ITEM
1. BUSINESS
Overview
We
are a biotechnology company focused on designing, developing and commercializing innovative gene therapies, therapeutics and proprietary
medical approaches to stimulate and guide an anti-tumor immune response for the treatment of cancer. We seek to overcome the problem
of tumor-induced immune subversion via intratumoral immunotherapy.
Our
Business and Mission
Our
mission is to pursue the advancement of immune system-stimulating treatments through the advancement of our proprietary immunotherapy
platform which is designed to overcome tumor immune tolerance. Our proprietary intratumoral electroporation-based therapy is a
platform which includes immune modulating therapeutic product candidates intended to treat a wide range of solid tumor types,
combined with our ImmunoPulse® delivery technology. ImmunoPulse® is an electroporation delivery device that we use in
combination with our therapeutic product candidates, including DNA plasmids that encode for immunologically active agents, to
deliver the therapeutic directly into the tumor and promote an inflammatory response against the cancer. This unique therapeutic
modality is intended to reverse the immunosuppressive microenvironment in the tumor and engender a systemic anti-tumor response
against untreated tumors in other parts of the body. Our electroporation delivery device consists of an electrical pulse generator
and disposable applicators, which can be adapted to treat different tumor types.
Our
Strategy
Traditional
modalities for treating cancer have limited clinical efficacy and are frequently associated with significant morbidity. Immunotherapy,
a relatively new therapeutic modality, focuses on modulating the immune system to treat cancer, rather than directly killing the
cancer cells. Systemic delivery of immune-modulating proteins such as interleukin-2 (IL-2) and interleukin-12 (IL-12) have shown
early encouraging results in terms of efficacy but with significant mechanism-based toxicity. More recently, monoclonal antibody
(mAb) drugs have been developed, which target critical “immune checkpoint” proteins and augment anti-tumor immunity.
Monoclonal antibodies such as, anti-CTLA-4 (cytotoxic T-lymphocyte-associated protein-4) and anti-PD-1 (program cell-death-1),
have been developed for treatment of several indications, and have already been approved for treatment of metastatic melanoma
and metastatic non-small cell lung cancer. These new immuno-oncology agents have shown tremendous clinical benefit for those patients
with late-stage cancer, across multiple tumor types. However, only a subset of patients responds to these therapies.
We
have several completed and have ongoing clinical trials for the use of our therapeutic candidates to treat different tumor
types with our electroporation delivery device. We also continue to investigate collaboration opportunities that will enable us
to identify rational combinations with current and emerging standard-of-care drugs, including immune-modulating checkpoint inhibitors
(such as anti-CTLA-4 or anti-PD-1). We expect to continue to conduct additional clinical trials for our product candidates in
accordance with the United States Food and Drug Administration (FDA) requirements, some of which may relate to therapeutic candidates
for select, rare cancers (orphan indications) that have limited therapeutic options. Our strategy also includes expanding the
applications of our technologies through strategic collaborations or evaluation of other opportunities such as in-licensing and
strategic acquisitions. We may collaborate with major pharmaceutical and biotechnology companies and government agencies, providing
us access to complementary technologies and/or greater resources. These business activities are intended to provide us with mutually
beneficial opportunities to expand or advance our product pipeline. We may license our intellectual property to other companies
to leverage our technologies for applications that may not be appropriate for our independent product development.
Clinical
Program
Our
lead product candidate, ImmunoPulse® IL-12, consists of a plasmid construct encoding the proinflammatory cytokine, IL-12,
which is delivered into the tumor through in vivo electroporation. A Phase 1 clinical trial in metastatic melanoma using electroporation
to deliver plasmid-DNA encoding for the IL-12 cytokine was completed in 2008. The data, published in the Journal of Clinical Oncology
(Daud A et al, JCO, 2008) indicate that the
in vivo
gene transfer of IL-12 DNA using electroporation in metastatic melanoma
is safe. In addition, anti-tumor activity was observed after a single cycle of treatment, including two complete responses. Importantly,
regression in distant, non-injected/non-electroporated lesions was also observed, suggesting that local treatment with ImmunoPulse®
IL-12 may lead to a systemic anti-tumor immune response (i.e. an abscopal effect). We are currently pursuing two Phase 2 trials:
ImmunoPulse® IL-12 monotherapy in patients with metastatic melanoma and ImmunoPulse® IL-12 plus pembrolizumab in patients
with advanced, metastatic melanoma. In addition, we are pursuing ImmunoPulse® IL-12 monotherapy in patients with triple negative
breast cancer.
OMS-I100:
An Open-Label Phase 2 Trial of
ImmunoPulse
®
IL-12 monotherapy in patients with metastatic melanoma
On
December 5, 2014, we released top-line six-month data from the first Phase 2 trial of this product candidate in patients with
stage III and IV metastatic melanoma, which was presented in an abstract at the Melanoma Bridge 2014 conference in Naples, Italy.
In this Phase 2 study, 30 patients with stage III and IV melanoma received up to four cycles of pIL-12 EP into superficial cutaneous,
subcutaneous and nodal lesions on days 1, 5 and 8 of each 12-week cycle.
We reported that of the 29 patients who were evaluable, an objective response rate of 31% (9/29) was observed, with 14% (4/29)
of patients having a complete response (CR) and 17% (5/29) of patients having a partial response. Regression of distant lesions
was seen in 50% (13/26) of patients with evaluable non-injected, non-electroporated lesions. Clinical endpoints included objective
response rate, local and distant lesion regression, duration of response, overall survival and safety. The results of this study
demonstrated that multiple treatment cycles of ImmunoPulse® IL-12 is safe and well-tolerated, with no treatment-limiting toxicities.
The vast majority of adverse events were localized to the treatment site and were Grade 1 or 2 in severity. Importantly, there
was no evidence of systemic toxicities, which is a key feature of the ImmunoPulse® IL-12 intratumoral treatment strategy.
In order to continue to acquire clinical and immune correlational data on melanoma patients treated with ImmunoPulse® IL-12,
the protocol was amended to enroll up to an additional 30 patients (OMS-I100 Addendum). Enrollment in OMS-I100 Addendum is complete
and activities related to closing out this clinical trial is underway, including completion of a clinical study report that will
be filed to the FDA.
Long-term,
follow-up data of patients who participated in the OMS-I100 trial at the University of California, San Francisco (UCSF) and later
went on to receive an anti-PD-1/PD-L1 therapy was presented by Dr. Alain Algazi at the American Association for Cancer Research
(AACR) Annual Meeting 2016 in New Orleans. These data suggest that ImmunoPulse® IL-12 may prime and enhance response rates
to PD-1/PD-L1 blockade. Fourteen (14) of the 29 patients who completed ImmunoPulse® IL-12 or progressed went on to receive
an anti-PD-1/PD-L1 antibody treatment. Overall, 5 of these 14 patients (36%) experienced a CR and 4 patients had a partial response
(PR) (29%), for an ORR of 64%. Two patients experienced SD (14%) and three patients had progressive disease (21%) (Algazi et al.
2016; Chen and Daud 2016). The promising single-agent activity observed in the Phase 1 and Phase 2 clinical studies, as well as
the potential of an immune-priming effect with ImmunoPulse® IL-12 prior to anti-PD-1/PD-L1 therapy warrants further clinical
investigation.
We
consider the results of the OMS-I100 Phase 2 study in advanced melanoma, along with the emerging long-term follow-up data, to
be significant and thus we are continuing to identify and develop new therapeutic targets that, like IL-12, can (i) be encoded
into DNA, (ii) be delivered intratumorally using electroporation, and (iii) have an ability to reverse the immunosuppressive mechanisms
of the tumor. We plan to expand our ImmunoPulse® pipeline beyond the delivery of plasmid-DNA encoding for cytokines to include
other molecules that may be critical to key pathways associated with tumor immune subversion.
OMS-I140:
Triple Negative Breast Cancer — Biomarker-Focused Pilot Study
Worldwide,
approximately 170,000 new cases of triple negative breast cancer (TNBC) are diagnosed each year, accounting for approximately
15% of all breast cancer. TNBC frequently affects younger women (less than 40 years old) and is characterized by higher relapse
rates when compared with estrogen receptor (ER)-positive breast cancers. TNBC is also associated with an increased risk of recurrence,
both locally and in distant sites including the lung and brain. Advanced TNBC remains a significant area of unmet medical need
and there is no established standard-of-care. Treatment generally includes chemotherapy, with or without radiation and/or surgery.
However, no treatment regimen has clearly demonstrated superiority.
Toward
the end of October 2015, we enrolled the first patient in our biomarker-focused pilot study of ImmunoPulse
®
IL-12 in patients with TNBC. The study is open for enrollment and on-going. The primary objective of the study is to evaluate
the potential of ImmunoPulse® IL-12 to promote a pro-inflammatory molecular and histological signature in tumor samples and
the secondary objectives include the evaluation of safety and tolerability; evaluation of local ablation effect (% of necrosis)
and description of other evidence of anti-tumor activity. The study is being conducted at Stanford University and is designed
to assess whether ImmunoPulse® IL-12 increases TNBC tumor immunogenicity by driving a pro-inflammatory cascade that leads
to increases in cytotoxic tumor-infiltrating lymphocytes (TILs). The presence and number of TILs is thought to be a key requirement
for promoting the anti-tumor activity of antibodies like anti-PD-1/PD-L1. By driving cytotoxic immune cells into the tumor, ImmunoPulse®
IL-12 may be an ideal candidate to combine with checkpoint blockade therapies which have reported some, but limited activity in
TNBC.
CC-15852:
An Open-Label Phase 2 Trial of
ImmunoPulse® IL-12 plus
Pembrolizumab in Patients with Advanced, Metastatic Melanoma
In
August 2015, we enrolled the first patient into the Phase 2 investigator sponsored clinical trial led by the University of California,
San Francisco to assess the anti-tumor activity, safety, and tolerability of the combination of ImmunoPulse
®
IL-12, and Merck’s approved anti-PD-1 agent, KEYTRUDA® (pembrolizumab), in patients with unresectable metastatic melanoma.
The primary endpoint is the best Overall Response Rate (bORR) of the combination regimen in patients whose tumors are characterized
by low numbers of tumor-infiltrating lymphocytes (TILs). Recent data suggest that patients whose tumors are not associated with
TILs or CD8+ T-cells at the tumor margin are unlikely to respond to anti-PD-1 therapies such as KEYTRUDA®, while those who
are PD-L1 positive and have increased TILs are more likely to have a clinical benefit. Therefore, therapies that promote TIL generation
and PD-L1 positivity may play an important role in augmenting the clinical efficacy of the anti-PD1/PD-L1 agents. IL-12 is an
inflammatory cytokine believed to be a master regulator of the immune system, promoting up-regulation of both the innate and adaptive
immune responses and biasing the immune system towards a proinflammatory state. More specifically, IL-12 stimulates the production
of another cytokine, interferon gamma (IFN-γ), which, in turn, results in the stimulation of antigen processing and presentation
machinery, leading to increased TILs and anti-tumor cytotoxic T-cell (CTL) activity. The sponsor of this investigator-initiated
study, UCSF, expects to enroll up to 42 patients; The study is enrolling and on-going. We currently are on track to complete enrollment
by the end of calendar year 2016.
In
addition to the three clinical trials described above, we have also pursued Phase 2 clinical trials in patients with merkel cell
carcinoma and head and neck cancer.
Our
ImmunoPulse® Platform
The
effectiveness of many drugs and DNA-based therapeutics is dependent upon their crossing the cell membrane. In the 1970s, it was
discovered that the brief application of high-intensity, pulsed electric fields to the cell resulted in a temporary and reversible
increase in the permeability of the cell membrane, a mechanism known as “electroporation.”
The
transient, reversible nature of the electrical permeabilization of cell membranes and the resulting increase in intracellular
delivery of therapeutic agents is the underlying basis of our ImmunoPulse® therapeutic approach. The electroporation delivery
system consists of an electrical pulse generator and various disposable applicators. While the extent of membrane permeabilization
depends on various electrical, physical, chemical, and biological parameters, research with electroporation delivery has demonstrated
an improvement of cellular uptake of chemical molecules from 100 to 1,000-fold above baseline. After cessation of the electrical
pulse, the membrane re-stabilizes, trapping the molecules within the cell and allowing them to perform their function.
DNA
Delivery With Electroporation — ImmunoPulse®
The
greatest obstacles to the wide acceptance and use of DNA-based therapeutics has been the safe, efficient, and economical delivery
and expression of plasmid-DNA constructs. We believe that electroporation is uniquely capable of overcoming these obstacles. Together
with our partners and collaborators, we plan to be the leader in establishing electroporation-delivered DNA immunotherapies. We
believe that electroporation could become the method of choice for plasmid-DNA delivery into cells in many clinical applications.
The
ImmunoPulse® approach employs an electroporation system designed to create favorable conditions to deliver plasmid DNA encoding
immunotherapeutic cytokines directly into cells of the tumor microenvironment. The cytokine-encoding plasmid is first injected
into the selected tumor. A needle-electrode array then delivers the electrical pulses produced in the pulse generator. OncoSec
is developing new technologies called TRACE and Helix to improve electroporation. TRACE, or tissue-based real-time adaptive control
electroporation, technology is used to perform electroporation with electrochemical impedance spectroscopy feedback operating
in a closed-loop configuration to optimize each pulse duration in real-time. The Helix technology improves the distribution of
the therapeutic agent in tissue and achieves delivery to an area that is three times larger than a standard injection needle.
Our
ImmunoPulse® product candidates are based on our proprietary DNA based immunotherapy technology, which is designed to stimulate
the human immune system, resulting in systemic anti-tumor immune responses. Because our candidate therapeutics are plasmid constructs,
we expect to benefit from a simpler, more consistent and scalable manufacturing process in comparison to therapies based on patient-derived
cells or recombinant proteins. Our lead product candidate, ImmunoPulse® IL-12, consists of a plasmid construct encoding the
proinflammatory cytokine, IL-12, which is delivered into the tumor through in vivo electroporation. ImmunoPulse® IL-12 is
being studied in several open-label Phase 2 clinical trials.
Cancer
deploys multiple immune-subversive mechanisms in parallel to suppress anti-tumor immune responses and we believe it is unlikely
that any single immunotherapy product will suffice to achieve durable responses in most patients and in most tumor types. Therefore,
we are conducting research and development on other DNA-encoded, immunologically-active molecules with an aim to produce additional
immunotherapeutic drugs capable of breaking the immune system’s tolerance to cancer. We have the opportunity to leverage
the flexibility of a DNA plasmid-based technology to rapidly pursue candidate molecules and combinations of therapeutics. We
can introduce, for example, pro-inflammatory cytokines and chemokines, immune stimulatory receptors, co-stimulatory molecules,
adhesion molecules, and T-cell engagement molecules. We expect that electroporation-mediated intratumoral expression of immunologically-active
molecules such as these can reverse the immunosuppressive microenvironment of the tumor and drive systemic anti-tumor immune responses
while limiting systemic exposure and toxicities associated with these potent immunologic effector molecules.
Advisory
Panels
We
have consulted with senior and respected oncology researchers and clinicians to provide counsel as part of our advisory panels
for our ImmunoPulse® clinical programs. We expect to continue to establish relationships with scientific, clinical and medical
experts in academia, as needed, to assist us on issues related to potential product applications, product development, and clinical
testing.
Commercialization
We
plan to continue our clinical development strategy for the ImmunoPulse® IL-12 program with Phase 2 and subsequent pivotal
clinical trials focused on various cancers, including those that have a demonstrated response to anti-PD-1/PD-L1 checkpoint therapies
such as metastatic melanoma and squamous cell carcinoma of the head and neck. We believe that there is a significant unmet medical
need for patients who are non-responsive or refractory to anti-PD-1/PD-L1 therapies.
We
hope to be first-to-market in treatment for metastatic melanoma for patients who are non-responsive or refractory to currently
approved anti-PD-1 checkpoint therapies. We continue to also focus on partnering and commercialization strategies that leverage
Phase 2 clinical studies in the United States. Our near term plan is to identify and engage potential partners who are established
industry leaders in the field of immuno-oncology, or plan to expand their portfolio in this space.
Competition
We
are in a highly competitive industry. We are in competition with traditional and alternative therapies for the indications we
are targeting, as well as pharmaceutical and biotechnology companies, hospitals, research organizations, individual scientists
and nonprofit organizations engaged in the development of drugs and other therapies for these indications. Our competitors may
succeed, and many have already succeeded, in developing competing products, obtaining FDA approval for products, or gaining patient
and physician acceptance of products before us for the same markets and indications that we are targeting. Many of these companies,
and large pharmaceutical companies in particular, have greater research and development, regulatory, manufacturing, marketing,
financial and managerial resources, and experience than we have, and many of these companies may have products and product candidates
that are in a more advanced stage of development than our product candidates. If we are not “first to market” for
a particular indication, it may be more difficult for us or our collaborators to effectively enter markets unless we can demonstrate
our products are clearly superior to existing therapies (see also “Intellectual Property” below).
Examples
of competitive therapies include the following:
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Immunotherapy
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This therapeutic approach stimulates the patient’s own immune system to attack malignant tumor cells, which have managed
to circumvent the body’s natural immune processes that would normally recognize and destroy these cells before they
are able to form growing cancerous tumors. Several methods have been employed to evoke this immune response, including monoclonal
antibodies and autologous cell-based vaccines, as well as viral and non-viral targeted delivery of immunotherapeutic agents.
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YERVOY®
(ipilimumab), approved in 2011, is a monoclonal antibody that acts to block the CTLA-4 receptor (an immune checkpoint receptor)
on T-cells. In the presence of CTLA-4 receptor it is believed tumors are able to suppress the immune system from recognizing
cancerous cells, however blockade of this receptor with YERVOY® (an anti-CTLA-4 antibody) appears to allow the immune
system to generate an antitumor T-cell response.
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YERVOY®
was the first approved immunotherapy in melanoma, and current research is evaluating the use of other anti-checkpoint monoclonal
antibodies.
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Other
monoclonal antibodies approved that act to block a checkpoint receptor, PD-1, were recently approved by the FDA. KEYTRUDA®
(pembrolizumab) and OPDIVO® (nivolumab), were both approved for use in late-stage unresectable metastatic melanoma in
2014 based on the impressive objective response rate data from Phase I and II clinical trials. A third monoclonal antibody
like KEYTRUDA and OPDIVO, that targets the PD-1/PD-L1 checkpoint axis, TECENTRIQ (atezolizumab), was approved on May 18, 2016
by the FDA for the treatment of urothelial carcinoma, the most common type of bladder cancer.
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Moreover,
there are an increasing number of combination immunotherapies being evaluated, including combinations of checkpoint inhibitor
therapies. In October 2015, the FDA announced the approval of the first immune checkpoint inhibitor combination of YERVOY®
(ipilimumab) plus OPDIVO® (nivolumab) in advanced melanoma. We expect more approvals of this combination, and other novel
combinations, to be approved in the coming years as more and more combinations continue to be investigated.
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Provenge®,
a product developed and marketed by Dendreon Corporation, and many emerging therapies continue to employ an autologous cell-based
mode of delivery, which involves the harvesting of a patient’s own cells, growing them in a lab, incubating with a vaccine
or immune stimulating agent, and re-administering the resulting product to the patient.
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Other
cell-based approaches include Tumor Infiltrating Lymphocyte (TIL) and chimeric antigen receptor T-cell (CART) therapies. These
therapies continue to be investigated in clinical trials for both solid and hematologic cancers.
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Viral
vectors, such as adenoviruses and oncolytic viruses, have also been used to deliver immunotherapeutic payloads to fight against
cancerous cells, either systemically or through direct injection into the tumor. Clinical trials for this therapeutic delivery
method are ongoing with no approved therapies yet to be available in the clinic. Recently, Amgen’s tamoligene laherparapvec,
or T-VEC, completed its Phase III trial and met its primary endpoint. This data was presented to the Oncologic Drugs Advisory
Committee, who voted to recommend approval of this therapy to the FDA. The final decision on approval of this therapy remains
with the FDA.
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Other
non-viral vector methods, that deliver nucleic-acid based therapies, are also currently being developed and employed in ongoing
clinical trials. Examples of other non-viral vector methods include, liposome-based delivery systems, bacterial-based delivery
systems, and mechanical delivery systems.
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Vaccination
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The use of peripheral vaccination has long held interest as another potential modality that could prove beneficial in treating
and limiting systemic oncologic disease. Several antigen-specific investigational vaccines have been tested in humans in the
past, in particular in melanoma, such as MAGE-A3, however none of these have proven to be successful in a large Phase 3 registration
trial.
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Employees
We
have assembled a senior management team with many years of experience and success in biotech/pharma operations, business and commercial
development, and capital markets. In addition, we have assembled a clinical and regulatory team experienced in developing and
advancing novel therapeutic approaches through clinical testing and regulatory approvals. As of October 7, 2016, we have a total
of 46 employees. None of our employees is represented by a labor union or covered by a collective bargaining agreement, and we
believe that our relations with our employees are good.
We
expect to hire additional staff and to engage consultants in regulatory, compliance, investor and public relations, and general
administration as necessary. We also expect to engage experts in healthcare and in general business to advise us in various capacities.
Intellectual
Property
Our
success and ability to compete depends upon our intellectual property. We have acquired or been issued 28 U.S. patents and have
two U.S. patent applications pending. We have filed 14 U.S. provisional patent applications, and have converted three provisional
applications into regular utility applications. We will continue to file additional patent applications, when appropriate. We
have a total of 13 issued patents and six pending patent applications in other jurisdictions. In addition, we have licensed intellectual
property rights that allow us to use certain electroporation technology and methods of delivering DNA-based cytokines as an immunotherapy,
including using catheter-based delivery. The bulk of our patents, including fundamental patents directed toward our proprietary
technology, expire between 2017 and 2027.
We
are party to a cross-license agreement with Inovio Pharmaceuticals, Inc. (“Inovio”), which we entered into concurrently
with the closing of our acquisition of certain assets from Inovio in 2011. This agreement provides for the exclusive license to
Inovio of patent rights sold to us by Inovio. Inovio is restricted to using these patent rights for the electroporation mediated
delivery of gene or nucleic acids, outside of those encoding cytokines. We received a non-exclusive cross-license by Inovio to
patent rights related to certain technology patents in exchange for specified sublicensing and other licensing fees and royalties.
Government
Regulation
United
States
In
the United States, our product candidates are subject to extensive regulation by the FDA. Federal and state statutes and regulations,
many of which are administered by the FDA, 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. Failure to comply with applicable FDA or other requirements may subject a company
to a variety of administrative or judicial sanctions, such as the FDA’s refusal to approve pending applications, a clinical
hold, warning letters, recall or seizure of products, partial or total suspension of production, withdrawal of the product from
the market, injunctions, fines, civil penalties or criminal prosecution.
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 United States. The process required by the FDA before a drug may be marketed in the United States generally involves,
among other things:
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completion
of pre-clinical testing and formulation studies in compliance with the FDA’s good laboratory practice regulations;
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submission
to the FDA of an investigational new drug application, or IND, for human clinical testing, which must become effective before
human clinical trials may begin in the United States;
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performance
of adequate human clinical trials in accordance with good clinical practices to establish the safety and efficacy of the proposed
drug product for each intended use; and
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submission
to the FDA of a new drug application, or NDA, which the FDA must review and approve.
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The
pre-clinical and clinical testing and approval process requires substantial time, effort, and financial resources, and the receipt
and timing of approval, if any, is highly uncertain. The results of pre-clinical tests, together with certain manufacturing information,
analytical data and a proposed clinical trial protocol and other information, are submitted as part of an IND to the FDA. Once
an IND is in effect, the protocol for each clinical trial to be conducted under the IND must be submitted to the FDA, which may
or may not allow the trial to proceed. A separate submission to an existing IND must also be made for each successive clinical
trial conducted during product development.
Clinical
trials involve the administration of the investigational new drug to human subjects under the supervision of qualified investigators
in accordance with good clinical practice requirements. For purposes of an NDA submission and approval, human clinical trials
are typically conducted in the following sequential phases, which may overlap or be combined:
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Phase
1
: The drug is initially introduced into healthy human
subjects or patients and tested for safety, dose tolerance, absorption, metabolism, distribution, and excretion and, if possible,
to gain an early indication of its effectiveness.
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Phase
2
: The drug is administered to a limited patient population
to identify possible adverse effects and safety risks, to preliminarily evaluate the efficacy of the product for specific
targeted indications, and to determine dose tolerance and optimal dosage. Multiple Phase II clinical trials may be conducted.
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Phase
3
: The drug is administered in large patient populations
to obtain additional evidence of clinical efficacy and safety in an expanded patient population at multiple, geographically-dispersed
clinical trial sites and to establish the overall risk-benefit relationship of the drug.
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Phase
4
: In some cases, the FDA may condition approval of an
NDA for a product candidate on the sponsor’s agreement to conduct additional clinical trials to further assess the drug’s
safety and effectiveness after NDA approval.
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The
results of product development, pre-clinical studies and clinical trials are submitted to the FDA as part of an NDA requesting
approval to market the product. NDAs must also contain extensive information relating to the product’s pharmacology, chemistry,
manufacture, controls, and proposed labeling, among other things.
Once
the submission has been accepted for filing, the FDA begins an in-depth substantive review. Pursuant to the FDA’s performance
goals, NDA reviews are to be completed within ten months, subject to extensions by the FDA. Before approving an NDA, the FDA often
inspects the facility or facilities where the product is manufactured and will not approve an application unless it determines
that the manufacturing processes and facilities are in compliance with good manufacturing practices. Additionally, the FDA will
typically inspect one or more clinical sites to assure compliance with good clinical practices before approving an NDA. If the
FDA determines that the NDA is not acceptable, then the FDA may outline the deficiencies in the NDA and often will request additional
information or additional clinical trials. Notwithstanding the submission of any requested additional testing or information,
the FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.
Even
if regulatory approval of a product candidate is obtained, such approval will usually impose limitations on the indicated uses
for which the product may be marketed. Additionally, the FDA may require post-approval testing, such as Phase IV studies, or surveillance
programs to monitor the effect of approved products, and the FDA has the power to prevent or limit further marketing of a product
based on the results of these post-marketing programs.
After
FDA approval, a product will be subject to pervasive and continuing regulation by the FDA, including, among other things, requirements
relating to drug/device listing, recordkeeping, periodic reporting, product sampling and distribution, manufacturing practices,
labeling, advertising and promotion, and reporting of adverse experiences with the product. The FDA may withdraw its approval
of a product if compliance with regulatory requirements and manufacturing 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, among
other things: restrictions on the marketing or manufacturing of the product; complete withdrawal of the product from the market
or product recalls; fines, warning letters or holds on post-approval clinical trials; or injunctions or the imposition of civil
or criminal penalties.
International
Regulation
When
we pursue research and/or commercialization of our product candidates in countries other than the United States, we will need
to obtain the necessary approvals by the regulatory authorities of such foreign countries comparable to the FDA before we could
commence clinical trials or marketing of our product candidates in those countries, and we would be subject to a variety of foreign
regulations regarding safety and efficacy and governing, among other things, clinical trials and commercial sales and distribution
of our products. The approval processes and requirements vary by country and can involve additional product testing and additional
review periods, and the time may be longer or shorter than that required to obtain FDA approval.
Other
Regulatory Requirements and Environmental Matters
We
are or may become subject to various laws and regulations regarding laboratory practices and the experimental use of animals,
as well as environmental laws and regulations governing, among other things, any use and disposal by us of hazardous or potentially
hazardous substances in connection with our research. In each of these areas, as above, the FDA and other government agencies
have broad regulatory and enforcement powers, including, among other things, the ability to levy fines and civil penalties, suspend
or delay issuance of approvals, seize or recall products, and withdraw approvals, any one or more of which could have a material
adverse effect on us. Additionally, if we are able to successfully obtain approvals for and commercialize our product candidates,
then we may become subject to various federal, state, and local laws targeting fraud, abuse, privacy, and security in the healthcare
industry.
Manufacturing
We
currently contract with third parties for the manufacture, testing and storage of our plasmid product candidate and intend to
continue to do so in the future.
We currently assemble certain
components of our electroporation systems, which is our delivery mechanism for our biologic to a patient’s cell. We utilize
the services of contract manufacturers to manufacture the remaining components of these systems and our product supplies for clinical
trials and intend to continue to do so in the future. We are ISO 13485 certified and have an audited quality management system.
In addition, all manufacturers of our products must comply with cGMP requirements enforced by the FDA through its facilities inspection
program.
We
do not own and have no plans to build our own clinical or commercial plasmid manufacturing capabilities. The use of contracted
manufacturing is relatively cost-efficient and has eliminated the need for our direct investment in manufacturing facilities.
Because we rely on contract manufacturers, we employ personnel with extensive technical, manufacturing, analytical and quality
experience to oversee contract manufacturing and testing activities, and to compile manufacturing and quality information for
our regulatory submissions.
Manufacturing
is subject to extensive regulations that impose various procedural and documentation requirements, and which govern record keeping,
manufacturing processes and controls, personnel, quality control and quality assurance, among others. Our systems and our contractors
are required to be in compliance with these regulations, and this is assessed regularly through monitoring of performance and
a formal audit program. We believe that there are alternate sources of raw material supply and finished goods manufacturing that
can satisfy our requirements, although we cannot be certain that transitioning to such vendors, if necessary, would not result
in significant delay or material additional costs.
Research
and Development
We
recognized $14.7 million and $13.1 million in research and development expenses in the fiscal years ended July 31, 2016 and 2015,
respectively. From our inception through July 31, 2016, we have incurred an aggregate of approximately $39.7 million of research
and development expenses, the significant majority of which relate to our development of immuno-oncology therapeutic product candidates,
with the use of an electroporation device.
Corporate
Information
We
were incorporated under the laws of Nevada on February 8, 2008 under the name “Netventory Solutions Inc.” Initially,
we provided online inventory services to small and medium sized companies. On March 1, 2011, we changed our name to “OncoSec
Medical Incorporated.” In March 2011, we acquired certain assets related to the use of drug-medical device combination products
for the treatment of various cancers from Inovio. With this acquisition, we abandoned our efforts in the online inventory services
industry and began focusing our efforts in the biotechnology industry. Our corporate headquarters is currently located at 5820
Nancy Ridge Drive, San Diego, CA 92121 and the telephone number is 855-662-6732.
We
make available, free of charge, on our website,
www.oncosec.com
, our reports on Forms 10-K, 10-Q, 8-K and amendments thereto,
as soon as reasonably practical after we file such materials with the Securities and Exchange Commission. Any information that
we include on or link to our website is not a part of this report or any registration statement that incorporates this report
by reference.
ITEM
1A. RISK FACTORS
Investment
in our common stock involves a high degree of risk. You should carefully consider the risks described below, as well as all other
information included in this Annual Report on Form 10-K, including our financial statements, the notes thereto and the section
entitled “Management’s Discussion and Analysis of Financial Condition and Results of Operations. Our business, financial
condition, results of operations and stock price could be materially adversely affected by any of these risks.
We
will need to raise additional capital in future periods to continue operating our business, and such additional funds may not
be available on acceptable terms or at all.
We
do not generate any cash from operations and will need to raise additional funds in future periods in order to continue operating
our business. We estimate our cash requirements for the next 12 months to be approximately $22.3 million. As of July 31, 2016,
we had cash and cash equivalents of approximately $29.0 million.
We
have a history of raising funds through offerings of our common stock and warrants to purchase our common stock. We expect to
continue to fund our operations primarily through public or private equity financings in the near future, and we may also raise
funds through debt financings, grants, corporate collaborations, or licensing arrangements.
We
will require additional financing to fund our planned operations, including developing and commercializing our intellectual property,
seeking to license or acquire new assets, researching and developing any potential patents, related compounds, and other intellectual
property, funding potential acquisitions, and supporting clinical trials and seeking regulatory approval relating to our assets
and any assets we may develop or acquire in the future. Additional financing may not be available to us when needed or, if available,
may not be available on commercially reasonable terms. If we issue equity or convertible debt securities to raise additional funds,
our existing stockholders may experience substantial dilution, and the new equity or debt securities may have rights, preferences,
and privileges senior to those of our existing stockholders. If we incur debt, it may increase our leverage relative to our earnings
or to our equity capitalization, requiring us to pay additional interest expense. Obtaining commercial loans, assuming those loans
would be available, would increase our liabilities and future cash commitments.
We
may not be able to obtain additional financing if the volatile and uncertain conditions in the capital and financial markets,
and more particularly the market for early-development-stage biotechnology and life science company stocks, persist. Weak economic
and capital markets conditions could result in increased difficulties in raising capital for our operations. We may not be able
to raise money through the sale of our equity securities or through borrowing funds on terms we find acceptable. If we cannot
raise the funds that we need, we may be unable to continue our operations, and our stockholders could lose their entire investment
in our Company.
We
may be unable to successfully develop and commercialize the assets we have acquired or develop and commercialize new assets and
product candidates.
Our
future results of operations will depend to a significant extent upon our ability to successfully develop and commercialize our
product candidates, including the assets we acquired from Inovio. In addition, we plan to expand our clinical pipeline and to
build our product portfolio through the acquisition or licensing of new assets, product candidates or approved products. There
are numerous difficulties inherent in acquiring, developing and commercializing new products and product candidates, including
difficulties related to:
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successfully
identifying potential product candidates;
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developing
potential product candidates;
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conducting
or completing clinical trials, including receiving incomplete, unconvincing, or equivocal clinical trials data;
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obtaining
requisite regulatory approvals for such products in a timely manner or at all;
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acquiring,
developing, testing, and manufacturing products in compliance with regulatory standards in a timely manner or at all;
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being
subject to legal actions brought by our competitors, which may delay or prevent the development and commercialization of new
products;
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significant
and unpredictable changes in the payor landscape, coverage, and reimbursement for any products we successfully develop and
commercialize; and
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delays
or unanticipated costs, including those related to the foregoing.
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As
a result of these and other difficulties, we may be unable to develop potential product candidates using our intellectual property,
and our potential products in development may not receive regulatory approvals in a timely manner or at all. If we do not acquire
or develop product candidates, if any of our product candidates are not approved in a timely manner or at all, or if any of our
product candidates, when acquired or developed and approved, cannot be successfully manufactured and commercialized, our operating
results would be adversely affected. In addition, we may not recoup our investment in developing products, even if we are successful
in commercializing those products. Our business expenditures may not result in the successful acquisition, development, or commercialization
of products that will prove to be commercially successful or result in the long-term profitability of our business.
If
the commencement or completion of clinical testing for product candidates based on our technology is delayed or prevented, that
could result in increased costs to us and delay or limit our ability to pursue regulatory approval or generate revenues.
Clinical
trials are very expensive, time-consuming, and difficult to design and implement. Even if we are able to complete our proposed
clinical trials and the results are favorable, clinical trials for product candidates based on our technology will continue for
several years and may take significantly longer than expected to complete.
Delays
in the commencement or completion of clinical testing could significantly affect our product development costs and business plan.
We do not know whether our Phase 2 clinical trials will be completed on schedule, if at all; however, current enrollment in the
clinical trials suggest completion in late calendar 2016 or early calendar 2017. We do not know whether any other pre-clinical
or clinical trials, including Phase 3 clinical trials, will begin on time or be completed on schedule, if at all. In addition,
a number of pre-clinical and clinical trials related to our product candidates are investigator-initiated and sponsored. An investigator-initiated
trial is a research effort in which the investigator designs and implements the study and the investigator or the institution
acts as the study sponsor. The trial sponsor has control over the design, conduct and timing of such trials, and we have limited
or no control over the commencement and completion of such trials.
In
addition, to the extent that our strategy focuses on the combination of our product candidates with third parties’ anti-PD-1/PD-L1
products or product candidates, certain of our clinical studies may invole the combination of our product candidates with the
products or product candidates of third parties. This is true of our combination IST, a Phase 2 investigator sponsored clinical
trial led by the University of California San Francisco to assess the combination of ImmunoPulse® IL-12 and Merck’s
anti-PD-1 antibody KEYTRUDA®. This study raises additional risks due to its reliance on factors outside our control, such
as those relating to the availability and marketability of KEYTRUDA®. If we or our clinical investigators are unable to secure
a sufficient supply of third-party products or candidates, such as KEYTRUDA®, on commercially reasonable terms, our clinical
studies could be delayed or we could be forced to terminate these studies. Such a delay or termination would have a material impact
on our development strategy, business, results of operations, financial conditions, and prospects.
The
commencement and completion of clinical trials can be delayed or prevented for a number of reasons, including delays or issues
related to:
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obtaining
clearance from the
Food and Drug Administration, or FDA, or
respective international regulatory body equivalents to commence a clinical trial;
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reaching
agreement on acceptable terms with prospective clinical research organizations, or CROs, clinical investigators, and trial
sites;
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obtaining
institutional review board, or IRB, approval to initiate and conduct a clinical trial at a prospective site;
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identifying,
recruiting and training suitable clinical investigators;
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identifying,
recruiting and enrolling subjects to participate in clinical trials for a variety of reasons, including competition from other
clinical trial programs for similar indications;
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retaining
patients who have initiated a clinical trial but may be prone to withdraw due to side effects from the therapy, lack of efficacy,
personal issues, death, or for any other reason they choose, or who are lost to further follow-up; and
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identifying
and maintaining a sufficient supply of third-party products or product candidates, including those produced by third parties,
on commercially reasonable terms.
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We
believe that we have planned and designed an adequate development strategy for our electroporation technology. However, the FDA
could determine that it is not satisfied with our plan or the details of our pivotal clinical trial protocols and designs.
Additionally,
changes in applicable regulatory requirements and guidance may occur and we may need to amend clinical trial protocols to reflect
these changes. Amendments may require us to resubmit our clinical trial protocols to IRBs for reexamination, which may impact
the costs, timing or successful completion of a clinical trial. If we experience delays in completion of, or if we terminate,
any of our clinical trials, the commercial prospects for our product candidates may be harmed, which may have a material adverse
effect on our business, results of operations, financial condition and prospects.
If
we are unable to successfully recruit and retain qualified personnel, we may not successfully maintain or grow our business.
In
order to successfully implement and manage our business plan, we will depend upon, among other things, successfully recruiting
and retaining qualified executives, managers, scientists and other employees having relevant experience in the biotechnology industry.
Competition for qualified individuals is intense, particularly in our geographical location where there are several larger, more
established biotechnology companies that compete with us for talent. We also experience competition 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 research and 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 support us. If we are not able to retain existing personnel and find,
attract, and retain new qualified personnel on acceptable terms and in a timely manner to coincide with our growth, we may not
be able to successful maintain or grow our business and our business operations and prospects could suffer.
Additionally,
although we have employment agreements with each of our executive officers, these agreements are terminable by them at will and
we may not be able to retain any one or more of our executives. The loss of the services of any one or more members of our senior
management team, including recent changes within our management team, could (i) disrupt or divert our focus from pursuing our
business plan while we seek to recruit other executives, (ii) impact the perceptions of our employees, partners and investors,
and perceptions of prospective employees, partners and investors, regarding our business and prospects, (iii) cause us to incur
substantial costs in connection with managing transitions and recruiting suitable replacements, and (iv) delay or prevent the
development and commercialization of our product candidates. These and other potential consequences could cause significant harm
to our business, especially to the extent that we are not able to recruit suitable replacements in a timely manner.
Future
growth could strain our resources, and if we are unable to manage our growth, we may not be able to successfully implement our
business plan.
Our
business plan includes the continued growth of our operations, including, but not limited to, the opening of one or more foreign
subsidiaries and the expansion of our clinical studies beyond the U.S. Such growth could place a significant strain on our management,
administrative, operational, and financial infrastructure. Our future success will depend, in part, upon the ability of our executive
officers to manage growth effectively. This will require that we hire and train additional personnel to support our expanding
operations. International growth will expose us to more complexity in our regulatory and accounting compliance and will expose
us to new risks and challenges inherent in international operations with which we may not be familiar, such as changing taxes
or duties, fluctuations in currency exchange rates, changes in applicable laws or policies, and potential for war or civil unrest.
In addition, we must continue to improve our operational, financial, and management controls and our reporting systems and procedures,
which can be made even more challenging while our operations are growing. If we fail to successfully manage our growth, we may
be unable to execute upon our business plan.
Our
success depends in large part on our ability to protect our intellectual property using a combination of patents, trade secrets,
and confidentiality agreements. Certain of our patents will expire in the near future, and we may have difficulties protecting
our proprietary rights and technology and we may not be able to ensure their protection.
Our
commercial success will depend in large part on obtaining and maintaining patent, trademark, and trade secret protection of our
product candidates and their respective components, including devices, formulations, manufacturing methods, and methods of treatment,
as well as successfully defending these patents against third-party challenges. Our ability to stop third parties from making,
using, selling, offering to sell, or importing our product candidates is dependent upon the extent to which we have rights under
valid and enforceable patents or trade secrets that cover these activities. As we describe elsewhere in this Annual Report, we
have patent protection for components of our ImmunoPulse® product candidates. Our current device portfolio includes US7,412,284
and EP999867, which cover our current clinical device. These patents will expire between 2017 and 2018, at which point we can
no longer enforce these against third parties to prevent them from making, using, selling, offering to sell, or importing our
current clinical device. This could expose us to substantially more competition and have a material adverse impact on our business
and our ability to commercialize or license our technology and products.
In
addition, the coverage claimed in a patent application typically is significantly reduced before a patent is issued, either in
the United States or abroad. Consequently, any of our pending or future patent applications may not result in the issuance of
patents and any patents issued may be subjected to further proceedings limiting their scope and may in any event not contain claims
broad enough to provide meaningful protection. Any patents that are issued to us or our future collaborators may not provide significant
proprietary protection or competitive advantage and may be circumvented or invalidated. In addition, unpatented proprietary rights,
including trade secrets and know-how, can be difficult to protect and may lose their value if they are independently developed
by a third party or if their secrecy is lost. Further, because development and commercialization of our potential product candidates
can be subject to substantial delays, our patents may expire or provide only a short period of protection, if any, following any
future commercialization of products. Moreover, obtaining and maintaining patent protection depends on compliance with various
procedural, document submission, fee payment, and other requirements imposed by government patent agencies, and our patent protection
could be reduced or eliminated for non-compliance with these requirements. If any of our patents are found to be invalid or unenforceable,
or if we are otherwise unable to adequately protect our rights, it could have a material adverse impact on our business and our
ability to commercialize or license our technology and products.
We
have never generated, and may never generate, profit from our operations.
We
have not generated any revenue from operations since our inception. During the fiscal year ended July 31, 2016, we incurred a
net loss of approximately $26.9 million. From inception through July 31, 2016, we have incurred an aggregate net loss of approximately
$73.5 million. We expect that our operating expenses will continue to increase as we expand our current headcount, further our
development activities, and continue to pursue FDA approval for our product candidates.
Because
of the numerous risks and uncertainties associated with our product development and commercialization efforts, we are unable to
predict the extent of our future losses or when or if we will become profitable, and it is possible we will never commercialize
any of our product candidates or become profitable. Our failure to obtain regulatory approval and successfully commercialize any
of our product candidates would have a material adverse effect on our business, results of operations, financial condition, and
prospects and could result in our inability to continue operations.
Regulatory
authorities may not approve our product candidates or the approvals we secure may be too limited or too late for us to earn sufficient
revenues.
The
research, testing, manufacturing, labeling, approval, selling, marketing and distribution of our product candidates are subject
to extensive regulation by the FDA and other regulatory authorities in the United States and other countries, which regulations
differ from country to country. The FDA and other foreign regulatory agencies can delay approval of or refuse to approve our product
candidates for a variety of reasons, including failure to meet safety and efficacy endpoints in our clinical trials. Our product
candidates may not be approved even if they achieve their endpoints in clinical trials. Regulatory agencies, including the FDA,
may disagree with our or our partners’ trial design and our interpretation of data from preclinical studies and clinical
trials. Clinical trials of our product candidates may not demonstrate that they are safe and effective to the extent necessary
to obtain regulatory approvals. Our clinical trial addendum to assess our ImmunoPulse® IL-12 single-agent therapy in patients
with metastatic melanoma recently closed enrollment and we have one biomarker-focused pilot study of ImmunoPulse® IL-12 in
patients with triple negative breast cancer open for enrollment. In addition, our combination IST, a Phase 2 investigator sponsored
clinical trial led by the University of California San Francisco to assess the combination of ImmunoPulse® IL-12 and Merck’s
anti-PD-1 antibody KEYTRUDA®, is ongoing and continues to enroll patients. This combination trial raises additional risks
due to its reliance on factors outside our control, such as those risks described elsewhere in these Risk Factors relating to
the availability and marketability of KEYTRUDA®.
If
we cannot adequately demonstrate through the clinical trial process that a therapeutic product we are developing is safe and effective,
regulatory approval of that product would be delayed or prevented, which would impair our reputation, increase our costs and prevent
us from earning revenues. Success in preclinical testing and early clinical studies does not ensure that later clinical trials
will generate adequate data to demonstrate the efficacy and safety of an investigational drug. A number of companies in the pharmaceutical
and biotechnology industries, including many with greater resources and experience than us, have suffered significant setbacks
in clinical trials, even after seeing promising results in earlier clinical trials. Even if a product candidate is approved, it
may be approved for fewer or more limited indications than requested or the approval may be subject to the performance of significant
post-marketing studies. In addition, regulatory agencies may not approve the labeling claims that are necessary or desirable for
the successful commercialization of our product candidates. Any limitation, condition or denial of approval would have an adverse
effect on our business, reputation and results of operations.
Because
of the substantial competition we face, even if we are able to secure regulatory approval of our product candidates, delays in
such regulatory approval could delay or even prevent our ability to commercialize our product candidates. Even a failure to secure
accelerated regulatory approval under the FDA Accelerated Approval Program, or similar foreign programs, could lead us to reconsider
our development strategies and delay or prevent us from commercializing our product candidates.
We
must rely on third parties to conduct our clinical trials. If these third parties do not successfully carry out their duties or
meet expected deadlines, we may not be able to obtain regulatory approval for or commercialize our product candidates and our
business could be substantially harmed.
We
have entered into, and expect to continue to enter into, agreements with third-party clinical research organizations, or CROs,
to conduct our clinical trials. We currently rely on these parties for the execution of our clinical and pre-clinical studies,
and control only certain aspects of their activities. We, and our CROs, are required to comply with the current FDA Code of Federal
Regulations for Conducting Clinical Trials and Good Clinical Practice, or GCP, and International Conference on Harmonisation of
Technical Requirements for Registration of Pharmaceuticals for Human Use, or ICH, guidelines. The FDA and similar foreign regulators
enforce these GCP regulations through periodic inspections of trial sponsors, principal investigators, CRO trial sites, laboratories,
and any entity having to do with the completion of the study protocol and processing of data. If we, or our CROs, fail to comply
with applicable GCP regulations, the data generated in our clinical trials may be deemed unreliable and the FDA may require us
to perform additional clinical trials before approving our marketing applications. Upon inspection, the FDA and similar foreign
regulators may determine that our clinical trials are not compliant with GCP regulations. Our failure to comply with these regulations
may require us to repeat clinical trials, which would increase costs and delay the regulatory approval process.
If
any of our relationships with third-party CROs terminate, we may not be able to enter into arrangements with alternative CROs
on commercially reasonable terms, on a timely basis, or at all. If 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 our product candidates. As a result, our results of operations and the commercial prospects for our product candidates
could be harmed, our costs could increase and our ability to generate additional revenues could be delayed.
We
have participated in, and continue to participate in, clinical trials conducted under an approved investigator-sponsored investigational
new drug (IND) application, and correspondence and communication with the FDA pertaining to these trials will strictly be between
the investigator and the FDA.
We
have participated in, and continue to participate in, clinical trials conducted under an approved investigator-sponsored investigational
new drug (IND) application, including our Phase 2 investigator sponsored clinical trial led by the University of California San
Francisco to assess the combination of ImmunoPulse® IL-12 and Merck’s anti-PD-1 antibody KEYTRUDA®. Regulations
and guidelines imposed by the FDA with respect to IND applications include a requirement that the sponsor of a clinical trial
provide ongoing communication with the agency as it pertains to safety of the treatment. This communication can be relayed to
the agency in the form of safety reports, annual reports, or verbal communication at the request of the FDA. Accordingly, it is
the responsibility of each investigator (as the sponsor of the trial) to be the point of contact with the FDA. The communication
and information provided by the investigator may not be appropriate and accurate, and the investigator has the ultimate responsibility
and final decision-making authority with respect to submissions to the FDA. This may result in reviews, audits, delays, or clinical
holds by the FDA ultimately affecting the timelines for these studies and potentially risking the completion of these trials.
We
are an early-stage, pre-commercial company with a limited operating history, which may hinder our ability to successfully generate
revenues and meet our objectives.
We
are an early-stage, pre-commercial company with only a limited operating history upon which to base an evaluation of our current
business and future prospects and how we will respond to competitive, financial, or technological challenges. Although we plan
to investigate licensing and partnering opportunities, we are not currently planning on generating any significant near term revenue;
therefore, the income potential of our business is unproven. In addition, because of our limited operating history, we have limited
insight into trends that may emerge and affect our business. Errors may be made in predicting and reacting to relevant business
trends and we will be subject to the risks, uncertainties, and difficulties frequently encountered by early-stage companies in
evolving markets. We may not be able to successfully address any or all of these risks and uncertainties. Failure to adequately
do so could cause our business, results of operations, and financial condition to suffer or fail.
We
have not commercialized any of our product candidates. Our ability to generate revenues from any of our product candidates will
depend on a number of factors, including our ability to successfully complete clinical trials, obtain necessary regulatory approvals,
and negotiate arrangements with third parties to help finance the development of, and market and distribute, any product candidate
that receives regulatory approval. In addition, even if we achieve regulatory approval for one or more of our product candidates,
we will be subject to the risk that the marketplace may not accept our products in sufficient levels for us to achieve profitability,
or at all.
The
biotechnology industry is highly competitive and our competitors tend to be larger and have been in business longer than us.
The
biotechnology industry has an intensely competitive environment that will require an ongoing, extensive search for technological
innovations and the ability to market products effectively, including the ability to communicate the effectiveness, safety, and
value of products to healthcare professionals in private practice, group practices, and payors in managed care organizations,
group purchasing organizations, and Medicare & Medicaid services.
We
face competition from a number of sources, including large pharmaceutical companies, biotechnology companies, academic institutions,
government agencies and private and public research institutions. We are smaller than almost all of our competitors. Most of our
competitors have been in business for a longer period of time than us, have a greater number of products on the market, and have
greater financial and other resources than we do. Furthermore, recent trends in this industry are that large drug companies are
consolidating into a smaller number of very large entities, which further concentrates financial, technical, and market strength
and increases competitive pressure in the industry.
Our
competitors may obtain regulatory approval of their products more rapidly than we are able to or may obtain patent protection
or other intellectual property rights that limit or block us from developing or commercializing our product candidates. If we
are able to obtain regulatory approval of our product candidates or any assets we may acquire in the future, we will face competition
from products currently marketed by larger competitors that address our targeted indications. If we directly compete with these
very large entities for the same markets and/or products, their financial strength could prevent us from capturing a share of
those markets. Our competitors may also develop products that are more effective, more useful, better tolerated, subject to fewer
or less severe side effects, more widely prescribed or accepted, or less costly than ours and may also be more successful than
us in manufacturing and marketing their products.
We
also face competition from product candidates that are or could be under development. We expect our product candidates, if approved
and commercialized, to compete on the basis of, among other things, product efficacy and safety, time to market, price, patient
reimbursement by third-party payors, extent of adverse side effects, and convenience of treatment procedures. We may not be able
to effectively compete in one or more of these areas.
If
we are unable to compete effectively with the marketed therapeutics of our competitors or if such competitors are successful in
developing products that compete with our potential product candidates, our business, results of operations, financial condition,
and prospects may be materially adversely affected.
Our
failure to successfully develop, acquire, and market additional product candidates or approved products would impair our ability
to grow.
Our
business plan includes the expansion of our clinical pipeline and our product portfolio through the acquisition, in-license, development
and/or marketing of additional products and product candidates. The success of our efforts to expand our clinical pipeline and
to build our product portfolio will depend in significant part on our ability to successfully identify, select and acquire promising
product candidates and products.
The
process of proposing, negotiating and implementing a license or acquisition of a product candidate or approved product can be
lengthy and complex. Other companies, including many of our competitors with substantially greater financial, marketing and sales
resources, may compete with us for the license or acquisition of product candidates and approved products. Our experience in making
acquisitions, entering collaborations and in-licensing product candidates is limited, and we have limited resources to identify
and execute the acquisition or in-licensing of third-party products, businesses and technologies and integrate them into our current
infrastructure. We may incorrectly judge the value or worth of an acquired or in-licensed product candidate, approved product
or other asset. Moreover, we may devote resources to potential acquisitions or in-licensing opportunities that are never completed,
or we may fail to realize the anticipated benefits of such efforts. We may not be able to acquire the rights to additional product
candidates on terms that we find acceptable, or at all.
In
addition, future acquisitions may entail numerous operational and financial risks, including:
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exposure
to unknown liabilities;
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disruption
of our business and diversion of our management’s time and attention to manage the acquisition and develop acquired
products or technologies;
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incurrence
of substantial debt or dilutive issuances of securities to pay for acquisitions;
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higher
than expected acquisition and integration costs;
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increased
amortization expenses;
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difficulty
and cost in combining the operations and personnel of any acquired business with our operations and personnel;
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impairment
of relationships with key suppliers or customers of any acquired business due to changes in management and ownership; and
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inability
to retain key employees of any acquired business.
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Any
collaboration arrangement that we have entered into or may enter into in the future may not be successful, which could adversely
affect our ability to develop and commercialize our current and potential future product candidates.
We
may seek collaboration arrangements with pharmaceutical or biotechnology companies for the development or commercialization of
our current and potential future product candidates, including our pursuit of combination trials to develop and commercialize
our product candidates as combination products. Drug/device combination products are particularly complex, expensive and time-consuming
to develop due to the number of variables involved in the final product design, including ease of patient and doctor use, maintenance
of clinical efficacy, reliability and cost of manufacturing, regulatory approval requirements and standards, and other important
factors. Thereafter, such products face continued risk and uncertainty related to manufacturing and supply until the commercial
supply chain is validated and proven.
We
will face, to the extent that we decide to enter into collaboration agreements, significant competition in seeking appropriate
collaborators. Moreover, collaboration arrangements are complex and time-consuming to negotiate, document and implement. We may
not be successful in our efforts to establish and implement collaborations or other alternative arrangements should we choose
to enter into such arrangements, or the terms of such arrangements may not be favorable to us. If and when we collaborate with
a third party for development and commercialization of a product candidate, we can expect to relinquish some or all of the control
over the future success of that product candidate to the third party. The success of our collaboration arrangements will depend
heavily on the efforts and activities of our collaborators, who would likely have significant discretion in determining the efforts
and resources that they will apply to these collaborations.
Disagreements
between parties to a collaboration arrangement regarding clinical development and commercialization matters can lead to delays
in the development process or commercializing the applicable product candidate and, in some cases, termination of the collaboration
arrangement. These disagreements can be difficult to resolve if neither party has final decision-making authority. Collaborations
with third parties often are terminated or allowed to expire by the third party, which would adversely affect us financially and
could harm our business reputation.
We
may incur liability if our promotions of product candidates are determined, or are perceived, to be inconsistent with regulatory
guidelines.
The
FDA provides guidelines with respect to appropriate product promotion and continuing medical and health education activities.
Although we endeavor to follow these guidelines, the FDA or the Office of the Inspector General: U.S. Department of Health and
Human Services may disagree, and we may be subject to significant liability, including civil and administrative remedies as well
as criminal sanctions. In addition, management’s attention could be diverted and our reputation could be damaged.
If
we and the contract manufacturers upon whom we rely fail to produce our systems and product candidates in the volumes that we
require on a timely basis, or fail to comply with stringent regulations, we may face delays in the development and commercialization
of our electroporation equipment and product candidates.
We
currently assemble certain components of our electroporation systems, which is our delivery mechanism for our biologic to a patient’s
cell. We utilize the services of contract manufacturers to manufacture the remaining components of these systems and our product
supplies for clinical trials. We expect to increase our reliance on third party manufacturers if and when we commercialize our
product candidates and systems. The manufacture of our systems and product supplies requires significant expertise and capital
investment, including the development of advanced manufacturing techniques and process controls. Manufacturers often encounter
difficulties in production, particularly in scaling up for commercial production. These problems include difficulties with production
costs and yields, quality control, including stability of the equipment and product candidates and quality assurance testing,
shortages of qualified personnel, as well as compliance with strictly enforced federal, state and foreign regulations. If we or
our manufacturers were to encounter any of these difficulties or our manufacturers otherwise fail to comply with their obligations
to us, our ability to provide our electroporation equipment to our partners and products to patients in our clinical trials or
to commercially launch a product would be jeopardized. Any delay or interruption in the supply of clinical trial supplies could
delay the completion of our clinical trials, increase the costs associated with maintaining our clinical trial program, and, depending
upon the period of delay, require us to commence new trials at significant additional expense or terminate the trials completely.
In
addition, all manufacturers of our products must comply with cGMP requirements enforced by the FDA through its facilities inspection
program. These requirements include, among other things, quality control, quality assurance, and the generation and maintenance
of records and documentation. Manufacturers of our products may be unable to comply with these cGMP requirements and with other
FDA, state, and foreign regulatory requirements. We have little control over our manufacturers’ compliance with these regulations
and standards. A failure to comply with these requirements may result in fines and civil penalties, suspension of production,
suspension or delay in product approval, product seizure or recall, or withdrawal of product approval. If the safety of any product
is compromised due to our or our manufacturers’ failure to adhere to applicable laws or for other reasons, we may not be
able to obtain regulatory approval for or successfully commercialize our products, and we may be held liable for any injuries
sustained as a result. Any of these factors could cause a delay of clinical trials, regulatory submissions, approvals, or commercialization
of our products, entail higher costs, or result in our being unable to effectively commercialize our products. Furthermore, assuming
we are successful in commercializing one or more of our product candidates, if our manufacturers fail to deliver the required
commercial quantities on a timely basis, pursuant to provided specifications and at commercially reasonable prices, we may be
unable to meet demand for our products and would lose potential revenues.
We
may not be successful in executing our strategy for the commercialization of our product candidates. If we are unable to successfully
execute our commercialization strategy, we may not be able to generate significant revenue.
We
intend to advance a commercialization strategy that leverages previous in-depth clinical experiences, previous CE (
Conformité
Européene
) approvals, and late-stage clinical studies in the United States. This strategy includes seeking approval
from the FDA and similar foreign regulators to initiate pivotal registration studies in the United States and abroad, including
studies in select rare cancers that have limited, adverse, or no therapeutic alternatives. This strategy also includes expanding
the addressable markets for our therapies through the addition of relevant indications. Our commercialization plan also includes
partnering and/or co-developing our technology in developing regions, such as Eastern Europe and Asia, where local resources are
best leveraged and appropriate collaborators can be secured.
We
may not be able to implement a commercialization strategy as we have planned. Further, we have not proven our ability to succeed
in the biotechnology industry and are not certain that our implementation strategy, if implemented correctly, would lead to significant
revenue. If we are unable to successfully implement our commercialization plans and drive adoption by patients and physicians
of our potential future products through our sales, marketing, and commercialization efforts, then we will not be able to generate
significant revenue which will have a material adverse effect on our business, results of operations, financial condition, and
prospects.
If
any product candidate for which we receive regulatory approval does not achieve broad market acceptance or coverage by third-party
payors, our revenues may be limited.
The
commercial success of any potential product candidates for which we obtain marketing approval from the FDA or other regulatory
authorities will depend upon the acceptance of these products by physicians, patients, healthcare payors, and the medical community.
Coverage and reimbursement of our approved product by third-party payors is also necessary for commercial success. The degree
of market acceptance of any potential product candidates for which we may receive regulatory approval will depend on a number
of factors, including:
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our
ability to provide acceptable evidence of safety and efficacy;
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acceptance
by physicians and patients of the product as a safe and effective treatment;
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the
prevalence and severity of adverse side effects;
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limitations
or warnings contained in a product’s FDA-approved labeling or other regulator-approved labeling;
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the
clinical indications for which the product is approved;
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availability
and perceived advantages of alternative treatments;
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any
negative publicity related to our or our competitors’ products;
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the
effectiveness of our or any current or future collaborators’ sales, marketing, and distribution strategies;
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pricing
and cost effectiveness;
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our
ability to obtain sufficient third-party payor coverage or reimbursement; and
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the
willingness of patients to pay out-of-pocket in the absence of third-party payor coverage.
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Cost
containment is a primary trend in the U.S. healthcare industry. Third-party payors have attempted to control costs by limiting
coverage and the amount of reimbursement for particular products and procedures. Increasingly, third-party payors are requiring
that companies provide them with predetermined discounts from list prices and are challenging the prices charged for medical products.
We cannot assure you that coverage and reimbursement will be available for any product that we commercialize and, if reimbursement
is available, what the level of reimbursement will be. Coverage and reimbursement may impact the demand for, or the price of,
any product for which we obtain marketing approval. If coverage and reimbursement is not available or is available only to limited
levels, we may not be able to successfully commercialize any product candidate that we successfully develop.
In
addition, the regulations that govern marketing approvals, pricing, coverage and reimbursement for new therapeutic products vary
widely from country to country. Some countries require approval of the sale price of a product before it can be marketed. In many
countries, the pricing review period begins after marketing or product licensing approval is granted. In some foreign markets,
prescription pharmaceutical pricing remains subject to continuing governmental control even after initial approval is granted.
As a result, we might obtain regulatory approval for a product in a particular country, but then be subject to price regulations
that delay our commercial launch of the product and negatively impact the revenue we are able to generate from the sale of the
product in that country.
Our
efforts to educate the medical community and third-party payors on the benefits of any of our potential product candidates may
require significant resources and may never be successful. If our potential products do not achieve an adequate level of acceptance
by physicians, third-party payors, and patients, physicians may not choose to utilize our product and we may not generate sufficient
revenue from these products to become or remain profitable.
In
order to market our proprietary products, we may choose to establish our own sales, marketing, and distribution capabilities,
and if we have problems establishing these capabilities, the commercialization of our products would be impaired.
We
may choose to establish our own sales, marketing, and distribution capabilities to market products to our target markets. Developing
these capabilities will require significant expenditures on personnel and infrastructure. While we intend to market products that
are aimed at a small patient population, we may not be able to create an effective sales force around even a niche market. In
addition, some of our product candidates may require a large sales force to call on, educate, and support physicians and patients.
We may desire in the future to enter into collaborations with one or more pharmaceutical companies to sell, market, and distribute
such products, but we may not be able to enter into any such arrangement on acceptable terms, if at all. Any collaboration we
do enter into may not be effective in generating meaningful product royalties or other revenues for us.
Extensive
industry regulation has had, and will continue to have, a significant impact on our business, especially our product development,
manufacturing, and distribution capabilities.
All
biotechnology companies are subject to extensive, complex, costly, and evolving government regulation. For the U.S., these regulations
are principally administered by the FDA and to a lesser extent by the United States Drug Enforcement Agency, or DEA, and state
government agencies, as well as by various regulatory agencies in foreign countries where products or product candidates are being
manufactured and/or marketed. The Federal Food, Drug and Cosmetic Act, the Controlled Substances Act, and other federal statutes
and regulations, and similar foreign statutes and regulations, govern or influence the testing, manufacturing, packing, labeling,
storing, record keeping, safety, approval, advertising, promotion, sale, and distribution of our products. Under these regulations,
we may become subject to periodic inspection of our facilities, procedures, and operations and/or the testing of our product candidates
and products by the FDA, the DEA, and other authorities, which conduct periodic inspections to confirm that we are in compliance
with all applicable regulations. In addition, the FDA and foreign regulatory agencies conduct pre-approval and post-approval reviews
and plant inspections to determine whether our systems and processes are in compliance with cGMP and other regulations. Following
such inspections, the FDA or other agency may issue observations, notices, citations, and/or warning letters that could cause
us to modify certain activities identified during the inspection. To the extent that we successfully commercialize any product,
we may also be subject to ongoing FDA obligations and continued regulatory review with respect to manufacturing, processing, labeling,
packaging, distribution, storage, advertising, promotion, and recordkeeping for the product. Additionally, we may be required
to conduct potentially costly post-approval studies and report adverse events associated with our products to the FDA and other
regulatory authorities. Unexpected or serious health or safety concerns would result in labeling changes, recalls, market withdrawals,
or other regulatory actions.
The
range of possible sanctions includes, among others, FDA issuance of adverse publicity, product recalls or seizures, fines, total
or partial suspension of production and/or distribution, suspension of the FDA’s review of product applications, enforcement
actions, injunctions, and civil or criminal prosecution. Any such sanctions, if imposed, could have a material adverse effect
on our business, operating results, financial condition, and cash flows. Under certain circumstances, the FDA also has the authority
to revoke previously granted drug approvals. Similar sanctions as detailed above may be available to the FDA under a consent decree,
depending upon the actual terms of such decree. If internal compliance programs do not meet regulatory agency standards or if
compliance is deemed deficient in any significant way, it could materially harm our business.
Moreover,
the regulations, policies, or guidance of the FDA or other regulatory agencies may change and new or additional statutes or government
regulations may be enacted that could prevent or delay regulatory approval of our product candidates or further restrict or regulate
post-approval activities. If we are not able to achieve and maintain regulatory compliance, we may not be permitted to market
our potential product candidates, which would adversely affect our ability to generate revenue and achieve or maintain profitability.
If
we fail to comply with applicable healthcare laws and regulations, we could face substantial penalties and our business, operations,
prospects and financial condition could be adversely affected.
Certain
federal and state healthcare laws and regulations may be applicable to our business, including:
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the
federal Anti-Kickback Statute, which prohibits, among other things, people from soliciting, receiving or providing remuneration,
directly or indirectly, to induce either the referral of an individual, for an item or service or the purchasing or ordering
of a good or service, for which payment may be made under federal healthcare programs such as the Medicare and Medicaid programs;
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federal
false claims laws which prohibit, among other things, individuals or entities from knowingly presenting, or causing to be
presented, claims for payment from Medicare, Medicaid, or other third-party payors that are false or fraudulent;
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the
Patient Protection and Affordable Care Act, or ACA, expands the government’s investigative and enforcement authority
and increases the penalties for fraud and abuse, including amendments to both the False Claims Act and the Anti-Kickback Statute
to make it easier to bring suit under those statutes;
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the
federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, which prohibits executing a scheme to defraud
any healthcare benefit program or making false statements relating to healthcare matters and which also imposes certain requirements
relating to the privacy, security and transmission of individually identifiable health information;
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the
Federal Food, Drug and Cosmetic Act, which among other things, strictly regulates drug product marketing, prohibits manufacturers
from marketing drug products for off-label use and regulates the distribution of drug samples; and
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state
law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to items or
services reimbursed by any third-party payor, including commercial insurers, and state laws governing the privacy and security
of health information in certain circumstances, many of which differ from each other in significant ways and often are not
preempted by Health Insurance Portability and Accountability Act, or HIPAA, thus complicating compliance efforts.
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Additionally,
the compliance environment is changing, with more states, such as California and Massachusetts, mandating implementation of compliance
programs, compliance with industry ethics codes, and spending limits, and other states, such as Vermont, Maine, and Minnesota
requiring reporting to state governments of gifts, compensation, and other remuneration to physicians. Under the ACA, pharmaceutical
companies must record any transfers of value made to doctors and teaching hospitals and to disclose such data to the U.S. Department
of Health and Human Services, or HHS. These laws all provide for penalties for non-compliance. The shifting regulatory environment,
along with the requirement to comply with multiple jurisdictions with different compliance and/or reporting requirements, increases
the possibility that a company may run afoul of one or more laws. It also may adversely affect:
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our
ability to set a price we believe is fair for our products;
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our
ability to generate revenues and achieve or maintain profitability;
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the
availability of capital; and
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our
ability to obtain timely approval of our products.
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Further,
even though we do not and will not control referrals of healthcare services or bill directly to third-party payors, certain federal
and state healthcare laws and regulations pertaining to fraud and abuse and patients’ rights may be applicable to our business.
We could be subject to healthcare fraud and abuse and patient privacy regulation by both the federal government and the states
in which we conduct our business.
To
the extent that we operate in a foreign country or any product we make is sold in a foreign country, we also may be subject to
foreign laws and regulations.
If
we or our operations are found to be in violation of any of the laws described above or any other governmental regulations that
apply to us, we may be subject to penalties, including civil and criminal penalties, damages, fines and the curtailment or restructuring
of our operations. Any penalties, damages, fines, curtailment or restructuring of our operations could adversely affect our ability
to operate our business and our financial results. Any action against us for violation of these laws, even if we successfully
defend against it, could cause us to incur significant legal expenses and divert our management’s attention from the operation
of our business. Moreover, achieving and sustaining compliance with applicable federal and state privacy, security and fraud laws
may prove costly and have a significant adverse effect on us.
We
face potential product liability exposure and if successful claims are brought against us, we may incur substantial liability.
The
clinical use of our product candidates exposes us to the risk of product liability claims. Any side effects, manufacturing defects,
misuse, or abuse associated with our product candidates could result in injury to a patient or even death. In addition, a liability
claim may be brought against us even if our product candidates merely appear to have caused an injury. Product liability claims
may be brought against us by consumers, healthcare providers, pharmaceutical companies, or others coming into contact with our
product candidates, among others.
Regardless
of merit or potential outcome, product liability claims against us may result in, among other effects, the inability to commercialize
our product candidates, impairment of our business reputation, withdrawal of clinical trial participants, and distraction of management’s
attention from our primary business. If we cannot successfully defend ourselves against product liability claims, we could incur
substantial liabilities.
We
may engage in strategic transactions that could impact our liquidity, increase our expenses, and present significant distractions
to our management.
From
time to time we may consider engaging in strategic transactions, such as acquisitions of companies, asset purchases and out-licensing
or in-licensing of products, product candidates or technologies. Any such transaction may require us to incur non-recurring or
other charges, may increase our near and long-term expenditures, and may pose significant integration challenges or disrupt our
management or business, which could adversely affect our operations and financial results. For example, these transactions may
entail numerous operational and financial risks, including, among others, exposure to unknown liabilities, disruption of our business
and diversion of our management’s time and attention in order to develop acquired products, product candidates, or technologies,
difficulty and cost in combining the operations and personnel of any acquired businesses with our operations and personnel, and
inability to retain key employees of any acquired businesses. The pursuit of such transactions could also create a distraction
for management and entail increased expenses in connection with the pursuit, evaluation, and negotiation of such transactions.
Further, such transactions could result in substantial dilution to our stockholders. Accordingly, although we may not choose to
undertake or may not be able to successfully complete any transactions of the nature described above, the pursuit of such transactions,
and any transactions that we do complete, could have a material adverse effect on our business, results of operations, financial
condition, and prospects.
Our
business and operations would suffer in the event of cyber-attacks or system failures.
Despite
the implementation of security measures, our internal computer systems and those of our current and any future partners, contractors,
and consultants are vulnerable to damage from cyber-attacks, computer viruses, unauthorized access, natural disasters, terrorism,
war, and telecommunication and electrical failures. System failures, accidents, or security breaches could cause interruptions
in our operations, and could result in a material disruption of our commercialization activities, development programs and our
business operations, in addition to possibly requiring substantial expenditures of resources to remedy. The loss of clinical trial
data from completed or future clinical trials could result in delays in our regulatory approval efforts and significantly increase
our costs to recover or reproduce the data. To the extent that any disruption or security breach were to result in a loss of,
or damage to, our data or applications, or inappropriate disclosure of confidential or proprietary information, we could incur
liability and the commercialization of any potential product candidate could be delayed or prevented.
If
we fail to maintain an effective system of internal controls, we may not be able to accurately report our financial results. As
a result, current and potential stockholders could lose confidence in our financial reporting, which would harm our business.
Effective
internal controls are necessary for us to provide reliable financial reports. If we cannot provide reliable financial reports,
our operating results could be misstated, our reputation may be harmed, and the trading price of our stock could be negatively
affected. Our controls over financial processes and reporting may not continue to be effective, or we may identify significant
deficiencies or material weaknesses in our internal controls in the future. Any failure to remediate any significant deficiencies
or material weaknesses or to implement required new or improved controls, or difficulties encountered in their implementation,
could harm our operating results, cause us to fail to meet our reporting obligations, or result in material misstatements in our
financial statements or other public disclosures. Inferior internal controls could also cause investors to lose confidence in
our reported financial information, which could have a negative effect on the trading price of our stock.
Maintaining
compliance with our obligations as a public company may strain our resources and distract management, and if we do not remain
compliant our stock price may be adversely affected.
We
are required to evaluate our internal control systems in order to allow management to report on our internal controls as required
by Section 404 of the Sarbanes-Oxley Act of 2002, and our management is required to attest to the adequacy of our internal controls.
The U.S. Financial Accounting Standards Board and International Accounting Standards Board have been working together since 2002
to achieve convergence of U.S. generally accepted accounting principles, or GAAP, and International Financial Reporting Standards,
or IFRS. As GAAP and IFRS converge into a single set of high quality standards, implementing the new standards could require us
to make adjustments to our previously reported financial statements and could require us to make significant investments in training,
hiring, consulting, and information technology, among other investments. All of these and other reporting requirements and heightened
corporate governance obligations that we face, or will face, will further increase the cost to us, perhaps substantially, of remaining
compliant with our obligations under the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and other
applicable laws, including the Sarbanes-Oxley Act and the Dodd-Frank Act of 2010.
We
may not be able to realize value from, or otherwise preserve and utilize, our net operating loss (NOL) carryforwards.
Significant
equity restructuring often results in an Internal Revenue Section 382 ownership change that limits the future use of net operating
loss (NOL) carryforwards and other tax attributes. The Company may have undergone such ownership changes, however, a Section 382
ownership change study has not been conducted; thus, our NOL carryforwards generated prior to the ownership change would be subject
to annual limitations, which could reduce, eliminate, or defer the utilization of these losses. Further, the recognition and measurement
of our NOL carryforwards may include estimates and judgments by our management, and the Internal Revenue Service has not audited
or otherwise validated the amount of our NOL carryforwards. Additionally, legislative changes could negatively impact our ability
to use any tax benefits associated with our NOL carryforwards. If we put in place limitations on ownership of our common stock
or adopt a shareholder rights plan to preserve our ability to use NOL carryforwards, this could deter potential buyers of our
common stock and adversely impact the trading price of our common stock.
Our
licensed intellectual property may not provide us with sufficient rights and may not prevent competitors from pursuing similar
technology.
We
have licensed certain technology and related assets that cover our current therapeutic methods. Patents for technology we have
licensed are still pending in certain jurisdictions, and the patent family will expire between 2025 and 2027. Method-of-use patents
protect the use of a product for the specified method. This type of patent does not prevent a competitor from making and marketing
a product that is identical to our product for an indication that is outside the scope of the patented method. Moreover, even
if competitors do not actively promote their product for our targeted indications, physicians may prescribe these products off-label.
Although off-label prescriptions may infringe or contribute to the infringement of method-of-use patents, the practice is common
and such infringement is difficult to prevent or prosecute.
We
have entered into a cross-license agreement for certain electroporation technology with Inovio. Under the terms of the cross-license
agreement, Inovio granted to us a non-exclusive, worldwide license to certain electroporation patents held by Inovio. In exchange,
we granted to Inovio an exclusive license to our acquired technology in a limited field of use. While we do not currently substantially
rely on the intellectual property we have non-exclusively licensed from Inovio, our product candidates may, in the future, utilize
this intellectual property. This license is non-exclusive and Inovio may use its technology to compete with us. As there are no
restrictions on Inovio’s ability to license their technology to others, Inovio could license to others, including our competitors,
the intellectual property rights covered by their license to us, including any of our improvements to the licensed intellectual
property. Either party may terminate the cross-license agreement with 30 days’ notice; and, if either party were to terminate
the cross-license agreement, they would no longer have the right to use intellectual property that is subject to the cross license.
We
may incur substantial costs as a result of litigation or other proceedings relating to protection of our patent and other intellectual
property rights, and we may be unable to successfully protect our rights to our potential products and technology.
If
we choose to go to court to stop a third party from using the inventions claimed by our patents, that third party may ask the
court to rule that the patents are invalid and/or should not be enforced. Even if we were successful in stopping the infringing
activity, these lawsuits are expensive and could consume time and other resources. In addition, the court could decide that our
patents are not valid and that we do not have the right to stop others from making, using, or selling the inventions claimed by
the patents.
Additionally,
even if the validity of these patents is upheld, the court could refuse to stop a third party’s infringing activity on the
ground that such activities do not infringe our patents. The U.S. Supreme Court has recently revised certain tests regarding granting
patents and assessing the validity of patents, making it more difficult to obtain patents. As a consequence, issued patents may
be found to contain invalid claims according to the newly revised standards. Some of our patents may be subject to challenge and
subsequent invalidation or significant narrowing of claim scope in a reexamination proceeding, or during litigation, under the
revised criteria.
Third
parties may claim that we infringe their proprietary rights and may prevent us from manufacturing and selling some of our products.
The
manufacture, use and sale of new products that are the subject of conflicting patent rights have been the subject of substantial
litigation in the biotechnology industry relating to the validity and infringement of patents or proprietary rights of third parties.
Litigation may be costly and time-consuming and could divert the attention of our management and technical personnel. In addition,
if we infringe on the rights of others, we could lose our right to develop, manufacture, or market products or could be required
to pay monetary damages or royalties to license proprietary rights from third parties. Although the parties to patent and intellectual
property disputes in the biotechnology industry have often settled their disputes through licensing or similar arrangements, the
costs associated with these arrangements may be substantial and could include ongoing royalties. Furthermore, we cannot be certain
that the necessary licenses would be available to us on commercially reasonable terms or at all. These risks may be amplified
by our size relative to many of our competitors. As a result, an adverse determination in a judicial or administrative proceeding
or failure to obtain necessary licenses could prevent us from manufacturing and selling our products, and could have a material
adverse effect on our business, results of operations, financial condition, and cash flows.
Our
common stock has low trading volume and the price of our common stock has been, and will likely continue to be, highly volatile.
Trading
of our common stock is frequently highly volatile, with low trading volume. We have experienced, and are likely to continue experiencing,
significant fluctuations in the stock price and trading volume. There is no assurance that a sufficient market will develop in
our stock, in which case it could be difficult for stockholders to sell their stock. Furthermore, the volatility of our stock
price could negatively impact our ability to raise capital or acquire businesses or technologies.
In
addition to the risks and uncertainties described in this section of this Annual Report, other factors affecting the trading price
and trading volume of our common stock may include:
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adverse
research and development or clinical trial results;
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conducting
open-ended clinical trials which could lead to results (success or setbacks) being obtained by the public prior to a formal
announcement by us;
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our
inability to obtain additional capital;
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announcement
that the FDA denied our request to approve our products for commercialization in the United States, or similar denial by other
regulatory bodies which make independent decisions outside the United States;
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potential
negative market reaction to the terms or volume of any issuance of shares of our stock to new investors or service providers;
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sales
of substantial amounts of our common stock, or the perception that substantial amounts of our common stock will be sold, by
our stockholders in the public market;
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declining
working capital to fund operations, or other signs of apparent financial uncertainty;
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significant
advances made by competitors that adversely affect our potential market position; and
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the
loss of key personnel and the inability to attract and retain additional highly-skilled personnel.
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If
we issue additional shares in the future, our existing stockholders will be diluted.
Our
articles of incorporation authorize the issuance of up to 160,000,000 shares of common stock with a par value of $0.0001 per share.
In addition to capital raising activities, other possible business and financial uses for our authorized common stock include,
without limitation, future stock splits, acquiring other companies, businesses, or products in exchange for shares of common stock,
issuing shares of our common stock to partners in connection with strategic alliances, attracting and retaining employees by the
issuance of additional securities under our various equity compensation plans, or other transactions and corporate purposes that
our Board of Directors deems are in the Company’s best interest. Additionally, shares of common stock could be used for
anti-takeover purposes or to delay or prevent changes in control or management of the Company. We cannot provide assurances that
any issuances of common stock will be consummated on favorable terms or at all, that they will enhance stockholder value, or that
they will not adversely affect our business or the trading price of our common stock. The issuance of any such shares will reduce
the book value per share and may contribute to a reduction in the market price of the outstanding shares of our common stock.
If we issue any such additional shares, such issuance will reduce the proportionate ownership and voting power of all current
stockholders. Further, such issuance may result in a change of control of our company.
Sales
of common stock by our stockholders, or the perception that such sales may occur, could depress our stock price.
The
market price of our common stock could decline as a result of sales by, or the perceived possibility of sales by, our existing
stockholders. Since March 2011, we have completed a number of offerings of our common stock and warrants. Future sales of common
stock by significant stockholders, including by those who acquired their shares in our prior offerings or who are affiliates,
or the perception that such sales may occur, could depress the price of our common stock.
If
outstanding options and warrants to purchase shares of our common stock are exercised or outstanding restricted stock units vest
or settle, the interests of our stockholders could be diluted.
Subsequent
to July 31, 2016 through the date of filing this Report, we have issued an aggregate of 1,105,593 shares of our common stock
related to the exercise of warrants. In addition, we have outstanding (i) options to purchase 3,507,671 shares of common stock,
(ii) warrants to purchase 11,903,693 shares of our common stock, including Series B Warrants to purchase 3,339,000 shares of common
stock at an exercise price of $0.01 per share, and (iii) 655,000 restricted stock units. In addition, we have as of October 7,
2016, 18,908 shares reserved for future issuance under our 2011 Stock Incentive Plan and 482,211 shares have been reserved for
future issuance under our 2015 Employee Stock Purchase Plan. The exercise of options and warrants, the vesting and settlement
of restricted stock units, the issuance of additional shares of common stock or other awards under our 2011 Stock Incentive Plan
and the sale of any resulting shares of our common stock in connection with the foregoing, could have an adverse effect on the
market for our common stock, including the price that an investor could obtain for their shares. Investors may experience dilution
in the net tangible book value of their investment upon the exercise of outstanding options and warrants or the vesting of restricted
stock units granted under our stock option plans, and options,restricted stock units and warrants that may be granted or issued
in the future. In addition, in future periods, we may elect to reduce the exercise price of outstanding warrants as a means of
providing additional financing to us.
If
our common stock is delisted from The Nasdaq Capital Market or we are found noncompliant with Nasdaq regulations, our stock’s
market price and liquidity could be negatively impacted.
Our
listing on The Nasdaq Capital Market (“NASDAQ”) is contingent upon our meeting all the continued listing requirements.
If we are found noncompliant by NASDAQ, or if our common stock is delisted from NASDAQ, our stock price could be negatively impacted,
our stock’s liquidity could be reduced, and our ability to raise capital in the future may be limited.