value hierarchy table presents information about the Company’s financial assets and liabilities measured at fair value on a recurring basis as of December 31, 20182021 and December 31, 2017:

   Fair Value Measurement As of December 31, 2018 
   Quoted Prices
in Active
Markets for
Identical Assets
(Level 1)
   Significant
Other Observable
Inputs
(Level 2)
   Significant
Unobservable
Inputs
(Level 3)
 

Cash equivalents

  $6,850,772   $—     $—   

Marketable securities

   22,131,936    —      —   

Warrant liabilities

   —      —      20,781,663 
  

 

 

   

 

 

   

 

 

 

Total

  $28,982,708   $—     $20,781,663 
  

 

 

   

 

 

   

 

 

 
2020 (in thousands):

   Fair Value Measurement As of December 31, 2017 
   Quoted Prices
in Active
Markets for
Identical Assets
(Level 1)
   Significant
Other Observable
Inputs
(Level 2)
   Significant
Unobservable
Inputs
(Level 3)
 

Cash equivalents

  $5,949,477   $—     $—   

Marketable securities

   39,858,864    —      —   

Warrant liabilities

   —      —      13,549,437 
  

 

 

   

 

 

   

 

 

 

Total

  $45,808,341   $—     $13,549,437 
  

 

 

   

 

 

   

 

 

 

The Company issued a warrant to the representative of the underwriter of its initial public offering (the “Representative’s Warrant”). The Company determined that this warrant should be classified as a liability and considers it as a Level 3 financial instrument (see also Note 9, “Capital Structure”). The Representative’s Warrant will bere-measured at each subsequent reporting period and changes in fair value will be recognized in the consolidated statement of operations. The following assumptions were used in a Black-Scholes option-pricing model to determine the fair value of the warrant liability:

   As of
December 31, 2018
  As of
December 31, 2017
 

Expected volatility

   70.9  88.1

Remaining contractual term (in years)

   0.67   1.67 

Risk-free interest rate

   2.63  1.89

Expected dividend yield

   —     —   

   
Fair Value Measurement as of December 31, 2021
 
   
Quoted Prices

in Active

Markets for

Identical Assets

(Level 1)
   
Significant

Other Observable

Inputs

(Level 2)
   
Significant

Unobservable

Inputs

(Level 3)
 
Cash equivalents
  $7,734   $—     $—   
Marketable securities
   37,631    —      —   
Warrant liabilities
   —      —      2,530 
   
 
 
   
 
 
   
 
 
 
Total
  $45,365   $
 

  
   $2,530 
   
 
 
   
 
 
   
 
 
 
   
Fair Value Measurement as of December 31, 2020
 
   
Quoted Prices

in Active

Markets for

Identical Assets

(Level 1)
   
Significant

Other Observable

Inputs

(Level 2)
   
Significant

Unobservable

Inputs

(Level 3)
 
Cash equivalents
  $12,921   $—     $—   
Marketable securities
   27,005    —      —   
Warrant liabilities
   —      —      29,404 
   
 
 
   
 
 
   
 
 
 
Total
  $39,926   $—     $29,404 
   
 
 
   
 
 
   
 
 
 
The Company issued warrants to the purchasers of its 2016 Offering (the “2016 Warrants”). The Company determined that these warrants should be classified as a liability and considered as a Level 3 financial instrument (see also Note 9, “Capital Structure”). The 2016 Warrants will bewere
re-measured
at each subsequent reporting period and changes in fair value will bewas recognized in the consolidated statement of operations. The 2016 Warrants expired in accordance with their terms on July 27, 2021. The following assumptions were used in a Black-Scholes option-pricing model to determine the fair value of the warrant liability:

   As of
December 31, 2018
  As of
December 31, 2017
 

Expected volatility

   72.6  80.3

Remaining contractual term (in years)

   2.58   3.58 

Risk-free interest rate

   2.46  2.09

Expected dividend yield

   —     —   

As of

December 31, 2020
Expected volatility
59.7
Remaining contractual term (in years)
0.58
Risk-free interest rate
0.09
Expected dividend yield
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Table of Contents
The Company issued warrants to the purchasers of its 2017 Offering (the “2017 Warrants”). The Company determined that these warrants should be classified as a liability and considered as a Level 3 financial instrument (see also Note 9, “Capital Structure”). The 2017 Warrants will beare
re-measured
at each subsequent reporting period and changes in fair value will beare recognized in the consolidated statement of operations.
The following assumptions were used in a Black-Scholes option-pricing model to determine the fair value of the warrant liability:

   As of
December 31, 2018
  As of
December 31, 2017
 

Expected volatility

   87.3  81.5

Remaining contractual term (in years)

   3.58   4.58 

Risk-free interest rate

   2.49  2.20

Expected dividend yield

   —     —   

         
   
As of

December 31, 2021
  
As of

December 31, 2020
 
Expected volatility
   56.5  100.1
Remaining contractual term (in years)
   0.58   1.58 
Risk-free interest rate
   0.19  0.12
Expected dividend yield
     
The Company issued warrants to the purchasers of its 2020 Offering (the “2020 Warrants”). The Company determined that these warrants should be classified as a liability and considered as a Level 3 financial instrument (see also Note 9, “Capital Structure”). The 2020 Warrants are
re-measured
at each subsequent reporting period and changes in fair value are recognized in the consolidated statement of operations.
The following assumptions were used in a Black-Scholes option-pricing model to determine the fair value of the warrant liability:
         
   
As of

December 31, 2021
  
As of

December 31, 2020
 
Expected volatility
   61.9  111.9
Remaining contractual term (in years)
   1.42   2.42 
Risk-free interest rate
   0.56  0.15
Expected dividend yield
     
The following tables present a reconciliation of the Company’s financial liabilities measured at fair value on a recurring basis using significant unobservable inputs (Level 3) for the years ended December 31, 2018, 20172021, 2020 and 2016:

2019 (in thousands):

Warrant liabilities

   Year Ended December 31, 
   2018   2017   2016 

Balance at beginning of period

  $13,549,437   $12,698,980   $444,324 

Issuance of 2017 Warrants

   —      12,383,435    —   

Issuance of 2016 Warrants

   —      —      18,601,228 

Change in fair value

   7,232,226    (11,532,978   (6,346,572
  

 

 

   

 

 

   

 

 

 

Balance at end of period

  $20,781,663   $13,549,437   $12,698,980 
  

 

 

   

 

 

   

 

 

 

             
   
Year Ended December 31,
 
   
2021
   
2020
   
2019
 
Balance at beginning of period
  $29,404   $6,069   $20,782 
Issuance of 2020 Warrants
   —      31,391    —   
Change in fair value
   (26,874   (8,056   (14,713
   
 
 
   
 
 
   
 
 
 
Balance at end of period
  $2,530   $29,404   $6,069 
   
 
 
   
 
 
   
 
 
 
The key inputs into the Black-Scholes option pricing model are the per share value and the expected volatility of the Company’s common stock. Significant changes in these inputs will directly increase or decrease the estimated fair value of the Company’s warrant liability.

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Table of Contents
5. Property, Equipment, and Leasehold Improvements

Property, equipment, and leasehold improvements, at cost, consisted of:

   December 31, 
   2018   2017 

Computer equipment

  $19,691   $19,691 

Furniture

   434,697    434,697 

Lab equipment

   1,844,369    1,710,881 

Leasehold improvements

   1,855,004    1,855,004 
  

 

 

   

 

 

 
   4,153,761    4,020,273 

Less: accumulated depreciation and amortization

   (3,077,662   (2,926,370
  

 

 

   

 

 

 
  $1,076,099   $1,093,903 
  

 

 

   

 

 

 

Depreciation expense was $151,292, $187,249 and $451,008of the following for the years ended December 31, 2018, 20172021 and 2016,2020 (in thousands):

         
   
December 31,
 
   
2021
   
2020
 
Computer equipment
  $20   $20 
Furniture
   435    435 
Lab equipment
   1,864    1,864 
Leasehold improvements
   1,985    2,006 
   
 
 
   
 
 
 
    4,304    4,325 
Less: accumulated depreciation and amortization
   (3,563   (3,415
   
 
 
   
 
 
 
   $741   $910 
   
 
 
   
 
 
 
Depreciation expense was $148, $168 and $169 for the years ended December 31, 2021, 2020 and 2019, respectively.

6. Accrued Expenses

Liabilities

Accrued expensesliabilities consisted of the following:

   December 31, 
   2018   2017 

Accrued research and development service fees

  $2,076,764   $578,562 

Accrued compensation costs

   1,585,689    2,107,118 

Accrued professional fees

   433,498    168,168 

Accrued facilities operation expenses

   232,673    221,103 

Other accrued expenses

   41,108    43,286 
  

 

 

   

 

 

 
  $4,369,732   $3,118,237 
  

 

 

   

 

 

 
following for the years ended December 31, 2021 and 2020 (in thousands):

         
   
December 31,
 
   
2021
   
2020
 
Accrued research and clinical development service fees

  $5,641   $801 
Accrued compensation costs
   2,215    2,069 
Accrued professional fees
   819    457 
Accrued facilities operation expenses
   307    173 
Other accrued expenses
   146    110 
   
 
 
   
 
 
 
   $9,128   $3,610 
   
 
 
   
 
 
 
7. Net Loss Per Share of Common Stock

Diluted loss per share is the same as basic loss per share for all periods presented because the effects of potentially dilutive items were anti-dilutive given the Company’s net loss. Basic loss per share is computed by dividing net loss available to common stockholders by the weighted-average number of common shares outstanding.

The following table sets forth the computation of basic and diluted loss per share for common stockholders:

   Year Ended December 31, 
   2018   2017   2016 

Net loss applicable to common stockholders

  $(37,684,424  $(15,517,658  $(28,538,399

Weighted average shares of common stock outstanding

   76,062,664    55,595,732    33,539,465 
  

 

 

   

 

 

   

 

 

 

Net loss per share of common stock—basic and diluted

  $(0.50  $(0.28  $(0.85
  

 

 

   

 

 

   

 

 

 

stockholders (in thousands, except share and per share data):

             
   
Year Ended December 31,
 
   
2021
   
2020
   
2019
 
Net loss applicable to common stockholders
  $(20,282  $(28,156  $(12,794
Weighted average shares of common stock outstanding
   36,775,950    22,763,528    8,283,509 
   
 
 
   
 
 
   
 
 
 
Net loss per share of common
stock—basic and diluted
  $(0.55  $(1.24  $(1.54
   
 
 
   
 
 
   
 
 
 
F-18

Table of Contents
The following potentially dilutive securities outstanding at December 31, 2018, 20172021, 2020 and 20162019 have been excluded from the computation of diluted weighted average shares outstanding, as they would have been antidilutive given the Company’s net loss:

   December 31, 
   2018   2017   2016 

Options to purchase common stock

   7,187,885    6,200,151    4,691,746 

Warrants to purchase common stock

   31,243,026    36,270,103    27,214,775 
  

 

 

   

 

 

   

 

 

 
   38,430,911    42,470,254    31,906,521 
  

 

 

   

 

 

   

 

 

 

   
December 31,
 
   
2021
   
2020
   
2019
 
Options to purchase common stock
   2,899,694    1,853,841    1,216,338 
Warrants to purchase common stock
   10,926,594    12,350,293    3,033,910 
   
 
 
   
 
 
   
 
 
 
   
13,826,288
   
14,204,134
   
4,250,248
 
   
 
 
   
 
 
   
 
 
 
8. Commitments and Contingencies

Operating Leases

In December 2010, the Company entered into a
non-cancellable
operating lease for office space and laboratory facilities in Yonkers, New York expiring in December 2025. In December 2011, the Company entered into an amendment which extended the termsterm of the lease through December 2027 (the “Third Floor Lease”). The lease provides for the option to renew for two2 additional five-year terms. The premises were occupied in June 2011. Monthly rent payments began the date the office and laboratory facilities were ready for occupancy.

In January 2012, the Company entered into a

non-cancellable
operating lease for additional office space and laboratory facilities in the same building in Yonkers, New York expiring in December 2027 (the “Fourth Floor Lease”). The Fourth Floor Lease provides for an option to renew for two2 additional five-year terms. Effective August 1, 2017, the Company relinquished 10,912 square feet of space under the Fourth Floor Lease and was relieved of its obligations related to such space. Monthly rental payments were adjusted and together with
The balance sheet classification of the Third Floor Lease, future minimumCompany’s lease liabilities was as follows (in thousands):
   
December 31,
 
Description
  
2021
   
2020
 
Operating lease liabilities:
          
Current portion of lease liabilities
  $657   $644 
Long-term portion of lease liabilities
  $2,609   $2,959 
Operating lease liabilities are based on the net present value of the remaining lease payments over the remaining lease term. The leases are as follows:

   Amount 

Year ending December 31:

  

2019

  $653,324 

2020

   666,391 

2021

   679,719 

2022

   693,313 

2023

   707,179 

Thereafter

   2,973,011 
  

 

 

 
  $6,372,937 
  

 

 

 

Rent expense is recognizedrenewable at the end of the lease term at the Company’s option. For the purposes of determining the remaining lease term in contemplation of available extensions, the Company did not consider either renewal to be probable at this time. In determining the present value of lease payments, the Company estimated its incremental borrowing rate based on the straight-line method overinformation available at the adoption date of Topic 842. As of January 1, 2019, the remaining lease term was 9.0 years and the discount rate used to determine the operating lease liability was 9.93%.

F-19

Table of Contents
As of December 31, 2021, the maturities of the Company’s operating lease liabilities were as follows (in thousands):
   
Amount
 
Year ending December 31:
     
2022
  $693 
2023
   707 
2024
   721 
2025
   736 
2026
   750 
Thereafter
   702 
   
 
 
 
Total lease payments
   4,309 
Less: Present value adjustment
   (1,043
   
 
 
 
Operating lease liabilities
  $3,266 
   
 
 
 
Lease costs under the terms of each lease. Rent expensethe Company’s leases for the years ended December 31, 2018, 20172021 and 2016, was approximately $618,000, $587,000 and $880,000, respectively.

2020 are as follows (in thousands):

   
Year Ended

December 31,
 
   
2021
   
2020
 
Operating lease cost (1)
  $616   $615 
Variable lease costs (2)
   148    126 
   
 
 
   
 
 
 
Total lease cost
  $764   $741 
   
 
 
   
 
 
 
(1)
Operating lease payments included in the measurement of the Company’s lease liabilities are comprised of fixed payments according to the terms of the Company’s leases.
(2)
Variable lease payments consist of the Company’s utility costs billed by and paid to its landlord. Variable lease payments are presented as operating expenses in the Company’s Consolidated Statement of Operations in the same line item as expense arising from fixed lease payments and in net cash used in operating activities in the Company’s Statement of Cash Flows.
Rockefeller University

License Agreements

The Company has entered into the following license agreements with The Rockefeller University:

On July 12, 2011, the Company entered into a license agreement for the worldwide, exclusive right to a patent covering the composition of matter for the lysin PlySS2 for the treatment and prevention of diseases caused by gram-positive bacteria (the
“CF-301
License”). The Company rebranded PlySS2 as
CF-301
and subsequently, exebacase. The license gives the Company the right to exclusively develop, make, have made, use, import, lease, sell and offer for sale products that would otherwise infringe a claim of this patent application or patent.

On June 1, 2011, the Company entered into a license agreement for the exclusive rights to The Rockefeller University’s interest in a joint patent application covering the method of delivering antibodies through the cell wall of gram-positive bacteria to the periplasmic space. This intellectual property was developed as a result of the sponsored research agreement between the Company and The Rockefeller University and was jointly discovered and filed by the two parties.

On September 23, 2010, the Company entered into a license agreement for the worldwide, exclusive right to develop, make, have made, use, import, lease, sell, and offer for sale products that would otherwise infringe a claim of the suite of patents and patent applications covering the composition of matter for eight individual lysin molecules for the treatment and prevention of diseases caused by gram-positive bacteria. The lysins in this suite have activity against Group BStreptococci,Staphylococcus aureus, Streptococcus pneumonia, Bacillus anthracis, Enterococcus faecalis and Enterococcus faecium.

F-20

Table of Contents
On September 23, 2010, the Company entered into a license agreement for the worldwide, exclusive right to develop, make, have made, use, import, lease, sell, and offer for sale products that would otherwise infringe a claim of the suite of patents and patent applications covering the composition of matter for eight individual lysin molecules for the treatment and prevention of diseases caused by gram-positive bacteria. The lysins in this suite have activity against Group B
Streptococci
,
Staphylococcus aureus, Streptococcus pneumonia, Bacillus anthracis, Enterococcus faecalis and Enterococcus faecium
.
In consideration for the licenses, wethe Company paid Rockefeller license initiation fees in cash and stock and are required to paystock. The Company paid annual maintenance fees of $200,000 in each of 2021, 2020 and 2019, and are required to pay $200,000
 each year thereafter until the licenses terminate,terminate. Depending on the success of its programs, the Company may also incur regulatory milestone payments up to a total of $5.0 million and royalties of up to 5%
5
% on net sales from products to Rockefeller. There were no milestone, royalty or sublicense payments made during the years ended December 31, 2018 and 2017. The Company made a milestone payment under theCF-301 License of $180,000 in 2016 for the completion of the

Phase 1 trial. We are allowed to grant sublicenses to third parties without prior approval, subject to certain conditions and the payment of a certain percentage of all payments we receive from sublicensees.

There

were 0 milestone, royalty or sublicense payments made during the years ended December 31, 2021 or 2020. The Company made a milestone payment under the
CF-301
License of $430,000 during the year ended December 31, 2019 for the completion of the Phase 2 trial. The Company has made total milestone payments under the
CF-301
License of $810,000 as of December 31, 2021.
Each license agreement terminates upon the later of (i) the expiration or abandonment of the last licensed patent under the license agreement to expire or become abandoned, or (ii) 10 years after the first commercial sale of the first licensed product. The Rockefeller University may terminate any license agreement in the event of a breach of such agreement by the Company or if the Company challenges the validity or enforceability of the underlying patent rights. The Company may terminate any license agreement at any time on 60 days’ notice.

Collaborative Research Agreements

Beginning in October 2009, we entered into a research agreement with Rockefeller where we provided funding for the research. The initial agreement focused on producing and testing monoclonal antibodies against proteins ofStaph aureus. On October 24, 2011, we entered into a second research agreement with Rockefeller where we provide funding for the research, to identify lysins, enzymes or small molecules that will kill gram-negative bacteria, and identify and characterize lysins fromClostridia difficile to be engineered into gut commensal bacteria. On October 25, 2016, we entered into a third research agreement with Rockefeller, where we provide funding for the identification of novel lysin therapeutic candidates which target gram-negative pathogens. The research collaboration will focus on gram-negative pathogens such asP. aeruginosa, E. coli, andK. pneumoniae, including antibiotic-resistant strains.

Our current agreement runs through October 24, 2019. Either party may terminate the agreement upon breach of the agreement, following 30 days written notice and failure to cure such breach. Following the expiration or termination of the agreement, each party will have anon-exclusive license to use for internal research purposes all research results, including joint intellectual property. If Rockefeller or joint intellectual property develops from these programs, we will have theright-of-first refusal to negotiate to acquire a royalty-bearing license to utilize such intellectual property for commercial purposes.

Trellis Biosciences, LLC

On January 29, 2014, the Company entered into a license agreement with Trellis Biosciences, LLC (“Trellis”) that gives it exclusive rights to all Trellis mAbs in the field of influenza discovered from the Trellis CellSpot platform. Particularly, the license provides the Company with three fully human mAbs that bind, neutralize and protect animals from all strains of H1, H3 and B influenza, and that will also cross bind, neutralize and protect animals from all other seasonal or pandemic influenza strains that may arise (including H5N1 and H7N9).

The Company will also be required to make payments to Trellis upon the achievement of specified development and regulatory milestones and upon the achievement of future sales and for royalty on future net sales from products of up to 4%. There were no development or regulatory milestones or royalty payments made during the years ended December 31, 2018, 2017 and 2016. The Company is allowed to grant sublicenses to third parties. The license agreement terminates upon the earlier of (i) the Company’s decision to terminate the agreement at will or for safety reasons, (ii) material breach by either party that is not cured within ninety (90) days, or (iii) either party’s insolvency.

Separation Agreement

On December 12, 2017, the Company notified Lisa R. Ricciardi that she would no longer be needed to serve as Chief Operating Officer of the Company effective December 31, 2017. Subject to Ms. Ricciardi entering into a separation agreement, the Company accrued expense of $0.7 million for the severance payments and continued medical, dental and vision coverage under the Company’s group healthcare plans, to be provided for a period of 18 months following the effective date of Ms. Ricciardi’s termination, and recognized share-based compensation

expense of $0.2 million for the accelerated vesting of all unvested portions of Ms. Ricciardi’s stock option grants. The total amount of these charges was recognized as part of general and administrative expenses in the consolidated statement of operations for the year ended December 31, 2017.

Legal Contingencies

From time to time, the Company may be involved in disputes and legal proceedings in the ordinary course of its business. These proceedings may include allegations of infringement of intellectual property, employment or other matters. The Company records a liability in its financial statements for these matters when a loss is known or considered probable and the amount can be reasonably estimated. The Company reviews these estimates each accounting period as additional information is known and adjusts the loss provision when appropriate. If a matter is both probable to result in a liability and the amounts of loss can be reasonably estimated, the Company estimates and discloses the possible loss or range of loss to the extent necessary to make the financial statements not misleading. If the loss is not probable or cannot be reasonably estimated, a liability is not recorded in the Company’s financial statements. The Company currently has no legal proceedings ongoing that management estimates could have a material effect on the Company’s financial statements.

9.

9
. Capital Structure

Common Stock

As of December 31, 2018,2021, the Company was authorized to issue 200,000,000125,000,000 shares of common stock at $0.0001 par value per share.

Follow-on
Offerings

On August 3, 2018,March 22, 2021, the Company completed an underwritten public offering of 5,750,00011,500,000 shares of its common stock, including shares sold pursuant to the fully exercised overallotment option granted to the underwriters in connection with the offering, at a public offering price of $2.00$5.00 per share, resulting in net proceeds to the Company of approximately $10.4$53.8 million after underwriting discounts and commissions and offering expenses payable by the Company.

​​​​​​​
F-21

Table of Contents
On July 25, 2017,May 27, 2020, the Company sold 32,000,000completed an underwritten public offering of 11,797,752 shares of its common stock and warrants to purchase an additional 16,000,0008,848,314 shares of its common stock inat an underwrittenfollow-onexercise price of $4.90 per share. The public offering price was $4.45 for gross proceedsone share of $40.0 million (the “2017 Offering”). The Company receivedcommon stock and an accompanying warrant to purchase 0.75 shares of common stock, resulting in net proceeds to the Company of approximately $37.1$48.9 million after underwriting discounts and commissions and offering expenses payable by the Company.

On July 27, 2016, The Company completed a concurrent private placement to Pfizer of 674,156 shares of common stock and an accompanying warrant to purchase an additional 505,617 shares of its common stock at an exercise price of $4.90 per share at a price of $4.45 for one share of common stock and an accompanying warrant to purchase 0.75 shares of common stock, resulting in net proceeds to the Company sold 14,000,000of approximately $3.0 million. Warrants to purchase 22,560 and 5,850 shares of common stock were exercised during the years ended December 31, 2021 and 2020, respectively.

On December 18, 2019, the Company completed an underwritten public offering of 2,565,000 shares of its common stock resulting in gross proceeds to the Company of approximately $10.0 million. On December 12, 2019, the Company completed an underwritten public offering of 3,715,000 shares of its common stock and warrants to purchase an additional 14,000,000a concurrent private placement of 1,111,111 shares of its common stock to Pfizer Inc. resulting in an underwrittenFollow-on Offering fortotal gross proceeds to the Company of $35.0 million (the “2016 Offering”).approximately $13.0 million. The Company receivedcombined net proceeds of approximately $32.0both public offerings together with the private placement was $21.3 million after underwriting discounts and commissions and offering expenses payable by the Company.

The Company issued warrants in theits 2020, 2017 and 2016 Offerings. The 2017 Warrants have an exercise priceofferings of $1.55 per share and expire five years from the date of issuance. The 2016 Warrants have an exercise price of $3.00 per share and expire five years from the date of issuance. The 2017 Warrants and 2016 Warrantssecurities. These warrants contain a fundamental transaction provision that obligates the Company to cash settle the warrants under a limited set of conditions not entirely within the Company’s control. Due to this conditional obligation, the Company determined that boththe 2020 Warrants, the 2017 Warrants and the 2016 Warrants should be classified as liabilities in the Company’s consolidated balance sheet. At issuance, the Company determined the fair value of the 2020 Warrants, the 2017 Warrants and 2016 Warrants to be $31.4 million, $12.4 million and $18.6 million, respectively, and reclassified these balances from stockholders’ equity to warrant liability. The fair value of these warrants is
re-measured
at each reporting period and changes in fair value are recognized in the consolidated statement of operations (see Note 4, “Fair Value

Measurements”). Additionally, the Company allocated approximately $2.2 million, $0.9 million and $1.6 million of issuance costs to the 2020 Warrants, the 2017 Warrants and 2016 Warrants, respectively, based on the proportion of the proceeds allocated to the fair value of the warrants. The allocated issuance costs were expensed as other expense in the Company’s consolidated statement of operations.

Private Placement

On June 12, 2015,July 27, 2021, the 2016 Warrants expired in accordance with their terms and are 0 longer exercisable.

The Pfizer Warrant does not contain the same fundamental transaction provision that obligates the Company closedto cash settle the warrants under a private placementlimited set of its securities with a group of institutional investors (the “PIPE”). Each investor received one share of common stock and a warrant to purchaseone-half share of common stock at a price of $4.23 per common share purchased. The closing ofconditions not entirely within the PIPE resulted inCompany’s control. Therefore, the issuance of an aggregate of 4,728,128 common shares and warrants to purchase an additional 2,364,066 shares of common stock at an exercise price of $8.00 per full share (the “PIPE Warrants”). None ofCompany determined that the PIPE Warrants were exercised prior to expiration on June 12, 2018 and therefore have been terminated and are no longer exercisable. The Company received net proceeds from the PIPE of $18.3 million, after deducting expenses payable by the Company.

The placement agents in the PIPE received warrants to purchase 4% of the total number of shares of common stock sold in the PIPE (the “Placement Agent Warrants”), for a total of 189,126 shares of common stock underlying the Placement Agent Warrants. The Placement Warrants became exercisable upon issuance at an exercise price of $4.65 per share and expire on June 11, 2020.

The common stock and accompanying PIPE Warrants and Placement Agent Warrants werePfizer Warrant should be classified to stockholders’as equity in the Company’s consolidated balance sheet.

Representative’s Warrant

The Maxim Group, LLC, the representative of the underwriters in the IPO, received the Representative’s Warrant to purchase 3% of the total number of shares of common stock sold in the IPO, including those shares sold upon the exercise of the over-allotment, for a total of 206,410 shares of common stock underlying the Representative’s Warrant. The Representative’s Warrant became exercisable at an exercise price of $7.50 per share beginning 180 days after the effective date of the Company’s registration statement (January 24, 2015) and expires on August 27, 2019. The Company classified the Representative’s Warrant as a liability since it did not meet the requirements to be included in equity. The fair value of the Representative’s Warrant will bere-measured at each reporting period and changes in fair value will be recognized in the statement of operations (see Note 3, “Fair Value Measurements”).

Convertible Notes

The Company issued approximately $15.0 million aggregate principal amount of its 8.00% Convertible Notes due May 31, 2015 (the “Convertible Notes”) from June 2013 through June 2014. On August 1, 2014, in conjunction with the closing of the Company’s IPO, the principal amount of the Convertible Notes, and all accrued and unpaid interest thereon, automatically converted into 5,109,988 shares of common stock. Each purchaser of the Convertible Notes also received a warrant which included an exercise price “cap” that was analogous to “down round protection” (the “Note Warrants”). Upon the closing of the IPO and based on the terms of the Note Warrants, the Company determined the total number of shares of the Company’s common stock underlying the Note Warrants to be 3,321,416 at an exercise price of $3.00 per share. There were 2,645,176 Note Warrants that expired during 2018 and therefore have been terminated and are no longer exercisable. There are 670,702 shares of common stock underlying the remaining outstanding Note Warrants as of December 31, 2018. The Note Warrants expire five years from the date of issuance.

Voting

The holders of shares of common stock are entitled to one vote for each share of common stock held at all meetings of stockholders and written actions in lieu of meetings.

Dividends

The holders of shares of common stock are entitled to receive dividends, if and when declared by the board of directors. As of December 31, 2018, no2021, 0 dividends have been declared or paid on the Company’s common stock since inception.

F-22

Reserved for Future Issuance

The Company has reserved for future issuance the following number of shares of common stock as of December 31, 2018 and 2017:

   December 31, 
   2018   2017 

Options to purchase common stock

   7,187,885    6,200,151 

Warrants to purchase common stock

   31,243,026    36,270,103 
  

 

 

   

 

 

 
   38,420,811    42,470,254 
  

 

 

   

 

 

 

10. Stock Warrants

As of December 31, 20182021 and 2017,2020:

   
December 31,
 
   
2021
   
2020
 
Outstanding options to purchase common stock
   2,899,694    1,853,841 
Outstanding warrants to purchase common stock
   10,926,594    12,350,293 
For future issuance under the 2014 Omnibus Incentive Plan
   77,631    41,079 
For future issuance under the 2021 Employment Inducement Plan
   1,000,000    —   
   
 
 
   
 
 
 
   
14,903,919
   
14,245,213
 
   
 
 
   
 
 
 
1
0
. Stock Warrants
As of December 31, 2021 and 2020, the Company had warrants outstanding to purchase the underlying number of shares of common stock as shown in the table below.

   December 31, 
   2018   2017 

Note Warrants

   670,702    3,315,878 

PIPE Warrants (1)

   —      2,364,066 

2017 Warrants

   15,996,450    16,000,000 

2016 Warrants

   14,000,000    14,000,000 

Representative’s Warrant

   206,410    206,410 

Placement Agent Warrants

   189,126    189,126 

Other warrants (2)

   180,338    194,623 
  

 

 

   

 

 

 

Warrants to purchase common stock

   31,243,026    36,270,103 

Weighted-average exercise price per share

  $2.31   $2.74 

   
December 31,
 
   
2021
   
2020
 
2020 Warrants
   8,819,904    8,842,464 
2017 Warrants
   1,599,645    1,599,645 
2016 Warrants
   0      1,400,000 
Pfizer Warrant
   505,617    505,617 
Other warrants (1)
   1,428    2,567 
   
 
 
   
 
 
 
Warrants to purchase common stock
   10,926,594    12,350,293 
Weighted-average exercise price per share
  $6.47   $9.14 
(1)

On June 12, 2018, the PIPE Warrants to purchase common stock expired in accordance with their terms. None of the PIPE Warrants were exercised prior to expiration and have been terminated and are no longer exercisable.

(2)

Other warrants are comprised of warrants issued prior to the Company’s IPO, generally in exchange for services rendered to the Company.

The following table summarizes information regarding the Company’s warrants outstanding and the corresponding exercise price at December 31, 2018:

2021:

Exercise Prices

  
Shares

Underlying

Outstanding

Warrants
   

Expiration Date

£ $2.00

≤ $10.00
   16,002,1649,325,521   September 1, 2021 – July 25, 2022May 27, 2023

$2.01 - $4.99

> $10.00 ≤ $20.00
   14,960,9291,599,645 March 30, 2019 – July 27, 2021

³ $5.00

279,933   July 22, 2019 – January 5,25, 2022

> $20.00
   
1,428   31,243,026January 5,
2022
 
 
   
 

10,926,594
   
1
1

11.. Stock Option and Incentive Plans

Amended and Restated 2008 Equity Incentive Plan

In July 2008, the Company adopted the 2008 Equity Incentive Plan (the “Plan”). On February 26, 2013, the board of directors approved an amended and restated plan (the “Amended Plan”) under which the number of shares of common stock available for issuance was 1,571,428.157,143. For new awards, the period that vested awards
F-23

Table of Contents
would remain exercisable upon termination of service was reduced from ten years to two years. The board of directors also increased the number of shares of common stock available under the Company’s Amended Plan on February 24, 2014 and April 29, 2014 to 1,857,142185,714 and 2,357,142,235,714, respectively. As of the closing of the Company’s IPO, there were no further grants made under the Amended Plan.

2014 Omnibus Incentive Plan

In April 2014, the Company’s board of directors adopted the 2014 Omnibus Incentive Plan (the “2014 Plan”). The 2014 Plan was approved by the Company’s shareholders on July 3, 2014. The 2014 Plan allows for the granting of incentive and
non-qualified
stock options, restricted stock and stock unit awards, stock appreciation rights and other performance-based awards to the Company’s employees, members of the board of directors and consultants of the Company. On July 28, 2014, the effective date of the 2014 Plan, the number of shares of common stock reserved pursuant to the 2014 Plan was 571,429.57,143. The 2014 Plan provides for an annual increase, to be added on the first day of each fiscal year, beginning with the fiscal year ending December 31, 2015 and ending on January 1, 2024, equal to the lesser of (i) 4% of the outstanding shares of common stock on December 31 immediately preceding such date or (ii) a lesser amount determined by the Company’s board of directors. Consistent with the provision for an annual increase, an additional 6,520,4772,695,373 shares of common stock have been reserved under the 2014 Plan as of December 31, 2018.

2021.

2021 Employment Inducement Omnibus Incentive Plan
In September 2021, the Company’s board of directors adopted the 2021 Employment Inducement Omnibus Incentive Plan (the “2021 Plan”), under which the number of shares of common stock reserved for issuance was 1,000,000. The 2021 Plan allows for the granting of non-qualified stock options, restricted stock and stock unit awards, stock appreciation rights and other performance-based awards only to newly hired employees of the Company.
The Company recognizes compensation expense for share-basedstock-based compensation based on the fair value of the underlying instrument. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. Stock option activity for the year ended December 31, 2018,2021, is summarized as follows:

   Number of
Options
   Weighted
Average
Exercise Price
   Weighted
Average Remaining
Contractual Life
(in years)
   Aggregate
Intrinsic Value
 

Options outstanding at December 31, 2017

   6,200,151   $3.81     

Granted

   2,320,000    1.47     

Exercised

   —      —       

Expired

   (865,606   3.93     

Forfeited

   (466,660   1.77     
  

 

 

       

Options outstanding at December 31, 2018

   7,187,885   $3.17    6.61   $290,781 
  

 

 

       

 

 

 

Vested and exercisable at December 31, 2018

   4,974,057   $3.78    5.73   $170,919 
  

 

 

       

 

 

 

Of the option grants outstanding to purchase 7,187,885 shares of common stock, grants to purchase 657,156 shares of common stock were issued and are outstanding outside the Company’s incentive plans.

   
Number of

Options
   
Weighted

Average

Exercise Price
   
Weighted

Average Remaining

Contractual Life

(in years)
   
Aggregate

Intrinsic Value
 
Options outstanding at December 31, 2020
   1,853,841   $14.33           
Granted
   1,227,500   $4.31           
Exercised
   0      0             
Expired
   (109,115  $45.57           
Forfeited
   (72,532  $5.86           
   
 
 
   
 
 
           
Options outstanding at December 31, 2021
   2,899,694   $9.12    7.85   $0   
   
 
 
   
 
 
        
 
 
 
Vested and exercisable at December 31, 2021
   1,476,281   $12.65    6.86   $0   
   
 
 
   
 
 
        
 
 
 
The fair value of each option grant is estimated on the date of the grant using the Black-Scholes option-pricing model. The weighted average grant date fair value of options granted during the years ended December 31, 2018, 20172021, 2020 and 20162019 was $1.47, $1.62$4.31, $9.67 and $3.25,$4.30, respectively. Total compensation expense recognized amounted to $1,555,523, $1,623,128$3.2 million, $2.6 million and $2,231,883$1.4 million for the years ended December 31, 2018, 20172021, 2020 and 2016,2019, respectively. As of December 31, 2018,2021, the total remaining unrecognized compensation cost related to unvested stock options was $2,308,848approximately $5.7 million which will be recognized over a weighted average period of approximately 2.522.38 years.

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Table of Contents
The following weighted average assumptions were used to compute the fair value of stock option grants:

   Year Ended December 31, 
   2018  2017  2016 

Risk free interest rate

   2.58  2.07  1.22

Expected dividend yield

   —     —     —   

Expected term (in years)

   6.02   6.01   5.01 

Expected volatility

   82.3  79.6  79.5

   
Year Ended December 31,
 
   
2021
  
2020
  
2019
 
Risk free interest rate
   0.83  1.14  2.35
Expected dividend yield
   0     0     0   
Expected term (in years)
   5.99   6.03   6.06 
Expected volatility
   94.5  94.6  89.7
Expected volatility—
The Company estimated the expected volatility based on an average of the Company’s historical volatility of a representative peer group of publicly traded biopharmaceutical companies selected based on their stage of drug development, area of therapeutic focus, number of employees and market capitalization.

data.

Expected term—
The Company based expected term on the midpoint of the vesting period and the contractual term of each respective option grant.

Risk-free interest rate—
The Company estimated the risk-free interest rate in reference to yield on U.S. Treasury securities with a maturity date commensurate with the expected term of the associated award.

Expected dividend yield—
The Company estimated the expected dividend yield based on consideration of its historical dividend experience and future dividend expectations. The Company has not historically declared or paid dividends to common stockholders. Moreover, it does not intend to pay dividends in the future, but instead expects to retain any earnings to invest in its continued growth.

12.

1
2
. 401k Savings Plan

In 2010, the Company established a defined-contribution savings plan under Section 401(k) of the Internal Revenue Code (the 401(k) Plan). The 401(k) Plan covers all employees who meet defined minimum age and service requirements and allows participants to defer a portion of their annual compensation on a
pre-tax
basis. During 2015, the Company established an employer matching program for participants in the 401(k) Plan. The Company incurred approximately $104,000, $100,000$0.2 million, $0.1 million and $124,000$0.1 million of expense for matching contributions to the 401(k) Plan during the years ended December 31, 2018, 20172021, 2020 and 2016,2019, respectively.

13.

1
3
. Income Taxes

The Company has available approximately $175,406,000$275.5
 million and $189,031,000
$293.9
 million of 
unused operating loss carryforwards for federal and state tax purposes, respectively, that may be applied against future taxable income. The net operating lossNOL carryforwards will begin to expire throughin the year 20382028 and research and development (R&D) credits will begin to expire in 2031 if not utilized prior to that date. The Company has evaluated the positive and negative evidence bearing upon the realizability of its net deferred tax assets. Based on the Company’s history of operating losses since inception, the Company has concluded that it is

more likely than not that the benefit of its deferred tax assets will not be realized. Accordingly, no provision for a deferred tax asset has been made for the tax benefits of the net operating loss carryforwards as the entire amount is offset by a valuation allowance. The valuation allowance increased by approximately $9,006,000$12.8

 million and decreased by approximately $7,797,000
$10.7 million during the years 20182021 and 2017,2020, respectively, and was approximately $54,153,000$85.6 
million and $45,146,000
$72.8 million at December 31, 20182021 and 2017,2020, respectively.

The Internal Revenue Code of 1986, as amended (the Code)“Code”) provides for a limitation of the annual use of net operating losses and other tax attributes (such as research and development tax credit carryforwards) following certain ownership changes (as defined by the Code) that could limit the Company’s ability to utilize these carryforwards. At this time, the Company has not completed a study to assess whether an ownership change under Section 382 of the Code has occurred, or whether there have been multiple ownership changes since the Company’s formation, due to the costs and complexities associated with such a study. The Company may have experienced various ownership changes, as defined by the Code, as a result of past financing transactions.
F-25

Table of Contents
Accordingly, the Company’s ability to utilize the aforementioned carryforwards may be limited. Additionally, U.S. tax laws limit the time during which these carryforwards may be applied against future taxes. Therefore, the Company may not be able to take full advantage of these carryforwards for federal or state income tax purposes.

The Company’s reserves related to taxes are based on a determination of whether and how much of a tax benefit taken by the Company in its tax filings or positions is more likely than not to be realized following resolution of any potential contingencies present related to the tax benefit. For the three years ended December 31, 2018,2021, the Company had no0 unrecognized tax benefits or related interest and penalties accrued. The Company has not, as yet, conducted a study of research and development (R&D)R&D credit carryforwards. This study may result in an adjustment to the Company’s R&D credit carryforwards; however, until a study is completed and any adjustment is known, no amounts are being presented as an uncertain tax position. A full valuation allowance has been provided against the Company’s R&D credits and, if an adjustment is required, this adjustment would be offset by an adjustment to the valuation allowance. Thus, there would be no impact to the
consolidated
balance sheet or statement of operations if an adjustment were required. The Company would recognize both accrued interest and penalties related to unrecognized benefits in income tax expense. The Company’s uncertain tax positions are related to years that remain subject to examination by relevant tax authorities. Since the Company is in a loss carryforward position, the Company is generally subject to examination by the U.S. federal, state and local income tax authorities for all tax years in which a loss carryforward is available.

On December 22, 2017, the Tax Cuts and Jobs Act” (the “2017 Tax Act”) was enacted. The 2017 Tax Act lowered the U.S. federal corporate income tax rate from 35% to 21% effective January 1, 2018. As a result, the change in the U.S. federal tax rate required the Company tore-measure its federal deferred tax assets and liabilities. Effective for tax years beginning on January 1, 2018, the 2017 Tax Act repealed the performance exception permitting certain executive officer compensation greater than $1 million to be deducted. During the fourth quarter of 2017, the Company reduced its net deferred tax asset balance and offsetting valuation allowance by $18,284,538 for there-measurement of its U.S. deferred tax balances. There were no changes to the interim re-measurement amount and the Company’s accounting for the 2017 Tax Act is complete.

The principal components of the Company’s deferred tax assets and liabilities are as follows:

   December 31, 
   2018   2017 

Deferred tax assets:

    

Net operating loss carryovers

  $49,294,211   $40,879,826 

Share-based compensation

   1,754,362    1,702,036 

R&D tax credits

   2,545,920    1,750,785 

Accrued compensation and severance

   442,090    659,458 

Deferred rent

   198,278    200,968 

Intangible assets

   131,503    154,669 
  

 

 

   

 

 

 

Total deferred tax assets

  $54,366,364   $45,347,742 

Valuation allowance

   (54,152,886   (45,146,454
  

 

 

   

 

 

 

Total deferred tax assets net of valuation allowance

  $213,478   $201,288 

Deferred tax liabilities:

    

Depreciation

   (213,478   (201,288
  

 

 

   

 

 

 

Total deferred tax liabilities

  $(213,478  $(201,288
  

 

 

   

 

 

 

Net deferred tax asset (liability)

  $—    $—  
  

 

 

   

 

 

 

follows (in thousands):

   
December 31,
 
   
2021
  
2020
 
Deferred tax assets:
         
Net operating loss carryovers
  $77,431  $65,990 
Stock-based compensation
   2,457   2,265 
R&D tax credits
   5,031   3,833 
Accrued compensation and severance
   563   587 
Lease liability
   911   1,013 
Intangible assets
   88   99 
   
 
 
  
 
 
 
Total deferred tax asset
s
  $86,481  $73,787 
Valuation allowance
   (85,613  (72,803
   
 
 
  
 
 
 
Total deferred tax assets net of valuation allowance
  $868  $984 
Deferred tax liabilities:
         
Right-of-use
asset
   (746  (833
Depreciation
   (122  (151
   
 
 
  
 
 
 
Total deferred tax liabilities
  $(868 $(984
   
 
 
  
 
 
 
Net deferred tax asset (liability)
  $0    $0   
   
 
 
  
 
 
 
F-26

Table of Contents
A reconciliation of the statutory U.S. Federal rate to the company’s effective tax rate is as follows:

   Year Ended December 31, 
   2018  2017  2016 

Federal income tax benefit at statutory rate

   (21.00)%   (34.00)%   (34.00)% 

State income tax, net of federal benefit

   (5.64  (9.95  (5.49

Permanent items including change in fair value of warrants

   4.80   (22.03  (1.54

Change in valuation allowance

   23.95   (50.33  42.12 

R&D tax credits

   (2.11  (3.02  (1.03

Deferredre-measurement

   —     118.03   —   

Other

   —     (1.30  (0.06
  

 

 

  

 

 

  

 

 

 

Effective income tax (benefit) expense rate

   0  0  0
  

 

 

  

 

 

  

 

 

 

14. Selected Quarterly Financial Data (Unaudited)

The following tables show a summary

   
Year Ended December 31,
 
   
2021
  
2020
  
2019
 
Federal income tax benefit at statutory rate
   (21.00)%   (21.00)%   (21.00)% 
State income tax, net of federal benefit
   (14.41  (9.09  (15.09
Permanent items including change in fair value of warrants
   (26.27  (5.35  (21.87
Change in valuation allowanc
e
   63.08   37.88   62.56 
R&D tax credits
   (5.89  (2.43  (4.72
Other
   4.49   (0.01  0.12 
   
 
 
  
 
 
  
 
 
 
Effective income tax (benefit) expense rate
   0  0  0
   
 
 
  
 
 
  
 
 
 
F-27

Table of the Company’s unaudited quarterly financial data for each of the four quarters of 2018 and 2017:

   2018 
   1st Quarter   2nd Quarter   3rd Quarter   4th Quarter 

Loss from operations

  $(6,984,169  $(7,496,454  $(7,799,290  $(8,844,512

Net (loss) income

  $(19,106,481  $(20,135,892  $(4,377,747  $5,935,696 

Net (loss) income per share of common stock, basic and diluted

  $(0.26  $(0.27  $(0.06  $0.07 

   2017 
   1st Quarter   2nd Quarter   3rd Quarter   4th Quarter 

Loss from operations

  $(6,345,013  $(6,079,121  $(6,735,188  $(7,404,435

Net loss

  $(6,348,164  $(2,836,887  $(1,575,098  $(4,757,509

Net loss per share of common stock, basic and diluted

  $(0.15  $(0.07  $(0.02  $(0.06
Contents

SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

CONTRAFECT CORPORATION
By: 
Date: March 24, 2022
 
By:
/s/ Steven C. Gilman, Ph.D.Roger J. Pomerantz, M.D., F.A.C.P.
 

Steven C. Gilman, Ph.D.

Roger J. Pomerantz, M.D., F.A.C.P.
President and Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.

Signature

  

Title

 

Date

/s/ Steven C. Gilman, Ph.D.

Steven C. Gilman, Ph.D.

President and Chief Executive Officer,

Chairman of the Board

(Principal Executive Officer)

March 14, 2019

/s/ Michael Messinger

Michael Messinger

Chief Financial Officer

(Principal Financial Officer and Principal Accounting Officer)

March 14, 2019

/s/ Sol J. Barer, Ph.D.

Sol J. Barer, Ph.D.

Lead Independent Director

March 14, 2019

/s/ Isaac Blech

Isaac Blech

Director

March 14, 2019

/s/ David N. Low, Jr.

David N. Low, Jr.

Director

March 14, 2019

/s/ Michael J. Otto, Ph.D.

Michael J. Otto, Ph.D.

Director

March 14, 2019

/s/ Roger J. Pomerantz, M.D., F.A.C.P.

Roger J. Pomerantz, M.D., F.A.C.P.

  

Vice

President and Chief Executive Officer,
Chairman of the Board

(Principal Executive Officer)
 March 14, 201924, 2022

/s/ Michael Messinger
Michael Messinger
Chief Financial Officer
(Principal Financial Officer and
Principal Accounting Officer
)
March 24, 2022
/s/ Sol J. Barer, Ph.D.
Sol J. Barer, Ph.D.
Lead Independent DirectorMarch 24, 2022
/s/ Steven C. Gilman, Ph.D.
Steven C. Gilman, Ph.D.
Vice Chairman of the BoardMarch 24, 2022
/s/ Lishan Aklog, M.D.
Lishan Aklog, M.D.
DirectorMarch 24, 2022
/s/ Jane F. Barlow, M.D., M.P.H., M.B.A.
Jane F. Barlow, M.D., M.P.H., M.B.A.
DirectorMarch 24, 2022
/s/ David N. Low, Jr.
David N. Low, Jr.
DirectorMarch 24, 2022
/s/ Michael J. Otto, Ph.D.
Michael J. Otto, Ph.D.
DirectorMarch 24, 2022
/s/ Cary W. Sucoff

Cary W. Sucoff

  

Director

 March 14, 201924, 2022