UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 6-K
REPORT OF FOREIGN PRIVATE ISSUER PURSUANT TO
RULE 13a-16 OR 15d-16
UNDER THE SECURITIES EXCHANGE ACT OF 1934
For the month of June 2024
Commission File Number 001-40996
MDXHEALTH SA
(Translation of registrant’s name into English)
CAP Business Center
Zone Industrielle des Hauts-Sarts
4040 Herstal, Belgium
+32 4 257 70 21
(Address of principal executive office)
Indicate by check mark whether the registrant
files or will file annual reports under cover of Form 20-F or Form 40-F.
Form 20-F ☒ Form
40-F ☐
MDXHEALTH SA
MDxHealth SA (the “Company”) held
an extraordinary general shareholders’ meeting (“EGM”) on Thursday, June 20, 2024. The items on the agenda of the EGM
included (i) the approval of a new 2024 Share Option Plan and the issuance 2,000,000 share options thereunder, (ii) the approval of the
issuance of 1,000,000 new subscription rights for ordinary shares of the Company for the benefit of a subsidiary of Exact Sciences Corporation,
and (iii) the approval of the issuance of 1,243,060 new subscription rights for ordinary shares of the Company for the benefit of OrbiMed
Royalty & Credit Opportunities IV, LP and OrbiMed Royalty & Credit Opportunities IV Offshore, LP (the “OrbiMed Warrants”).
There was no attendance quorum for the EGM, and the proposed resolutions that were submitted to the meeting were all duly passed.
In connection with the issuance of the OrbiMed
Warrants, the Company entered into a Registration Rights Agreement with OrbiMed Royalty & Credit Opportunities IV, LP and OrbiMed
Royalty & Credit Opportunities IV Offshore, LP, dated June 20, 2024 (the “Registration Rights Agreement”). Pursuant
to the Registration Rights Agreement, the Company agreed to file a registration statement with the U.S. Securities and Exchange Commission
(the “SEC”) within 10 business days of the issuance of the OrbiMed Warrants for purposes of registering the resale of the
ordinary shares of the Company issuable upon exercise of the OrbiMed Warrants, to use its reasonable best efforts to have such registration
statement declared effective within the time period set forth in the Registration Rights Agreement, and to keep such registration statement
effective for the duration specified in the Registration Rights Agreement.
Information Incorporated by Reference
This Report on Form 6-K, including Exhibit 1.1,
shall be deemed to be incorporated by reference into the registration statement on Form F-3 (Registration No. 333-268885) and
to be a part thereof from the date on which this report is filed, to the extent not superseded by documents or reports subsequently filed
or furnished.
SIGNATURES
Pursuant to the requirements of the Securities
Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
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MDXHEALTH SA |
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Date: June 20, 2024 |
By: |
/s/ Michael McGarrity |
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Name: |
Michael McGarrity |
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Title: |
Chief Executive Officer |
2
Exhibit 1.1
REGISTRATION RIGHTS AGREEMENT
This Registration Rights Agreement (this “Agreement”)
is made and entered into as of June 20, 2024, by and among MDXHEALTH SA, a public limited liability company organized under the laws of
Belgium, with registered office at Rue d’Abhooz 31, 4040 Herstal (Belgium), registered with the Crossroads Bank for Enterprises under
company number 0479.292.440 (the “Company”), OrbiMed Royalty & Credit Opportunities IV, LP, a Delaware limited
partnership (“OrbiMed IV”), and OrbiMed Royalty & Credit Opportunities IV Offshore, LP, a Delaware limited partnership
(“OrbiMed IV Offshore”, and together with OrbiMed IV, “Holder”). The Company and the Holder are
referred to each as a “Party” and collectively as the “Parties.” Capitalized terms used and not
otherwise defined herein shall have the respective meanings set forth in the Credit Agreement.
In consideration of the mutual covenants and agreements
set forth herein and for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged by each Party, the
Parties agree as follows:
1. Definitions.
As used in this Agreement, the following terms shall have the respective meanings set forth in this Section 1:
“Affiliate” means, with respect
to any Person, any other Person that, directly or indirectly, Controls or is Controlled by or is under common Control with, such Person;
provided, however, that for purposes of this Agreement, the Holder shall not be deemed an Affiliate of the Company or any
of its Subsidiaries. “Affiliates” has a correlative meaning.
“Business Day” means any day
that is not a Saturday, a Sunday or other day on which banks are required or authorized by law to remain closed for the entirety of such
day in New York, New York or Brussels, Belgium.
“Commission” means the U.S.
Securities and Exchange Commission or any other federal agency then administering the Securities Act or Exchange Act.
“Company Common Stock” means
the ordinary shares, no par value per share, of the Company.
“Company Indemnified Persons”
has the meaning set forth in Section 5(a).
“Control” means, with respect
to any Person, the possession, directly or indirectly, of the power to direct or cause the direction of the management policies of such
Person, whether through the ownership of voting securities, by contract or otherwise. “Controlled” has a correlative meaning.
“Credit Agreement” means that
certain Credit Agreement, dated May 1, 2024, by and among MDxHealth, Inc., a Delaware corporation, as borrower, the Company, the lenders
party thereto, and ORC SPV LLC, as administrative agent for the lenders, as may be amended, restated, supplemented or otherwise modified
from time to time.
“Exchange Act” means the Securities
Exchange Act of 1934.
“FINRA” means the Financial
Industry Regulatory Authority.
“Form F-1 Shelf” has the meaning
set forth in Section 2(a).
“Form F-3 Shelf” has the meaning
set forth in Section 2(a).
“Holder” has the meaning set
forth in the preamble.
“Holder Indemnified Persons”
has the meaning set forth in Section 5(b).
“Indemnified Persons” has the
meaning set forth in Section 5(b).
“Losses” has the meaning set
forth in Section 5(a).
“Parties” has the meaning set
forth in the preamble.
“Person” means any individual,
partnership, corporation, company, association, trust, limited liability company, organization, entity or division, or any government,
governmental department or agency or political subdivision thereof.
“Proceeding” means any action,
claim, suit, proceeding or investigation (including a preliminary investigation or partial proceeding, such as a deposition) pending or
known to the Company to be threatened.
“Prospectus” means the prospectus
included in a Registration Statement (including a prospectus that includes any information previously omitted from a prospectus filed
as part of an effective Registration Statement in reliance upon Rule 430A), all amendments and supplements to the Prospectus, including
post-effective amendments, and all information incorporated by reference or deemed to be incorporated by reference in such Prospectus.
“Registrable Securities” means
(a) any Company Common Stock issuable to the Holder upon exercise of the Warrant, (b) any securities issued or issuable with respect to,
on account of or in exchange for Company Common Stock described in clause (a), whether by stock split, stock dividend, recapitalization,
merger, consolidation or other reorganization, charter amendment or otherwise, and (c) any options, warrants or other rights to acquire,
and any securities received as a dividend or distribution in respect of, any of the securities described in clauses (a) and (b) above,
in each case that are held by the Holder and its Affiliates or any transferee or assignee of the Holder or its Affiliates, all of which
securities are subject to the rights provided herein until such rights terminate pursuant to the provisions of this Agreement. As to any
particular Registrable Securities, such securities shall not be Registrable Securities when (i) a Registration Statement registering such
Registrable Securities under the Securities Act has been declared effective and such Registrable Securities have been sold, transferred
or otherwise disposed of by the Holder thereof pursuant to such effective Registration Statement, (ii) such Registrable Securities are
sold, transferred or otherwise disposed of pursuant to Rule 144, (iii) such securities cease to be outstanding or (iv) such securities
have become eligible for sale by the Holder pursuant to Rule 144 without any restriction on the volume or manner of such sale and all
restrictive legends and stop transfer instructions have been removed with respect to all book entries representing the applicable Registrable
Securities.
“Registration Expenses” means
all expenses incurred by the Company in complying with this Agreement, including, without limitation, all registration, qualification
and filing fees, printing expenses, escrow fees, fees and expenses of counsel for the Company and reasonable and documented fees and expenses
of one counsel for the Holder, blue sky fees and expenses and the expense of any special audits incident to or required by any such registration.
“Registration Statement” means
a registration statement of the Company filed with or to be filed with the Commission under the Securities Act that covers the resale
of any of the Registrable Securities pursuant to the provisions of this Agreement, and including any Prospectus, amendments and supplements
to each such registration statement or Prospectus, including pre- and post-effective amendments, all exhibits thereto, and all information
incorporated by reference or deemed to be incorporated by reference in such registration statement.
“Related Person” has the meaning
set forth in Section 8(m).
“Representatives” of the Holder
means its partners, shareholders, members, directors, officers, employees, agents, counsel, accountants, consultants, investment advisers
or other professionals or representatives, or its affiliates or wholly owned subsidiaries.
“Rule 144” means Rule 144 promulgated
by the Commission pursuant to the Securities Act.
“Rule 405” means Rule 405 promulgated
by the Commission pursuant to the Securities Act.
“Rule 415” means Rule 415 promulgated
by the Commission pursuant to the Securities Act.
“Rule 424” means Rule 424 promulgated
by the Commission pursuant to the Securities Act.
“Rule 430A” means Rule 430A
promulgated by the Commission pursuant to the Securities Act.
“Seasoned Issuer” means an issuer
eligible to use Form F-3 under the Securities Act and who is not an “ineligible issuer” as defined in Rule 405.
“Securities Act” means the Securities
Act of 1933.
“Shelf Period” has the meaning
set forth in Section 2(a).
“Shelf Registration” means the
registration of an offering of Registrable Securities on a Form F-1 Shelf or a Form F-3 Shelf, as applicable, on a delayed or continuous
basis under Rule 415, pursuant to Section 2(a).
“Shelf Registration Statement”
has the meaning set forth in Section 2(a).
“Subsidiary” means, when used
with respect to any Person, any corporation or other entity, whether incorporated or unincorporated, of which (a) such Person or any other
Subsidiary of such Person is a general partner (excluding partnerships if the general partnership interests of which held by such Person
or any Subsidiary of such Person do not have a majority of the voting interests in such partnership) or (b) at least a majority of the
securities or other interests that have voting power to elect a majority of the board of directors or others performing similar functions
with respect to such corporation or other entity is directly or indirectly owned or controlled by such Person or by any one or more of
its Subsidiaries, or by such Person and one or more of its Subsidiaries.
“Suspension Period” has the
meaning set forth in Section 2(b).
“Trading Market” means the principal
national securities exchange in the United States on which the Company Common Stock is listed.
“Warrant” means the Warrants
Terms and Conditions, dated June 20, 2024, issued by the Company.
Unless the context requires otherwise: (a) any
pronoun used in this Agreement shall include the corresponding masculine, feminine or neuter forms; (b) references to Sections, paragraphs
and clauses refer to Sections, paragraphs and clauses of this Agreement; (c) the terms “include,” “includes,”
“including” or words of like import shall be deemed to be followed by the words “without limitation”; (d) the
terms “hereof,” “herein” or “hereunder” refer to this Agreement as a whole and not to any particular
provision of this Agreement; (e) unless the context otherwise requires, the term “or” is not exclusive and shall have the
inclusive meaning of “and/or”; (f) defined terms herein will apply equally to both the singular and plural forms and derivative
forms of defined terms will have correlative meanings; (g) references to any law or statute shall be deemed to refer to such law or statute
as amended or supplemented from time to time and shall include all rules and regulations and forms promulgated thereunder, and references
to any law, rule, form or statute shall be construed as including any legal and statutory provisions, rules or forms consolidating, amending,
succeeding, replacing or having substantially the same effect as the applicable law, rule, form or statute; (h) references to any Person
include such Person’s successors and permitted assigns; and (i) references to “days” are to calendar days unless otherwise
indicated. Each of the Parties hereto acknowledges that each Party was actively involved in the negotiation and drafting of this Agreement
and that no law or rule of construction shall be raised or used in which the provisions of this Agreement shall be construed in favor
or against any Party hereto because one is deemed to be the author thereof.
2. Registration.
(a) Shelf
Registration. No later than ten (10) Business Days after the date the Company’s shareholders approve the issuance of the Warrant,
the Company shall file a Registration Statement for a Shelf Registration covering the resale of any Registrable Securities with the Commission
for an offering to be made on a continuous basis pursuant to Rule 415, or if Rule 415 is not available for offers and sales of the Registrable
Securities, by such other means of distribution of Registrable Securities as the Holder may reasonably specify (the “Initial
Registration Statement”). The Initial Registration Statement shall be on Form F-3 (or any successor to Form F-3) covering the
resale of all of the Registrable Securities held by the Holder (the “Form F-3 Shelf”), or if the Company is not a Seasoned
Issuer at the time of filing, the Company shall file a Registration Statement for a Shelf Registration on Form F-1 (or any successor to
Form F-1) (the “Form F-1 Shelf” and, together with the Form F-3 Shelf, the “Shelf Registration Statement”).
Subject to the terms of this Agreement, including any applicable Suspension Period, the Company shall cause the Shelf Registration Statement
to be declared effective under the Securities Act as promptly as possible after the filing thereof, but in any event (x) no later than
the tenth (10th) Business Day following the filing of the Shelf Registration Statement in the event of no “review” by the
Commission and (y) no later than the seventy-fifth (75th) day following the filing of the Shelf Registration Statement in the event that
the Commission reviews the Shelf Registration Statement (the number of days in (x) and (y) each being a “Review Period”),
depending on the nature of the Commission’s review, and shall use its reasonable best efforts to keep such Shelf Registration Statement
continuously effective under the Securities Act until the date that all Registrable Securities covered by such Registration Statement
are no longer Registrable Securities (the period during which the Company shall use its reasonable best efforts to keep the Shelf Registration
Statement continuously effective, the “Shelf Period”). The Company shall notify the Holder by email with electronic
confirmation of the effectiveness of the Shelf Registration Statement as promptly as practicable, and in any event within twenty-four
(24) hours, after the Company telephonically or otherwise confirms effectiveness with the Commission. The Company shall file a final Prospectus
with the Commission to the extent required by Rule 424. The “Plan of Distribution” section of such Shelf Registration Statement
shall provide for all permitted means of disposition of Registrable Securities, including firm-commitment underwritten public offerings,
agented transactions, sales directly into the market, purchases or sales by brokers and sales not involving a public offering. Notwithstanding
anything to the contrary contained herein, in the event the Commission informs the Company that all of the Registrable Securities cannot,
as a result of the application of Rule 415, be registered for resale as a secondary offering on a single registration statement, the Company
agrees to promptly (A) inform the Holder, (B) file amendments to the Initial Registration Statement as required by the Commission or (C)
withdraw the Initial Registration Statement and file a new Registration Statement (a “New Registration Statement”),
in either case of clause (B) or (C) covering the maximum number of Registrable Securities permitted to be registered by the Commission,
on Form F-3 or, if the Company is ineligible to register for resale the Registrable Securities on Form F-3, such other form available
to register for resale the Registrable Securities as a secondary offering; provided, however, that prior to filing such
amendment or New Registration Statement, the Company shall be obligated to use its reasonable efforts to advocate with the Commission
for the registration of all of the Registrable Securities. In the event the Company amends the Initial Registration Statement or files
a New Registration Statement, as the case may be, under clauses (B) or (C) above, the Company will use its reasonable efforts to file
with the Commission, as promptly as allowed by the Commission, one or more Registration Statements on Form F-3 or, if the Company is ineligible
to register for resale the Registrable Securities on Form F-3, such other form available to register for resale those Registrable Securities
that were not registered for resale on the Initial Registration Statement, as amended, or the New Registration Statement.
(b) Suspension
Period. Notwithstanding any other provision of this Section 2, the Company shall have the right, but not the obligation, to
defer the filing of (but not the preparation of), or suspend the use by the Holder of, any Registration Statement for the shortest period
possible, in no event to exceed thirty (30) days (i) upon issuance by the Commission of a stop order suspending the effectiveness of such
Registration Statement with respect to Registrable Securities or the initiation of proceedings with respect to such Registration Statement
under Section 9(d) or 8(e) of the Securities Act or (ii) if the Company believes in good faith that any such registration or offering
would require the Company (after consultation with external legal counsel), under applicable securities or other laws, to make disclosure
of material nonpublic information that would not otherwise be required to be disclosed at that time and that would be materially adverse
to the Company (any such period, a “Suspension Period”); provided, that in no event shall the Company declare
Suspension Periods lasting more than sixty (60) days in the aggregate in any twelve (12) month period. The Company shall (A) give prompt
written notice to the Holder of its declaration of a Suspension Period and of the expiration or termination of the relevant Suspension
Period and (B) promptly resume the process of filing or requesting for effectiveness, or update the suspended Registration Statement,
as the case may be, as may be necessary to permit the Holder to offer and sell its Registrable Securities in accordance with applicable
law.
(c) Required
Information. The Company may require the Holder of Registrable Securities as to which any Registration Statement is being filed or
sale is being effected to furnish to the Company such information regarding the intended method of distribution of such securities and
such other information relating to the Holder and its ownership of Registrable Securities as the Company may reasonably request in writing
(provided that such information shall be used only in connection with such registration). The Holder agrees to furnish such information
to the Company and to cooperate with the Company as reasonably necessary to enable the Company to comply with the provisions of this Agreement.
(d) Cessation
of Registration Rights. All registration rights granted under this Section 2 shall continue to be applicable with respect to
the Holder until the Holder no longer holds any Registrable Securities.
3. Registration
Procedures. The procedures to be followed by the Company and the Holder to register the sale of Registrable Securities pursuant
to a Registration Statement in accordance with this Agreement, and the respective rights and obligations of the Company and the Holder
with respect to the preparation, filing and effectiveness of such Registration Statement, are as follows:
(a) The
Company shall (i) prepare and file a Registration Statement with the Commission (within the time period specified in Section 2(a))
which Registration Statement (A) shall be on a form required by this Agreement (or if not so required, selected by the Company) for which
the Company qualifies, (B) shall be available for the sale of the Registrable Securities in accordance with the intended method or methods
of distribution, and (C) shall comply as to form in all material respects with the requirements of the applicable form and include or
incorporate by reference all financial statements required by the Commission to be filed therewith, (ii) use its reasonable best efforts
to cause such Registration Statement to become effective and remain effective for the period provided under Section 2(a), (iii)
use its reasonable best efforts to prevent the occurrence of any event that would cause a Registration Statement to contain a material
misstatement or omission or to be not effective and usable for resale of the Registrable Securities registered pursuant thereto (during
the period that such Registration Statement is required to be effective as provided under Section 2(a)), and (iv) cause each Registration
Statement and the related Prospectus and any amendment or supplement thereto, as of the effective date of such Registration Statement,
amendment or supplement, (x) to comply in all material respects with any requirements of the Securities Act and the rules and regulations
of the Commission and (y) not to contain any untrue statement of a material fact or omit to state a material fact required to be stated
therein or necessary to make the statements therein not misleading (provided, however, the Company shall have no liability
for any information furnished in writing by or on behalf of the Holder to the Company specifically for inclusion in any such Registration
Statement that has not been corrected in a subsequent writing to the Company prior to the filing or other disclosure of such information).
The Company will, (1) at least three (3) Business Days prior to the anticipated filing of a Registration Statement or any related Prospectus
or any amendment or supplement thereto (including any documents incorporated by reference therein), furnish to the Holder and its counsel
copies of all such documents proposed to be filed and make such representatives of the Company as shall be reasonably requested by the
Holder available for discussion of such documents, (2) use its reasonable best efforts to address in each such document prior to being
so filed with the Commission such comments as the Holder or its counsel reasonably shall propose within two (2) Business Days of receipt
of such copies by the Holder and (3) not file any Registration Statement or any related Prospectus or any amendment or supplement thereto
containing information regarding the Holder to which the Holder objects, unless such information is required to comply with any applicable
law or regulation.
(b) The
Company will as promptly as reasonably practicable (i) prepare and file with the Commission such amendments, including post-effective
amendments, and supplements to each Registration Statement and the Prospectus used in connection therewith as (A) may be reasonably requested
by the Holder of Registrable Securities covered by such Registration Statement necessary to permit the Holder to sell in accordance with
its intended method of distribution, including as may be required in connection with any underwritten distribution of Registrable Securities
or (B) may be necessary under applicable law to keep such Registration Statement continuously effective with respect to the disposition
of all Registrable Securities covered thereby for the period provided under Section 2(a) in accordance with the intended method
of distribution and, subject to the limitations contained in this Agreement, prepare and file with the Commission such additional Registration
Statements in order to register for resale under the Securities Act all of the Registrable Securities held by the Holder, (ii) cause the
related Prospectus to be amended or supplemented by any required prospectus supplement, and as so supplemented or amended, to be filed
pursuant to Rule 424, (iii) respond to any comments received from the Commission with respect to each Registration Statement or Prospectus
or any amendment thereto, (iv) as promptly as reasonably practicable, provide the Holder true and complete copies of all correspondence
from and to the Commission relating to such Registration Statement or Prospectus other than any comments that the Company determines in
good faith would result in the disclosure to the Holder of material non-public information concerning the Company that is not already
in the possession of the Holder and (v) enter into such customary agreements (including, as applicable, underwriting agreements in customary
form) and take all such other actions as the Holder or the underwriters, if any, reasonably request in order to expedite or facilitate
the disposition of Registrable Securities under such Registration Statement or Prospectus and otherwise to facilitate, cooperate with
and participate in each proposed offering contemplated herein and customary selling efforts related thereto. The Company will comply in
all material respects with the provisions of the Securities Act and the Exchange Act (including Regulation M under the Exchange Act) with
respect to each Registration Statement and the disposition of all Registrable Securities covered by each Registration Statement.
(c) The
Company will notify the Holder as promptly as practicable: (i)(A) when a Registration Statement, any pre-effective amendment, any Prospectus
or any prospectus supplement or post-effective amendment to a Registration Statement is proposed to be filed; (B) when the Commission
notifies the Company whether there will be a “review” of such Registration Statement and whenever the Commission comments
on such Registration Statement (in which case the Company shall provide true and complete copies thereof and all written responses thereto
to the Holder and its counsel, other than information which the Company determines in good faith would constitute material non-public
information that is not already in the possession of the Holder); and (C) with respect to each Registration Statement or any post-effective
amendment thereto, when the same has been declared effective; (ii) of any request by the Commission or any other federal or state governmental
or regulatory authority for amendments or supplements to a Registration Statement or Prospectus or for additional information (whether
before or after the effective date of the Registration Statement) or any other correspondence with the Commission or any such authority
relating to, or which may affect, the Registration Statement; (iii) of the issuance by the Commission or any other governmental or regulatory
authority of any stop order, injunction or other order or requirement suspending the effectiveness of a Registration Statement covering
any or all of the Registrable Securities or preventing or suspending the use of any Prospectus or the initiation or threatening of any
Proceedings for such purpose; (iv) of the receipt by the Company of any notification with respect to the suspension of the qualification
or exemption from qualification of any of the Registrable Securities for sale in any jurisdiction, or the initiation or threatening of
any Proceeding for such purpose; or (v) of the occurrence of any event that makes any statement made in such Registration Statement or
Prospectus or any document incorporated or deemed to be incorporated therein by reference untrue in any material respect or if, as a result
of such event or the passage of time, such Registration Statement, Prospectus or other documents requires revisions so that, in the case
of such Registration Statement or the Prospectus, as the case may be, it will not contain any untrue statement of a material fact or omit
to state any material fact required to be stated therein or necessary to make the statements therein (in the case of the Prospectus, in
light of the circumstances under which they were made) not misleading, or if, for any other reason, it shall be necessary during such
time period to amend or supplement such Registration Statement or Prospectus in order to comply with the Securities Act, which shall correct
such misstatement or omission or effect such compliance.
(d) The
Company will use its reasonable best efforts to avoid the issuance of, or, if issued, obtain the withdrawal of (i) any stop order or other
order suspending the effectiveness of a Registration Statement, or preventing or suspending the use of any Prospectus, or (ii) any suspension
of the qualification (or exemption from qualification) of any of the Registrable Securities for sale in any jurisdiction, as promptly
as practicable, or if any such order or suspension is made effective during any Suspension Period, as promptly as practicable after the
Suspension Period is over.
(e) During
the Shelf Period, upon request of the Holder and without charge, the Company shall furnish to the Holder and its counsel, (i) promptly
after the same is prepared and filed with the Commission, at least one copy of the Registration Statement and any amendment thereto, including
all documents incorporated therein by reference and all exhibits to the extent requested by the Holder or its counsel, (ii) upon the effectiveness
of any amendment to a Registration Statement, a copy of the prospectus included in such Registration Statement and all amendments and
supplements thereto (or such other number of copies as the Holder may reasonably request) and (iii) such other documents, including copies
of any preliminary or final prospectus, as the Holder may reasonably request from time to time in order to facilitate the disposition
of the Registrable Securities owned by the Holder.
(f) The
Company will promptly deliver to the Holder and its counsel as many copies of each Prospectus (including each form of prospectus) and
each amendment or supplement thereto as the Holder or its counsel may reasonably request in order to facilitate the disposition of the
Registrable Securities by the Holder. The Company hereby consents to the use of such Prospectus and each amendment or supplement thereto
by the Holder in connection with the offering and sale of the Registrable Securities covered by such Prospectus and any amendment or supplement
thereto, so long as the same are used in compliance with the Securities Act and all other applicable laws and regulations.
(g) To
the extent that the Company has certificated shares of Company Common Stock, the Company will cooperate with the Holder to facilitate
the timely preparation and delivery of certificates representing Registrable Securities to be delivered to a transferee pursuant to a
Registration Statement, which certificates shall be free of all restrictive legends indicating that the Registrable Securities are unregistered
or unqualified for resale under the Securities Act, Exchange Act or other applicable securities laws, and to enable such Registrable Securities
to be in such denominations and registered in such names as the Holder may request in writing. In connection therewith, if required by
the Company’s transfer agent, the Company will promptly, after the effective date of the Registration Statement, cause an opinion
of counsel as to the effectiveness of the Registration Statement to be delivered to and maintained with such transfer agent, together
with any other authorizations, certificates and directions required by the transfer agent which authorize and direct the transfer agent
to issue such Registrable Securities without any such legend upon sale by the Holder of such Registrable Securities pursuant to the Registration
Statement.
(h) Upon
the occurrence of any event contemplated by Section 3(c)(v), as promptly as practicable, the Company will prepare a supplement
or amendment, including a post-effective amendment, if required by applicable law, to the affected Registration Statement or a supplement
to the related Prospectus or any document incorporated or deemed to be incorporated therein by reference, and file any other required
document so that, as thereafter delivered, no Registration Statement nor any Prospectus will contain an untrue statement of a material
fact or omit to state a material fact required to be stated therein or necessary to make the statements therein (in the case of a Prospectus,
in light of the circumstances under which they were made) not misleading, such that the Holder can resume disposition of such Registrable
Securities covered by such Registration Statement or Prospectus.
(i) The
Company will comply with all applicable rules and regulations of the Commission, the Trading Market and FINRA.
(j) The
Holder agrees by its acquisition of Registrable Securities that, upon receipt of a notice from the Company of the occurrence of any event
of the kind described in clauses (ii) through (v) of Section 3(c) or the occurrence of a Suspension Period, the Holder will promptly
discontinue disposition of such Registrable Securities under the applicable Registration Statement until the Holder receives copies of
the supplemental Prospectus or amended Registration Statement or is advised in writing by the Company that the use of the applicable Prospectus
may be resumed, and, in either case, has received copies of any additional or supplemental filings that are incorporated or deemed to
be incorporated by reference in such Prospectus or Registration Statement. If the Company gives any such notice, the period during which
the applicable Registration Statement is required to be maintained effective shall be extended by the number of days during the period
from and including the date of the giving of such notice to and including the date when the Holder either receives the copies of the supplemented
Prospectus or amended Registration Statement or is advised in writing by the Company that the use of the Prospectus may be resumed.
4. Registration
Expenses. All Registration Expenses incurred by the Company and the Holder in connection with any registration, qualification,
exemption or compliance pursuant to Section 2 hereof shall be borne by the Company.
5. Indemnification.
(a) To
the fullest extent permitted by law, the Company shall indemnify and hold harmless the Holder, its partners, stockholders, equity holders,
general partners, managers, members and Affiliates and each of their respective officers and directors and any Person who controls the
Holder (within the meaning of the Securities Act or the Exchange Act) and any employee or Representative thereof (each, a “Company
Indemnified Person” and collectively, “Company Indemnified Persons”), from and against any and all losses,
claims, damages, liabilities, joint or several, costs (including reasonable costs of preparation and reasonable attorneys’, accountants’
and experts’ fees) and expenses, judgments, fines, penalties, interest, settlements or other amounts arising from any claims, demands,
actions, suits or proceedings, whether civil, criminal, administrative or investigative, in which any Company Indemnified Person may be
involved, or is threatened to be involved, as a party or otherwise, under the Securities Act, the Exchange Act or otherwise (collectively,
“Losses”), as incurred, arising out of, based upon, resulting from or relating to (i) any untrue or alleged untrue
statement of a material fact contained in any Registration Statement under which any Registrable Securities were registered, Prospectus
(including in any preliminary prospectus, if used prior to the effective date of such Registration Statement), or in any summary or final
prospectus or in any amendment or supplement thereto or in any documents incorporated or deemed incorporated by reference in any of the
foregoing or (ii) any omission or alleged omission to state therein a material fact required to be stated therein or necessary to make
the statements made therein (in the case of the Prospectus, in light of the circumstances under which they were made) not misleading,
or (iii) any violation or alleged violation by the Company or any of its Subsidiaries of the Securities Act, the Exchange Act, any state
securities law or any rule or regulation promulgated under the Securities Act, the Exchange Act or any federal, state, foreign or common
law rule or regulation in connection with such Registration Statement, disclosure document or related document or report or any offering
covered by such Registration Statement, and the Company shall reimburse such Company Indemnified Person for any reasonable legal or other
expenses reasonably incurred by it in connection with investigating or defending any such Loss, claim, damage, liability, demand, action,
suit or proceeding (the matters in the foregoing clauses (i) through (iii) being, collectively, “Company Violations”).
Notwithstanding anything to the contrary contained herein, the indemnification agreement contained in this Section 5(a): (A) shall
not apply to a Loss by a Company Indemnified Person arising out of or based upon a Company Violation which occurs in reliance upon and
in conformity with information furnished in writing to the Company by the Holder or such Company Indemnified Person expressly for use
in connection with the preparation of such Registration Statement, such preliminary, summary or final prospectus or such amendment or
supplement, or other disclosure document; (B) with respect to any superseded prospectus, shall not inure to the benefit of any such person
from whom the person asserting any such Loss purchased the Registrable Securities that are the subject thereof (or to the benefit of any
other Company Indemnified Person) if the untrue statement or omission of material fact contained in the superseded prospectus was corrected
in the revised prospectus, as then amended or supplemented, if such revised prospectus was timely made available by the Company pursuant
to Section 3(f), and the Company Indemnified Person was promptly advised in writing not to use the incorrect prospectus prior to
the use giving rise to a violation; (C) shall not be available to the extent such Loss is based on a failure of the Holder to deliver,
or to cause to be delivered, the prospectus made available by the Company, if such prospectus was theretofore made available by the Company
pursuant to Section 3(f); and (D) shall not apply to amounts paid in settlement of any Loss if such settlement is effected without
the prior written consent of the Company, which consent shall not be unreasonably withheld, conditioned or delayed.
(b) In
connection with any Registration Statement filed by the Company pursuant to Section 2(a) hereof in which the Holder has registered
for sale its Registrable Securities, the Holder agrees to indemnify and hold harmless, to the fullest extent permitted by law, the Company,
its directors and officers, employees, agents and each Person who controls the Company (within the meaning of the Securities Act or the
Exchange Act) (collectively, “Holder Indemnified Persons,” and together with the Company Indemnified Persons, each
an “Indemnified Person,” and collectively, the “Indemnified Persons”) from and against any Losses
resulting from (i) any untrue or alleged untrue statement of a material fact contained in any Registration Statement under which such
Registrable Securities were registered or sold under the Securities Act, Prospectus (including in any preliminary prospectus (if used
prior to the effective date of such Registration Statement)), or in any summary or final prospectus or in any amendment or supplement
thereto or in any documents incorporated by reference in any of the foregoing, (ii) any omission or alleged omission to state therein
a material fact required to be stated therein or necessary to make the statements therein (in the case of the Prospectus, in light of
the circumstances under which they were made) not misleading, or (iii) any violation or alleged violation by the Holder of any federal,
state or common law rule or regulation relating to action or inaction in connection with any information provided by the Holder in such
registration, disclosure document or related document or report in the case of clauses (i) and (ii) to the extent, but only to the extent,
that such untrue statement or omission occurs in reliance upon and in conformity with any information furnished in writing by or on behalf
of the Holder specifically for inclusion in such registration, disclosure document or related document or report and has not been corrected
in a subsequent writing prior to the sale of the Registrable Securities thereunder, and the Holder will reimburse the Company for any
legal or other expenses reasonably incurred by it in connection with investigating or defending such Losses. In no event shall the liability
of the Holder hereunder be greater in amount than the dollar amount of the net proceeds (after deducting any underwriters’ discounts
and commissions) received by the Holder under the sale of Registrable Securities giving rise to such indemnification obligation.
(c) Any
Indemnified Person under paragraph (a) or (b) of this Section 5 shall (i) give prompt written notice to the indemnifying person
under paragraph (a) or (b) of this Section 5 of any claim with respect to which it seeks indemnification (provided that
any delay or failure to so notify the indemnifying person shall not relieve the indemnifying party of its obligations hereunder except
to the extent, if at all, that the indemnifying person’s ability to defend such claim (through the forfeiture of substantive rights
or defenses) is actually and materially prejudiced by reason of such delay or failure) and (ii) permit such indemnifying person to assume
the defense of such claim with counsel reasonably satisfactory to the Indemnified Person; provided, however, that any Indemnified
Person shall have the right to select and employ separate counsel and to participate in the defense of such claim, but the fees and expenses
of such counsel shall be at the expense of such Indemnified Person unless (A) the indemnifying person has agreed in writing to pay such
fees or expenses, (B) the Indemnified Person has reasonably concluded (based upon advice of its counsel) that there may be legal defenses
available to it or other Indemnified Persons that are different from or in addition to those available to the indemnifying person, or
(C) in the reasonable judgment of any such Indemnified Person (based upon advice of its counsel) a conflict of interest may exist between
such Indemnified Person and the indemnifying person with respect to such claims (in which case, if the Indemnified Person notifies the
indemnifying person in writing that such Indemnified Person elects to employ separate counsel at the expense of the indemnifying person,
the indemnifying person shall not have the right to assume the defense of such claim on behalf of such Indemnified Person). If any action
is settled or if there be a final judgment for the plaintiff, the indemnifying person agrees to indemnify each Indemnified Person from
and against any Losses by reason of such settlement or judgment. No action may be settled without the written consent of the Indemnified
Person, provided that the consent of the Indemnified Person shall not be required if (x) such settlement includes an unconditional
release of such Indemnified Person in form and substance satisfactory to such Indemnified Person from all liability on the claims that
are the subject matter of such settlement; (y) such settlement provides solely for the payment by the indemnifying person of money as
the sole relief for such action and (z) such settlement does not include any statement as to or any admission of fault, culpability or
a failure to act by or on behalf of any Indemnified Person. It is understood that the indemnifying person or persons shall not, except
as specifically set forth in this Section 5(c), in connection with any proceeding or related proceedings in the same jurisdiction,
be liable for the reasonable fees, disbursements or other charges of more than one separate firm (in addition to any local counsel that
is required to effectively defend against any such proceeding) for all Indemnified Persons and that all such fees and expenses shall be
paid or reimbursed promptly.
(d) If
the indemnification provided for in this Section 5 is held by a court of a competent jurisdiction to be unavailable to an Indemnified
Person with respect to any loss, damage, claim or liability, the indemnifying party, in lieu of indemnifying such Indemnified Person thereunder,
shall to the extent permitted by law, contribute to the amount paid or payable by such Indemnified Person as a result of such loss, damage,
claim or liability in such proportion as is appropriate to reflect the relative fault of the indemnifying party on the one hand and of
the Indemnified Person on the other in connection with the actions that resulted in such loss, claim, damage or liability, as well as
any other relevant equitable considerations. The relative fault of the indemnifying person and of the Indemnified Person shall be determined
by a court of law by reference to, among other things, whether the untrue or alleged untrue statement of a material fact or the omission
to state a material fact relates to information supplied by the indemnifying person or Indemnified Person and the parties’ relative
intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. The Parties agree that it would
not be just and equitable if contribution pursuant to this Section 5(d) were determined by pro rata allocation or by any other
method of allocation that does not take account of the equitable considerations referred to in the immediately preceding sentences. Notwithstanding
the provisions of this Section 5(d), the Holder shall not be required to contribute any amount in excess of the net proceeds (after
deducting the underwriters’ discounts and commissions) received by the Holder under the sale of Registrable Securities giving rise
to such indemnification obligation. No Person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Securities
Act) shall be entitled to contribution from any Person who was not guilty of such fraudulent misrepresentation.
(e) The
remedies provided for in this Section 5 are not exclusive and shall not limit any rights or remedies which may otherwise be available
to any Indemnified Person at law or in equity. The obligations of the Company and the Holder under this Section 5 shall survive
completion of any offering of Registrable Securities pursuant to a Registration Statement and the termination of this Agreement.
6. Facilitation
of Sales Pursuant to Rule 144. The Company shall timely file the reports required to be filed by it under the Exchange Act or
the Securities Act and the rules adopted by the Commission thereunder (including the reports under Sections 13 and 15(d) of the Exchange
Act referred to in subparagraph (c)(1) of Rule 144), all to the extent required from time to time to enable the Holder to sell Registrable
Securities without registration under the Securities Act within the limitations of the exemption provided by Rule 144. Upon the written
request of the Holder in connection with that Holder’s sale pursuant to Rule 144, the Company shall deliver to the Holder a written
statement as to whether it has complied with such requirements.
7. Registration
Rights Covenant. The Company covenants that it will not, and it will cause its Subsidiaries not to, grant any right of registration
under the Securities Act to any Person other than pursuant to this Agreement, unless the rights so granted to another Person do not limit
or restrict the rights of the Holder hereunder.
8. Miscellaneous.
(a) Remedies.
In the event of a breach by the Company or the Holder of any of its obligations under this Agreement, any Party, in addition to being
entitled to exercise all rights granted by law and under this Agreement, including recovery of damages, will be entitled to specific performance
of its rights under this Agreement. The Parties agree that monetary damages would not provide adequate compensation for any losses incurred
by reason of a breach by the Company of any of the provisions of this Agreement and further agree that, in the event of any action for
specific performance in respect of such breach, the Company shall waive the defense that a remedy at law would be adequate and shall waive
any requirement for the posting of a bond. No failure or delay by any Person in exercising any right, power or privilege hereunder shall
operate as a waiver thereof nor shall any single or partial exercise thereof preclude any other or further exercise thereof or the exercise
of any other right, power or privilege. The rights and remedies herein provided shall be cumulative and not exclusive of any rights or
remedies provided by law.
(b) Amendment;
Modification; Waivers. This Agreement may be amended or waived if, and only if, such amendment or waiver is in writing and signed
by the Company and the Holder, which writing shall specifically reference this Agreement, specify the provision(s) hereof that it is intended
to amend or waive and further specify that it is intended to amend or waive such provision(s).
(c) Notices.
All notices and other communications in connection with this Agreement shall be in writing and shall be deemed given if delivered personally,
sent via email (with confirmation), mailed by registered or certified mail (return receipt requested) or delivered by an express courier
(with confirmation) to the Parties at the following addresses (or at such other address for a Party as may be specified by like notice):
If to the Company:
MDxHealth SA
15279 Alton Parkway, Suite 100
Irvine, CA 92618
United States
Attn: General Counsel
Email: joseph.sollee@mdxhealth.com
with a copy (which shall not constitute notice)
to:
K&L Gates LLP
300 South Tryon Street, Suite 1000
Charlotte, North Carolina 28202
United States
Attention: Mark Busch
Email: Mark.Busch@klgates.com
If to the Holder:
c/o OrbiMed Advisors LLC
601 Lexington Avenue, 54th
Floor
New York, NY 10022
Attention: Matthew Rizzo; Mark Jelley;
OrbiMed Credit Report
Email: RizzoM@OrbiMed.com; JelleyM@OrbiMed.com;
ROSCreditops@orbimed.com
with a copy (which shall not constitute
notice) to:
Covington & Burling LLP
The New York Times Building
620 Eighth Avenue
New York, NY 10018
Attention: Peter Schwartz
E-mail: pschwartz@cov.com
(d) Governing
Law; Jurisdiction; Waiver of Jury Trial. This Agreement shall be governed by, and construed in accordance with, the internal Laws
of the State of New York without giving effect to any choice of Law or conflict of Law provision or rule (whether of the State of New
York or any other jurisdiction) that would cause the application of Laws of any jurisdiction other than the State of New York. In any
action or proceeding between any of the parties arising out of or relating to this Agreement, each of the parties: (a) irrevocably and
unconditionally consents and submits to the exclusive jurisdiction and venue of the federal courts of the United States or the courts
of the State of New York, in each case located in the city and county of New York; (b) agrees that all claims in respect of such action
or proceeding shall be heard and determined exclusively in accordance with clause (a) of this Section 8(d); (c) waives any objection
to laying venue in any such action or proceeding in such courts; (d) waives any objection that such courts are an inconvenient forum or
do not have jurisdiction over any party hereto; and (e) irrevocably and unconditionally waives the right to trial by jury.
(e) Successors
and Assigns. This Agreement shall be binding upon and inure to the benefit of the Parties hereto and their respective heirs, executors,
administrators, successors, legal representatives and permitted assigns. The Holder may not assign its rights under this Agreement without
the prior written consent of the Company.
(f) Waiver
of Venue. The Parties irrevocably and unconditionally waive, to the fullest extent permitted by applicable law, (i) any objection
that they may now or hereafter have to the laying of venue of any action or proceeding arising out of or relating to this Agreement in
any court referred to in Section 8(d) and (ii) the defense of an inconvenient forum to the maintenance of such action or proceeding
in any such court.
(g) Waiver
of Trial by Jury. EACH PARTY ACKNOWLEDGES AND AGREES THAT ANY CONTROVERSY WHICH MAY ARISE UNDER THIS AGREEMENT IS LIKELY TO INVOLVE
COMPLICATED AND DIFFICULT ISSUES, AND THEREFORE EACH SUCH PERSON HEREBY IRREVOCABLY AND UNCONDITIONALLY WAIVES ANY RIGHT SUCH PERSON MAY
HAVE TO A TRIAL BY JURY WITH RESPECT TO ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AGREEMENT. EACH PARTY
CERTIFIES AND ACKNOWLEDGES THAT (i) NO REPRESENTATIVE, AGENT OR ATTORNEY OF THE OTHER PERSON HAS REPRESENTED, EXPRESSLY OR OTHERWISE,
THAT SUCH OTHER PERSON WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER, (ii) SUCH PERSON UNDERSTANDS AND HAS
CONSIDERED THE IMPLICATIONS OF THIS WAIVER, (iii) SUCH PERSON MAKES THIS WAIVER VOLUNTARILY, AND (iv) SUCH PERSON HAS BEEN INDUCED TO
ENTER INTO THIS AGREEMENT AND EACH ANCILLARY AGREEMENT BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION.
(h) Severability.
The provisions of this Agreement shall be deemed severable and the invalidity or unenforceability of any provision hereof shall not affect
the validity or enforceability of any other provision. Whenever possible, each provision or portion of any provision of this Agreement
shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Agreement, or the
application thereof to any Person or any circumstance, is invalid or unenforceable, (i) a suitable and equitable provision shall be substituted
therefor to carry out, so far as may be valid and enforceable, the intent and purpose of such invalid or unenforceable provision and (ii)
the remainder of this Agreement and the application of such provision to other Persons or circumstances shall not be affected by such
invalidity or unenforceability, nor shall such invalidity or unenforceability affect the validity or enforceability of such provision,
or the application thereof, in any other jurisdiction; provided, that, if any one or more of the provisions contained in this Agreement
shall be determined to be excessively broad as to activity, subject, duration or geographic scope, it shall be reformed by limiting and
reducing it to the minimum extent necessary, so as to be enforceable under applicable law.
(i) Business
Days. If the last or appointed day for the taking of any action or the expiration of any right required or granted herein shall be
a day other than a Business Day, then such action may be taken or such right may be exercised on the next succeeding Business Day.
(j) Entire
Agreement. This Agreement constitutes the entire agreement among the Parties with respect to the subject matter hereof and supersedes
all prior contracts or agreements with respect to the subject matter hereof and supersedes any and all prior or contemporaneous discussions,
agreements and understandings, whether oral or written, that may have been made or entered into by or among any of the Parties or any
of their respective Affiliates relating to the transactions contemplated hereby.
(k) Execution
of Agreement. This Agreement may be executed and delivered (by facsimile, email or other means of electronic transmission) in any
number of counterparts, each of which, when executed and delivered, shall be deemed an original, and all of which together shall constitute
the same agreement.
(l) Determination
of Ownership. In determining ownership of Company Common Stock hereunder for any purpose, the Company may rely solely on the records
of the transfer agent for the Company Common Stock from time to time, or, if no such transfer agent exists, the Company’s stock
ledger.
(m) No
Recourse. Notwithstanding anything that may be expressed or implied in this Agreement, each Party covenants, agrees and acknowledges
that no recourse under this Agreement or any documents or instruments delivered in connection with this Agreement shall be had against
any of the Company’s or the Holder’s former, current or future direct or indirect equity holders, controlling persons, stockholders,
directors, officers, employees, agents, Affiliates, members, financing sources, managers, general or limited partners or assignees (each,
a “Related Person” and collectively, the “Related Persons”), in each case other than the Company,
the Holder or any of their respective permitted assigns under this Agreement, whether by the enforcement of any assessment or by any legal
or equitable proceeding, or by virtue of any applicable law, it being expressly agreed and acknowledged that no personal liability whatsoever
shall attach to, be imposed on or otherwise be incurred by any of the Related Persons, as such, for any obligation or liability of the
Company or the Holder under this Agreement or any documents or instruments delivered in connection herewith for any claim based on, in
respect of or by reason of such obligations or liabilities or their creation; provided, however, nothing in this Section
8(m) shall relieve or otherwise limit the liability of the Company or the Holder, as such, for any breach or violation of its obligations
under this Agreement or such agreements, documents or instruments. For the avoidance of doubt, none of the Parties will have any recourse,
be entitled to commence any proceeding or make any claim under this Agreement or in connection with the transactions contemplated hereby
except against any of the Parties or their respective successors and permitted assigns, as applicable.
(n) Third-Party
Beneficiaries. Nothing in this Agreement, express or implied, is intended to confer upon any Person other than a Party and its successors
and permitted assigns any rights, benefits or remedies of any nature whatsoever.
(o) Headings;
Section References; Signatories. All heading references contained in this Agreement are for convenience purposes only and shall not
be deemed to limit or affect any of the provisions of this Agreement.
[Signature Pages Follow]
IN WITNESS WHEREOF, the undersigned Parties have
executed this Agreement as of the date first written above.
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MDXHEALTH SA |
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By: |
/s/ Michael McGarrity |
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Name: |
Michael McGarrity |
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Title: |
CEO |
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ORBIMED ROYALTY & CREDIT
OPPORTUNITIES IV, LP, as a Holder |
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By: |
OrbiMed ROF IV LLC, its General Partner |
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By: |
OrbiMed Advisors LLC, its Managing Member |
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By: |
/s/ Matthew Rizzo |
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Name: |
Matthew Rizzo |
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Title: |
Member |
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ORBIMED ROYALTY & CREDIT
OPPORTUNITIES IV OFFSHORE, LP, as a Holder |
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By: |
OrbiMed ROF IV LLC, its General Partner |
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By: |
OrbiMed Advisors LLC, its Managing Member |
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By: |
/s/ Matthew Rizzo |
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Name: |
Matthew Rizzo |
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Title: |
Member |
[Signature Page to Registration Rights Agreement]
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