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Allakos Inc.

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FY2021 Annual Report · Allakos Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-K

☒

☐

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

(Mark One)

For the fiscal year ended December 31, 2021
OR

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

FOR THE TRANSITION PERIOD FROM                      TO
Commission File Number 001-38582

Allakos Inc. 

(Exact name of Registrant as specified in its Charter)

Delaware
(State or other jurisdiction of
incorporation or organization)
975 Island Drive, Suite 201
Redwood City, California
(Address of principal executive offices)

45-4798831
(I.R.S. Employer
Identification No.)

94065
(Zip Code)

Registrant’s telephone number, including area code: (650) 597-5002

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

Title of Each Class

Common Stock, par value $0.001

Trading Symbol(s)

ALLK

Name of Each Exchange on Which Registered

The Nasdaq Global Select Market

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

Indicate by check mark if the Registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. YES ☐ NO ☒
Indicate by check mark if the Registrant is not required to file reports pursuant to Section 13 or 15(d) of the Act. YES ☐ NO ☒ 
Indicate by check mark whether the Registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for 
such shorter period that the Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. YES ☒ NO ☐ 
Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) 
during the preceding 12 months (or for such shorter period that the Registrant was required to submit such files). YES ☒ NO ☐ 
Indicate  by  check  mark  whether  the  registrant  is  a  large  accelerated  filer,  an  accelerated  filer,  a  non-accelerated  filer,  smaller  reporting  company,  or  an  emerging  growth  company.  See  the 
definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer

Non-accelerated filer

Emerging growth company

  ☒

  ☐

  ☐

Accelerated filer

Smaller reporting company

   ☐

   ☐

If  an  emerging  growth  company,  indicate  by  check  mark  if  the  registrant  has  elected  not  to  use  the  extended  transition  period  for  complying  with  any  new  or  revised  financial  accounting 
standards provided pursuant to Section 13(a) of the Exchange Act.  ☐
Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting under Section 
404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report.  ☒
Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). YES ☐ NO ☒
The aggregate market value of the common stock held by non-affiliates of the Registrant based on the closing price of the Registrant’s Common Stock on the Nasdaq Global Select Market as of 
June 30, 2021 was $3,236.6 million. 
The number of shares of Registrant’s Common Stock outstanding as of February 23, 2022 was 54,691,012. 
Portions of the Registrant’s Definitive Proxy Statement relating to the registrant’s 2022 Annual Meeting of Shareholders are incorporated by reference into Part III of this Annual Report on Form 
10-K  where  indicated.  Such  Definitive  Proxy  Statement  will  be  filed  with  the  Securities  and  Exchange  Commission  within  120  days  after  the  end  of  the  registrant’s  2021  fiscal  year  ended 
December 31, 2021. 

 
 
 
 
 
 
 
 
 
 
  
 
  
   
   
 
PART I
Item 1.
Item 1A.
Item 1B.
Item 2.
Item 3.
Item 4.

PART II
Item 5.
Item 6.
Item 7.
Item 7A.
Item 8.
Item 9.
Item 9A.
Item 9B.
Item 9C.

PART III
Item 10.
Item 11.
Item 12.
Item 13.
Item 14.

PART IV
Item 15.
Item 16.

Table of Contents

Business
Risk Factors
Unresolved Staff Comments
Properties
Legal Proceedings
Mine Safety Disclosures

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
[Reserved]
Management’s Discussion and Analysis of Financial Condition and Results of Operations
Quantitative and Qualitative Disclosures About Market Risk
Financial Statements and Supplementary Data
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Controls and Procedures
Other Information
Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

Directors, Executive Officers and Corporate Governance
Executive Compensation
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Certain Relationships and Related Transactions, and Director Independence
Principal Accounting Fees and Services

Exhibits, Financial Statement Schedules
Form 10-K Summary
Signatures

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Item 1. Business. 

Overview 

PART I

We are a clinical stage biotechnology company developing therapeutics which target immunomodulatory receptors present on immune effector cells 

involved in allergy, inflammatory and proliferative diseases. Activating these immunomodulatory receptors allows us to directly target cells involved in 
disease pathogenesis and, in the setting of allergy and inflammation, has the potential to result in broad inhibition of inflammatory cells. In the setting of 
proliferative diseases, blocking the inhibitory function of the receptors could restore the immune cell’s ability to identify and kill proliferative cells. Our 
most advanced antibodies are lirentelimab (AK002) and AK006. Lirentelimab selectively targets both mast cells and eosinophils, two types of white blood 
cells that are widely distributed in the body and play a central role in the inflammatory response. Inappropriately activated mast cells and eosinophils have 
been identified as key drivers in a number of severe diseases affecting the gastrointestinal tract, eyes, skin, lungs and other organs. We are developing 
lirentelimab for the treatment of eosinophilic esophagitis (“EoE”), eosinophilic gastritis (“EG”), eosinophilic duodenitis (“EoD”), atopic dermatitis, chronic 
spontaneous urticaria and potentially additional indications. Lirentelimab has received orphan disease status for EG, EoD, and EoE from the U.S. Food and 
Drug Administration (the “FDA”). 

AK006 targets Siglec-6, an inhibitory receptor expressed selectively on mast cells. AK006 appears to have the potential to provide deeper mast cell 

inhibition than lirentelimab and, in addition to its inhibitory activity, reduce mast cell numbers. We plan to begin human studies with AK006 in the first half 
of 2023. 

To date, lirentelimab has completed a Phase 2 study (ENIGMA 1) and Phase 3 study (ENIGMA 2) in patients with EG and/or EoD, a Phase 2/3 study 
in patients with EoE (KRYPTOS), as well as proof of concept studies in chronic spontaneous urticaria, severe allergic conjunctivitis, and indolent systemic 
mastocytosis.

The Phase 2 EG and/or EoD study with lirentelimab (ENIGMA 1) met all prespecified primary and secondary endpoints when compared to placebo 

and results were published in The New England Journal of Medicine. More recently, the ENIGMA 2 study met the histologic co-primary endpoint but 
failed to meet the symptomatic co-primary endpoint when compared to placebo. Similarly, the KRYPTOS study met the histologic co-primary endpoint but 
failed to meet the symptomatic co-primary endpoint when compared to placebo. After conducting post-hoc analyses, we believe that the trials missed their 
symptomatic co-primary endpoints due to the inclusion of mild patients and/or patients who had not failed standard of care. Although post-hoc analyses 
cannot be used to establish efficacy, these analyses can be helpful in generating hypothesis for future clinical studies. Based on these analyses, we believe 
that lirentelimab may have potential to treat the more severe EG/EoD and EoE patient populations. As a result, we plan to conduct additional studies with 
lirentelimab in these indications after discussions with the FDA.

EoE is a severe orphan gastrointestinal disease characterized by dysphagia (difficulty swallowing) resulting from inflammation caused by elevated 
and inappropriately activated mast cells and eosinophils. The estimated prevalence of EoE in the United States is approximately 150,000-200,000 patients 
and there are no treatments currently approved specifically for this disease.

EG and/or EoD are chronic, often severe, inflammatory diseases characterized by persistent gastrointestinal symptoms and elevated and activated 

eosinophils in the stomach and/or duodenum, respectively. Emerging data suggests that activated mast cells also contribute to disease pathogenesis. 
Common symptoms of the diseases include abdominal pain, nausea, bloating, cramping, early satiety and loss of appetite. There are no treatments approved 
specifically for these diseases. Treatment with systemic steroids can provide symptomatic improvement, but long-term treatment with steroids is generally 
not possible due to the numerous side effects. Published literature reports the prevalence of EG and EoD in the United States to be approximately 50,000 
people. However, we believe that these diseases may be significantly underdiagnosed or misdiagnosed as other gastrointestinal diseases.

Beyond EoE, EG and EoD, additional lirentelimab clinical testing is ongoing or planned. Allakos initiated a randomized, double-blind, placebo-
controlled Phase 2 clinical trial of subcutaneous (SC) lirentelimab in adult patients with moderate-to-severe atopic dermatitis. The company also announced 
plans to initiate a randomized, double-blind, placebo-controlled trials of SC lirentelimab in patients with chronic spontaneous urticaria in the middle of 
2022. Both diseases are complex, chronic inflammatory skin diseases believed to be driven by activated eosinophils and mast cells.

1

 
Atopic dermatitis is a chronic pruritic inflammatory condition that is characterized by dry, red, itchy patches of skin. Atopic dermatitis affects 

approximately 16.5 million (7.3%) adults in the U.S., of which around 6.6 million (40%) have moderate-to-severe disease. Chronic urticaria is an often-
debilitating skin condition characterized by frequent and unpredictable eruption of hives, severe itching and swelling. Chronic urticaria affects up to 3.5 
million patients in the U.S., of which half are refractory to standard-of-care antihistamines.

Figure 1: Expected Development Timeline

Lirentelimab has shown activity in open label clinical studies in indolent systemic mastocytosis (“ISM”, see Indolent Systemic Mastocytosis for 

clinical results), severe allergic conjunctivitis (“SAC”, see severe allergic conjunctivitis for clinical results), and mast cell gastrointestinal disease 
(“MGID”, see mast cell gastritis clinical results). In addition, patients in clinical studies with atopic comorbidities such as asthma, atopic dermatitis, and 
allergic rhinitis experienced improvements in these conditions. The activity observed in these studies suggests that lirentelimab could provide significant 
benefit to patients suffering from these diseases and highlights the potential of lirentelimab to broadly inhibit mast cells and deplete eosinophils in different 
disease settings. 

Figure 2: Allakos Pipeline

To date, lirentelimab has been administered intravenously in our completed clinical efficacy studies. Lirentelimab has generally been well-tolerated 

in each of our clinical trials. The most common adverse event with 

2

 
 
 
 
 
 
 
 
 
intravenous lirentelimab has been the occurrence of mild to moderate infusion related reactions, consisting of flushing, feeling of warmth, headache, nausea 
or dizziness, which occurred mostly during the first infusion and diminished or did not occur on subsequent infusions. 

We have also developed a formulation of lirentelimab for subcutaneous (“SC”) administration which will be used in all current and future studies. SC 
lirentelimab has completed a Phase 1 study in healthy volunteers evaluating the safety, tolerability and pharmacokinetics of SC lirentelimab (for additional 
information, see “Lirentelimab Clinical Development–Subcutaneous Lirentelimab”). SC lirentelimab provided prolonged eosinophil depletion and was 
well tolerated; there were no serious adverse events, no injection site reactions, and no injection-related reactions.

Understanding the Foundation of Our Approach

Background on Mast Cells, Eosinophils, Siglec-8 and Siglec-6

Mast cells and eosinophils are involved in many inflammatory conditions and therefore represent attractive drug targets. Mast cells and eosinophils 
can respond to signals from allergens, tissues, bacteria, viruses and also cells of the innate and adaptive immune system. In response, they release a large 
variety of mediators which can result in tissue damage, fibrosis and the recruitment and activation of other innate and adaptive immune cells. The ability to 
respond to signals from multiple cell types and the diverse array of mediators that they produce place mast cells and eosinophils in the center of multiple 
aspects of the inflammatory response.

Eosinophils are normally present in the blood and tissues, especially in the mucosal linings of the respiratory and lower gastrointestinal tract. 
However, they can be recruited to any site of the body in the setting of inflammation. Mast cells reside within tissues and all vascularized organs, often 
located in close proximity to blood vessels, nerves and lymphatics. Sites include the dermis, gut mucosa and submucosa, conjunctiva and pulmonary 
alveoli and airways. As a result of their widespread location and potent inflammatory activity, mast cells and eosinophils have been identified as key 
drivers in a number of severe diseases of the gastrointestinal tract, eyes, skin and lungs as well as diseases which affect multiple organ systems.

Siglec-8 is an inhibitory receptor selectively expressed on eosinophils and mast cells. Because Siglec-8 is expressed in high abundance only on mast 
cells and eosinophils, it presents a novel way to selectively target these important immune cells. Siglec-6 is an inhibitory receptor that our research shows is 
selectively expressed on mast cells. As inhibitory receptors, the natural function of Siglec-8 and Siglec-6 is to counteract activating signals within mast 
cells and eosinophils that lead to an inflammatory response. 

Mast cells and Eosinophils are Effector Cells That are Central to Initiating and Maintaining Inflammatory Responses

Mast cells and/or eosinophils respond to a variety of activating signals including those from cell-cell contact, allergens bound to IgE, neuropeptides 
(such as Substance P), cytokines including IL-33, thymic stromal lymphopoietin (“TSLP”), IL-5, IL-4 and IL-13 and viruses through Toll-Like Receptors. 
In response to these and other activating signals, mast cells and eosinophils produce a broad range of inflammatory mediators that cause tissue damage and 
contribute to acute and chronic inflammation. These mediators include vasoactive amines, bioactive lipids, proteases, chemokines and cytokines. The 
mediators, their functions and their contribution to disease pathogenesis are described in more detail below.

•

•

•

Mast cells play an important role in inflammation as the main producer of histamine. Histamine causes vasodilation and produces intense 
itching. It is believed to contribute to increased gastrointestinal peristalsis (diarrhea), the skin symptoms of urticaria and ISM, the diffuse 
vasodilation of anaphylaxis and bronchospasm in asthma.

Proteases secreted from mast cells and eosinophils are the key cause of tissue damage and contribute to tissue fibrosis. Eosinophil and mast 
cell secretions are toxic to surrounding cells and break down tissues, resulting in fibrosis and tissue remodeling.

Mast cells and eosinophils drive inflammation by signaling to other cells of the immune system. Mast cells and eosinophils release lipid 
mediators and a large variety of cytokines including TNFa, IL-1, IL-3, IL-4, IL-5, IL-6, IL-8, IL-9, IL-13, MCP-1, CCL2, CCL3, CCL5, 
CCL17, TGFa, TGFb and 

3

 
  
 
 
granulocyte-macrophage colony stimulating factor, that attract and activate cells of the innate and adaptive immune system, such as 
neutrophils, monocytes, macrophages, basophils, B-cells, T-cells and dendritic cells, as well as other mast cells and eosinophils.

Figure 3. Mast Cell and Eosinophil Functions

4

 
 
 
 
 
Due to their ability to respond to signals from multiple cell types and elicit responses from others, mast cells and eosinophils mediate the immediate 

hypersensitivity and late phase responses responsible for allergies and many innate and adaptive immune responses.

Siglec-8 is an Attractive Target for Mast Cell and Eosinophil Driven Diseases

Siglec-8 (sialic acid immunoglobulin-like lectin 8) is a constitutively expressed inhibitory receptor that is restricted to eosinophils, mast cells and to a 

lesser extent, basophils (approximately 1/100 the level on mast cells and eosinophils). The physiological function of Siglec-8 is to provide an inhibitory 
signal to mast cells and eosinophils. Siglec-8 exerts these effects through an intracellular immunoreceptor tyrosine-based inhibitory motif (“ITIM”) and 
ITIM-like motif. In contrast to approaches which block a single activating cytokine or receptor, targeting the ITIM signaling cascade (via Siglec-8) has the 
potential to counteract a broad array of activating signals, which could allow for the treatment of multiple diseases. Antibodies to Siglec-8 have been shown 
to trigger antibody-dependent cellular cytotoxicity (“ADCC”) of blood eosinophils and apoptosis of tissue eosinophils and to inhibit the release of 
inflammatory mediators from mast cells. 

5

 
 
  
  
Figure 4. Siglec-8 Triggers Apoptosis of Eosinophils and Inhibition of Mast Cells

Lirentelimab (AK002) Binds to Siglec-8

Lirentelimab was designed to take advantage of the selective expression pattern and inhibitory function of Siglec-8, an inhibitory receptor found on 

eosinophils and mast cells. Lirentelimab is a humanized antibody that binds to Siglec-8 with high affinity (bivalent binding avidity KD = 17 pM, 
determined by surface plasmon resonance analysis). Binding of lirentelimab to Siglec-8 on mast cells and eosinophils triggers apoptosis of eosinophils and 
inhibition of mast cells. Lirentelimab is a non-fucosylated IgG1 antibody engineered to have potent ADCC. ADCC is a mechanism whereby the binding of 
an antibody like lirentelimab to a target cell in the blood, such as an eosinophil, triggers a natural killer (“NK”) cell, to bind to the Fc portion of the 
antibody bound to the target cell, thereby destroying the antibody-bound cell. This provides lirentelimab with an additional mechanism to deplete 
eosinophils present in blood. As a result of these dual modes of action, lirentelimab has been shown to deplete eosinophils in blood and tissue, and to 
inhibit the release of inflammatory mediators from mast cells.

Siglec-6 is an Attractive Target for Mast Cell Driven Diseases

Siglec-6 (sialic acid immunoglobulin-like lectin 6) is a constitutively expressed inhibitory receptor that is selectively expressed on mast cells. The 

physiological function of Siglec-6 is to provide an inhibitory signal to mast cells. Siglec-6 exerts these effects through an intracellular immunoreceptor 
tyrosine-based inhibitory motif (“ITIM”) and ITIM-like motif. In preclinical studies, AK006, our humanized antibody to Siglec-6 reduces mast cell 
numbers and has been shown to have broader and deeper inhibition of mast cell activity than lirentelimab, including the ability to inhibit c-KIT activation. 
The increased inhibitory activity could give AK006 increased therapeutic activity while avoiding toxicities associated with less selective mast cell targeting 
drugs.

6

 
 
 
 
  
 
Figure 5. AK006 Triggers Potent Inhibition of Mast Cells 

Our Strategy

Lirentelimab has shown activity in human clinical studies as well as activity in a broad array of animal disease models of mast cell and eosinophil 
driven diseases. We have prioritized our lirentelimab development efforts based on our assessment of the probability of clinical and regulatory success, 
unmet medical need and potential market opportunity. We have assembled a team with a proven track record and deep experience in antibody discovery 
and in clinical development, operations and finance. 

The key elements of our strategy are to:

•

•

•

Advance lirentelimab through clinical development in Eosinophilic Gastrointestinal Diseases (“EGIDs”). Lirentelimab has secured orphan 
drug designation for the treatment of EoE, EG and EoD from the FDA. Despite positive results from the Phase 2 EG and/or EoD study with 
lirentelimab (ENIGMA 1), the ENIGMA 2 failed to meet the symptomatic co-primary endpoint when compared to placebo. Similarly, the 
KRYPTOS study met the histologic co-primary endpoint but failed to meet the symptomatic co-primary endpoint when compared to placebo. 
After conducting post-hoc analyses, we believe that the trials missed their symptomatic co-primary endpoints due to the inclusion of mild 
patients and/or patients who had not failed standard of care. Based on these analyses, we believe that lirentelimab may have potential to treat 
the more severe EG/EoD and EoE patient populations. As a result, we plan to conduct additional studies with SC lirentelimab in these 
indications after discussions with the FDA.

Evaluate additional eosinophilic and mast cell driven conditions. We have an ongoing Phase 2 trial in patients with AD and a planned 
Phase 2b trial in patients with CSU. These diseases are believed to be driven by activated eosinophils and mast cells. We have also completed 
trials in patients with MGID, CU, ISM, and SAC and will continue to evaluate potential commercial opportunities in these, as well as other 
indications.

Build therapeutic pipeline. Our research is focused on immunomodulatory receptors present on immune effector cells involved in allergy, 
inflammatory and proliferative diseases. Activating these immunomodulatory receptors allows us to directly target cells involved in disease 
pathogenesis and, in 

7

 
 
 
 
 
the setting of allergy and inflammation, has the potential to result in broad inhibition of inflammatory cells. In the setting of proliferative 
diseases, blocking the inhibitory the function of the receptors could restore the immune cell’s ability to identify and kill proliferative cells. 
Following this approach, we have developed lirentelimab and AK006 and have research programs directed at other immunomodulatory 
targets.

Lirentelimab Clinical Development 

To date, lirentelimab has completed a Phase 2 study (ENIGMA 1) and Phase 3 study (ENIGMA 2) in patients with EG and/or EoD, a Phase 2/3 study 
in patients with EoE (KRYPTOS), as well as proof of concept studies in chronic spontaneous urticaria, severe allergic conjunctivitis, and indolent systemic 
mastocytosis. In addition, phase 2 clinical studies are being conducted or planned in atopic dermatitis and chronic spontaneous urticaria.

The Phase 2 EG and/or EoD study with lirentelimab (ENIGMA 1) met all prespecified primary and secondary endpoints when compared to placebo 

and results were published in The New England Journal of Medicine. More recently, the ENIGMA 2 study met the histologic co-primary endpoint but 
failed to meet the symptomatic co-primary endpoint when compared to placebo. Similarly, the KRYPTOS study met the histologic co-primary endpoint but 
failed to meet the symptomatic co-primary endpoint when compared to placebo. After conducting post-hoc analyses, we believe that the trials missed their 
symptomatic co-primary endpoints due to the inclusion of mild patients and/or patients who had not failed standard of care. Although post-hoc analyses 
cannot be used to establish efficacy, these analyses can be helpful in generating hypothesis for future clinical studies. Based on these analyses, we believe 
that lirentelimab may have potential to treat the more severe EG/EoD and EoE patient populations. As a result, we plan to conduct additional studies with 
SC lirentelimab in these indications after discussions with the FDA.

Subcutaneous Lirentelimab

To date, lirentelimab has been administered intravenously in our completed clinical efficacy studies. We have developed a formulation of 
lirentelimab for SC administration which will be used in all current and future studies. SC Lirentelimab completed a randomized, double-blind, placebo-
controlled, single dose, dose ranging Phase 1 study in healthy volunteers evaluating the safety, tolerability and pharmacokinetics of SC lirentelimab. 
Administration of SC lirentelimab resulted in extended eosinophil suppression at all dose levels tested. At dose levels of 3.0 and 5.0 mg/kg and with the 
fixed dose of 300 mg, SC lirentelimab resulted in eosinophil suppression in all subjects through Day 85. The pharmacokinetic and pharmacodynamic 
results suggest that SC lirentelimab may be given monthly or potentially less frequently. SC lirentelimab was well tolerated, and there were no serious 
adverse events, no injection site reactions, and no injection-related reactions with SC lirentelimab.

Eosinophilic Gastrointestinal Diseases (“EGIDs”)

EGIDs are a collection of chronic inflammatory disorders that share a similar eosinophilic driven inflammation that occurs along different segments 

of the gastrointestinal (“GI”) tract. Based on the site of eosinophilic infiltration, EGIDs are categorized into EoE (esophagus), EG (stomach), EoD 
(duodenum), and eosinophilic colitis (colon). There are no treatments currently approved specifically for these diseases and lirentelimab has secured orphan 
drug designation for EG, EoD, and EoE from the FDA. 

It is believed that EGIDs arise in some patients from food allergies or other allergens that cause a hypersensitivity reaction that leads to recruitment 

of eosinophils to the GI tract. Mast cells are also elevated and activated and are believed to play a significant role. The gastrointestinal symptoms are 
believed to be due to the release of inflammatory mediators from activated eosinophils and mast cells. Elevated serum immunoglobulin E (“IgE”) levels 
and food-specific IgE are correlated with EG in some patients and provide evidence for the allergy hypothesis and mast cell involvement. We have 
demonstrated that in biopsies of patients with symptomatic EG, mast cells are present in elevated numbers compared to normal controls and that the mast 
cells are also in an increased activation state, providing additional evidence for a pathogenic role of mast cells in EGIDs. 

8

 
 
  
 
  
Figure 6. Mast Cells and Eosinophils are Elevated in EGIDs

Because lirentelimab has the potential to directly deplete eosinophils and broadly inhibits mast cells, we believe it has the potential to overcome 

limitations of other agents acting only on one cell type or pathway. 

Eosinophilic Esophagitis

EoE is an orphan disease characterized by eosinophil and mast cell driven inflammation of the esophagus. Common symptoms of EoE include 
dysphagia (difficulty swallowing), food impaction, nausea and vomiting. Diagnosis is established based on clinical presentation (dysphagia) combined with 
increased tissue eosinophils in biopsy specimens from the esophagus without any other cause for the eosinophilia. The presence of greater than 15 
eosinophils per HPF in an esophageal biopsy identifies the presence of EoE. The estimated prevalence of EoE in the United States is approximately 
150,000-200,000 patients.  

Eosinophilic Gastritis and Eosinophilic Duodenitis

EG and EoD are diseases characterized by chronic inflammation due to infiltration of eosinophils and mast cells into layers of the stomach and 

duodenum. Symptoms commonly include abdominal pain, nausea, early satiety, loss of appetite, abdominal cramping, bloating, malnutrition and weight 
loss. EG and EoD can occur with eosinophilia isolated to the stomach or duodenum, or often in combination. Diagnosis is established based on clinical 
presentation (gastrointestinal symptoms) combined with increased tissue eosinophils in biopsy specimens from the stomach and/or duodenum without any 
other cause for the eosinophilia. The presence of greater than or equal to 30 eosinophils per high-powered field (“HPF”) in 5 HPFs in the stomach indicates 
the presence of EG, and the presence of greater than or equal to 30 eosinophils per HPF in 3 HPFs in the duodenum indicates the presence of EoD. Based 
on ICD-9 codes, the prevalence of EG and EoD in the United States has previously been reported in the literature to be approximately 50,000 patients. 
However, we believe these diseases may be significantly under-diagnosed, or mis-diagnosed as other gastrointestinal diseases (such as irritable bowel 
syndrome or functional dyspepsia), based on observations from the ENIGMA study, ENIGMA 2 study as well as results of a prevalence study we 
conducted to assess the prevalence of EG and EoD in patients with chronic gastrointestinal symptoms. 

Current Therapies and Limitations

There are no FDA-approved treatments for EG, EoD or EoE. Current therapies and disease management strategies include restricted/elemental diets 
and systemic or topical corticosteroids. Restricted/elemental diets are designed to avoid foods which trigger symptoms. Unfortunately for most patients the 
restricted/elemental diets are only partially effective and mainly used as a strategy to provide nutrition despite continuing symptoms. Corticosteroids, 
systemic or topical, can provide symptom relief, but are not appropriate for long-term treatment due to their numerous side effects. 

9

 
 
 
 
 
 
 
 
ENIGMA Study: Phase 2 Study in Patients with EG and/or EoD

Study Design

The ENIGMA study, a randomized, double-blind, placebo-controlled Phase 2 study of lirentelimab enrolled patients with active, biopsy-confirmed 
EG and/or EoD. Patients were required to be moderately to severely symptomatic based on a patient reported symptom questionnaire and to subsequently 
have biopsy confirmed eosinophilia of the stomach (≥ 30 eosinophils/HPF in 5 HPFs) and/or duodenum (≥ 30 eosinophils/HPF in 3 HPFs). Qualifying 
patients were randomized 1:1:1 to receive: (a) 0.3 mg/kg of lirentelimab for the first month followed by three doses of 1.0 mg/kg given monthly, (b) 0.3 
mg/kg of lirentelimab for the first month followed by 1.0 mg/kg, 3.0 mg/kg and 3.0 mg/kg given monthly, or (c) a monthly placebo. Disease symptoms 
were measured daily using a patient reported symptom questionnaire that scored 8 symptoms on a scale from 0 to 10 (abdominal pain, nausea, vomiting, 
early satiety, loss of appetite, abdominal cramping, bloating, and diarrhea). Endpoints were assessed per protocol in a prespecified hierarchical order using 
biopsies collected at the end of study and symptom questionnaires collected over the last two weeks of study prior to biopsy. The primary endpoint was the 
percent change from baseline in the number of tissue eosinophils obtained from gastric or duodenal biopsies. The secondary endpoints were (1) proportion 
of patients with a greater than 75% reduction in tissue eosinophil counts from biopsies and a greater than 30% reduction in Total Symptom Score (“TSS”) 
from the patient reported questionnaire and (2) the percent change from baseline in the TSS.

Study Results

Lirentelimab showed a statistically significant benefit when compared to placebo on all primary and secondary endpoints for each of the high dose, 

low dose, and combined high/low dose lirentelimab groups. The data demonstrate that lirentelimab produced histological resolution of gastrointestinal 
tissue eosinophilia and improved disease symptoms, and that these benefits occurred in the same individuals. Results from this study were published in The 
New England Journal of Medicine. 

Figure 7: Topline results from the ENIGMA study

Primary and Secondary Endpoints
1° Endpoint: change in gastric or duodenal eosinophil counts

p–value

1
2° Endpoint: treatment responders 

p–value

2
2° Endpoint: change in TSS 

p–value

Placebo
(n=20)
+10%
—
5%
—
-24%
—

High Dose
lirentelimab
(n=20)
-97%
<0.0001
70%
0.0009
-58%
0.0012

Low Dose
lirentelimab
(n=19)
-92%
<0.0001
68%
0.0019
-49%

0.0150    

Combined
lirentelimab
(n=39)
-95%
<0.0001
69%
0.0008
-53%
0.0012

1

2

Treatment responders defined as patients with greater than a 75% reduction in biopsy eosinophil counts and a greater than 30% reduction in TSS.
TSS is the sum of all 8 patient reported symptoms each measured on a scale from 0 to 10 (abdominal pain, nausea, vomiting, early satiety, loss of 
appetite, abdominal cramping, bloating, and diarrhea).

Safety

Lirentelimab was generally well tolerated. The only treatment emergent adverse event occurring more frequently on lirentelimab than on placebo 

was mild to moderate IRRs, such as flushing, feeling of warmth, headache, nausea, and/or dizziness, which occurred in 60% of patients receiving 
lirentelimab versus 23% of patients receiving placebo. There was 1 drug-related serious adverse event (“SAE”) in the study, consisting of an infusion-
related reaction (“IRR”) that resolved within 24 hours. Treatment emergent SAEs occurred in 9% of patients receiving lirentelimab versus 14% of patients 
receiving placebo.

Results in Patients with EoE

Esophageal eosinophil counts and dysphagia improved in patients with comorbid eosinophilic esophagitis.

10

 
 
 
 
  
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
   
 
 
Figure 8: EoE endpoints from the ENIGMA study

Exploratory Endpoints
EoE: proportion of patients with esophageal eosinophil counts <6/HPF
EoE: change in patient reported dysphagia questionnaire

Steroid Use

Placebo
1/9 (11%)
-17%

Combined
lirentelimab
13/14 (93%)
-53%

All allowed baseline medications remained constant throughout the baseline period and study. Acute steroids could be used at the physician’s 

discretion to prevent or treat IRRs. Acute steroid use was balanced between lirentelimab and placebo groups with 28% and 35% of patients in the 
lirentelimab and placebo group receiving acute steroids, respectively. Statistically significant results were also observed on all primary and secondary 
endpoints in the subgroup of patients who did not receive acute steroids.

ENIGMA 2: Phase 3 Study in Patients with EG and/or EoD

Study Design

The ENIGMA 2 study, a randomized, double-blind, placebo-controlled Phase 3 trial of intravenous lirentelimab enrolled 180 patients with EG 

and/or EoD. Patients were required to be moderately to severely symptomatic based on a patient reported symptom questionnaire and have biopsy-
confirmed eosinophilia of the stomach (≥30 eosinophils/HPF in 5 HPFs) and/or duodenum (≥30 eosinophils/HPF in 3 HPFs). Patients were randomized 1:1 
to receive: 1.0 mg/kg of lirentelimab for the first month followed by five doses of 3.0 mg/kg given monthly or (b) a monthly placebo. Disease symptoms 
were measured daily using a patient reported symptom questionnaire that scored 6 symptoms (abdominal pain, nausea, bloating, early satiety, abdominal 
cramping, loss of appetite) each on a scale from 0 to 10 (TSS). Co-primary endpoints were (1) proportion of responders with ≤4 eosinophils/hpf in 5 HPFs 
in the stomach and/or ≤15 eosinophils/HPF in 3 HPFs in the duodenum at the end of week 24 and (2) absolute change from baseline in TSS at weeks 23-
24.

Study Results

Lirentelimab showed a statistically significant benefit when compared to placebo on the histology co-primary endpoint but failed to meet the 

symptomatic co-primary endpoint when compared to placebo.

Figure 9: Topline results from the ENIGMA 2 study

Co-Primary Endpoints
Histology Endpoint: Proportion of responders as determined by gastric or duodenal tissue eosinophil 
1
count

p-value

2
Symptom Endpoint: Absolute mean change in patient reported Total Symptom Score (TSS-6)

p-value

Placebo
(n=91)

4.5%

—    

  Baseline TSS:
27.7

Lirentelimab
(n=89)

84.6%

<0.0001
Baseline TSS:
29.5

-11.5      
—      

-10.0  
0.343  

1

2

A responder is a patient achieving the following peak eosinophil counts: eosinophil count ≤4 cells per HPF in 5 gastric HPFs and/or eosinophil count 
≤15 cells per HPF in 3 duodenal HPFs. Endpoint assessed at end of Week 24.
TSS-6 is daily patient reported symptom questionnaire assessing 6 symptoms (abdominal pain, nausea, bloating, early satiety, abdominal cramping, 
and loss of appetite) on a scale from 0 to 10. Endpoint assessed as mean change from baseline to Weeks 23-24.

11

 
 
  
 
 
 
 
 
 
 
  
  
 
   
 
 
   
 
  
 
  
   
 
  
  
 
 
Post-hoc Analyses

Although post-hoc analyses cannot be used to establish efficacy, these analyses can be helpful in generating hypothesis for future clinical studies. 

After conducting post-hoc analyses, we believe that the trial missed its symptomatic co-primary endpoint due to the inclusion of mild patients and/or 
patients who had not failed standard of care. In the study, the overall demographics, baseline characteristics, and disease burden as assessed by TSS-6 were 
well balanced across treatment groups and placebo. However, despite using similar inclusion criteria, our post-hoc analysis indicated that patients enrolled 
in the Phase 3 study (ENIGMA 2) had notably lower levels of tissue eosinophils, blood eosinophils, IgE, and history of prior EG/EoD diagnosis when 
compared to ENIGMA. 

A post hoc analyses identified that new sites utilized in the conduct of the Phase 3 studied enrolled a high proportion of patients with low levels of 
tissue eosinophils, blood eosinophils, IgE, and prior history of EG/EoD, whereas sites previously participating in the Phase 2 study enrolled more severe 
patients with higher levels of these characteristics.

Figure 10: Baseline Demographics & Patient Characteristics: Post-hoc Site Comparison

In a post hoc analyses of symptom improvement, sites with more severe patients with higher levels of tissue eosinophils, blood eosinophils, IgE 

levels, and prior history of EG/EoD, reported greater improvements on lirentelimab relative to placebo. The results suggest that future studies with 
lirentelimab should focus on more severe populations with higher levels of these characteristics.  

12

 
 
 
 
 
 
Figure 11: Consistent Effects Observed in Post-hoc Analysis of ENIGMA1 Site Patients

1 = LS Means and p-values derived from ANCOVA/MMRM models

Figure 12: ENIGMA2: Post-hoc Analysis of Non-ENIGMA1 Site Patients

Safety

The safety results of the trial were generally consistent with previously reported lirentelimab studies. No new safety signals were observed. Mild to 
moderate infusion-related reactions (including flushing, feeling of warmth, headache, nausea, and/or dizziness etc.) occurred in 34% of lirentelimab-treated 
patients and 13% of placebo-treated patients.

13

 
 
 
 
  
 
 
 
 
Phase 3 EoD Study (EoDyssey)

We have a Phase 3 study in patients with EoD without EG ongoing and expect to report topline data in the third quarter of 2022. In this study, in 

addition to the duodenum, we plan to examine eosinophil and mast cell levels in the terminal ileum and colon before and after lirentelimab treatment. 
Evaluation of the terminal ileum and colon will help characterize EoD patients and could provide insights for further development of lirentelimab in 
colonic conditions such as eosinophilic colitis and ulcerative colitis. As of December 31, 2021, the study was fully enrolled and baseline characteristics of 
patients enrolled in this study are likely to be similar to those in ENIGMA 2.  As a result, the EoDyssey trial could fail to meet the symptomatic co-primary 
endpoint when compared to placebo.

Future Studies in EG/EoD

We believe encouraging signs of efficacy were observed in the ENIGMA 1 study. In addition, post hoc analyses of ENIGMA 2 suggest that future 
studies with lirentelimab should focus on more severe populations with higher levels of tissue eosinophil counts, peripheral blood eosinophil counts, IgE 
levels with a prior history of EG/EoD. After completion of the EoDyssey study we plan to discuss our findings with the FDA to determine the design of a 
Phase 3 study using SC lirentelimab.

KRYPTOS: Phase 2/3 Study in Patients with EoE

Study Design

The KRYPTOS study, a randomized, double-blind, placebo-controlled Phase 2/3 trial of intravenous lirentelimab enrolled 276 patients with 
dysphagia and biopsy-confirmed EoE (≥15 eosinophils in 1 HPF). Patients were randomized 1:1:1 to receive: 1.0 mg/kg of lirentelimab for the first month 
followed by five doses of 3.0 mg/kg given monthly (b) monthly 1.0 mg/kg of lirentelimab (c) a monthly placebo. Disease symptoms were measured daily 
using a patient reported symptom questionnaire that assessed difficulty swallowing. Co-primary endpoints were (1) proportion of responders with ≤6 
eosinophils in 1 HPF in the esophagus and (2) absolute change in dysphagia symptom questionnaire from baseline.

Study Results

Lirentelimab showed a statistically significant benefit when compared to placebo on the histology co-primary endpoint but failed to meet the 

symptomatic co-primary endpoint when compared to placebo.

Co-Primary Endpoints
Histology Endpoint: Proportion of responders (eos ≤6 /hpf) as determined by esophageal 
1
tissue eosinophil counts

p-value

Symptom Endpoint: Absolut mean change in patient reported Dysphagia Symptom 
2
Questionnaire (DSQ)

p-value

Placebo
(n=92)

10.9%

Lirentelimab Low 
Dose
(n=93)

Lirentelimab High 
Dose
(n=91)

92.5%

—    

<0.0001

87.9%

<0.0001

  DSQ Baseline:
34.2

    DSQ Baseline:

36.4

    DSQ Baseline:

35.2

-14.6      

—      

-11.9      

0.247      

-17.4  

0.237  

1

2

A responder is a patient achieving the following peak eosinophil counts: ≤6 eosinophils (eos) / high powered field (HPF) in 1 HPF in the esophagus. 
Endpoint assessed at end of Week 24.
DSQ is patient reported symptom questionnaire assessing difficulty swallowing. Endpoint assessed as absolute mean change from baseline to Weeks 
23-24.

Post-hoc Analyses

After conducting post-hoc analyses, we believe that the trial missed its symptomatic co-primary endpoint due to the inclusion of mild patients and/or 

patients who had not failed standard of care. Although post-hoc analyses cannot be used to establish efficacy, these analyses can be helpful in generating 
hypothesis for future clinical 

14

 
  
  
 
 
 
 
   
   
 
 
   
   
 
  
   
 
  
 
  
  
 
 
studies. In the study, the overall demographics, baseline characteristics, and disease burden as assessed by DSQ were well balanced across treatment groups 
and placebo. However, in reviewing the data with key opinion leaders (“KOL”), they noted that the percentage of patients with a history of esophageal 
dilatations and prior standard of care steroid and proton pump use was lower than expected, as was the mean peak eosinophil counts, IgE levels and 
duration of EoE history, indicating that the study enrolled a number of mild EoE patients and/or patients with eosinophilia not caused by EoE. Based on 
KOL input and medical literature indicating that a single peak eosinophil count of greater than 24 eos/hpf avoids mild EoE patients and patients with 
eosinophilia not caused by EoE, we conducted a post-hoc analysis of demographics and symptoms improvements using this threshold. 

Patients with tissue biopsies containing greater than 24 eos/hpf had higher blood eosinophils, tissue eosinophils and IgE levels as well as more prior 

use of topical steroids and proton pump inhibitors, consistent with this threshold identifying more severe patients. In contrast, patients with less than 24 
eos/hpf had lower levels of these characteristics. In the more severe patients with above 24 eos/hpf, improvements in dysphagia symptoms were observed 
in the high dose lirentelimab group relative to placebo. The results suggest that future studies with lirentelimab should focus on more severe populations 
with higher tissue eosinophil levels, IgE levels and more prior use of steroid and proton pump inhibitors.

Figure 13: Post-hoc Analysis of Baseline Demographics and Patient Characteristics By Peak Esophageal Eosinophils

15

 
 
  
 
  
Figure 14: Post-hoc Analysis DSQ Response by Baseline Peak Eosinophil Count

* LS Means and HD lirentelimab from placebo p-values derived from MMRM model

Safety

The safety results of the trial were generally consistent with previously reported lirentelimab studies. No new safety signals were observed. Mild to 

moderate infusion-related reactions (including flushing, feeling of warmth, headache, nausea, and/or dizziness etc.) occurred in 39% of high dose 
lirentelimab- treated patients, 26% of low dose lirentelimab-treated patients and 12% of placebo-treated patients.

Future Studies in EoE

We believe encouraging signs of efficacy were observed in post hoc analyses of the KRYPTOS study, although post hoc analyses cannot be used to 

demonstrate efficacy. The post hoc analyses suggest that future studies with lirentelimab should focus on more severe populations with higher tissue 
eosinophil levels, IgE levels and more prior use of steroid and proton pump inhibitors. We are planning to discuss our finding with the FDA with the goal 
of initiating a Phase 3 study in EoE with SC lirentelimab in 2022. 

Mast Cell Gastrointestinal Disease 

During the enrollment phase of the ENIGMA study, we identified a group of patients who were symptomatic but upon biopsy had ≥ 30 stomach 

and/or duodenal mast cell counts in the absence of elevated eosinophils (<30 eosinophils/HPF). The presence of elevated mast cell counts and lack of 
elevated eosinophils or other cell type suggests that these patients may suffer from mast cell driven gastrointestinal symptoms. We refer to this condition as 
Mast Cell Gastrointestinal Disease (“MGID”). As detailed above, we conducted a prospective prevalence study examining the rates of elevated eosinophil 
and mast cell levels in 556 patients with chronic unexplained gastrointestinal symptoms or FGIDs such as IBS and FD. 73% (405 of 556) of patients 
screened underwent endoscopy with biopsy. Of the patients biopsied, 50% (204 of 405) met the histologic criteria for MGID, representing 37% (204 of 
556) of patients screened. The results suggest that a large number of patients meet the criteria we established for MGID.

We have conducted a proof of concept Phase 1 study with lirentelimab in patients with MGID. The open-label, multi-dose, 6-month, Phase 1 study 

of lirentelimab consisted of seven patients with moderate to severe gastrointestinal symptoms and elevated mast cells (≥30 mast cells/HPF in at least 5 
HPFs in the stomach and/or ≥30 mast cells/HPF in at least 3 HPFs in the duodenum) who did not have >30 eosinophils/HPF. Patients received 0.3 mg/kg of 
lirentelimab for the first dose, followed by 1.0 mg/kg the following month, then monthly doses of 3.0 mg/kg for four additional months. Disease symptoms 
were assessed using the patient reported outcome (“PRO”) questionnaire used in our Phase 2 (ENIGMA) and Phase 3 EG and/or EoD studies (Total 
Symptom Score TSS-8: 

16

 
  
 
 
 
 
  
abdominal pain, nausea, vomiting, early satiety, loss of appetite, abdominal cramping, bloating, and diarrhea). Six-month treatment with lirentelimab 
resulted in a 64% mean reduction in TSS-8 compared to baseline and five of seven (71%) patients had >50% reduction in TSS-8. The treatment effect of 
lirentelimab in this open label study was similar to that observed with lirentelimab in patients with EG and/or EoD in the Phase 2 ENIGMA Study.

Chronic Urticaria

Disease Overview

Chronic urticaria (“CU”) is a group of mast cell driven skin conditions which are characterized by recurrent transient pruritic wheal and flare type 

skin reactions and, in roughly 40% of patients, angioedema. Symptoms include hives, itching, redness, burning, warmth, tingling and irritation of the skin. 
Patients with CU are often severely impaired in their quality of life, with negative effects on sleep, daily activities, school/work life and social interactions. 
Urticaria symptoms are caused by degranulation of dermal mast cells, with IgE signaling believed to contribute to mast cell activation in many cases. The 
most common forms of CU are chronic spontaneous urticaria (“CSU”), cholinergic urticaria and symptomatic dermatographism. 

Despite sharing similar inflammatory pathology, the various forms of urticaria differ in the triggers that elicit the inflammatory response and 

symptoms. Patients with cholinergic urticaria typically develop symptoms a few minutes after exercise or passive warming in a bath or shower. In some 
cholinergic patients, emotional stress or hot and spicy food or beverages can also elicit symptoms. Symptomatic dermatographism is characterized by hives 
and pruritis following a minor stroking pressure, rubbing or scratching of the skin. In CSU, pruritic wheal-and-flare-type skin reactions spontaneously 
appear on the skin at any time of the day or night. In most CSU patients, an underlying cause of CSU cannot be identified making a causal and/or curative 
treatment difficult. We estimate that approximately 200,000-500,000 patients with severe CSU, cholinergic urticaria and symptomatic dermatographism 
could be candidates for therapy with lirentelimab in the United States.

Current Therapies and Limitations

The current treatment guidelines for the management of all forms of urticaria recommend the use of non-sedating oral H1-antihistamines as first-line 
therapy. For patients who do not respond to standard doses of H1-antihistamines, doses are increased to as high as four times the standard dose. Though this 
can increase the response rates, side effects also increase, including sedation and anticholinergic effects, such as dry mouth, blurred vision, urinary retention 
and constipation. Patients who do not respond to or are unable to tolerate high dose antihistamines have few options. For cholinergic urticaria and 
symptomatic dermatographism patients, it is recommended that they avoid target triggers such as overheated spaces, hot baths/showers, exercise, specific 
food allergens and excessive contact. For antihistamine refractory patients with CSU, the only currently approved treatment is Xolair, a monoclonal anti-
IgE antibody. Unfortunately, approximately 60% of CSU patients continue to have symptoms despite treatment with Xolair.

Phase 2 Study Design and Results

We conducted an open-label Phase 2 study with lirentelimab in patients with uncontrolled CU despite treatment with H1 antihistamines at up to 4x 

the labeled dose. The study enrolled four cohorts consisting of 13 Xolair naïve patients with CSU, 11 Xolair refractory patients with CSU (average duration 
of Xolair treatment 10 months at doses as high as 600mg/month), 11 patients with cholinergic urticaria, and 10 patients with symptomatic dermographism. 
Baseline symptom scores, as measured by Urticaria Control Test (“UCT”) and Urticaria Activity Score (“UAS7”) were collected over a 4-week screening 
period. Patients with baseline UCT scores of less than 12, indicative of poorly controlled urticaria, were enrolled in the study and treated with up to 6 doses 
of lirentelimab given once monthly. Patients received an initial dose of 0.3 mg/kg at baseline, followed by a dose of 1.0 mg/kg on day 28, and then received 
monthly doses of either 1.0 or 3.0 mg/kg for a total of 6 doses. The primary endpoint of the trial was patient-reported symptoms measured by the UCT. 
Secondary endpoints include safety and tolerability, as well as patient-reported symptoms as measured by UAS7 (CSU patients only), pulse controlled 
ergometry (cholinergic urticaria patients only), and Fric testing (symptomatic dermographism patients only).

Results for each cohort are shown in Figure 15. Patients in all cohorts reported high levels of disease control and some patients experienced 
complete resolution of symptoms while receiving lirentelimab. Importantly, lirentelimab also produced high levels of response in patients that were 
refractory to Xolair.

17

 
 
 
 
 
Figure 15. Data from the Phase 2 CU clinical trial

Xolair Naïve CSU Cohort (N=13)
Average UCT Score
UCT Complete Response
UCT Partial Response
UCT No Response
Average UAS7 Score
Proportion with UAS7 ≤ 6
Proportion with UAS7 = 0
Proportion with ISS7 = 0
Proportion with HSS7 = 0

Xolair Failure CSU Cohort (N=11)
Average UCT Score
UCT Complete Response
UCT Partial Response
UCT No Response
Average UAS7
Proportion with UAS7 ≤ 6
Proportion with UAS7 = 0
Proportion with ISS7 = 0
Proportion with HSS7 = 0

Cholinergic Urticaria Cohort (N=11)
Average UCT Score
UCT Complete Response
UCT Partial Response
UCT No Response
Pulse Control Ergometry Exercise Test Negative

Symptomatic Dermographism Cohort (N=10)
Average UCT Score
UCT Complete Response
UCT Partial Response
UCT No Response
Fric Test Itch Negative
Fric Test Hives Negative (Critical Friction Threshold)

Baseline
3.2
—
—
—
18.5
0%
0%
0%
0%

Baseline
3.7
—
—
—
28.7
0%
0%
0%
0%

Baseline
5.4
—
—
—
0%

Baseline
5.7
—
—
—
0%
0%

Week 22
14.2
12/13 (92%)
0/13 (0%)
1/13 (8%)
4.6 (-75%)
8/13 (62%)
7/13 (54%)
7/13 (54%)
10/13 (77%)

Week 22
8.5
4/11 (36%)
2/11 (18%)
5/11 (45%)
14.7 (-49%)
2/11 (18%)
1/11 (9%)
1/11 (9%)
1/11 (9%)

Week 22
11.8
9/11 (82%)
0/11 (0%)
2/11 (18%)
7/7 (100%)

Week 22
9.1
4/10 (40%)
3/10 (30%)
3/10 (30%)
5/10 (50%)
4/10 (40%)

Intravenous lirentelimab was generally well tolerated in the Phase 2 CU study. The most common adverse event was the occurrence of mild to 

moderate IRRs such as flushing, feeling of warmth, headache, nausea or dizziness, which occurred in 34% of first infusions and 4% of subsequent 
infusions. 

Current and Future Studies

Based on the results from the Phase 2 CU study, we plan to initiate a Phase 2b study in patients with chronic spontaneous urticaria. The planned 

Phase 2b study in chronic spontaneous urticaria will be a multicentered, randomized, double-blind, placebo-controlled study in patients who are naïve to 
omalizumab and refractory to antihistamines. The primary end point of the trial will be the change from baseline in UAS7 at week 12.

Figure 16. Ongoing and Planned Lirentelimab CSU Clinical Studies

Study

Phase 2b SC Chronic Spontaneous Urticaria

  Milestone

Initiation Expected Mid 2022

18

 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
  
  
  
  
  
  
  
  
  
  
  
  
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
  
 
 
 
Atopic Dermatitis

Disease Overview

Atopic dermatitis (“AD”) is a chronic pruritic inflammatory condition that is characterized by dry, red, itchy patches of skin. Multiple mechanisms 

contribute to the disease, including epithelial barrier impairment, systemic immune dysregulation, neuroinflammation, fibrotic remodeling and dysbiosis of 
skin microbiota. Crosstalk between eosinophils, mast cells, and sensory neurons has been shown to drive inflammation and chronic itch in atopic dermatitis 
via IgE, IL-4, IL-13, IL-33, and MRGPRX2. The disease affects approximately 16.5 million (7.3%) adults in the United States (US), of which 
approximately 6.6 million (40%) have moderate-to-severe disease.

Current Therapies and Limitations

Atopic dermatitis is treated with oral antihistamines, topical moisturizers and emollients and topical steroids. Unfortunately, many patients continue 

to have lesions and symptoms despite these treatments and many of the drugs are not suitable for long-term treatment due to undesirable side effects. For 
patients who do not respond to these options or for more serious patients, FDA approved therapies include dupilumab (anti-IL-4 and IL-13 antibody), 
tralokinumab (anti IL-13 antibody), ruxolitinib (topical JAKi), abrocitinib (JAKi small molecule) and upadacitinib (JAKi small molecule). The IL-4 & IL-
13 class was initially approved in 2017 for patients with moderate-to-severe AD. The JAKi class was initially for AD in 2021 however these drugs come 
with a boxed warning for serious infections, mortality, malignancies, major adverse cardiovascular events (MACE) and thrombosis. There remains a need 
for novel mechanisms of action to treat patients with AD.

Preclinical Data Showing Mast Cell and Eosinophil in Atopic Dermatitis Skin Lesions

In atopic dermatitis skin lesions, eosinophils and mast cells are elevated in number and mast cells are activated with high levels of surface-bound 

IgE. These cells have further been shown to induce chronic inflammation and itch via the wide array of activating receptors expressed on their cell surface, 
and through crosstalk with sensory neurons and other cell types. 

Moreover, mast cells and eosinophils are major sources of IL-4 and IL-13, cytokines that have been shown to be clinically relevant mediators of 

inflammation and fibrosis. 

Figure 17: Mast Cells and Eosinophils Are Elevated in Atopic Dermatitis Skin Lesions

Observations in Patients with Atopic Dermatitis in Lirentelimab Clinical Studies

Evidence of activity was observed in two separate clinical studies of lirentelimab in patients with comorbid atopic dermatitis. In the EG/EoD Phase 

3 study (ENIGMA 2), patients with comorbid atopic dermatitis were assessed using a daily questionnaire for the global disease severity and reported a 
decrease in disease severity of 63% compared to 12% on placebo (n=9). In a single-arm, Phase 1b severe allergic conjunctivitis study, patients with 
comorbid atopic dermatitis reported a 56% decrease in disease severity (n=11). 

19

 
 
 
  
 
 
 
Figure 18: Improvement in Concomitant Atopic Dermatitis

Biomarker data from Phase 1b Severe Allergic Conjunctivitis Study

In the Phase 1b study in patients with Severe Allergic Conjunctivitis, clinically-relevant cytokines of atopic dermatitis were measured. These 
cytokines were measured via tear ducts to understand ocular inflammation and included IL-4, IL-13, CCL26/Eotaxin-3 as well as CCL/MIP-α. Upon 
lirentelimab dosing, these biomarkers showed meaningful decreases. Moreover these cytokines rebounded to baseline levels following study conclusion.

Current and Future Studies

We initiated a Phase 2 study in patients with moderate-to-severe atopic dermatitis. The Phase 2 study in atopic dermatitis is a 14-week, 

multicentered, randomized, double-blind, placebo-controlled trial that will enroll approximately 120 adult patients with moderate-to-severe disease who are 
inadequately controlled by topical treatments. Patients will be randomized 1:1 to receive a dose of subcutaneous 300mg lirentelimab every two weeks or 
placebo. The primary endpoint will be the proportion of patients who achieve eczema area and severity index (EASI)-75 at week 14.

Figure 19. Ongoing and Planned Lirentelimab Atopic Dermatitis Clinical Studies 

Study

Phase 2 SC Atopic Dermatitis

Severe Allergic Conjunctivitis

Disease Overview

  Milestone

Initiated Q4 2021

Atopic keratoconjunctivitis (“AKC”), vernal keratoconjunctivitis (“VKC”) and perennial allergic conjunctivitis (“PAC”) are a set of allergic ocular 

conjunctival diseases primarily associated with an IgE-mediated hypersensitivity reaction. We are focused on SAC, the severe forms of these collective 
diseases. These conditions are often caused by airborne allergens, such as grass and tree pollens, coming into contact with the eyes, which induces IgE 
mediated mast cell degranulation and allergic inflammation. The inflammatory mediators released by the mast cell result in inflammation and the 
infiltration of eosinophils, neutrophils and other immune cells. Eosinophils and mast cells are believed to be the main effector cells, with protease 
secretions directly damaging the 

20

 
  
 
 
  
  
 
 
conjunctiva, and play a key role in triggering and maintaining the inflammatory response. Symptoms include itching, hyperemia, light sensitivity (or 
“photophobia”), pain, eye discharge and the sensation of having a foreign body in the eye. These symptoms can affect quality of life and daily activities, 
such as reading, driving and being in bright outdoor environments. In addition, patients with untreated disease, in particular those with VKC and AKC, can 
experience remodeling of the ocular surface tissues that can lead to vision loss. In addition to the primary symptoms of allergic conjunctivitis, a high 
correlation of allergic rhinitis, allergic asthma and atopic dermatitis comorbidities occur in this patient population. We believe that approximately 50,000-
150,000 patients in the United States suffer from SAC and could be candidates for treatment with lirentelimab.

Current Therapies and Limitations

PAC is treated with topical antihistamines and mast cell stabilizers. More serious forms are treated with topical and systemic corticosteroids, 
cyclosporine and other immunomodulatory drugs. There are no drugs approved for AKC and VKC, and as a result, patients are typically treated similarly 
to patients with PAC. Unfortunately, many patients continue to have symptoms despite these topical and/or systemic treatments and many of the drugs are 
not suitable for long-term treatment due to undesirable side effects.

Study Design and Results

We conducted an open-label Phase 1 study with lirentelimab in patients with SAC. The trial was open-label, multi-dose, six-month study and 
enrolled 29 total SAC patients. Of the 29 patients, 13 patients had AKC, 15 patients had PAC, and one patient had VKC. Patients received a 0.3 mg/kg dose 
of lirentelimab for the first month, followed by a 1 mg/kg dose the next month, then monthly doses of 1 or 3 mg/kg for four additional months. The primary 
endpoint of the trial was safety and tolerability. Key secondary endpoints included patient-reported symptom measures of ocular itch, pain, lacrimation, 
photophobia and foreign body sensation. Patients administered lirentelimab reported a 78% median improvement in ocular symptoms by ACS and a 71% 
median improvement in physician assessed signs and symptoms using the OSS. In addition, a number of patients enrolled in the trial also had concomitant 
allergic rhinitis, asthma, and atopic dermatitis. Patients suffering from comorbid atopic dermatitis, asthma and allergic rhinitis, despite treatment with 
currently available therapies, reported improvements in their symptoms while receiving lirentelimab. 

Intravenous lirentelimab was generally well tolerated. The most common adverse event was mild to moderate IRRs, such as flushing, feeling of 

warmth, headache, nausea, dizziness, which occurred mostly during the first infusion. 

Figure 20. SAC Phase 1 Trial Results

ACS Symptom (N=29)
Itching
Light Sensitivity
Eye Pain
Foreign Body Sensation
Watering Eyes

OSS Symptom (N=29)
Itching
Redness
Tearing
Chemosis

Patient Assessed
Median Change from Baseline to Weeks 21 to 22
-75%
-57%
-75%
-80%
-76%

Investigator Assessed
Median Change from Baseline to Day 140
-67%
-67%
-50%
-100%

21

 
 
  
 
 
Comorbid Condition
Asthma (N=9)
Atopic Dermatitis (N=11)
Rhinitis (N=11)

Indolent Systemic Mastocytosis

Disease Overview

Patient Assessed
Change in Median Global Severity from
Baseline to Weeks 21 to 22
-72%
-65%
-69%

Indolent systemic mastocytosis (“ISM”) is a rare disease characterized by the clonal proliferation and accumulation of mast cells in the bone 

marrow, respiratory and gastrointestinal tracts, and organs such as the skin, liver, spleen and brain. Common symptoms include pruritus, flushing, 
headache, cognitive impairment, fatigue, diarrhea, gastrointestinal cramps, hypotension and skin lesions, as well as an increased risk for osteoporosis and 
anaphylaxis, which in some cases can be life threatening. The symptoms of ISM are attributed to mast cell activation and the systemic release of mediators. 
Approximately 30,000 patients in the United States suffer from ISM. Lirentelimab has received orphan drug designation from the FDA and the European 
Medicines Agency (“EMA”) for the treatment of ISM. 

Current Therapies and Limitations

There are currently no drugs approved for the treatment of ISM by the FDA or EMA. ISM is treated with drugs targeting mast cell mediators, 
including antihistamines, cromolyn sodium and leukotriene blocking agents. Most patients’ symptoms remain poorly controlled by these treatments. 
Glucocorticoids can provide temporary relief in some cases; however long-term treatment with steroids is not appropriate due to their many side effects.

Study Design and Results

Lirentelimab has been evaluated in an open-label, single and multiple ascending dose Phase 1 study in patients with ISM. The single dose portion of 
this trial was completed during the second quarter of 2017, with subsequent completion of the six-month multi-dose portion in the first quarter of 2019. The 
primary endpoints of the trial were safety and tolerability. Key secondary endpoints were the pharmacokinetic and pharmacodynamic profile of 
lirentelimab, including peripheral counts of eosinophils and patient-reported mastocytosis disease symptoms including itching, hives, skin flushing, 
diarrhea, abdominal pain, fatigue, headache, difficulty concentrating and muscle and joint pain. In the single dose portion, 13 patients received single 
escalating doses of 0.0003 to 1.0 mg/kg, including three patients receiving 0.3 mg/kg and three patients receiving 1.0 mg/kg of lirentelimab. Five out of six 
patients receiving 0.3 or 1.0 mg/kg reported to the study investigators that they had improvements in symptoms, including diarrhea, abdominal pain, 
fatigue, pruritus, difficulty concentrating and headaches.

In the multi-dose portion of the trial, 6 patients received six doses of 1.0 mg/kg of lirentelimab given monthly and 5 patients received 1.0 mg/kg for 

the first month and then monthly doses of 3.0 to 10 mg/kg of lirentelimab for the five months thereafter. Depletion of eosinophils was observed for all 
patients throughout the dosing period with lirentelimab. ISM symptoms and quality of life were assessed using the Mastocytosis Questionnaire (“MSQ”), 
an internally developed Patient Reported Outcome (“PRO”) instrument, the Mastocytosis Questionnaire (“MSQ”), as well as two published questionnaires, 
the Mastocytosis Activity and Symptom Severity questionnaire (“MAS”) and the Mastocytosis Quality of Life questionnaire (“MC-QoL”). The MSQ is a 
proprietary daily PRO Mastocytosis Questionnaire that we developed based on published guidance from the FDA on the development of PRO instruments 
and is expected to be used to help determine safety and efficacy in future clinical trials. The MSQ consists of nine symptom assessments, with each 
symptom being scored on a 0-10 scale with higher values representing greater symptom burden. Total score for the MSQ ranges from 0-90 points. For each 
PRO, baseline scores were collected over 14 to 28 days and compared to scores at Weeks 21 to 22, two weeks after the final dose of lirentelimab. PRO data 
obtained from patients in the multidose portion of the trial are presented in Figure 21. Consistent with the improvements reported in the single ascending 
dose study, lirentelimab produced clinically meaningful improvement in patient symptoms for multiple symptoms across all three PROs used in the study. 

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Figure 21. Patient Reported Outcomes from multi-dose portion of ISM trial

1
MSQ Symptom (N=8) 
Itching
Hives
Flushing (#)
Abdominal Pain
Diarrhea
Headache
Fatigue
Difficulty Concentrating
Muscle Pain
Joint Pain

1

The MSQ was not available for use in 3 patients.

MAS2 Symptom (N=11)
Itching
Hives
Flushing
Abdominal Pain
Diarrhea
Headache
Fatigue
Difficulty Concentrating
Bone-Joint-Muscle Pain

MC-QoL Domain (N=11)
Symptoms
Social Life / Functioning
Emotions
Skin

Median Change from Baseline
at Weeks 21 to 22
-56%
-38%
-46%
-60%
-49%
-50%
-47%
-59%
-27%
-26%

Median Change from Baseline
at Weeks 21 to 22
-53%
-59%
-57%
-84%
-72%
-57%
-22%
-30%
-22%

Median Change from Baseline
at Day 145
-39%
-42%
-57%
-44%

Intravenous lirentelimab was generally well tolerated in the Phase 1 ISM study. The most common adverse event was the occurrence of mild to 

moderate IRRs, such as flushing, feeling of warmth, headache, nausea or dizziness, which occurred mostly during the first infusion.

AK006 Preclinical Data

AK006 targets Siglec-6, an inhibitory receptor expressed selectively on mast cells. In preclinical studies, AK006, our humanized antibody to Siglec-

6 reduces mast cell numbers and has been shown to have broader and deeper inhibition of mast cell activity than lirentelimab, including the ability to 
inhibit c-KIT activation. The increased inhibitory activity could give AK006 increased therapeutic activity while potentially avoiding toxicities associated 
with less selective mast cell targeting drugs.

AK006 induces potent mast cell inhibition in ex vivo human tissues

We developed an IgE-mediated mast cell activation assay in human tissue. In this assay, mast cells are activated via FceRI using an agonistic anti-
FceRI antibody and mast cell activation is evaluated using CD63 expression by flow cytometry. CD63 is a activation marker found on mast cell granules 
and upon activation fuses with the plasma membrane making CD63 accessible to detection by flow cytometry. While AK002 showed potent mast cell 
inhibition, AK006 was able to provide deeper levels of inhibition. 

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Figure 22: IgE-mediated mast cell activation in human tissue

AK006 inhibits KIT-mediated mast cell activation in vivo

AK006 also has been show to inhibit KIT activation of mast cells in vivo.  Administration of stem cell factor (SCF), a potent KIT activator, to 
Siglec-6 transgenic mice induces mast cell activation and inflammation. AK006 reduced KIT-mediated mast cell activation as assessed by CD63 expression 
compared to sham treated mice (mice that did not receive SCF). In addition, AK006 treated mice displayed reduced levels of inflammatory mediators (TNF 
and IL-6) compared to isotype control mice. 

Figure 23: KIT-mediated mast cell activation and inflammation in Siglec-6 transgenic mice

AK006 reduces mast cells in ex vivo human tissue

In human tissue processed into single cell suspensions and cultured overnight with or without human macrophages activated with IFNg, AK006 
significantly reduced human tissue mast cells in the presence of activated macrophages relative to an isotype control mAb (“ISO”). In contrast, AK002 
does not reduce mast cells in the presence or absence of activated macrophages, suggesting AK006 has unique activity that reduces mast cells in the 
presence of activated effector cells, such as macrophages. 

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Figure 24: Mast cell numbers in ex vivo cultured human tissue

The above data suggests that AK006 selectively targets mast cells and has the potential to induce broad inhibition of mast cell activation and reduce 

mast cell numbers. This profile could give AK006 increased therapeutic activity while potentially avoiding toxicities associated with less selective mast 
cell targeting drugs.

We plan to begin human studies with AK006 in the first half of 2023.  

Other Pipeline Programs

We are developing additional antibodies targeting novel inhibitory receptors expressed on key disease-driving immune cells. These antibodies have 

demonstrated in vitro and in vivo activity in murine models and are being evaluated for further development. 

Competition

The biotechnology and pharmaceutical industries are characterized by rapid technological advancement, significant competition and an emphasis on 

intellectual property. We face potential competition from many different sources, including major and specialty pharmaceutical and biotechnology 
companies, academic research institutions, governmental agencies and public and private research institutions. Any product candidates that we successfully 
develop and commercialize will compete with current therapies and new therapies that may become available in the future. We believe that the key 
competitive factors affecting the success of any of our product candidates will include efficacy, safety profile, convenience, cost, level of promotional 
activity devoted to them and intellectual property protection.

We are not aware of any other company or organization that is conducting clinical trials of a product candidate that targets both mast cells and 
eosinophils, including any product candidate that specifically targets Siglec-8. The competition we may face with respect to each of the indications we are 
targeting with lirentelimab includes:

•

•

•

EG, EoD and EoE. Currently, there are no therapies that have been approved by the FDA specifically for EG, EoD or EoE. Several 
companies, including but not limited to, Regeneron (dupilumab), AstraZeneca (benralizumab), Bristol Myers Squibb (cendakimab), Shire 
(oral budesonide), and Dr. Falk Pharma (oral budesonide) have or are conducting studies in these indications. 

ISM. We are not aware of any FDA-approved treatments for ISM. Blueprint Medicines is developing avapritinib in smoldering systemic 
mastocytosis and ISM.

CU. Omalizumab (Roche and Novartis) is an FDA-approved drug for the treatment of CSU. We are not aware of any FDA-approved 
treatment options for cholinergic urticaria or symptomatic dermatographism. Companies conducting studies in chronic spontaneous urticaria 
include: Novartis 

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•

•

(ligelizumab), Roche / Genentech (fenebrutinib), Regeneron (dupilumab), Celldex (CDX-0159) and Third Harmonic (THB001).

AD. Dupilumab (Regeneron), tralokinumab (Leo Pharma), ruxolitinib (Incyte), abrocitinib (Pfizer) and upadacitinib (Abbvie) are FDA-
approved drugs for the treatment of AD. Several companies, including but not limited to, Eli Lilly (baricitinib & lebrikizumab), Bristol 
Myers (branebrutinib), Sanofi (rilzabrutinib), Pfizer (etrasimod) and AstraZeneca (benralizumab) have or are conducting studies in this 
indication.

SAC. The products that are currently available for treatment of SAC only provide temporary relief for most patients and have little effect on 
moderate to severe cases. Companies conducting studies in SAC include Aldeyra (reproxalap).

Many of the companies against which we may compete have significantly greater financial resources and expertise in research and development, 

manufacturing, preclinical testing, conducting clinical trials, obtaining regulatory approvals and marketing approved products than we do. Smaller or early-
stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large and established companies. These 
competitors also compete with us in recruiting and retaining qualified scientific and management personnel and establishing clinical trial sites and patient 
registration for clinical trials, as well as in acquiring technologies complementary to, or necessary for, our programs.

Our commercial potential could be reduced or eliminated if our competitors develop and commercialize products that are safer or more effective, 

have fewer or less severe adverse events, and are more convenient or less expensive than products that we may develop. Our competitors also may obtain 
FDA or other regulatory approval for their products more rapidly than we can, which could result in our competitors establishing a strong market position 
before we are able to enter the market or could otherwise make our development more complicated.

Sales and Marketing

In light of our stage of development, we currently have limited marketing and sales capabilities. We hold worldwide commercialization rights to all 

of our product candidates. We intend to retain the rights to our compounds in key geographic markets for the time being, and plan to build our own focused, 
specialty sales force to commercialize approved products in the United States. We intend to build the necessary infrastructure and capabilities over time for 
the United States, and potentially other regions, following further advancement of our product candidates. Clinical data, the size of the addressable patient 
population, and the size of the commercial infrastructure and manufacturing needs may all influence or alter our commercialization plans. The 
responsibilities of the marketing and sales organization would include developing educational initiatives with respect to approved products and establishing 
relationships with researchers and practitioners in relevant fields of medicine.

Manufacturing

We must manufacture drug product for clinical trial use in compliance with cGMP regulations. The cGMP regulations include requirements relating 

to organization of personnel, buildings and facilities, equipment, control of components and drug product containers and closures, production and process 
controls, packaging and labeling controls, holding and distribution, laboratory controls, records and reports and returned or salvaged products. The 
manufacturing facilities for our product candidates must meet cGMP requirements and FDA or comparable foreign regulatory authority’s satisfaction 
before any product is approved and our commercial products can be manufactured. Our third-party manufacturers will also be subject to periodic 
inspections of facilities by the FDA and other foreign authorities, including procedures and operations used in the testing and manufacture of our products 
to assess our compliance with applicable regulations.

We do not currently have the infrastructure or internal capability to manufacture our product candidates for use in clinical development and 
commercialization, and we currently have no plans to establish any manufacturing facilities. We rely, and expect to continue to rely, on third-party 
manufacturers for the production, packaging, labeling, storage, and distribution of our product candidates for pre-clinical testing and in compliance with 
cGMP requirements for clinical trials under our guidance. In the case of lirentelimab, to date we have relied on a single third-party manufacturer and we are 
currently in the process of developing alternative manufacturing capabilities. We expect to continue to rely on third-party manufacturers for the commercial 
supply of any of our product candidates if any of our product candidates obtain marketing approval. We have personnel with significant technical, 

26

 
manufacturing, analytical, quality, regulatory, cGMP and project management experience to oversee our third-party manufacturers and to manage 
manufacturing and quality data and information for regulatory compliance purposes. 

Failure to comply with statutory and regulatory requirements subjects a manufacturer to possible legal or regulatory action, including warning 

letters, the seizure or recall of products, injunctions, consent decrees placing significant restrictions on or suspending manufacturing operations and civil 
and criminal penalties. Contract manufacturers often encounter difficulties involving production yields, quality control and quality assurance, as well as 
shortages of qualified personnel. Any of these actions or events could have a material impact on the availability of our products.

In-Licensing Agreements 

We have entered into two in-licensing agreements with third-parties for the development, manufacturing and commercialization of our products 

including lirentelimab. The specific terms of the individual agreements are discussed in further detail below. 

Exclusive License Agreement with The Johns Hopkins University

We have exclusively licensed intellectual property from The Johns Hopkins University (“JHU”) in a license agreement dated December 20, 2013 

and amended and restated September 30, 2016. In December 2013, we entered into an agreement with JHU for an exclusive worldwide license to develop 
and commercialize for the treatment and prevention of disease products covered by the JHU licensed patent rights or derived from materials provided by 
JHU. In September 2016, we and JHU amended and restated the license agreement to an exclusive worldwide license to develop and commercialize in all 
fields products covered by the licensed patent rights, or derived from materials provided by JHU.

Under the license agreement we are obligated to make payments to JHU for therapeutic products aggregating up to $4.0 million based on achieving 

specified development and regulatory approval milestones. We will also pay single-digit royalties to JHU based on net sales of each licensed therapeutic 
product by us and our affiliates and sublicensees and have up to a low six-digit dollar minimum annual royalty payment. In addition, in the event we 
sublicense the JHU intellectual property, we are obligated to pay JHU a specified portion of income we receive from sublicensing.

Our royalty obligation with respect to each licensed product in a country extends until the later of the expiration of the last-to-expire patent licensed 

from JHU covering the licensed product in the country or the expiration of a specified number of years after the first commercial sale of any licensed 
product in any country. The last expiration date of patents licensed under the agreement was 2021 in all applicable countries, in the absence of any patent 
extensions that may be available for such patents

Non-Exclusive License Agreement with BioWa Inc. and Lonza Sales AG

We have licensed on a non-exclusive basis intellectual property from BioWa Inc. (“BioWa”) and Lonza pursuant to a license agreement dated 

October 31, 2013. The agreement grants Allakos a non-exclusive worldwide license to develop and commercialize certain products manufactured in a 
particular mammalian host cell line for the prevention, diagnosis or treatment of human disease.

Under the license agreement, we are obligated to pay BioWa an annual commercial license fee of $40,000 until such time as BioWa receives royalty 
payments. We may also become obligated to make payments to BioWa aggregating up to $41.0 million based on achieving specified milestones, and to pay 
low single-digit royalties to BioWa based on net sales of licensed product by us and our affiliates and sublicensees. Our royalty obligation to BioWa with 
respect to each licensed product in a country extends until the later of the expiration of the last-to-expire licensed patent covering the licensed product in 
the country or the expiration of either regulatory exclusivity or a specified number of years after the first commercial sale of the licensed product in the 
country, whichever is later.

27

 
We may also pay low single-digit royalties to Lonza based on net sales of each licensed product by us and our affiliates and sublicensees. We will be 

required to pay an annual license fees to Lonza if we (or our strategic partner) manufactures a particular product using the particular cell line, or if we 
utilize a third party CMO to manufacture a product using such system. Our royalty obligation to Lonza with respect to each licensed product in a country 
extends until the later of the expiration of the last-to-expire licensed patent covering the licensed product in the country or a specified number of years after 
the first commercial sale of the licensed product in the country, whichever is later. The latest possible expiration date of patents licensed under the 
agreement is 2021 or 2023, depending on the country, in the absence of any patent extensions that may be available for such patents.

Total Royalty Burden

In aggregate, we anticipate our total royalty obligation on lirentelimab from our in-licensing agreements will be a mid-single digit percentage of net 

sales by us and our affiliates and sublicensees. 

Government Regulation

Government authorities in the United States at the federal, state and local level and in other countries regulate, among other things, the research, 

development, testing, manufacture, quality control, approval, labeling, packaging, storage, record-keeping, promotion, advertising, distribution, post-
approval monitoring and reporting, marketing and export and import of drug and biological products. Generally, before a new drug or biologic can be 
marketed, considerable data demonstrating its quality, safety and efficacy must be obtained, organized into a format specific for each regulatory authority, 
submitted for review and approved by the regulatory authority.

U.S. Drug Development

In the United States, the FDA regulates drugs under the Federal Food, Drug, and Cosmetic Act (“FDCA”) and its implementing regulations, and 

biologics under the FDCA, the Public Health Service Act (“PHSA”) and their implementing regulations. Both drugs and biologics also are subject to other 
federal, state and local statutes and regulations. The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, 
state, local and foreign statutes and regulations requires the expenditure of substantial time and financial resources. Failure to comply with the applicable 
U.S. requirements at any time during the product development process, approval process or after approval may subject an applicant to administrative or 
judicial sanctions. These sanctions could include, among other actions, the FDA’s refusal to approve pending applications, withdrawal of an approval, a 
clinical hold, untitled or warning letters, product recalls or market withdrawals, product seizures, total or partial suspension of production or distribution, 
injunctions, fines, refusals of government contracts, restitution, disgorgement and civil or criminal penalties. Any agency or judicial enforcement action 
could have a material adverse effect on us.

Any future product candidates must be approved by the FDA through either a BLA or New Drug Application (“NDA”) process before they may be 

legally marketed in the United States. The process generally involves the following:

•

•

•

•

•

completion of extensive preclinical studies in accordance with applicable regulations, including nonclinical laboratory and animal tests that 
must be conducted in accordance with good laboratory practice (“GLP”), requirements;

submission to the FDA of an Investigational New Drug (“IND”) application, which must become effective before human clinical trials may 
begin;

approval by an independent institutional review board (“IRB”), or ethics committee at each clinical trial site before each trial may be 
initiated;

performance of adequate and well-controlled human clinical trials in accordance with applicable IND regulations, good clinical practice 
(“GCP”), requirements and other clinical trial-related regulations to establish the safety and efficacy of the investigational product for each 
proposed indication;

submission to the FDA of an NDA or BLA and payment of user fees, if applicable;

28

 
•

•

•

•

•

a determination by the FDA within 60 days of its receipt of an NDA or BLA to accept the filing for review;

satisfactory completion of a FDA pre-approval inspection of the manufacturing facility or facilities where the drug or biologic will be 
produced to assess compliance with cGMP requirements to assure that the facilities, methods and controls are adequate to preserve the drug 
or biologic’s identity, strength, quality and purity;

satisfactory completion of FDA audit of the preclinical and/or clinical trial sites that generated the data in support of the NDA or BLA to 
assure compliance with GCPs and the integrity of the clinical data;

FDA review and approval of the NDA or BLA, including consideration of the views of any FDA advisory committee, prior to any 
commercial marketing or sale of the drug or biologic in the United States; and

compliance with any post-approval requirements, including the potential requirement to implement a Risk Evaluation and Mitigation 
Strategy (“REMS”), and the potential requirement to conduct post-approval studies.

The data required to support an NDA or BLA are generated in two distinct developmental stages: preclinical and clinical. The preclinical and 

clinical testing and approval process requires substantial time, effort and financial resources, and we cannot be certain that any approvals for any future 
product candidates will be granted on a timely basis, or at all.

Preclinical Studies and IND

The preclinical development stage generally involves laboratory evaluation of drug chemistry, formulation and stability, as well as in vitro and 

animal studies to evaluate toxicity, assess potential safety and efficacy, assess the potential for adverse events, support subsequent clinical testing, and in 
some cases to establish a rationale for therapeutic use. The conduct of preclinical studies is subject to federal regulations and requirements, including GLP 
regulations for safety/toxicology studies. The sponsor must submit the results of the preclinical studies, together with manufacturing information, analytical 
data, any available clinical data or literature and a proposed clinical protocol, to the FDA as part of the IND. Some long-term preclinical testing, such as 
animal tests of reproductive adverse events and carcinogenicity, may continue after the IND is submitted. An IND is a request for authorization from the 
FDA to administer an investigational product to humans, and must become effective before human clinical trials may begin. An IND automatically 
becomes effective 30 days after receipt by the FDA, unless before that time, the FDA raises concerns or questions related to one or more proposed clinical 
trials and places the trial on clinical hold. In such a case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical trial can 
begin. As a result, submission of an IND may not result in the FDA allowing clinical trials to commence.

Clinical Trials

The clinical stage of development involves the administration of the investigational product to human subjects under the supervision of qualified 

investigators in accordance with GCP requirements, which include the requirement that all research subjects provide their informed consent for their 
participation in any clinical trial. Investigators must also provide information to the clinical trial sponsors to allow the sponsors to disclose any financial 
interests and arrangements to the FDA that could affect the reliability or integrity of data submitted. Clinical trials are conducted under protocols detailing, 
among other things, the objectives of the clinical trial, dosing procedures, subject selection and exclusion criteria and the parameters to be used to monitor 
subject safety and assess efficacy. Each protocol, and any subsequent amendments to the protocol, must be submitted to the FDA as part of the IND. 
Furthermore, each clinical trial must be reviewed and approved by an IRB for each institution at which the clinical trial will be conducted to ensure that the 
risks to individuals participating in the clinical trials are minimized and are reasonable in relation to anticipated benefits. The IRB also approves the 
informed consent form that must be provided to each clinical trial subject or his or her legal representative, and must monitor the clinical trial until 
completed. There also are requirements governing the reporting of ongoing clinical trials and completed clinical trial results to public registries. The 
manufacture of investigational drugs for the conduct of human clinical trials is subject to cGMP requirements.

29

 
A sponsor who wishes to conduct a clinical trial outside of the United States may, but need not, obtain FDA authorization to conduct the clinical 

trial under an IND. If a foreign clinical trial is not conducted under an IND, the sponsor may submit data from the clinical trial to the FDA in support of an 
NDA or BLA. The FDA will accept a well-designed and well-conducted foreign clinical trial not conducted under an IND if the trial was conducted in 
accordance with GCP requirements and the FDA is able to validate the data through an onsite inspection if deemed necessary.

Clinical trials in the United States generally are conducted in three sequential phases, known as Phase 1, Phase 2 and Phase 3, and may be combined 

or overlap.

•

•

•

Phase 1 clinical trials generally involve a small number of healthy volunteers or disease-affected subjects who are initially exposed to a 
single dose and then multiple doses of the product candidate. The primary purpose of these clinical trials is to assess the metabolism, 
pharmacologic action, tolerability and safety of the drug.

Phase 2 clinical trials involve studies in disease-affected subjects to determine the dose required to produce the desired benefits. At the same 
time, safety and further PK and PD information is collected, possible adverse effects and safety risks are identified and a preliminary 
evaluation of efficacy is conducted.

Phase 3 clinical trials generally involve a large number of subjects at multiple sites and are designed to provide the data necessary to 
demonstrate the effectiveness of the product for its intended use, its safety in use and to establish the overall benefit/risk relationship of the 
product and provide an adequate basis for product labeling and approval. These trials may include comparisons with placebo and/or other 
comparator treatments. The duration of treatment is often extended to mimic the actual use of a product during marketing.

Post-approval trials, sometimes referred to as Phase 4 clinical trials, may be conducted after initial marketing approval. These trials are used to gain 
additional experience from the treatment of patients in the intended therapeutic indication. In certain instances, the FDA may mandate the performance of 
Phase 4 clinical trials as a condition of approval of an NDA or BLA. The results of Phase 4 trials may confirm the effectiveness of a product candidate and 
may provide important safety information.

Progress reports detailing the results of the clinical trials, among other information, must be submitted at least annually to the FDA and written IND 

safety reports must be submitted to the FDA and the investigators for serious and unexpected suspected adverse events, findings from other studies 
suggesting a significant risk to humans exposed to the drug or biologic, findings from animal or in vitro testing that suggest a significant risk for human 
subjects and any clinically important increase in the rate of a serious suspected adverse reaction over that listed in the protocol or investigator brochure.

Phase 1, Phase 2 and Phase 3 clinical trials may not be completed successfully within any specified period, if at all. The FDA or the sponsor may 

suspend or terminate a clinical trial at any time on various grounds, including a finding that the research subjects or patients are being exposed to an 
unacceptable health risk. Similarly, an IRB can suspend or terminate approval of a clinical trial at its institution if the clinical trial is not being conducted in 
accordance with the IRB’s requirements or if the drug or biologic has been associated with unexpected serious harm to patients. Additionally, some clinical 
trials are overseen by an independent group of qualified experts organized by the clinical trial sponsor, known as a data safety monitoring board or 
committee. This group provides authorization for whether a trial may move forward at designated check points based on access to certain data from the 
trial. Concurrent with clinical trials, companies usually complete additional animal studies and also must develop additional information about the 
chemistry and physical characteristics of the drug or biologic as well as finalize a process for manufacturing the product in commercial quantities in 
accordance with cGMP requirements. The manufacturing process must be capable of consistently producing quality batches of the product and, among 
other things, companies must develop methods for testing the identity, strength, quality and purity of the final product. Additionally, appropriate packaging 
must be selected and tested and stability studies must be conducted to demonstrate that our product candidates do not undergo unacceptable deterioration 
over their shelf life. We may also be required to develop and implement additional clinical trial policies and procedures as a result of the COVID-19 

30

 
pandemic. For example, FDA has issued guidance documents on protecting subjects from the COVID-19 virus and cGMP considerations for responding to 
COVID-19 infection in employees in product manufacturing.

NDA/BLA Review Process

Following completion of the preclinical testing and clinical trials, data are analyzed to assess whether the investigational product is safe and 

effective for the proposed indicated use or uses. The results of preclinical studies and clinical trials are then submitted to the FDA as part of an NDA or 
BLA, along with proposed labeling, chemistry and manufacturing information to ensure product quality and other relevant data. In short, the NDA or BLA 
is a request for approval to market the drug or biologic for one or more specified indications and must contain proof of safety and efficacy for a drug or 
safety, purity and potency for a biologic. The application may include both negative and ambiguous results of preclinical studies and clinical trials, as well 
as positive findings. Data may come from company-sponsored clinical trials intended to test the safety and efficacy of a product’s use or from a number of 
alternative sources, including studies initiated by investigators. To support marketing approval, the data submitted must be sufficient in quality and quantity 
to establish the safety and efficacy of the investigational product to the satisfaction of FDA. FDA approval of an NDA or BLA must be obtained before a 
drug or biologic may be marketed in the United States.

The submission of an NDA requires payment of a substantial user fee to the FDA, unless otherwise exempted, such as in the case of an NDA for a 

drug with orphan drug designation. Under the Prescription Drug User Fee Act (“PDUFA”), as amended, each NDA or BLA must be accompanied by a user 
fee. FDA adjusts the PDUFA user fees on an annual basis. According to the FDA’s fee schedule, for the FDA’s fiscal year 2022, the user fee for an 
application requiring clinical data, such as an NDA or BLA, is $3.12 million. PDUFA also imposes an annual program fee for human drugs and biologics 
of $0.3 million. Fee waivers or reductions are available in certain circumstances, including a waiver of the application fee for the first application filed by a 
small business. Additionally, no user fees are assessed on NDAs or BLAs for products designated as orphan drugs, unless the product also includes a non-
orphan indication.

The FDA reviews all submitted NDAs and BLAs before it accepts them for filing, and may request additional information rather than accepting the 
NDA or BLA for filing. The FDA must make a decision on accepting an NDA or BLA for filing within 60 days of receipt. Once the submission is accepted 
for filing, the FDA begins an in-depth review of the NDA or BLA. Under the goals and policies agreed to by the FDA under PDUFA, the FDA has ten 
months, from the filing date, in which to complete its initial review of a new molecular-entity NDA or original BLA and respond to the applicant, and six 
months from the filing date of a new molecular-entity NDA or original BLA designated for priority review. The FDA does not always meet its PDUFA 
goal dates for standard and priority NDAs or BLAs, and the review process is often extended by FDA requests for additional information or clarification.

Before approving an NDA or BLA, the FDA will conduct a pre-approval inspection of the manufacturing facilities for the new product to determine 
whether they comply with cGMP requirements. The FDA will not approve the product unless it determines that the manufacturing processes and facilities 
are in compliance with cGMP requirements and adequate to assure consistent production of the product within required specifications. The FDA also may 
audit data from clinical trials to ensure compliance with GCP requirements. Additionally, the FDA may refer applications for novel drug products or drug 
products which present difficult questions of safety or efficacy to an advisory committee, typically a panel that includes clinicians and other experts, for 
review, evaluation and a recommendation as to whether the application should be approved and under what conditions, if any. The FDA is not bound by 
recommendations of an advisory committee, but it considers such recommendations when making decisions on approval. The FDA likely will reanalyze 
the clinical trial data, which could result in extensive discussions between the FDA and the applicant during the review process. After the FDA evaluates an 
NDA or BLA, it will issue an approval letter or a Complete Response Letter. An approval letter authorizes commercial marketing of the drug with specific 
prescribing information for specific indications. A Complete Response Letter indicates that the review cycle of the application is complete and the 
application will not be approved in its present form. A Complete Response Letter usually describes all of the specific deficiencies in the NDA or BLA 
identified by the FDA. The Complete Response Letter may require additional clinical data, additional pivotal Phase 3 clinical trial(s) and/or other 
significant and time-consuming requirements related to clinical trials, preclinical studies or manufacturing. If a Complete Response Letter is issued, the 
applicant may either resubmit the NDA or BLA, 

31

 
addressing all of the deficiencies identified in the letter, or withdraw the application. Even if such data and information are submitted, the FDA may decide 
that the NDA or BLA does not satisfy the criteria for approval. Data obtained from clinical trials are not always conclusive and the FDA may interpret data 
differently than we interpret the same data.

Orphan Drugs

Under the Orphan Drug Act, the FDA may grant orphan designation to a drug or biological product intended to treat a rare disease or condition, 

which is generally a disease or condition that affects fewer than 200,000 individuals in the United States, or more than 200,000 individuals in the United 
States and for which there is no reasonable expectation that the cost of developing and making the product available in the United States for this type of 
disease or condition will be recovered from sales of the product.

Orphan drug designation must be requested before submitting an NDA or BLA. After the FDA grants orphan drug designation, the identity of the 

therapeutic agent and its potential orphan use are disclosed publicly by the FDA. Orphan drug designation does not convey any advantage in or shorten the 
duration of the regulatory review and approval process.

If a product that has orphan designation subsequently receives the first FDA approval for the disease or condition for which it has such designation 

or for a select indication or use within the rare disease or condition for which it was designated, the product generally will be receiving orphan drug 
exclusivity, which means that the FDA may not approve any other applications to market the same drug for the same indication for seven years from the 
date of such approval, except in limited circumstances, such as a showing of clinical superiority to the product with orphan exclusivity by means of greater 
effectiveness, greater safety or providing a major contribution to patient care or in instances of drug supply issues. Competitors, however, may receive 
approval of either a different product for the same indication or the same product for a different indication but that could be used off-label in the orphan 
indication. Orphan drug exclusivity also could block the approval of one of our products for seven years if a competitor obtains approval before we do for 
the same product, as defined by the FDA, for the same indication we are seeking approval, or if a product candidate is determined to be contained within 
the scope of the competitor’s product for the same indication or disease. If one of our products designated as an orphan drug receives marketing approval 
for an indication broader than that which is designated, it may not be entitled to orphan drug exclusivity. Orphan drug status in the European Union has 
similar, but not identical, requirements and benefits.

Expedited Development and Review Programs

The FDA has various programs, including Fast Track designation, Breakthrough Therapy designation, accelerated approval and Priority Review 

designation, which are intended to expedite or facilitate the process for reviewing new drugs and biologics that meet certain criteria. 

The purpose of these programs is to ensure that therapies for serious conditions are approved and available to patients as soon as it can be concluded 
that the therapies’ benefits justify their risks. Under the Fast Track program, the sponsor of a new drug candidate may request that FDA designate the drug 
candidate for a specific indication as a Fast Track drug concurrent with, or after, the IND submission for the drug candidate, but ideally no later than the 
pre-NDA meeting because many of the features of Fast Track designation will not apply after that time. To be eligible for a Fast Track designation, the 
FDA must determine, based on the request of a sponsor, that a product is intended to treat a serious or life-threatening disease or condition and nonclinical 
or clinical data demonstrate the potential to address an unmet medical need. The FDA will determine that a product has the potential to fill a medical need 
if it will provide a therapy where none exists or the condition is not adequately addressed by current available therapy. Fast Track designation provides 
additional opportunities for interaction with the FDA’s review team and rolling review of NDA components before the completed application is submitted. 
For rolling submission, the sponsor provides a schedule for the submission of the sections of the NDA, the FDA agrees to accept sections of the NDA and 
determines that the schedule is acceptable, and the sponsor pays any required user fees upon submission of the first section of the NDA. However, the 
FDA’s time period goal for reviewing an application does not begin until the last section of the NDA is submitted. The FDA may decide to rescind the Fast 
Track designation if it determines that the qualifying criteria no longer apply, and a sponsor may also withdraw Fast Track designation if the designation is 
no longer supported by emerging data or the drug development program is no longer being pursued.

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Any product submitted to the FDA for marketing, including under a fast-track program, may be eligible for other types of FDA programs intended 

to expedite development and review, such as priority review and accelerated approval. Any product is eligible for priority review if it treats a serious or 
life-threatening condition and, if approved, would provide a significant improvement in safety and effectiveness compared to available therapies. A sponsor 
may request Priority Review designation of an NDA for a drug that is intended to treat a serious condition at the time of the original NDA (or efficacy 
supplement) submission. FDA may assign a Priority Review designation if FDA determines that the product, if approved, would provide a significant 
improvement in safety or effectiveness or any supplement that proposes a labeling change pursuant to a report on a pediatric study. A Priority Review 
designation means that the goal for the FDA to review an application is six months, rather than the standard review of ten months under the Prescription 
Drug User Fee Act (“PDUFA”) goals. Under the current PDUFA performance goals, these six- and ten-month review periods are measured from the 60-day 
filing date rather than the receipt date for NDAs for new molecular entities (“NME”), which typically adds approximately two months to the timeline for 
review from the date of submission.

A product may also be eligible for accelerated approval, if it treats a serious or life-threatening condition and generally provides a meaningful 
advantage over available therapies. In addition, it must demonstrate an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit or 
on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality (“IMM”), that is reasonably likely to predict an effect on IMM 
irreversible morbidity or mortality or other clinical benefit(i.e., an intermediate clinical endpoint), taking into account the severity, rarity or prevalence of 
the condition and the availability or lack of alternative treatments. As a condition of approval, the FDA may require that a sponsor of a drug or biologic 
receiving accelerated approval perform adequate and well-controlled post-marketing clinical trials. Failure to conduct required post approval studies or 
confirm a clinical benefit during post marketing studies may lead to the FDA withdrawing the drug from the market. All promotional materials for drug 
candidates approved under accelerated approval regulations are subject to prior review by the FDA. If the FDA concludes that a drug or biologic shown to 
be effective can be safely used only if distribution or use is restricted, it may require such post-marketing restrictions, as it deems necessary to assure safe 
use of the product.

Additionally, a drug or biologic may be eligible for designation as a Breakthrough Therapy if the product is intended, alone or in combination with 

one or more other drugs or biologics, to treat a serious or life-threatening condition and preliminary clinical evidence indicates that the product may 
demonstrate substantial improvement over currently approved therapies on one or more clinically significant endpoints. The benefits of Breakthrough 
Therapy designation include the same benefits as Fast Track designation, plus intensive guidance from the FDA to ensure an efficient drug development 
program, organizational commitment to the development and review of the product, including involvement of senior managers. Like Fast Track products, 
Breakthrough Therapy products are also eligible for rolling review of the NDA. A designation may be rescinded if a product candidate no longer meets the 
qualifying criteria for breakthrough therapy. A sponsor may also withdraw breakthrough therapy designation if the designation is no longer supported by 
the emerging data or the drug development program is no longer being pursued.

Fast Track designation, priority review, accelerated approval and Breakthrough Therapy designation do not change the standards for approval, but 

may expedite the development or approval process.

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Abbreviated Licensure Pathway of Biological Products as Biosimilar or Interchangeable

The Patient Protection and Affordable Care Act, or Affordable Care Act (“ACA”), signed into law in 2010, includes a subtitle called the Biologics 
Price Competition and Innovation Act of 2009 (“BPCIA”), created an abbreviated approval pathway for biological products shown to be highly similar to 
an FDA-licensed reference biological product. The BPCIA attempts to minimize duplicative testing, and thereby lower development costs and increase 
patient access to affordable treatments. An application for licensure of a biosimilar product must include information demonstrating biosimilarity based 
upon the following, unless the FDA determines otherwise:

•

•

•

analytical studies demonstrating that the proposed biosimilar product is highly similar to the approved product notwithstanding minor 
differences in clinically inactive components;

animal studies (including the assessment of toxicity); and

a clinical trial or trials (including the assessment of immunogenicity and PK or PD) sufficient to demonstrate safety, purity and potency in 
one or more conditions for which the reference product is licensed and intended to be used.

In addition, an application must include information demonstrating that:

•

•

•

•

the proposed biosimilar product and reference product utilize the same mechanism of action for the condition(s) of use prescribed, 
recommended or suggested in the proposed labeling, but only to the extent the mechanism(s) of action are known for the reference product;

the condition or conditions of use prescribed, recommended or suggested in the labeling for the proposed biosimilar product have been 
previously approved for the reference product;

the route of administration, the dosage form and the strength of the proposed biosimilar product are the same as those for the reference 
product; and

the facility in which the biological product is manufactured, processed, packed or held meets standards designed to assure that the biological 
product continues to be safe, pure and potent.

Biosimilarity means that the biological product is highly similar to the reference product notwithstanding minor differences in clinically inactive 

components; and that there are no clinically meaningful differences between the biological product and the reference product in terms of the safety, purity 
and potency of the product. In addition, the law provides for a designation of “interchangeability” between the reference and biosimilar products, whereby 
the biosimilar may be substituted for the reference product without the intervention of the health care provider who prescribed the reference product. The 
higher standard of interchangeability must be demonstrated by information sufficient to show that:

•

•

•

the proposed product is biosimilar to the reference product;

the proposed product is expected to produce the same clinical result as the reference product in any given patient; and

for a product that is administered more than once to an individual, the risk to the patient in terms of safety or diminished efficacy of 
alternating or switching between the biosimilar and the reference product is no greater than the risk of using the reference product without 
such alternation or switch.

FDA approval is required before a biosimilar may be marketed in the United States. However, complexities associated with the large and intricate 

structures of biological products and the process by which such products are manufactured pose significant hurdles to the FDA’s implementation of the law 
that are still being worked out by the FDA. For example, the FDA has discretion over the kind and amount of scientific evidence—laboratory, preclinical 
and/or clinical—required to demonstrate biosimilarity to a licensed biological product.

The FDA intends to consider the totality of the evidence, provided by a sponsor to support a demonstration of biosimilarity, and recommends that 

sponsors use a stepwise approach in the development of their biosimilar products. Biosimilar product applications thus may not be required to duplicate the 
entirety of preclinical and clinical testing used to establish the underlying safety and effectiveness of the reference product. However, the FDA may refuse 
to approve a biosimilar application if there is insufficient information to show that the active ingredients are the same or to demonstrate that any impurities 
or differences in active ingredients do not affect the safety, purity 

34

 
or potency of the biosimilar product. In addition, as with BLAs, biosimilar product applications will not be approved unless the product is manufactured in 
facilities designed to assure and preserve the biological product’s safety, purity and potency.

The submission of a biosimilar application does not guarantee that the FDA will accept the application for filing and review, as the FDA may refuse 

to accept applications that it finds are insufficiently complete. The FDA will treat a biosimilar application or supplement as incomplete if, among other 
reasons, any applicable user fees assessed under the Biosimilar User Fee Act of 2012 have not been paid. In addition, the FDA may accept an application 
for filing but deny approval on the basis that the sponsor has not demonstrated biosimilarity, in which case the sponsor may choose to conduct further 
analytical, preclinical or clinical studies and submit a BLA for licensure as a new biological product.

The timing of final FDA approval of a biosimilar for commercial distribution depends on a variety of factors, including whether the manufacturer of 
the branded product is entitled to one or more statutory exclusivity periods, during which time the FDA is prohibited from approving any products that are 
biosimilar to the branded product. The FDA cannot approve a biosimilar application for twelve years from the date of first licensure of the reference 
product. Additionally, a biosimilar product sponsor may not submit an application for four years from the date of first licensure of the reference product. A 
reference product may also be entitled to exclusivity under other statutory provisions. For example, a reference product designated for a rare disease or 
condition (an “orphan drug”) may be entitled to seven years of exclusivity, in which case no product that is biosimilar to the reference product may be 
approved until either the end of the twelve-year period provided under the biosimilarity statute or the end of the seven-year orphan drug exclusivity period, 
whichever occurs later. In certain circumstances, a regulatory exclusivity period can extend beyond the life of a patent, and thus block biosimilarity 
applications from being approved on or after the patent expiration date. In addition, the FDA may under certain circumstances extend the exclusivity period 
for the reference product by an additional six months if the FDA requests, and the manufacturer undertakes, studies on the effect of its product in children, 
a so-called pediatric extension.

The first biological product determined to be interchangeable with a branded product for any condition of use is also entitled to a period of 

exclusivity, during which time the FDA may not determine that another product is interchangeable with the reference product for any condition of use. This 
exclusivity period extends until the earlier of: (1) one year after the first commercial marketing of the first interchangeable product; (2) 18 months after 
resolution of a patent infringement against the applicant that submitted the application for the first interchangeable product, based on a final court decision 
regarding all of the patents in the litigation or dismissal of the litigation with or without prejudice; (3) 42 months after approval of the first interchangeable 
product, if a patent infringement suit against the applicant that submitted the application for the first interchangeable product is still ongoing or (4) 18 
months after approval of the first interchangeable product if the applicant that submitted the application for the first interchangeable product has not been 
sued.

Post-Approval Requirements

Following approval of a new product, the manufacturer and the approved product are subject to continuing regulation by the FDA, including, among 

other things, monitoring and record-keeping requirements, requirements to report adverse experiences and comply with promotion and advertising 
requirements, which include restrictions on promoting drugs for unapproved uses or patient populations (known as “off-label use”) and limitations on 
industry-sponsored scientific and educational activities. Although physicians may prescribe legally available drugs for off-label uses, manufacturers may 
not market or promote such uses. Prescription drug promotional materials must be submitted to the FDA in conjunction with their first use. Further, if there 
are any modifications to the drug or biologic, including changes in indications, labeling or manufacturing processes or facilities, the applicant may be 
required to submit and obtain FDA approval of a new NDA/BLA or NDA/BLA supplement, which may require the development of additional data or 
preclinical studies and clinical trials.

35

 
The FDA may also place other conditions on approvals including the requirement for a REMS, to assure the safe use of the product. A REMS could 

include medication guides, physician communication plans or elements to assure safe use, such as restricted distribution methods, patient registries and 
other risk minimization tools. Any of these limitations on approval or marketing could restrict the commercial promotion, distribution, prescription or 
dispensing of products. Product approvals may be withdrawn for non-compliance with regulatory standards or if problems occur following initial 
marketing.

The FDA may withdraw approval if compliance with regulatory requirements and standards is not maintained or if problems occur after the product 

reaches the market. Later discovery of previously unknown problems with a product, including adverse events of unanticipated severity or frequency, or 
with manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved labeling to add new safety 
information; imposition of post-market studies or clinical studies to assess new safety risks or imposition of distribution restrictions or other restrictions 
under a REMS program. Other potential consequences include, among other things:

•

•

•

•

•

•

restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from the market or product recalls;

fines, warning letters or holds on post-approval clinical studies;

refusal of the FDA to approve pending applications or supplements to approved applications;

applications, or suspension or revocation of product license approvals;

product seizure or detention, or refusal to permit the import or export of products; or

injunctions or the imposition of civil or criminal penalties.

The FDA strictly regulates marketing, labeling, advertising and promotion of products that are placed on the market. Drugs and biologics may be 

promoted only for the approved indications and in accordance with the provisions of the approved label. The FDA and other agencies actively enforce the 
laws and regulations prohibiting the promotion of off-label uses, and a company that is found to have improperly promoted off-label uses may be subject to 
significant liability.

Other U.S. Regulatory Matters

Manufacturing, sales, promotion and other activities following product approval are also subject to regulation by numerous regulatory authorities in 
the United States in addition to the FDA, including the Centers for Medicare & Medicaid Services, other divisions of the Department of Health and Human 
Services, the Department of Justice, the Drug Enforcement Administration, the Consumer Product Safety Commission, the Federal Trade Commission, the 
Occupational Safety & Health Administration, the Environmental Protection Agency and state and local governments.

For example, in the United States, sales, marketing and scientific and educational programs also must comply with state and federal fraud and abuse 

laws. These laws include the federal Anti-Kickback Statute, which makes it illegal for any person, including a prescription drug manufacturer (or a party 
acting on its behalf), to knowingly and willfully solicit, receive, offer or pay any remuneration that is intended to induce or reward referrals, including the 
purchase, recommendation, order or prescription of a particular drug, for which payment may be made under a federal healthcare program, such as 
Medicare or Medicaid. Violations of this law are punishable by up to five years in prison, criminal fines, administrative civil money penalties and exclusion 
from participation in federal healthcare programs. Moreover, the ACA provides that the government may assert that a claim including items or services 
resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the False Claims Act.

36

 
Pricing and rebate programs must comply with the Medicaid rebate requirements of the U.S. Omnibus Budget Reconciliation Act of 1990 and more 
recent requirements in the ACA. If products are made available to authorized users of the Federal Supply Schedule of the General Services Administration, 
additional laws and requirements apply. Products must meet applicable child-resistant packaging requirements under the U.S. Poison Prevention Packaging 
Act. Manufacturing, sales, promotion and other activities also are potentially subject to federal and state consumer protection and unfair competition laws.

The distribution of biologic and pharmaceutical products is subject to additional requirements and regulations, including extensive record-keeping, 

licensing, storage and security requirements intended to prevent the unauthorized sale of pharmaceutical products.

The failure to comply with any of these laws or regulatory requirements subjects firms to possible legal or regulatory action. Depending on the 
circumstances, failure to meet applicable regulatory requirements can result in criminal prosecution, fines or other penalties, injunctions, requests for recall, 
seizure of products, total or partial suspension of production, denial or withdrawal of product approvals or refusal to allow a firm to enter into supply 
contracts, including government contracts. 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. Prohibitions or restrictions on sales or 
withdrawal of future products marketed by us could materially affect our business in an adverse way.

Changes in regulations, statutes or the interpretation of existing regulations could impact our business in the future by requiring, for example: (i) 
changes to our manufacturing arrangements; (ii) additions or modifications to product labeling; (iii) the recall or discontinuation of our products; or (iv) 
additional record-keeping requirements. If any such changes were to be imposed, they could adversely affect the operation of our business.

U.S. Patent-Term Restoration and Marketing Exclusivity

Depending upon the timing, duration and specifics of FDA approval of any future product candidates, some of our U.S. patents may be eligible for 
limited patent term extension under the Drug Price Competition and Patent Term Restoration Act of 1984 (the “Hatch-Waxman Act”). The Hatch-Waxman 
Act permits restoration of the patent term of up to five years as compensation for patent term lost during product development and FDA regulatory review 
process. Patent-term restoration, however, cannot extend the remaining term of a patent beyond a total of 14 years from the product’s approval date. The 
patent-term restoration period is generally one-half the time between the effective date of an IND and the submission date of an NDA or BLA plus the time 
between the submission date of an NDA or BLA and the approval of that application, except that the review period is reduced by any time during which the 
applicant failed to exercise due diligence. Only one patent applicable to an approved drug is eligible for the extension and the application for the extension 
must be submitted prior to the expiration of the patent. The U.S. PTO, in consultation with the FDA, reviews and approves the application for any patent 
term extension or restoration. In the future, we may apply for restoration of patent term for our currently owned or licensed patents to add patent life 
beyond its current expiration date, depending on the expected length of the clinical trials and other factors involved in the filing of the relevant NDA or 
BLA.

Market exclusivity provisions under the FDCA also can delay the submission or the approval of certain applications. The FDCA provides a five-

year period of non-patent marketing exclusivity within the United States to the first applicant to gain approval of a NDA for a new chemical entity. A drug 
is a new chemical entity if the FDA has not previously approved any other new drug containing the same active moiety, which is the molecule or ion 
responsible for the action of the drug substance. During the exclusivity period, the FDA may not accept for review an abbreviated new drug application 
(“ANDA”), or a 505(b)(2) NDA submitted by another company for another version of such drug where the applicant does not own or have a legal right of 
reference to all the data required for approval. However, an application may be submitted after four years if it contains a certification of patent invalidity or 
non-infringement. The FDCA also provides three years of marketing exclusivity for a NDA, 505(b)(2) NDA or supplement to an existing NDA if new 
clinical investigations, other than bioavailability studies, that were conducted or sponsored by the applicant are deemed by the FDA to be essential to the 
approval of the application, for example, new indications, dosages or strengths of an existing drug. This three-year exclusivity covers only the conditions of 
use associated with the new clinical investigations and does not prohibit the FDA from approving ANDAs for drugs containing the original active agent. 
Five-year and three-year exclusivity will not delay the submission or approval of a full NDA. However, an applicant submitting a full NDA would be 
required to conduct or obtain a right of reference to all of the preclinical studies and adequate and well-controlled clinical trials necessary to demonstrate 
safety and effectiveness.

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A reference biological product is granted twelve years of data exclusivity from the time of first licensure of the product, and the FDA will not accept 

an application for a biosimilar or interchangeable product based on the reference biological product until four years after the date of first licensure of the 
reference product. “First licensure” typically means the initial date the particular product at issue was licensed in the United States. Date of first licensure 
does not include the date of licensure of (and a new period of exclusivity is not available for) a biological product if the licensure is for a supplement for the 
biological product or for a subsequent application by the same sponsor or manufacturer of the biological product (or licensor, predecessor in interest or 
other related entity) for a change (not including a modification to the structure of the biological product) that results in a new indication, route of 
administration, dosing schedule, dosage form, delivery system, delivery device or strength or for a modification to the structure of the biological product 
that does not result in a change in safety, purity or potency. Therefore, one must determine whether a new product includes a modification to the structure 
of a previously licensed product that results in a change in safety, purity or potency to assess whether the licensure of the new product is a first licensure 
that triggers its own period of exclusivity. Whether a subsequent application, if approved, warrants exclusivity as the “first licensure” of a biological 
product is determined on a case-by-case basis with data submitted by the sponsor.

European Union Drug Development

As in the United States, medicinal products can be marketed only if a marketing authorization from the competent regulatory agencies has been 

obtained.

Similar to the United States, the various phases of preclinical and clinical research in the European Union are subject to significant regulatory 
controls. Although the EU Clinical Trials Directive 2001/20/EC has sought to harmonize the EU clinical trials regulatory framework, setting out common 
rules for the control and authorization of clinical trials in the EU, the EU Member States have transposed and applied the provisions of the Directive 
differently. This has led to significant variations in the member state regimes. Under the current regime, before a clinical trial can be initiated it must be 
approved in each of the EU countries where the trial is to be conducted by two distinct bodies: the National Competent Authority (“NCA”), and one or 
more Ethics Committees (“ECs”). Under the current regime all suspected unexpected serious adverse reactions to the investigated drug that occur during 
the clinical trial have to be reported to the NCA and ECs of the Member State where they occurred.

The EU clinical trials legislation currently is undergoing a transition process mainly aimed at harmonizing and streamlining clinical-trial 

authorization, simplifying adverse-event reporting procedures, improving the supervision of clinical trials and increasing their transparency. Clinical Trials 
Regulation EU No 536/2014 ensures that the rules for conducting clinical trials in the EU will be identical. In the meantime, Clinical Trials Directive 
2001/20/EC continues to govern all clinical trials performed in the EU.

European Union Drug Review and Approval

In the European Economic Area (“EEA”), which is comprised of the 27 Member States of the European Union (including Norway and excluding 

Croatia), Iceland and Liechtenstein, medicinal products can only be commercialized after obtaining a Marketing Authorization (“MA”). There are two 
types of marketing authorizations.

•

•

The Community MA is issued by the European Commission through the Centralized Procedure, based on the opinion of the Committee for 
Medicinal Products for Human Use (“CHMP”), of the EMA, and is valid throughout the entire territory of the EEA. The Centralized 
Procedure is mandatory for certain types of products, such as biotechnology medicinal products, orphan medicinal products, advanced-
therapy medicines such as gene-therapy, somatic cell-therapy or tissue-engineered medicines and medicinal products containing a new active 
substance indicated for the treatment of HIV, AIDS, cancer, neurodegenerative disorders, diabetes, auto-immune and other immune 
dysfunctions and viral diseases. The Centralized Procedure is optional for products containing a new active substance not yet authorized in 
the EEA, or for products that constitute a significant therapeutic, scientific or technical innovation or which are in the interest of public health 
in the EU.

National MAs, which are issued by the competent authorities of the Member States of the EEA and only cover their respective territory, are 
available for products not falling within the mandatory scope of the Centralized Procedure. Where a product has already been authorized for 
marketing in a Member State of the EEA, this National MA can be recognized in another Member States through the Mutual Recognition 
Procedure. If the product has not received a National MA in any Member State at the time 

38

 
of application, it can be approved simultaneously in various Member States through the Decentralized Procedure. Under the Decentralized 
Procedure an identical dossier is submitted to the competent authorities of each of the Member States in which the MA is sought, one of 
which is selected by the applicant as the Reference Member State (“RMS”). The competent authority of the RMS prepares a draft assessment 
report, a draft summary of the product characteristics (“SPC”), and a draft of the labeling and package leaflet, which are sent to the other 
Member States (referred to as the Member States Concerned) for their approval. If the Member States Concerned raise no objections, based 
on a potential serious risk to public health, to the assessment, SPC, labeling or packaging proposed by the RMS, the product is subsequently 
granted a national MA in all the Member States (i.e., in the RMS and the Member States Concerned).

Under the above described procedures, before granting the MA, the EMA or the competent authorities of the Member States of the EEA make an 

assessment of the risk-benefit balance of the product on the basis of scientific criteria concerning its quality, safety and efficacy.

Coverage and Reimbursement

Sales of our products will depend, in part, on the extent to which our products will be covered by third-party payors, such as government health 

programs, commercial insurance and managed healthcare organizations. In the United States no uniform policy of coverage and reimbursement for drug or 
biological products exists. Accordingly, decisions regarding the extent of coverage and amount of reimbursement to be provided for any of our products 
will be made on a payor-by-payor basis. As a result, the coverage determination process is often a time-consuming and costly process that will require us to 
provide scientific and clinical support for the use of our products to each payor separately, with no assurance that coverage and adequate reimbursement 
will be obtained.

The United States government, state legislatures and foreign governments have shown significant interest in implementing cost containment 

programs to limit the growth of government-paid health care costs, including price-controls, restrictions on reimbursement and requirements for 
substitution of generic products for branded prescription drugs. For example, the ACA contains provisions that may reduce the profitability of drug 
products through increased rebates for drugs reimbursed by Medicaid programs, extension of Medicaid rebates to Medicaid managed care plans, mandatory 
discounts for certain Medicare Part D beneficiaries and annual fees based on pharmaceutical companies’ share of sales to federal health care programs. 
Adoption of general controls and measures, coupled with the tightening of restrictive policies in jurisdictions with existing controls and measures, could 
limit payments for pharmaceutical drugs.

The Medicaid Drug Rebate Program requires pharmaceutical manufacturers to enter into and have in effect a national rebate agreement with the 
Secretary of the Department of Health and Human Services as a condition for states to receive federal matching funds for the manufacturer’s outpatient 
drugs furnished to Medicaid patients. The ACA made several changes to the Medicaid Drug Rebate Program, including increasing pharmaceutical 
manufacturers’ rebate liability by raising the minimum basic Medicaid rebate on most branded prescription drugs from 15.1% of average manufacturer 
price (“AMP”), to 23.1% of AMP and adding a new rebate calculation for “line extensions” (i.e., new formulations, such as extended release formulations) 
of solid oral dosage forms of branded products, as well as potentially impacting their rebate liability by modifying the statutory definition of AMP. The 
ACA also expanded the universe of Medicaid utilization subject to drug rebates by requiring pharmaceutical manufacturers to pay rebates on Medicaid 
managed care utilization and by enlarging the population potentially eligible for Medicaid drug benefits. The Centers for Medicare & Medicaid Services 
(“CMS”), have proposed to expand Medicaid rebate liability to the territories of the United States as well.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (“MMA”), established the Medicare Part D program to provide a 

voluntary prescription drug benefit to Medicare beneficiaries. Under Part D, Medicare beneficiaries may enroll in prescription drug plans offered by private 
entities that provide coverage of outpatient prescription drugs. Unlike Medicare Part A and B, Part D coverage is not standardized. While all Medicare drug 
plans must give at least a standard level of coverage set by Medicare, Part D prescription drug plan sponsors are not required to pay for all covered Part D 
drugs, and each drug plan can develop its own drug formulary that identifies which drugs it will cover and at what tier or level. However, Part D 
prescription drug formularies must include drugs within each therapeutic category and class of covered Part D drugs, though not necessarily all the drugs in 
each category or class. Any formulary used by a Part D prescription drug plan must be 

39

 
developed and reviewed by a pharmacy and therapeutic committee. Government payment for some of the costs of prescription drugs may increase demand 
for products for which we receive marketing approval. However, any negotiated prices for our products covered by a Part D prescription drug plan likely 
will be lower than the prices we might otherwise obtain. Moreover, while the MMA applies only to drug benefits for Medicare beneficiaries, private payors 
often follow Medicare coverage policy and payment limitations in setting their own payment rates. Any reduction in payment that results from the MMA 
may result in a similar reduction in payments from non-governmental payors.

For a drug product to receive federal reimbursement under the Medicaid or Medicare Part B programs or to be sold directly to U.S. government 
agencies, the manufacturer must extend discounts to entities eligible to participate in the 340B drug pricing program. The required 340B discount on a 
given product is calculated based on the AMP and Medicaid rebate amounts reported by the manufacturer. As of 2010, the ACA expanded the types of 
entities eligible to receive discounted 340B pricing, although, under the current state of the law, with the exception of children’s hospitals, these newly 
eligible entities will not be eligible to receive discounted 340B pricing on orphan drugs. In addition, as 340B drug prices are determined based on AMP and 
Medicaid rebate data, the revisions to the Medicaid rebate formula and AMP definition described above could cause the required 340B discount to increase.

As noted above, the marketability of any products for which we receive regulatory approval for commercial sale may suffer if the government and 

third-party payors fail to provide adequate coverage and reimbursement. An increasing emphasis on cost containment measures in the United States has 
increased and we expect will continue to increase the pressure on pharmaceutical pricing. Coverage policies and third-party reimbursement rates may 
change at any time. Even if favorable coverage and reimbursement status is attained for one or more products for which we receive regulatory approval, 
less favorable coverage policies and reimbursement rates may be implemented in the future.

In addition, in most foreign countries, the proposed pricing for a drug must be approved before it may be lawfully marketed. The requirements 

governing drug pricing and reimbursement vary widely from country to country. For example, the European Union provides options for its member states 
to restrict the range of medicinal products for which their national health insurance systems provide reimbursement and to control the prices of medicinal 
products for human use. A member state may approve a specific price for the medicinal product or it may instead adopt a system of direct or indirect 
controls on the profitability of the company placing the medicinal product on the market. There can be no assurance that any country that has price controls 
or reimbursement limitations for pharmaceutical products will allow favorable reimbursement and pricing arrangements for any of our products. 
Historically, products launched in the European Union do not follow price structures of the United States and generally prices tend to be significantly 
lower.

Human Capital

We believe we must attract, develop, motivate and retain exceptional employees to achieve our objectives. To accomplish this, we offer competitive 

compensation, promote diversity and inclusion, and focus on employee health, safety and well-being. Our board of directors engages regularly with 
management on human capital matters. As of December 31, 2021, we had 192 full-time employees, 132 of whom were engaged in research and 
development activities. None of our employees are represented by a labor union or covered under a collective bargaining agreement. We consider our 
relationship with our employees to be strong based on engagement scores, employee comments and modest turnover.

Due to the clinical study results released in December 2021, our Board of Directors approved in February 2022, and we began implementing, a 

reorganization plan (the “Reorganization Plan”) to reduce operating costs and better align our workforce with the new clinical development plans of our 
business. Under the Reorganization Plan, we are reducing our workforce by approximately 35%. 

The management team and the Board of Directors and the Company consulted with outside compensation advisors to develop severance packages 
appropriate to the market conditions for similar situations and companies. At the time of departure from the Company, impacted employees are eligible to 
receive severance benefits and Company funded COBRA premiums. Additionally, the Company is providing job placement assistance and other services to 
help transitioning employees.

40

 
In addition, the Board of Directors approved, and management has implemented an employee retention program consisting of cash payments as well 

as grants of time-based RSUs and performance-based RSUs to the Company’s employees not impacted by the reduction in force. Refer to Note 12 
“Subsequent Events” to our financial statements for additional information.

Company Culture and Employee Development

We continue to build a culture that is both high performing and personally rewarding. We do this by clearly establishing a set of values to guide each 
of us.. We also look for opportunities to recognize employees fostering the culture as a way to reinforce these behaviors. Recognition is a key component in 
ensuring employee contributions are both seen and appreciated. We have developed several employee recognition programs to support that goal. 

We support the growth of our employees through educational programs that enhance technical skills as well as leadership capabilities. We have 

developed a course for leaders at all levels to hone their skills in key aspects of what teams in today’s environment need to thrive. The programs are 
conducted virtually so employees in all locations can participate equally. We have also developed an educational grant policy which supports employees in 
developing the skills relevant to their work at Allakos.

Health, Safety, and Wellness

The health, safety, and wellness of our employees is a priority in which we have always invested. These investments and the prioritization of 
employee health, safety, and wellness took on particular significance in 2020 and 2021 in light of COVID-19. We provide our employees and their families 
with access to a variety of innovative, flexible, and convenient health and wellness programs. Program benefits are intended to provide protection and 
security, so employees can have peace of mind concerning events that may require time away from work or that may impact their financial well-being. 
Additionally, we provide programs to help support employee physical and mental health by providing tools and resources to help them improve or maintain 
their health status, encourage engagement in healthy behaviors, and offer choices where possible so they are customized to meet their needs and the needs 
of their families.

In response to the COVID-19 pandemic, we implemented significant changes that we determined were in the best interest of our employees, as well 
as the communities in which we operate, in compliance with government regulations. This included having the vast majority of our employees work from 
home, while implementing additional safety measures for employees continuing to work on-site. To protect and support our essential team members, we 
have implemented health and safety measures that included providing personal protective equipment (PPE), instituting mandatory screening before 
accessing buildings and implementing protocols to address actual and suspected COVID-19 cases and potential exposure.

Compensation and Benefits

We provide compensation and benefits to help meet the needs of our employees. We benchmark our pay annually to ensure it is fair in comparison 
to local market conditions. In addition to base compensation, our employee programs include annual bonuses, stock incentive awards, an Employee Stock 
Purchase Plan, 401(k) matching, healthcare insurance benefits, health savings and flexible spending accounts, paid time off and family leave. 

Ensuring fair and equitable pay is integral to our commitment to our employees. Our executive team and Board of Directors strongly support this 

commitment. 

Facilities

Our corporate headquarters are currently located in Redwood City, California (the “Redwood City Lease”), where we lease 25,136 square feet of 
office, research and development and laboratory space. The Redwood City Lease will expire on April 30, 2022. On December 4, 2019, we entered into a 
lease agreement for approximately 98,000 square feet of office space to be constructed in San Carlos, California (the “San Carlos Lease”). These premises 
were delivered in November 2020, and we expect to move into this new headquarters in March 2022. The lease term will expire on October 31, 2031. Since 
commencement of the lease term, we have been responsible for 

41

 
monthly base rent payments of $5.75 per rentable square foot. We provided a security deposit in the form of a letter of credit in the amount of $1.5 million. 
This lease agreement includes an option to extend the term for an additional period of five years and provides us a right of first refusal for certain additional 
office space. We believe that these facilities will be adequate for our near-term needs. If required, we believe that suitable additional or alternative space 
would be available in the future on commercially reasonable terms.

Legal Proceedings

For information on our legal proceedings, see Item 3, Legal Proceedings, in this Annual Report on Form 10-K. 

Intellectual Property

Our success depends in part on our ability to obtain and maintain proprietary protection for our product candidates, technology and know-how, to 
operate without infringing the proprietary rights of others and to prevent others from infringing our proprietary rights. Our policy is to seek to protect our 
proprietary position by, among other methods, pursuing and obtaining patent protection in the United States and in jurisdictions outside of the United States 
related to our proprietary technology, inventions, improvements and product candidates that are important to the development and implementation of our 
business. Our patent portfolio is intended to cover our product candidates and components thereof, their methods of use and processes for their 
manufacture, our proprietary reagents and assays and any other inventions that are commercially important to our business. We also rely on trade secret 
protection of our confidential information and know-how relating to our proprietary technology, platforms and product candidates.

We believe that we have substantial know-how and trade secrets relating to our technology and product candidates. Our patent portfolio as of 
February 15, 2022 contains eight issued and unexpired U.S. patents and seven pending U.S. utility patent applications that are solely owned or exclusively 
licensed by us and numerous foreign counterparts of these patents and patent applications.

We have exclusively licensed from JHU four issued and unexpired U.S. patents and also foreign counterparts, with claims granted in Europe and 

Japan. The JHU licensed patent rights include issued U.S. patents with claims that recite anti-Siglec-8 antibodies comprising the CDRs of a particular 
antibody and methods of use a class of antibodies that bind to Siglec-8 for treating particular diseases. We own four granted U.S. patents that claim the 
active component of lirentelimab, an anti-Siglec-8 antibody, pharmaceutical compositions comprising lirentelimab, and methods for the treatment of 
particular diseases using antibodies to Siglec-8, with a projected expiration date in 2035 in the absence of patent extensions. Similar patents are issued in 
Europe, Japan and other territories. We have twelve further pending families of patent applications that include U.S. and foreign applications relating to 
methods of treatment for treating particular diseases using antibodies to Siglec-8, methods of delivering antibodies to Siglec-8, and formulations for 
antibodies to Siglec-8. We have also filed patent applications with claims pending relating to antibodies in preclinical development and methods for treating 
cancer with these antibodies. We also have a non-exclusive license to intellectual property from BioWa and Lonza regarding the expression and 
manufacturing of monoclonal antibodies in particular mammalian host cell lines.

The term of individual patents depends upon the legal term for patents in the countries in which they are granted. In most countries, including the 

United States, the patent term is generally 20 years from the earliest claimed filing date of a non-provisional patent application in the applicable country. In 
the United States, a patent’s term may, in certain cases, be lengthened by patent term adjustment, which compensates a patentee for administrative delays 
by the U.S. Patent and Trademark Office in examining and granting a patent, or may be shortened if a patent is terminally disclaimed over a commonly 
owned patent or a patent naming a common inventor and having an earlier expiration date. The Hatch-Waxman Act permits a patent term extension of up to 
five years beyond the expiration date of a U.S. patent as partial compensation for the length of time the drug is under regulatory review while the patent is 
in force. A patent term extension cannot extend the remaining term of a patent beyond a total of 14 years from the date of product approval, only one patent 
applicable to each regulatory review period may be extended and only those claims covering the approved drug, a method for using it or a method for 
manufacturing it may be extended.

42

 
Similar provisions are available in the European Union and certain other foreign jurisdictions to extend the term of a patent that covers an approved 
drug. In the future, if and when our product candidates, including lirentelimab, receive approval by the FDA or foreign regulatory authorities, we expect to 
apply for patent term extensions on issued patents covering those products, depending upon the length of the clinical trials for each drug and other factors. 
Expiration dates referred to above are without regard to potential patent term extension or other market exclusivity that may be available to us.

We also rely, in some circumstances, on trade secrets to protect our technology. However, trade secrets can be difficult to protect. We seek to protect 

our proprietary technology and processes, in part, by confidentiality agreements with our employees, consultants, scientific advisors and contractors. We 
also seek to preserve the integrity and confidentiality of our data and trade secrets by maintaining physical security of our premises and physical and 
electronic security of our information technology systems.

Corporate Information

We were incorporated in Delaware in March 2012. Our website is www.allakos.com. We use our website as a channel of distribution for company 

information, and financial and other material information regarding our company is routinely posted and accessible on our website.

On the Investor Relations section of our website, we post or will post, as applicable, the following filings as soon as reasonably practicable after 
they are electronically filed with or furnished to the Securities and Exchange Commission (the “SEC”): our Annual Report on Form 10-K (the “Annual 
Report”), our Proxy Statement on Schedule 14A, our Quarterly Reports on Form 10-Q, our Current Reports on Form 8-K and any amendments to those 
reports filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended. 

All of the information on our Investor Relations web page is available to be viewed free of charge. Information contained on our website is not part 
of this Annual Report or our other filings with the SEC. We assume no obligation to update or revise any forward-looking statements in this Annual Report 
whether as a result of new information, future events or otherwise, unless we are required to do so by law.

The SEC also maintains a website (www.sec.gov) that contains reports, proxy and information statements and other information regarding issuers 

that file electronically with the SEC.

Impact of COVID-19 on Our Business

The pandemic caused by an outbreak of a novel coronavirus causing a disease known as COVID-19 (“COVID-19”) has resulted, and is likely to 

continue to result, in significant national and global economic disruption and may have an adverse impact on our operations, supply chains and distribution 
systems or those of our contractors, and increase our expenses, including as a result of impacts associated with preventive and precautionary measures that 
are being taken, such as restrictions on travel, quarantine polices and social distancing. For example, the ability of our employees or those of our 
contractors to work has been and is likely to continue to be adversely affected. Moreover, we and our contractors have and are likely to continue to 
experience disruptions in supply of items that are essential for our research and development activities, including, for example, raw materials and other 
consumables used in the manufacturing of our product candidates or medical and laboratory supplies used in our clinical trials or preclinical studies, in each 
case, for which there are or may be shortages because of ongoing efforts to address the outbreak. In particular, pursuant to the U.S. Defense Production Act, 
as amended (the “Defense Production Act”), the U.S. federal government can require domestic industries to provide essential goods and services needed for 
the national defense, and they have begun to use it in the context of COVID-19 to divert supplies and materials to vaccine producers, and this has and likely 
will continue to cause delays with some of our suppliers. In addition, enrollment for our clinical studies may be adversely affected and the completion of 
such studies may be delayed. Also, the spread of COVID-19 has disrupted the United States’ healthcare and healthcare regulatory systems which could 
divert healthcare resources away from, or materially delay, FDA approval or any applicable foreign regulatory approval with respect to our product 
candidates. Furthermore, our clinical trials may be negatively affected by the COVID-19 outbreak. Given the daily evolution of the COVID-19 outbreak 
and the response to curb its spread, currently we are not able to estimate the effects of the COVID-19 outbreak to our results 

43

 
of operations or financial condition. For additional information, see “Risk Factors–Risks Related to the Discovery, Development and Commercialization of 
Our Product Candidates–Our business may be adversely affected by health epidemics, including the recent coronavirus outbreak.”

Item 1A. Risk Factors. 

Investing  in  our  common  stock  involves  a  high  degree  of  risk.  The  following  discussion  of  risk  factors  contains  forward-looking  statements.  You 
should  carefully  consider  the  risks  described  below,  as  well  as  the  other  information  in  this  Annual  Report  on  Form  10-K,  including  our  financial 
statements and the related notes and the section titled “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” The 
occurrence of any of the events or developments described below could materially harm our business, financial condition, results of operations and growth 
prospects. In such an event, the market price of our common stock could decline, and you may lose all or part of your investment. Additional risks and 
uncertainties not presently known to us or that we currently deem immaterial also may impair our business, financial condition, results of operations and 
growth prospects.

Risk Factors Summary

Risks Related to Our Financial Position and Need for Additional Capital

•

•

•

We are engaged in clinical drug development and have a limited operating history and no products approved for commercial sale, which may 
make it difficult for you to evaluate our current business and predict our future success and viability.

We have incurred significant net losses since inception and we expect to continue to incur significant net losses for the foreseeable future.

Our ability to generate revenue and achieve profitability depends significantly on our ability to achieve a number of objectives.

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

•

•

•

Our business may be adversely affected by health epidemics, including the recent coronavirus outbreak.

We are dependent on the success of our lead compound, lirentelimab, which is currently in multiple clinical trials, and if we are unable to 
obtain approval for and commercialize lirentelimab for one or more indications in a timely manner, our business could be materially harmed.

If we experience delays or difficulties in the enrollment of patients in clinical trials, our receipt of necessary marketing approvals could be 
delayed or prevented.

Risks Related to Regulatory Approval and Other Legal Compliance Matters

•

•

•

The regulatory approval processes of the FDA, European Medicines Agency (“EMA”) and comparable foreign regulatory authorities are 
lengthy, time-consuming and inherently unpredictable, and if we are ultimately unable to obtain regulatory approval for our product 
candidates, we will be unable to generate product revenue and our business will be substantially harmed.

We have no products approved for commercial sale and have not obtained marketing approvals, manufactured a commercial-scale product or 
conducted sales and marketing activities necessary for successful product commercialization. We may be unable to obtain U.S. or foreign 
regulatory approval and, as a result, unable to commercialize our product candidates.

Our clinical trials may reveal significant adverse events, toxicities or other side effects and may result in a safety profile that could inhibit 
regulatory approval or market acceptance of any of our product candidates.

44

 
Risks Related to Employee Matters, Managing Our Growth and Other Risks Related to Our Business

•

•

•

Our success is highly dependent on the services of our Chief Executive Officer, Dr. Robert Alexander, and our President and Chief Operating 
Officer, Dr. Adam Tomasi, and our ability to attract and retain highly skilled executive officers and employees.

If we are unable to establish sales or marketing capabilities or enter into agreements with third-parties to sell or market our product 
candidates, we may not be able to successfully sell or market our product candidates that obtain regulatory approval. 

In order to successfully implement our plans and strategies, we will need to grow the size of our organization, and we may experience 
difficulties in managing this growth. 

Risks Related to Intellectual Property

•

•

•

If we are unable to obtain or protect intellectual property rights, we may not be able to compete effectively in our market.

We may not be able to protect our intellectual property rights throughout the world. 

Changes in patent law could diminish the value of patents in general, thereby impairing our ability to protect our product candidates.

Risks Related to Our Dependence on Third-Parties

•

•

•

We rely on third-parties to conduct our clinical trials and those third-parties may not perform satisfactorily, including failing to meet 
deadlines for the completion of such trials, research and studies.

We contract with third-parties for the production of our product candidates for preclinical studies and, in the case of lirentelimab, our 
ongoing clinical trials, and expect to continue to do so for additional clinical trials and ultimately for commercialization, and this reliance on 
third-parties increases the risk that we will not have sufficient quantities of our product candidates or drugs or such quantities at an 
acceptable cost, which could delay, prevent or impair our development or commercialization efforts.

We may not gain the efficiencies we expect from further scale-up of manufacturing of lirentelimab, and our third-party manufacturers may be 
unable to successfully scale-up manufacturing in sufficient quality and quantity for lirentelimab or our other product candidates, which could 
delay or prevent the conducting of our clinical trials or the development or commercialization of our other product candidates.

Risks Related to Ownership of Our Common Stock

•

•

The market price of our stock may continue to be volatile, which could result in substantial losses for investors. 

Our operating results may fluctuate significantly, which makes our future operating results difficult to predict and could cause our operating 
results to fall below expectations or our guidance.

General Business Risks

•

•

•

•

If we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incur costs 
that could have a material adverse effect on our business.

Our business activities may be subject to the Foreign Corrupt Practices Act (“FCPA”), the UK Bribery Act 2010 (“UK Bribery Act”), and 
other similar anti-bribery and anti-corruption laws of other countries in which we operate. 

We may experience disruptions and delays or incur financial damages as a result of system failures or security breaches.

The other factors discussed under “Risk Factors”.

45

 
Risks Related to Our Financial Position and Need for Additional Capital

We are engaged in clinical drug development and have a limited operating history and no products approved for commercial sale, which may make it 
difficult for you to evaluate our current business and predict our future success and viability.

We are a clinical stage biopharmaceutical company with a limited operating history. We were incorporated and commenced operations in 2012, have 
no products approved for commercial sale and have not generated any revenue. Our operations to date have been limited to organizing and staffing our 
company,  business  planning,  raising  capital,  identifying  and  developing  potential  product  candidates,  conducting  preclinical  and  clinical  studies  of  our 
product  candidates,  including  Phase  1  and  Phase  2  clinical  trials  of  lirentelimab,  our  lead  compound.  All  of  our  product  candidates  currently  under 
development, other than lirentelimab, are in preclinical development. We have not yet demonstrated our ability to successfully complete any pivotal clinical 
trials,  obtain  marketing  approvals,  complete  large-scale  drug  manufacturing  or  arrange  for  a  third-party  to  do  so  on  our  behalf  or  conduct  sales  and 
marketing activities. For example, in December 2021, we announced that both our ENIGMA study and our KRYPTOS study failed to meet their patient-
reported symptomatic co-primary endpoints. As a result, it may be more difficult for you to accurately predict our future success or viability than it could 
be if we had a longer operating history.

In  addition,  as  a  business  with  a  limited  operating  history,  we  may  encounter  unforeseen  expenses,  difficulties,  complications,  delays  and  other 
known and unknown factors and risks frequently experienced by clinical stage biopharmaceutical companies in rapidly evolving fields. We also may need 
to transition from a company with a research focus to a company capable of supporting commercial activities. We have not yet demonstrated an ability to 
successfully overcome such risks and difficulties, or to make such a transition. If we do not adequately address these risks and difficulties or successfully 
make such a transition, our business will suffer.

We have incurred significant net losses since inception and we expect to continue to incur significant net losses for the foreseeable future.

We have incurred net losses in each reporting period since our inception, have not generated any revenue to date and have financed our operations 
principally through the sale and issuance of common stock and preferred stock. Our net losses were $269.9 million, $153.5 million and $85.4 million for 
the years ended December 31, 2021, 2020 and 2019, respectively. As of December 31, 2021, we had an accumulated deficit of $612.8 million. We have 
devoted substantially all of our resources and efforts to research and development. Our lead compound, lirentelimab, is in clinical development, and our 
other  product  candidates  are  in  preclinical  development.  As  a  result,  we  expect  that  it  will  be  several  years,  if  ever,  before  we  generate  revenue  from 
product sales. Even if we succeed in receiving marketing approval for and commercializing one or more of our product candidates, we expect that we will 
continue to incur substantial research and development and other expenses in order to develop and market additional potential products.

We expect to continue to incur significant expenses and increasing operating losses for the foreseeable future. The net losses we incur may fluctuate 
significantly  from  quarter-to-quarter  such  that  a  period-to-period  comparison  of  our  results  of  operations  may  not  be  a  good  indication  of  our  future 
performance. The size of our future net losses will depend, in part, on the rate of future growth of our expenses and our ability to generate revenue. Our 
prior losses and expected future losses have had and will continue to have an adverse effect on our working capital and our ability to achieve and maintain 
profitability.

Our ability to generate revenue and achieve profitability depends significantly on our ability to achieve a number of objectives.

Our business depends entirely on the successful development and commercialization of our product candidates. Our ability to develop lirentelimab 
and any other product candidates remains uncertain. For example, in December 2021, we announced that both our ENIGMA study and our KRYPTOS 
study failed to meet their patient-reported symptomatic co-primary endpoints. We currently generate no revenues from sales of any products. We have no 
products  approved  for  commercial  sale  and  do  not  anticipate  generating  any  revenue  from  product  sales  until  sometime  after  we  have  successfully 
completed clinical development and received marketing approval for the commercial sale 

46

 
of  a  product  candidate,  if  ever.  Our  ability  to  generate  revenue  and  achieve  profitability  depends  significantly  on  our  ability  to  achieve  a  number  of 
objectives, including:

•

•

•

•

•

•

•

•

•

•

•

•

•

successful and timely completion of preclinical and clinical development of our lead compound, lirentelimab, and any other future product 
candidates;

timely  receipt  of  marketing  approvals  for  lirentelimab  and  any  future  product  candidates  for  which  we  successfully  complete  clinical 
development and clinical trials from applicable regulatory authorities;

the extent of any required post-marketing approval commitments to applicable regulatory authorities;

developing  an  efficient  and  scalable  manufacturing  process  for  lirentelimab  and  any  future  product  candidates,  including  establishing  and 
maintaining commercially viable supply and manufacturing relationships with third-parties to obtain finished products that are appropriately 
packaged for sale;

successful launch of commercial sales following any marketing approval, including the development of a commercial infrastructure, whether 
in-house or with one or more collaborators;

a continued acceptable safety profile following any marketing approval;

commercial acceptance of lirentelimab and any future product candidates as viable treatment options by patients, the medical community and 
third-party payors;

addressing any competing technological and market developments;

identifying, assessing, acquiring and developing new product candidates;

obtaining and maintaining patent protection, trade secret protection and regulatory exclusivity, both in the United States and internationally;

protection of our rights in our intellectual property portfolio, including our licensed intellectual property;

negotiating  favorable  terms  in  any  collaboration,  licensing  or  other  arrangements  that  may  be  necessary  to  develop,  manufacture  or 
commercialize our product candidates; and

attracting, hiring and retaining qualified personnel.

We  may  never  be  successful  in  achieving  our  objectives  and,  even  if  we  do,  may  never  generate  revenue  that  is  significant  or  large  enough  to 
achieve profitability. If we do achieve profitability, we may not be able to sustain or increase profitability on a quarterly or annual basis. Our failure to 
become and remain profitable would decrease the value of our company and could impair our ability to maintain or further our research and development 
efforts, raise additional necessary capital, grow our business and/or continue our operations.

We will require substantial additional capital to finance our operations. If we are unable to raise such capital when needed, or on acceptable terms, we 
may be forced to delay, reduce and/or eliminate one or more of our research and drug development programs or future commercialization efforts.

Developing pharmaceutical products, including conducting preclinical studies and clinical trials, is a very time-consuming, expensive and uncertain 
process that takes years to complete. We expect our expenses to increase in connection with our ongoing activities, particularly as we conduct clinical trials 
of, and seek marketing approval for, lirentelimab and our other product candidates. In addition, if we obtain marketing approval for any of our product 
candidates,  we  expect  to  incur  significant  commercialization  expenses  related  to  drug  sales,  marketing,  manufacturing  and  distribution.  We  have  also 
incurred and expect to continue to incur additional costs associated with operating as a public company. Accordingly, we will need to obtain substantial 
additional funding in order to maintain our continuing operations. If we are unable to raise capital when needed or on acceptable terms, we may be forced 
to delay, reduce and/or eliminate one or more of our research and drug development programs or future commercialization efforts.

As of December 31, 2021, we had $424.2 million in cash, cash equivalents and investments in marketable securities, which includes proceeds from 
our July 2018 initial public offering and concurrent private placement that we completed on July 23, 2018 and from our subsequent follow-on offerings in 
August 2019 and November 2020, after deducting underwriting discounts and commissions. We believe that our existing cash, cash equivalents and 

47

 
investments  in  marketable  securities  will  enable  us  to  fund  our  operating  expenses  and  capital  expenditure  requirements  through  at  least  the  next  12 
months.  Our  estimate  as  to  how  long  we  expect  our  existing  cash,  cash  equivalents  and  investments  in  marketable  securities  to  continue  to  fund  our 
operations  is  based  on  assumptions  that  may  prove  to  be  wrong,  and  we  could  use  our  available  capital  resources  sooner  than  we  currently  expect. 
Changing circumstances, some of which may be beyond our control, could cause us to consume capital significantly faster than we currently anticipate, and 
we may need to seek additional funds sooner than planned.

We plan to use our existing cash, cash equivalents and investments in marketable securities to fund our development of lirentelimab and for other 
research  and  development  activities,  working  capital  and  other  general  corporate  purposes.  This  may  include  additional  research,  hiring  additional 
personnel,  capital  expenditures  and  the  costs  of  operating  as  a  public  company.  Advancing  the  development  of  lirentelimab  and  any  other  product 
candidates will require a significant amount of capital. Our existing cash, cash equivalents and investments in marketable securities will not be sufficient to 
fund all of the actions that are necessary to complete the development of lirentelimab or any of our other product candidates. We will be required to obtain 
further funding through public or private equity offerings, debt financings, collaborations and licensing arrangements or other sources, which may dilute 
our stockholders or restrict our operating activities. We do not have any committed external source of funds. Adequate additional financing may not be 
available to us on acceptable terms, or at all. Our failure to raise capital as and when needed would have a negative impact on our financial condition and 
our ability to pursue our business strategy.

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

Our business may be adversely affected by health epidemics, including the recent coronavirus outbreak.

In December 2019, an outbreak of a novel coronavirus causing a disease known as COVID-19 (“COVID-19”) originated and spread to a number of 

countries, including the U.S. On March 11, 2020, the World Health Organization characterized COVID-19 as a pandemic. 

COVID-19  may  have  an  adverse  impact  on  our  operations,  supply  chains  and  distribution  systems  or  those  of  our  contractors,  and  increase  our 
expenses,  including  as  a  result  of  impacts  associated  with  preventive  and  precautionary  measures  that  are  being  taken,  such  as  restrictions  on  travel, 
quarantine polices and social distancing. For example, the ability of our employees or those of our contractors to work has been and is likely to continue to 
be adversely affected. Moreover, we and our contractors have experienced and are likely to continue to experience disruptions in supply of items that are 
essential  for  our  research  and  development  activities,  including,  for  example,  raw  materials  and  other  consumables  used  in  the  manufacturing  of  our 
product candidates or medical and laboratory supplies used in our clinical trials or preclinical studies, in each case, for which there are or may be shortages 
because of ongoing efforts to address the outbreak. In particular, pursuant to the U.S. Defense Production Act, as amended (the “Defense Production Act”), 
the U.S. federal government may, among other things, require domestic industries to provide essential goods and services needed for the national defense, 
and they have begun to use the Defense Production Act in the context of COVID-19 to divert supplies and materials to vaccine producers. For example, 
one of our suppliers has informed us that, due to their obligation to prioritize other products or customers pursuant to the Defense Production Act, they are 
currently not able to fulfill our orders for certain materials previously ordered to be used in our manufacturing process. While this and similar delays in 
materials have not yet caused delays in our overall timeline for clinical trials or regulatory filings, it is quite possible that this or other such delays may 
occur in the future, whether as a result of actions taken pursuant to the Defense Production Act or general shortages of materials attributable to the global 
efforts to combat Covid-19, which could impact our proposed timeline for developing and commercializing lirentelimab and adversely impact our business, 
financial condition and results of operations. 

In addition, the spread of COVID-19 has disrupted the United States’ healthcare and healthcare regulatory systems which could divert healthcare 
resources away from, or materially delay, U.S. Food and Drug Administration (“FDA”) approval or any applicable foreign regulatory approval with respect 
to our product candidates. Furthermore, our clinical trials may be negatively affected by the COVID-19 outbreak. Site initiation and patient enrollment may 
be  delayed,  for  example,  due  to  factors  including  prioritization  of  hospital  resources  toward  the  COVID-19  outbreak,  travel  restrictions,  the  inability  to 
access  sites  for  initiation  and  monitoring,  and  difficulties  recruiting  or  retaining  patients  in  our  ongoing  and  planned  clinical  trials.  Furthermore,  if  we 
determine  that  our  clinical  trial  participants  may  suffer  from  exposure  to  COVID-19  as  a  result  of  their  participation  in  our  clinical  studies,  we  may 
voluntarily terminate certain clinical sites as a safety measure until we reasonably believe that the likelihood of exposure has 

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subsided. We may therefore be unable to complete our clinical trials on the timelines we expect, if at all, which could materially and adversely impact our 
ability to seek regulatory approval for our product candidates. COVID-19 may also reduce the effectiveness of our future sales efforts and/or impact our 
ability to launch and commercialize such product candidates; we have no experience in launching or selling a product amid pandemic conditions. COVID-
19 also may have an adverse impact on the economies and financial markets of many countries, including the United States, potentially resulting in an 
economic downturn that could affect demand for our product candidates, if approved, impair our ability to raise capital when needed or otherwise impact 
our business, results of operations, cash flows and financial condition. In addition, if the spread of COVID-19 continues and our operations are impacted, 
we risk a delay, default and/or nonperformance under our existing agreements arising from force majeure. Any of the foregoing could harm our business 
and we cannot anticipate all of the ways in which health epidemics such as COVID-19 could adversely impact our business. Although we are continuing to 
monitor and assess the effects of the COVID-19 pandemic on our business, the ultimate impact of the COVID-19 outbreak or a similar health epidemic is 
highly uncertain and subject to change. 

We are dependent on the success of our lead compound, lirentelimab, which is currently in multiple clinical trials. If we are unable to obtain approval 
for and commercialize lirentelimab for one or more indications in a timely manner, our business could be materially harmed.

Our  future  success  is  dependent  on  our  ability  to  timely  complete  clinical  trials  and  obtain  marketing  approval  for,  and  then  successfully 
commercialize lirentelimab, our lead compound, for one or more indications. Lirentelimab is in the clinical stages of development and we are investing the 
majority of our efforts and financial resources in the research and development of lirentelimab for multiple indications. Our ability to develop lirentelimab 
remains uncertain. For example, in December 2021, we announced that both our ENIGMA study and our KRYPTOS study failed to meet their patient-
reported symptomatic co-primary endpoints. Lirentelimab will require additional clinical development, evaluation of clinical, preclinical and manufacturing 
activities, marketing approval from government regulators, substantial investment and significant marketing efforts before we generate any revenues from 
product sales. In addition, some of our future development plans for lirentelimab may be based on a post-hoc analysis of our ENIGMA and KRYPTOS 
trials. Post-hoc analyses are potentially unreliable, and are not, in and of themselves, the basis for approval of lirentelimab. We are not permitted to market 
or  promote  lirentelimab,  or  any  other  product  candidates,  before  we  receive  marketing  approval  from  the  FDA  and  comparable  foreign  regulatory 
authorities, and we may never receive such marketing approvals.

The success of lirentelimab will depend on several factors, including the following:

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initiation and timely completion of our clinical trials of lirentelimab;

successful and timely enrollment of appropriate patients for the indication(s) included in our current and future clinical trials;

potential variability of patient-reported measures and outcomes;

our ability to address any potential delays resulting from factors related to the COVID-19 pandemic;

obtaining  positive  data  that  support  demonstration  of  efficacy,  safety  and  tolerability  profiles  and  durability  of  effect  for  our  product 
candidates that are satisfactory to the FDA or any comparable foreign regulatory authority for marketing approval;

timely receipt of marketing approvals for lirentelimab from applicable regulatory authorities;

the extent of any required post-marketing approval commitments to applicable regulatory authorities;

the maintenance of existing or the establishment of new supply arrangements with third-party drug product suppliers and manufacturers for 
clinical development and, if approved, commercialization of our product candidates;

the maintenance of existing or the establishment of new scaled production arrangements with third-party manufacturers to obtain finished 
products that are appropriately packaged for sale;

obtaining and maintaining patent protection, trade secret protection and regulatory exclusivity, both in the United States and internationally;

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protection of our rights in our intellectual property portfolio, including our licensed intellectual property;

establishing  sales,  marketing  and  distribution  capabilities  and  the  successful  launch  of  commercial  sales  of  our  product  candidates  if  and 
when approved for marketing, whether alone or in collaboration with others;

a continued acceptable safety profile following any marketing approval;

commercial acceptance by patients, the medical community and third-party payors; and

our ability to compete with other therapies.

We  do  not  have  complete  control  over  many  of  these  factors,  including  certain  aspects  of  clinical  development  and  the  regulatory  submission 
process, potential threats to our intellectual property rights and the manufacturing, marketing, distribution and sales efforts of any future collaborator. If we 
are  not  successful  with  respect  to  one  or  more  of  these  factors  in  a  timely  manner  or  at  all,  we  could  experience  significant  delays  or  an  inability  to 
successfully commercialize any product candidates from our lead programs, which would materially harm our business. If we do not receive marketing 
approvals for such product candidates, we may not be able to continue our operations.

If we experience delays or difficulties in the enrollment of patients in clinical trials, our receipt of necessary marketing approvals could be delayed or 
prevented.

We  may  not  be  able  to  initiate  or  continue  clinical  trials  for  our  product  candidates  if  we  are  unable  to  locate  and  enroll  a  sufficient  number  of 
eligible patients to participate in these trials as required by the FDA or comparable foreign regulatory authorities. Patient enrollment is a significant factor 
in the timing of clinical trials. In particular, our ability to enroll eligible patients may be limited or may result in slower enrollment than we anticipate.

Patient enrollment may be affected if our competitors have ongoing clinical trials for product candidates that are under development for the same 
indications as our product candidates, and patients who would otherwise be eligible for our clinical trials instead enroll in clinical trials of our competitors’ 
product candidates. Patient enrollment may also be affected by other factors, including:

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travel and other restrictions due to pandemics such as COVID-19;

size and nature of the patient population;

severity of the disease under investigation;

availability and efficacy of approved drugs for the disease under investigation;

patient eligibility criteria for the trial in question;

perceived risks and benefits of the product candidate under study;

efforts to facilitate timely enrollment in clinical trials;

patient referral practices of physicians;

the ability to monitor patients adequately during and after treatment;

proximity and availability of clinical trial sites for prospective patients; and

continued enrollment of prospective patients by clinical trial sites.

Our inability to enroll a sufficient number of patients for our clinical trials would result in significant delays or may require us to abandon one or 
more  clinical  trials  altogether.  The  COVID-19  global  pandemic  has  created  uncertainties  in  the  expected  timelines  for  clinical  stage  biotechnology 
companies such as us, and because of such uncertainties, it is extremely difficult for us to accurately predict at this time if we can continue to enroll patients 
and when we can complete our Phase 3 clinical trial. Enrollment delays in our clinical trials may result in increased development costs for our product 
candidates and jeopardize our ability to obtain marketing approval for the sale of our product candidates.

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The  clinical  trials  of  our  product  candidates  may  not  adequately  demonstrate  safety  and  efficacy  to  the  satisfaction  of  regulatory  authorities  or 
otherwise produce positive results, which would prevent or delay development, regulatory approval and commercialization.

Before obtaining marketing approval from regulatory authorities for the sale of our product candidates, we must complete preclinical development 
and  then  conduct  extensive  clinical  trials  to  demonstrate  the  safety  and  efficacy  of  our  product  candidates  in  each  target  indication.  Clinical  testing  is 
expensive, difficult to design and implement, can take many years to complete and its ultimate outcome is uncertain. A failure of one or more clinical trials 
can occur at any stage of the process. The outcome of preclinical studies and early-stage clinical trials may not be predictive of the success of later clinical 
trials. Moreover, preclinical and clinical data are often susceptible to varying interpretations and analyses, and many companies that have believed their 
product candidates performed satisfactorily in preclinical studies and clinical trials have nonetheless failed to obtain marketing approval of their drugs. Our 
product candidates are in an early stage of development, and there is a high risk of failure and we may never succeed in developing marketable products

We do not know whether our future clinical trials will begin on time or enroll patients on time, or whether our ongoing and/or future clinical trials 

will be completed on schedule or at all. Clinical trials can be delayed for a variety of reasons, including delays related to:

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obtaining approval to commence a trial;

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

obtaining institutional review board approval at each clinical trial site;

recruiting suitable patients to participate in a trial;

patients failing to comply with trial protocol or dropping out of a trial;

clinical trial sites deviating from trial protocol or dropping out of a trial;

the need to add new clinical trial sites; or

manufacturing sufficient quantities of product candidate for use in clinical trials.

We may experience numerous unforeseen events during, or as a result of, clinical trials that could delay or prevent receipt of marketing approval or 

our ability to commercialize our product candidates, including:

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receipt of feedback from regulatory authorities that requires us to modify the design of our clinical trials;

successful and timely enrollment of appropriate patients for the indication(s) included in our current and future clinical trials;

potential variability of patient-reported measures and outcomes;

negative or inconclusive clinical trial results that may require us to conduct additional clinical trials or abandon certain drug development 
programs;

the number of patients required for clinical trials being larger than anticipated, enrollment in these clinical trials being slower than anticipated 
or participants dropping out of these clinical trials at a higher rate than anticipated;

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

the suspension or termination of our clinical trials for various reasons, including non-compliance with regulatory requirements, a finding that 
our product candidates have undesirable side effects or other unexpected characteristics or risks;

the cost of clinical trials of our product candidates being greater than anticipated;

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

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regulators revising the requirements for approving our product candidates.

If any of these events occur, we may incur unplanned costs, be delayed in obtaining marketing approval, if at all, receive more limited or restrictive 
marketing  approval,  be  subject  to  additional  post-marketing  testing  requirements  or  have  the  drug  removed  from  the  market  after  obtaining  marketing 
approval.

The outcome of preclinical testing and early clinical trials may not be predictive of the success of later clinical trials, and the results of our clinical 
trials may not satisfy the requirements of the FDA or comparable foreign regulatory authorities.

We currently have no drugs approved for sale and we cannot guarantee that we will ever have marketable drugs. Clinical failure can occur at any 
stage of clinical development. Clinical trials may produce negative or inconclusive results, and we or any future collaborators may decide, or regulators 
may  require  us,  to  conduct  additional  clinical  trials  or  preclinical  studies.  We  will  be  required  to  demonstrate  with  substantial  evidence  through  well-
controlled clinical trials that our product candidates are safe and effective for use in a diverse population before we can seek marketing approvals for their 
commercial sale. Success in preclinical studies and early-stage clinical trials does not mean that future larger registration clinical trials will be successful. 
This is because product candidates in later-stage clinical trials may fail to demonstrate sufficient safety and efficacy to the satisfaction of the FDA and non-
U.S.  regulatory  authorities  despite  having  progressed  through  preclinical  studies  and  early-stage  clinical  trials.  In  particular,  no  compound  with  the 
mechanism of action of lirentelimab has been commercialized, and the outcome of preclinical studies and early-stage clinical trials may not be predictive of 
the success of later-stage clinical trials.

From time to time, we may publish or report interim or preliminary data from our clinical trials. Interim or preliminary data from clinical trials that 
we may conduct may not be indicative of the final results of the trial and are subject to the risk that one or more of the clinical outcomes may materially 
change as patient enrollment continues and more patient data become available. Interim or preliminary data also remain subject to audit and verification 
procedures that may result in the final data being materially different from the interim or preliminary data. As a result, interim or preliminary data should 
be viewed with caution until the final data are available.

In some instances, there can be significant variability in safety and efficacy results between different clinical trials of the same product candidate due 
to numerous factors, including changes in trial protocols, differences in size and type of the patient populations, differences in and adherence to the dosing 
regimen and other trial protocols and the rate of dropout among clinical trial participants. In addition, we use patient-reported outcome assessments in our 
clinical trials, which involve patients’ subjective assessments of efficacy of the treatments they receive in the trial. Such assessments can vary widely from 
day to day for a particular patient, and from patient to patient and site to site within a clinical trial. This subjectivity can increase the uncertainty of, and 
adversely impact, our clinical trial outcomes.

We  do  not  know  whether  any  clinical  trials  we  may  conduct  will  demonstrate  consistent  or  adequate  efficacy  and  safety  sufficient  to  obtain 

marketing approval to market our product candidates. 

Our  product  candidates  may  not  achieve  adequate  market  acceptance  among  physicians,  hospitals,  patients,  healthcare  payors  and  others  in  the 
medical community necessary for commercial success.

Even if our product candidates receive regulatory approval, they may not gain adequate market acceptance among physicians, hospitals, patients, 
healthcare  payors  and  others  in  the  medical  community.  The  degree  of  market  acceptance  of  any  of  our  approved  product  candidates  will  depend  on  a 
number of factors, including:

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the efficacy and safety profile as demonstrated in planned clinical trials;

the timing of market introduction of the product candidate as well as competitive products;

the clinical indications for which the product candidate is approved;

restrictions  on  the  use  of  our  products,  if  approved,  such  as  boxed  warnings  or  contraindications  in  labeling,  or  a  Risk  Evaluation  and 
Mitigation Strategy (“REMS”), if any, which may not be required of alternative treatments and competitor products;

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the potential and perceived advantages of product candidates over alternative treatments;

the cost of treatment in relation to alternative treatments;

the availability of coverage and adequate reimbursement and pricing by third-parties and government authorities;

relative convenience and ease of administration;

the effectiveness of sales and marketing efforts;

unfavorable publicity relating to the product candidate; and

the approval of other new therapies for the same indications.

If any product candidate is approved but does not achieve an adequate level of acceptance by physicians, hospitals, healthcare payors and patients, 
we may not generate or derive sufficient revenue from that product candidate and our financial results could be harmed. Lirentelimab was administered 
intravenously in our lead Phase 3 and Phase 2/3 studies and we additionally plan to administer lirentelimab subcutaneously in future studies. Intravenous 
and subcutaneous drugs are less convenient for patients than some other methods of administration, such as an orally delivered drug.

The sizes of the patient populations suffering from some of the diseases we are targeting are small and based on estimates that may not be accurate.

Our projections of both the number of people who have some of the diseases we are targeting, as well as the subset of people with these diseases 
who  have  the  potential  to  benefit  from  treatment  with  lirentelimab  and  any  other  future  product  candidates,  are  estimates.  These  estimates  have  been 
derived from a variety of sources, including scientific literature, surveys of clinics, physician interviews, patient foundations and market research, and may 
prove to be incorrect. Further, new studies may change the estimated incidence or prevalence of these diseases. The number of patients may turn out to be 
lower than expected. Additionally, the potentially addressable patient population for lirentelimab and any other future product candidates may be limited or 
may  not  be  amenable  to  treatment  with  lirentelimab  and  any  other  products,  if  and  when  approved.  Even  if  we  obtain  significant  market  share  for 
lirentelimab and any other products (if and when they are approved), small potential target populations for certain indications means we may never achieve 
profitability without obtaining market approval for additional indications.

Our business will be impacted by our ability to advance additional product candidates beyond lirentelimab into clinical development and through to 
regulatory approval and commercialization. Our other product candidates are at even earlier stages of development than lirentelimab and may fail in 
development or suffer delays that adversely affect their commercial viability.

Our  other  product  candidates  are  in  the  early  stages  of  development  and  may  fail  in  development  or  suffer  delays  that  adversely  affect  their 
commercial viability. A product candidate can unexpectedly fail at any stage of preclinical and clinical development. The historical failure rate for product 
candidates is high due to risks relating to safety, efficacy, clinical execution, changing standards of medical care and other unpredictable variables. The 
results from preclinical testing or early clinical trials of a product candidate may not be predictive of the results that will be obtained in later-stage clinical 
trials of the product candidate.

Our  future  operating  results  are  dependent  on  our  ability  to  successfully  develop,  obtain  regulatory  approval  for,  and  then  successfully 
commercialize other product candidates in addition to lirentelimab. The success of any product candidates we may develop will depend on many factors, 
including, among other things, the following:

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generating sufficient data to support the initiation or continuation of clinical trials;

obtaining regulatory permission to initiate clinical trials;

contracting with the necessary parties to conduct clinical trials;

successful enrollment of patients in, and the completion of, clinical trials;

the timely manufacture of sufficient quantities of the product candidate for use in clinical trials; and

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adverse events in the clinical trials.

Even if we successfully advance any other product candidates into clinical development, their success will be subject to all of the clinical, regulatory 
and commercial risks described elsewhere in this “Risk Factors” section. Accordingly, we cannot assure you that we will ever be able to develop, obtain 
regulatory approval of, commercialize or generate significant revenue from any other product candidates.

Any drugs we develop may become subject to unfavorable third-party reimbursement practices and pricing regulations.

The availability and extent of coverage and adequate reimbursement by governmental and private payors is essential for most patients to be able to 
afford expensive treatments. Sales of any of our product candidates that receive marketing approval will depend substantially, both in the United States and 
internationally, on the extent to which the costs of our product candidates will be paid by health maintenance, managed care, pharmacy benefit, and similar 
healthcare management organizations or reimbursed by government health administration authorities, private health coverage insurers and other third-party 
payors. If reimbursement is not available, or is available only to limited levels, we may not be able to successfully commercialize our product candidates. 
Even if coverage is provided, the approved reimbursement amount may not be high enough to allow us to establish or maintain pricing sufficient to realize 
an adequate return on our investment. Coverage and reimbursement may impact the demand for, or the price of, any product candidate for which we obtain 
marketing  approval.  If  coverage  and  reimbursement  are  not  available  or  reimbursement  is  available  only  to  limited  levels,  we  may  not  successfully 
commercialize any product candidate for which we obtain marketing approval.

There  is  significant  uncertainty  related  to  insurance  coverage  and  reimbursement  of  newly  approved  products.  In  the  United  States,  principal 
decisions about reimbursement for new products are typically made by the Centers for Medicare & Medicaid Services (“CMS”), an agency within the U.S. 
Department of Health and Human Services. CMS decides whether and to what extent a new product will be covered and reimbursed under Medicare, and 
private payors often follow CMS’s decisions regarding coverage and reimbursement to a substantial degree. However, one payor’s determination to provide 
coverage  for  a  drug  product  does  not  assure  that  other  payors  will  also  provide  coverage  for  the  drug  product.  As  a  result,  the  coverage  determination 
process is often time-consuming and costly. This process will require us to provide scientific and clinical support for the use of our products to each payor 
separately, with no assurance that coverage and adequate reimbursement will be applied consistently or obtained in the first instance.

Increasingly, third-party payors are requiring that drug companies provide them with predetermined discounts from list prices and are challenging 
the prices charged for medical products. Further, such payors are increasingly challenging the price, examining the medical necessity and reviewing the 
cost  effectiveness  of  medical  drug  products.  There  may  be  especially  significant  delays  in  obtaining  coverage  and  reimbursement  for  newly  approved 
drugs.  Third-party  payors  may  limit  coverage  to  specific  drug  products  on  an  approved  list,  known  as  a  formulary,  which  might  not  include  all  FDA-
approved drugs for a particular indication. We may need to conduct expensive pharmaco-economic studies to demonstrate the medical necessity and cost 
effectiveness of our products. Nonetheless, our product candidates may not be considered medically necessary or cost effective. We cannot be sure 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.

Outside the United States, international operations are generally subject to extensive governmental price controls and other market regulations, and 
we  believe  the  increasing  emphasis  on  cost  containment  initiatives  in  Europe,  Canada  and  other  countries  has  and  will  continue  to  put  pressure  on  the 
pricing and usage of therapeutics such as our product candidates. In many countries, particularly the countries of the European Union, medical product 
prices  are  subject  to  varying  price  control  mechanisms  as  part  of  national  health  systems.  In  these  countries,  pricing  negotiations  with  governmental 
authorities can take considerable time after a product receives marketing approval. To obtain reimbursement or pricing approval in some countries, we may 
be required to conduct a clinical trial that compares the cost-effectiveness of our product candidate to other available therapies. In general, product prices 
under such systems are substantially lower than in the United States. Other countries allow companies to fix their own prices for products but monitor and 
control company profits. Additional foreign price controls or other changes in pricing regulation could restrict the amount that we are able to charge for our 
product candidates. Accordingly, in markets 

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outside  the  United  States,  the  reimbursement  for  our  products  may  be  reduced  compared  with  the  United  States  and  may  be  insufficient  to  generate 
commercially reasonable revenue and profits.

If we are unable to establish or sustain coverage and adequate reimbursement for any future product candidates from third-party payors, the adoption 
of those products and sales revenue will be adversely affected, which, in turn, could adversely affect the ability to market or sell those product candidates, if 
approved. Coverage policies and third-party reimbursement rates may change at any time. Even if favorable coverage and reimbursement status is attained 
for one or more products for which we receive regulatory approval, less favorable coverage policies and reimbursement rates may be implemented in the 
future.

If  our  competitors  develop  and  market  products  that  are  more  effective,  safer  or  less  expensive  than  our  product  candidates,  our  commercial 
opportunities will be negatively impacted.

The biotechnology industry is highly competitive and subject to rapid and significant technological change. Products we may develop in the future 
are likely to face competition from other drugs and therapies, some of which we may not currently be aware. In addition, our products may need to compete 
with off-label drugs used by physicians to treat the indications for which we seek approval. This may make it difficult for us to replace existing therapies 
with our products.

We are not aware of any other company or organization that is conducting clinical trials of a product candidate that targets both eosinophils and mast 
cells, including any product candidate that specifically targets Siglec-8. The competition we may face with respect to the indications we are targeting with 
lirentelimab includes, without limitation, Regeneron, AstraZeneca, Bristol Meyers Squibb, Shire, and Dr. Falk Pharma for EGIDs, Blueprint Medicines for 
ISM,  Roche,  Novartis,  Regeneron,  Celldex  and  Gossamer  Bio  for  CU  and  Aldeyra  for  SAC.  In  addition,  we  are  currently  evaluating  a  host  of  other 
indications, and if we were to initiate trials in any such indication, we would likely face significant competition from a number of additional competitors. 
These  companies,  or  other  major  multinational  pharmaceutical  and  biotechnology  companies,  emerging  and  start-up  companies,  universities  and  other 
research institutions, could focus their future efforts on developing competing therapies and treatments for any of the indications we are currently targeting 
or  may  target  in  the  future.  Many  of  these  current  and  potential  competitors  have  significantly  greater  financial,  manufacturing,  marketing,  drug 
development, technical and human resources and commercial expertise than we do. Large pharmaceutical and biotechnology companies, in particular, have 
extensive experience in clinical testing, obtaining regulatory approvals, recruiting patients and manufacturing biotechnology products. These companies 
also have significantly greater research and marketing capabilities than we do and may also have products that have been approved or are in late stages of 
development,  and  collaborative  arrangements  in  our  target  markets  with  leading  companies  and  research  institutions.  Established  pharmaceutical  and 
biotechnology  companies  may  also  invest  heavily  to  accelerate  discovery  and  development  of  novel  compounds  or  to  in-license  novel  compounds  that 
could make the product candidates that we develop obsolete. As a result of all of these factors, our competitors may succeed in obtaining approval from the 
FDA or foreign regulatory authorities or discovering, developing and commercializing products in our field before we do.

Smaller and other clinical stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large 
and  established  companies.  These  companies  compete  with  us  in  recruiting  and  retaining  qualified  scientific  and  management  personnel,  establishing 
clinical trial sites and patient registration for planned clinical trials, as well as in acquiring technologies complementary to, or necessary for, our programs. 
In addition, the biotechnology industry is characterized by rapid technological change. If we fail to stay at the forefront of technological change, we may be 
unable  to  compete  effectively.  Technological  advances  or  products  developed  by  our  competitors  may  render  our  technologies  or  product  candidates 
obsolete, less competitive or not economical.

We  have  limited  resources  and  are  currently  focusing  our  efforts  on  developing  lirentelimab  for  particular  indications.  As  a  result,  we  may  fail  to 
capitalize on other product candidates or indications that may ultimately have proven to be more profitable.

We  are  currently  focusing  our  efforts  on  a  small  number  of  indications.  As  a  result,  we  may  forego  or  delay  pursuit  of  opportunities  for  other 
indications or with other product candidates that may have greater commercial potential. Our resource allocation decisions may cause us to fail to capitalize 
on  viable  commercial  drugs  or  profitable  market  opportunities.  Our  spending  on  current  and  future  research  and  development  activities  for  specific 
indications 

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may  not  yield  any  commercially  viable  drugs.  If  we  do  not  accurately  evaluate  the  commercial  potential  or  target  markets  for  a  particular  product 
candidate, we may relinquish valuable rights to that product candidate through collaboration, licensing or other strategic arrangements in cases in which it 
would have been more advantageous for us to retain sole development and commercialization rights to such product candidate.

Our business entails a significant risk of product liability and if we are unable to obtain sufficient insurance coverage such inability could have an 
adverse effect on our business and financial condition.

Our  business  exposes  us  to  significant  product  liability  risks  inherent  in  the  development,  testing,  manufacturing  and  marketing  of  therapeutic 
treatments.  Product  liability  claims  could  delay  or  prevent  completion  of  our  development  programs.  If  we  succeed  in  marketing  products,  such  claims 
could result in an FDA investigation of the safety and effectiveness of our products, our manufacturing processes and facilities or our marketing programs. 
FDA investigation could potentially lead to a recall of our products or more serious enforcement action, limitations on the approved indications for which 
they may be used or suspension or withdrawal of approvals. Regardless of the merits or eventual outcome, liability claims may also result in decreased 
demand for our products, injury to our reputation, costs to defend the related litigation, a diversion of management’s time and our resources and substantial 
monetary awards to trial participants or patients. We currently have product liability insurance that we believe is appropriate for our stage of development 
and may need to obtain higher levels prior to marketing any of our product candidates, if approved. Any insurance we have or may obtain may not provide 
sufficient coverage against potential liabilities. Furthermore, clinical trial and product liability insurance is becoming increasingly expensive. As a result, 
we  may  be  unable  to  obtain  sufficient  insurance  at  a  reasonable  cost  to  protect  us  against  losses  caused  by  product  liability  claims  that  could  have  an 
adverse effect on our business and financial condition.

Risks Related to Regulatory Approval and Other Legal Compliance Matters

The regulatory approval processes of the FDA, European Medicines Agency (“EMA”) and comparable foreign regulatory authorities are lengthy, time-
consuming and inherently unpredictable. If we are ultimately unable to obtain regulatory approval for our product candidates, we will be unable to 
generate product revenue and our business will be substantially harmed.

The time required to obtain approval by the FDA, EMA and comparable foreign regulatory authorities is unpredictable, typically takes many years 
following the commencement of clinical trials, and depends upon numerous factors, including the type, complexity and novelty of the product candidates 
involved. In addition, approval policies, regulations or the type and amount of clinical data necessary to gain approval may change during the course of a 
product  candidate’s  clinical  development  and  may  vary  among  jurisdictions,  which  may  cause  delays  in  the  approval  or  the  decision  not  to  approve  an 
application. Regulatory authorities have substantial discretion in the approval process and may refuse to accept any application or may decide that our data 
are insufficient for approval and require additional preclinical, clinical or other data. Even if we eventually complete clinical testing and receive approval of 
any regulatory filing for our product candidates, the FDA, EMA and comparable foreign regulatory authorities may approve our product candidates for a 
more limited indication or a narrower patient population than we originally requested. We have not submitted for, or obtained regulatory approval for any 
product candidate, and it is possible that none of our existing product candidates or any product candidates we may seek to develop in the future will ever 
obtain regulatory approval.

Applications for our product candidates could fail to receive regulatory approval in an initial or subsequent indication for many reasons, including 

but not limited to the following:

•

•

•

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

the  FDA,  EMA  or  comparable  foreign  regulatory  authorities  may  determine  that  our  product  candidates  are  not  safe  and  effective,  only 
moderately effective or have undesirable or unintended side effects, toxicities or other characteristics that preclude our obtaining marketing 
approval or prevent or limit commercial use;

the  population  studied  in  the  clinical  program  may  not  be  sufficiently  broad  or  representative  to  assure  efficacy  and  safety  in  the  full 
population for which we seek approval;

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•

•

•

•

•

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

the  data  collected  from  clinical  trials  of  our  product  candidates  may  not  be  sufficient  to  support  the  submission  of  a  Biologics  License 
Application  (“BLA”)  or  New  Drug  Application  (“NDA”),  or  other  submission  or  to  obtain  regulatory  approval  in  the  United  States  or 
elsewhere;

we may be unable to demonstrate to the FDA, EMA or comparable foreign regulatory authorities that a product candidate’s risk-benefit ratio 
for its proposed indication is acceptable;

the  FDA,  EMA  or  comparable  foreign  regulatory  authorities  may  fail  to  approve  the  manufacturing  processes,  test  procedures  and 
specifications or facilities of third-party manufacturers with which we contract for clinical and commercial supplies; and

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

Our development program is studying patients with eosinophilic gastritis (“EG”) and/or eosinophilic duodenitis (“EoD”). Varied terminology had 
been  used  in  the  literature  to  describe  mucosal  eosinophilia  in  the  stomach  and  duodenum  (including  eosinophilic  gastritis,  eosinophilic  duodenitis, 
eosinophilic gastroenteritis and eosinophilic enteritis), and the nomenclature for grouping non-esophageal eosinophil gastrointestinal disorders (“EGIDs”), 
both  within  the  medical  industry  and  the  relevant  regulatory  agencies,  as  well  as  the  ultimate  indication  and  label  for  lirentelimab,  have  yet  to  be 
finalized/agreed upon. For example, in a recent communication with the FDA, they commented that they believe further characterization of isolated EoD is 
needed to determine whether this condition is a subtype of EG or whether it should be considered a distinct indication. The FDA stated they were taking 
this  position  because  the  field  of  eosinophilic  gastrointestinal  diseases  is  advancing  rapidly  and  that  data  from  published  literature,  the  academic 
community, and your development program would be informative. It is possible based on our communications that the FDA may determine EoD or any 
other  subset  of  EGIDs  are  not  separate  disease  processes.  If  the  FDA  determines  that  EoD  is  not  a  separate  disease  process,  but  the  EoD  population  is 
included in the approval as a subset of an approved condition, then such  a determination could cause confusion and adversely impact doctors’ ability or 
willingness to prescribe our medication. In addition, if any particular subset of the EGID population falls outside the label, our marketing authorization 
would not extend to that population, which would impact the potential addressable market for our drug. Ultimately, whether lirentelimab will be used to 
treat  any  subset  of  EGID  patients  will  depend  on  the  agency’s  view  of  the  efficacy  and  safety  of  lirentelimab,  and  our  overall  clinical  development 
program.

The lengthy regulatory approval process, as well as the unpredictability of the results of clinical trials, may result in our failing to obtain regulatory 

approval to market any of our product candidates, which would significantly harm our business, results of operations and prospects.

We may be unable to obtain U.S. or foreign regulatory approval and, as a result, unable to commercialize our product candidates.

Our  product  candidates  are  subject  to  extensive  governmental  regulations  relating  to,  among  other  things,  research,  testing,  development, 
manufacturing,  safety,  efficacy,  approval,  recordkeeping,  reporting,  labeling,  storage,  packaging,  advertising  and  promotion,  pricing,  marketing  and 
distribution  of  drugs  and  therapeutic  biologics.  Rigorous  preclinical  testing  and  clinical  trials  and  an  extensive  regulatory  approval  process  must  be 
successfully completed in the United States and in many foreign jurisdictions before a new drug or therapeutic biologic can be marketed. Satisfaction of 
these  and  other  regulatory  requirements  is  costly,  time-consuming,  uncertain  and  subject  to  unanticipated  delays.  For  example,  despite  the  recent 
completion  of  our  Phase  2  clinical  trial  in  patients  with  EG  and/or  EoD,  significant  regulatory  hurdles  remain,  both  near  term  and  long  term,  before 
lirentelimab can obtain regulatory approval in the United States. There can be no assurance we will be able to successfully conclude these undertakings in a 
timely manner, and it is possible that none of the product candidates we may develop will obtain the regulatory approvals necessary for us to begin selling 
them.

Our company has not conducted or managed clinical trials through regulatory approval, including FDA approval. The time required to obtain FDA 
and other approvals is unpredictable but typically takes many years following the commencement of clinical trials, depending upon the type, complexity 
and novelty of the product 

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candidate. The standards that the FDA and its foreign counterparts use when regulating us require judgment and can change, which makes it difficult to 
predict  with  certainty  how  they  will  be  applied.  Any  analysis  we  perform  of  data  from  preclinical  and  clinical  activities  is  subject  to  confirmation  and 
interpretation by regulatory authorities, which could delay, limit or prevent regulatory approval. We may also encounter unexpected delays or increased 
costs due to new government regulations or due to any delays in FDA regulatory review due to the COVID-19 outbreak. Examples of such regulations 
include future legislation or administrative action, or changes in FDA policy during the period of product development, clinical trials and FDA regulatory 
review. It is impossible to predict whether legislative changes will be enacted, or whether FDA or foreign regulations, guidance or interpretations will be 
changed, or what the impact of such changes, if any, may be.

Any delay or failure in obtaining required approvals could have a material and adverse effect on our ability to generate revenue from the particular 
product  candidate  for  which  we  are  seeking  approval.  Furthermore,  any  regulatory  approval  to  market  a  product  may  be  subject  to  limitations  on  the 
approved uses for which we may market the product or the labeling or other restrictions. In addition, the FDA has the authority to require a REMS as part 
of a BLA or NDA, or after approval, which may impose further requirements or restrictions on the distribution or use of an approved drug or biologic. 
These  requirements  or  restrictions  might  include  limiting  prescribing  to  certain  physicians  or  medical  centers  that  have  undergone  specialized  training, 
limiting treatment to patients who meet certain safe-use criteria and requiring treated patients to enroll in a registry. These limitations and restrictions may 
limit the size of the market for the product and affect reimbursement by third-party payors.

We are also subject to numerous foreign regulatory requirements governing, among other things, the conduct of clinical trials, manufacturing and 
marketing authorization, pricing and third-party reimbursement. The foreign regulatory approval process varies among countries and may include all of the 
risks associated with FDA approval described above as well as risks attributable to the satisfaction of local regulations in foreign jurisdictions. Moreover, 
the time required to obtain approval may differ from that required to obtain FDA approval. Approval by the FDA does not ensure approval by regulatory 
authorities outside the United States and vice versa.

Our clinical trials may reveal significant adverse events, toxicities or other side effects and may result in a safety profile that could inhibit regulatory 
approval or market acceptance of any of our product candidates.

In order to obtain marketing approval for any of our product candidates, we must demonstrate the safety and efficacy of the product candidate for 
the relevant clinical indication or indications through preclinical studies and clinical trials as well as additional supporting data. If our product candidates 
are associated with undesirable side effects in preclinical studies or clinical trials, or have unexpected characteristics, we may need to interrupt, delay or 
abandon their development or limit development to more narrow uses or subpopulations in which the undesirable side effects or other characteristics are 
less prevalent, less severe or more acceptable from a risk-benefit perspective.

We have conducted Phase 1 and Phase 2 clinical trials in healthy volunteers, as well as in patients with EG, EoD, CU, ISM and SAC. However, we 
do  not  know  the  predictive  value  of  these  trials  for  our  future  clinical  trials,  and  we  cannot  guarantee  that  any  positive  results  in  preclinical  studies  or 
previous  clinical  trials  will  successfully  translate  to  patients  in  our  future  clinical  trials.  It  is  not  uncommon  to  observe  results  in  clinical  trials  that  are 
unexpected based on preclinical testing, and many product candidates fail in clinical trials despite promising preclinical results. Moreover, preclinical and 
clinical  data  are  often  susceptible  to  varying  interpretations  and  analyses,  and  many  companies  that  believed  their  product  candidates  performed 
satisfactorily  in  preclinical  studies  and  clinical  trials  have  nonetheless  failed  to  obtain  marketing  approval  for  their  products.  Because  Siglec-8  is  only 
naturally expressed in humans and certain other primates, there is no standard animal toxicology model for anti-Siglec-8 therapies, and the acceptability of 
our preclinical safety data for lirentelimab depends on the continued acceptance by the FDA and EMA, and the acceptance by other regulatory authorities, 
of the use of our proprietary transgenic mice models for toxicology studies. 

Lirentelimab has generally been well tolerated in our clinical trials. The most common adverse event has been the occurrence of mild to moderate 
infusion-related reactions (“IRRs”) (consisting of flushing, feeling of warmth, headache, nausea or dizziness) which occurred mostly, but not exclusively, 
during the first infusion. Temporal interruption of the lirentelimab infusion and minimal intervention generally resulted in prompt resolution of symptoms 
and  ability  to  resume  the  infusion  without  further  complications,  although  there  have  been  instances  when  an  IRR  has  resulted  in  a  subject  being 
discontinued from a trial. Subjects in our ongoing and planned clinical trials may in the 

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future suffer other significant adverse events or other side effects not observed in our preclinical studies or previous clinical trials. If clinical trials of our 
product  candidates  fail  to  demonstrate  efficacy  to  the  satisfaction  of  regulatory  authorities  or  do  not  otherwise  produce  positive  results,  we  may  incur 
additional costs or experience delays in completing, or ultimately be unable to complete, development and commercialization of our product candidates. 

If further significant adverse events or other side effects are observed in any of our current or future clinical trials, we may have difficulty recruiting 
patients to the clinical trials, patients may drop out of our trials, or we may be required to abandon the trials or our development efforts of that product 
candidate  altogether.  We,  the  FDA,  the  EMA,  other  applicable  regulatory  authorities  or  an  institutional  review  board  may  suspend  clinical  trials  of  a 
product candidate at any time for various reasons, including a belief that subjects in such trials are being exposed to unacceptable health risks or adverse 
side effects. Some potential therapeutics developed in the biotechnology industry that initially showed therapeutic promise in early-stage studies have later 
been found to cause side effects that prevented their further development. Even if the side effects do not preclude the drug from obtaining or maintaining 
marketing approval, undesirable side effects may inhibit market acceptance of the approved product due to its tolerability relative to other therapies. Any of 
these developments could materially harm our business, financial condition and prospects.

Further, if any of our product candidates obtains marketing approval, toxicities associated with our product candidates may also develop after such 
approval and lead to a requirement to conduct additional clinical safety trials, additional warnings being added to the labeling, significant restrictions on the 
use of the product or the withdrawal of the product from the market. We cannot predict whether our product candidates will cause toxicities in humans that 
would preclude or lead to the revocation of regulatory approval based on preclinical studies or early-stage clinical testing.

The FDA, EMA and applicable foreign regulatory authorities may not accept data from trials conducted in locations outside of their jurisdiction.

We currently conduct clinical trials both in the United States and in other countries. We may in the future choose to conduct additional clinical trials 
in countries outside the United States, including in Europe. The acceptance of study data by the FDA, EMA or applicable foreign regulatory authority from 
clinical trials conducted outside of their respective jurisdictions may be subject to certain conditions. In cases where data from foreign clinical trials are 
intended to serve as the basis for marketing approval in the United States, the FDA will generally not approve the application on the basis of foreign data 
alone  unless  (i)  the  data  are  applicable  to  the  United  States  population  and  United  States  medical  practice  and  (ii)  the  trials  are  performed  by  clinical 
investigators  of  recognized  competence  and  pursuant  to  current  good  clinical  practices  regulations.  Additionally,  the  FDA’s  clinical  trial  requirements, 
including sufficient size of patient populations and statistical powering, must be met. Many foreign regulatory bodies have similar approval requirements. 
In addition, such foreign trials would be subject to the applicable local laws of the foreign jurisdictions where the trials are conducted. There can be no 
assurance that the FDA, EMA or any applicable foreign regulatory authority will accept data from trials conducted outside of its applicable jurisdiction. If 
the FDA, EMA or any applicable foreign regulatory authority does not accept such data, it would result in the need for additional trials, which would be 
costly and time-consuming and delay aspects of our business plan, and which may result in our product candidates not receiving approval or clearance for 
commercialization in the applicable jurisdiction.

Obtaining and maintaining regulatory approval of our product candidates in one jurisdiction does not mean that we will be successful in obtaining 
regulatory approval of our product candidates in other jurisdictions.

Obtaining and maintaining regulatory approval of our product candidates in one jurisdiction does not guarantee that we will be able to obtain or 
maintain  regulatory  approval  in  any  other  jurisdiction.  For  example,  even  if  the  FDA  or  EMA  grants  marketing  approval  of  a  product  candidate, 
comparable regulatory authorities in foreign jurisdictions must also approve the manufacturing, marketing and promotion of the product candidate in those 
countries. However, a failure or delay in obtaining regulatory approval in one jurisdiction may have a negative effect on the regulatory approval process in 
others. Approval procedures vary among jurisdictions and can involve requirements and administrative review periods different from those in the United 
States, including additional preclinical studies or clinical trials as clinical trials conducted in one jurisdiction may not be accepted by regulatory authorities 
in other jurisdictions. In many jurisdictions outside the United States, a product candidate must be approved for reimbursement 

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before it can be approved for sale in that jurisdiction. In some cases, the price that we intend to charge for our products is also subject to approval.

Obtaining foreign regulatory approvals and compliance with foreign regulatory requirements could result in significant delays, difficulties and costs 
for us and could delay or prevent the introduction of our products in certain countries. If we or any partner we work with fail to comply with the regulatory 
requirements in international markets or fail to receive applicable marketing approvals, our target market will be reduced and our ability to realize the full 
market potential of our product candidates will be harmed.

Even if our product candidates receive regulatory approval, they will be subject to significant post-marketing regulatory requirements.

Any regulatory approvals that we may receive for our product candidates will require surveillance to monitor the safety and efficacy of the product 
candidate,  may  contain  significant  limitations  related  to  use  restrictions  for  specified  age  groups,  warnings,  precautions  or  contraindications,  and  may 
include burdensome post-approval study or risk management requirements. For example, the FDA may require a REMS in order to approve our product 
candidates, which could entail requirements for a medication guide, physician communication plans or additional elements, such as boxed warning on the 
packaging, to ensure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. In addition, if the FDA or foreign 
regulatory  authorities  approve  our  product  candidates,  the  manufacturing  processes,  labeling,  packaging,  distribution,  adverse  event  reporting,  storage, 
advertising,  promotion,  import,  export  and  recordkeeping  for  our  product  candidates  will  be  subject  to  extensive  and  ongoing  regulatory  requirements. 
These  requirements  include  submissions  of  safety  and  other  post-marketing  information  and  reports,  registration,  as  well  as  continued  compliance  with 
current good manufacturing practices (“cGMPs”) and good clinical practices (“GCPs”), for any clinical trials that we conduct post-approval. In addition, 
manufacturers of drug products and their facilities are subject to continual review and periodic inspections by the FDA and other regulatory authorities for 
compliance with cGMP regulations and standards. If we or a regulatory agency discover previously unknown problems with a product, such as adverse 
events  of  unanticipated  severity  or  frequency,  or  problems  with  the  facilities  where  the  product  is  manufactured,  a  regulatory  agency  may  impose 
restrictions  on  that  product,  the  manufacturing  facility  or  us,  including  requiring  recall  or  withdrawal  of  the  product  from  the  market  or  suspension  of 
manufacturing. In addition, failure to comply with FDA and foreign regulatory requirements may, either before or after product approval, if any, subject our 
company to administrative or judicially imposed sanctions, including:

•

•

•

•

•

•

•

•

•

•

•

restrictions on our ability to conduct clinical trials, including full or partial clinical holds on ongoing or planned trials;

restrictions on the products, manufacturers or manufacturing process;

warning or untitled letters;

civil and criminal penalties;

injunctions;

suspension or withdrawal of regulatory approvals;

product seizures, detentions or import bans;

voluntary or mandatory product recalls and publicity requirements;

total or partial suspension of production;

imposition of restrictions on operations, including costly new manufacturing requirements; and

refusal to approve pending BLAs or supplements to approved BLAs.

The occurrence of any event or penalty described above may inhibit our ability to commercialize our product candidates and generate revenue.

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We may not be able to obtain orphan drug designation or obtain or maintain orphan drug exclusivity for our product candidates and, even if we do, 
that exclusivity may not prevent the FDA or the EMA from approving competing products.

Regulatory  authorities  in  some  jurisdictions,  including  the  U.S.  and  the  European  Union,  may  designate  drugs  for  relatively  small  patient 
populations as orphan drugs. Under the Orphan Drug Act, the FDA may designate a product as an orphan drug if it is a drug intended to treat a rare disease 
or condition, which is generally defined as a patient population of fewer than 200,000 individuals annually in the U.S., or a patient population greater than 
200,000 in the United States where there is no reasonable expectation that the cost of developing the drug will be recovered from sales in the United States. 
We have obtained orphan drug designation for EG, EoD and EoE in the U.S. and for ISM in the U.S. and European Union and we may seek orphan drug 
designations for other indications or for other of our product candidates. There can be no assurances that we will be able to obtain such designations.

In the U.S., orphan drug designation entitles a party to financial incentives such as opportunities for grant funding towards clinical trial costs, tax 
advantages and user-fee waivers. In addition, if a product that has orphan drug designation subsequently receives the first FDA approval for the disease for 
which  it  has  such  designation,  the  product  is  entitled  to  orphan  drug  exclusivity.  Orphan  drug  exclusivity  in  the  U.S.  provides  that  the  FDA  may  not 
approve  any  other  applications,  including  a  full  BLA  or  NDA,  to  market  the  same  drug  for  the  same  indication  for  seven  years,  except  in  limited 
circumstances. The applicable exclusivity period is ten years in Europe. The European exclusivity period can be reduced to six years if a drug no longer 
meets the criteria for orphan drug designation or if the drug is sufficiently profitable so that market exclusivity is no longer justified.

Even  if  we  obtain  orphan  drug  designation  for  a  product  candidate,  we  may  not  be  able  to  obtain  or  maintain  orphan  drug  exclusivity  for  that 
product candidate. We may not be the first to obtain marketing approval of any product candidate for which we have obtained orphan drug designation for 
the orphan-designated indication due to the uncertainties associated with developing pharmaceutical products. In addition, exclusive marketing rights in the 
U.S. may be limited if we seek approval for an indication broader than the orphan-designated indication or may be lost if the FDA later determines that the 
request for designation was materially defective or if we are unable to assure sufficient quantities of the product to meet the needs of patients with the rare 
disease  or  condition.  Further,  even  if  we  obtain  orphan  drug  exclusivity  for  a  product,  that  exclusivity  may  not  effectively  protect  the  product  from 
competition because different drugs with different active moieties may be approved for the same condition. Even after an orphan drug is approved, the 
FDA can subsequently approve the same drug with the same active moiety for the same condition if the FDA concludes that the later drug is clinically 
superior  in  that  it  is  shown  to  be  safer,  more  effective  or  makes  a  major  contribution  to  patient  care  or  the  manufacturer  of  the  product  with  orphan 
exclusivity is unable to maintain sufficient product quantity. Orphan drug designation neither shortens the development time or regulatory review time of a 
drug nor gives the drug any advantage in the regulatory review or approval process.

Given the FDA’s stated uncertainty surrounding EGID diseases, it is possible the FDA could decide EGIDs in general, or any subset of the EGID 
population, is a much larger market and accordingly ineligible for orphan drug status. We have obtained orphan drug designation for EG, EoD and EoE in 
the  U.S.  but  further  redefinitions  of  the  EGID  diseases  by  the  FDA  could  cause  us  to  lose  such  status.  Were  this  to  occur,  we  would  not  only  lose  the 
financial incentives and exclusivity granted to orphan drugs, we could also be forced to undertake larger or additional clinical trials which could impact our 
proposed timeline for introducing lirentelimab and impact our business, financial condition and results of operations.

Although we may seek a breakthrough therapy designation for lirentelimab or one or more of our other product candidates, we might not receive such 
designation, and even if we do, such designation may not lead to a faster development or regulatory review or approval process.

We may seek a breakthrough therapy designation for lirentelimab in one or more indications or for other product candidates. A breakthrough therapy 
is defined as a drug that is intended, alone or in combination with one or more other drugs, to treat a serious condition, and preliminary clinical evidence 
indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial 
treatment  effects  observed  early  in  clinical  development.  For  drugs  and  biologics  that  have  been  designated  as  breakthrough  therapies,  interaction  and 
communication between the FDA and the sponsor of the trial can help to identify the most efficient path for clinical development while minimizing the 
number of patients placed in ineffective 

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control regimens. Drugs designated as breakthrough therapies by the FDA may also be eligible for priority review if supported by clinical data at the time 
the NDA is submitted to the FDA.

Designation as a breakthrough therapy is within the discretion of the FDA. Accordingly, even if we believe that one of our product candidates meets 
the  criteria  for  designation  as  a  breakthrough  therapy,  the  FDA  may  disagree  and  instead  determine  not  to  make  such  designation.  Even  if  we  receive 
breakthrough therapy designation, the receipt of such designation for a product candidate may not result in a faster development or regulatory review or 
approval process compared to drugs considered for approval under conventional FDA procedures and does not assure ultimate approval by the FDA. In 
addition, even if one or more of our product candidates qualify as breakthrough therapies, the FDA may later decide that the product candidates no longer 
meet the conditions for qualification or decide that the time period for FDA review or approval will not be shortened. 

We may face difficulties from changes to current regulations and future legislation.

Existing  regulatory  policies  may  change  and  additional  government  regulations  may  be  enacted  that  could  prevent,  limit  or  delay  regulatory 
approval of our product candidates. We cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or 
administrative  action,  either  in  the  U.S.  or  abroad.  If  we  are  slow  or  unable  to  adapt  to  changes  in  existing  requirements  or  the  adoption  of  new 
requirements or policies, or if we are not able to maintain regulatory compliance, we may lose any marketing approval that we may have obtained and we 
may not achieve or sustain profitability.

Certain members of Congress have made various efforts to repeal all or portions of the Affordable Care Act (“ACA”), including suspending the 
penalties for failing to comply with the individual insurance mandate, removing funds designed to drive enrollment in the program, repealing the “Cadillac 
tax” on certain high-cost, employee-sponsored health insurance plans and coming within a single vote in the U.S. Senate of repealing the ACA altogether. 
There is uncertainty with respect to the impact future actions by Congress or the courts may have and any changes likely will take time to unfold, and could 
have an impact on coverage and reimbursement for healthcare items and services covered by plans that were authorized by the ACA. However, we cannot 
predict  the  ultimate  content,  timing  or  effect  of  any  further  healthcare  reform  legislation  or  the  impact  of  potential  legislation  on  us.  In  addition,  other 
legislative changes have been proposed and adopted since the ACA was enacted. These changes included aggregate reductions to Medicare payments to 
providers of up to 2% per fiscal year, effective April 1, 2013, which, due to subsequent legislative amendments, will stay in effect through 2025 unless 
additional  Congressional  action  is  taken.  In  January  2013,  President  Obama  signed  into  law  the  American  Taxpayer  Relief  Act  of  2012,  which,  among 
other things, reduced Medicare payments to several providers, and increased the statute of limitations period for the government to recover overpayments 
to providers from three to five years. These laws may result in additional reductions in Medicare and other healthcare funding, which could have a material 
adverse effect on customers for our drugs, if approved, and accordingly, our financial operations.

We  expect  that  the  ACA,  as  well  as  other  healthcare  reform  measures  that  may  be  adopted  in  the  future,  may  result  in  more  rigorous  coverage 
criteria and in additional downward pressure on the price that we receive for any approved product. For example, President Biden made drug price reform a 
focal  point  of  his  2020  presidential  campaign.  Any  reduction  in  reimbursement  from  Medicare  or  other  government  programs  may  result  in  a  similar 
reduction in payments from private payors. The implementation of cost containment measures or other healthcare reforms may prevent us from being able 
to generate sufficient revenue, attain profitability or commercialize our product candidates.

Legislative  and  regulatory  proposals  have  been  made  to  expand  post-approval  requirements  and  restrict  sales  and  promotional  activities  for 
biotechnology products. We cannot be sure whether additional legislative changes will be enacted, or whether FDA regulations, guidance or interpretations 
will be changed, or what the impact of such changes on the marketing approvals of our product candidates, if any, may be. In addition, increased scrutiny 
by the U.S. Congress of the FDA’s approval process may significantly delay or prevent marketing approval, as well as subject us to more stringent product 
labeling and post-marketing testing and other requirements. 

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If we fail to comply with applicable U.S. and foreign privacy and data protection laws and regulations, we may be subject to liabilities that adversely 
affect our business, operations and financial performance.

We are subject to federal and state laws and regulations requiring that we take measures to protect the privacy and security of certain information we 
gather and use in our business. For example, federal and state security breach notification laws, state health information privacy laws and federal and state 
consumer  protection  laws  impose  requirements  regarding  the  collection,  use,  disclosure  and  storage  of  personal  information.  In  addition,  in  June  2018, 
California  enacted  the  California  Consumer  Privacy  Act  (the  “CCPA”),  which  took  effect  on  January  1,  2020.  The  CCPA  gives  California  residents 
expanded  rights  to  access  and  require  deletion  of  their  personal  information,  opt  out  of  certain  personal  information  sharing,  and  receive  detailed 
information about how their personal information is used. The CCPA provides for civil penalties for violations, as well as a private right of action for data 
breaches  that  may  increase  data  breach  litigation.  Although  the  CCPA  includes  exemptions  for  certain  clinical  trials  data,  and  HIPAA  protected  health 
information,  the  law  may  increase  our  compliance  costs  and  potential  liability  with  respect  to  other  personal  information  we  collect  about  California 
residents.  Additionally,  the  California  Privacy  Rights  Act,  amending  and  expanding  CCPA,  was  passed  via  ballot  initiative  during  the  November  2020 
election,  which  will  further  strengthen  privacy  laws  in  California  and  create  a  new  privacy  regulatory  agency  in  the  state.  The  CCPA  has  prompted  a 
number of proposals for new federal and state privacy legislation that, if passed, could increase our potential liability, increase our compliance costs and 
adversely affect our business.

We  may  also  be  subject  to  or  affected  by  foreign  laws  and  regulations,  including  regulatory  guidance,  governing  the  collection,  use,  disclosure, 
security, transfer and storage of personal data, such as information that we collect about patients and healthcare providers in connection with clinical trials 
and our other operations in the U.S. and abroad. The global legislative and regulatory landscape for privacy and data protection continues to evolve, and 
implementation standards and enforcement practices are likely to remain uncertain for the foreseeable future. This evolution may create uncertainty in our 
business,  result  in  liability  or  impose  additional  costs  on  us.  The  cost  of  compliance  with  these  laws,  regulations  and  standards  is  high  and  is  likely  to 
increase in the future. For example, the EU has adopted the General Data Protection Regulation (the “GDPR”), which introduces strict requirements for 
processing  personal  data.  The  GDPR  increases  our  compliance  burden  with  respect  to  data  protection,  including  by  mandating  potentially  burdensome 
documentation requirements and granting certain rights to individuals to control how we collect, use, disclose, retain and leverage information about them. 
The processing of sensitive personal data, such as information about health conditions, entails heightened compliance burdens under the GDPR and is a 
topic of active interest among foreign regulators. In addition, the GDPR provides for breach reporting requirements, more robust regulatory enforcement 
and fines of up to the greater of 20 million euros or 4% of annual global revenue. While companies are afforded some flexibility in determining how to 
comply with the GDPR’s various requirements, significant effort and expense are required to ensure continuing compliance with the GDPR. Moreover, the 
requirements  under  the  GDPR  and  guidance  issued  by  different  EU  member  states  may  change  periodically  or  may  be  modified,  and  such  changes  or 
modifications could have an adverse effect on our business operations if compliance becomes substantially costlier than under current requirements. For 
example, on July 16, 2020, the Court of Justice of the European Union invalidated the EU-US Privacy Shield Framework under which personal data could 
be  transferred  from  the  EEA  to  United  States  entities  that  had  self-certified  under  the  Privacy  Shield  scheme.  It  is  currently  unclear  what  additional 
measures will need to be put in place as a result of this court ruling. It is also possible that each of these privacy laws may be interpreted and applied in a 
manner  that  is  inconsistent  with  our  practices.  Any  failure  or  perceived  failure  by  us  to  comply  with  federal,  state,  or  foreign  laws  or  self-regulatory 
standards could result in negative publicity, diversion of management time and effort, proceedings against us by governmental entities or others, and fines. 
In  many  jurisdictions,  enforcement  actions  and  consequences  for  noncompliance  are  rising.  As  we  continue  to  expand  into  other  foreign  countries  and 
jurisdictions, we may be subject to additional laws and regulations that may affect how we conduct business.

Our  relationships  with  customers  and  third-party  payors  will  be  subject  to  applicable  anti-kickback,  fraud  and  abuse,  transparency  and  other 
healthcare laws and regulations, which could expose us to, among other things, criminal sanctions, civil penalties, contractual damages, reputational 
harm, administrative burdens and diminished profits and future earnings.

Healthcare providers and third-party payors play a primary role in the recommendation and prescription of any product candidates for which we 
obtain marketing approval. Our future arrangements with third-party payors and customers may expose us to broadly applicable fraud and abuse and other 
healthcare laws and regulations that may 

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constrain the business or financial arrangements and relationships through which we market, sell and distribute our products for which we obtain marketing 
approval. Restrictions under applicable federal and state healthcare laws and regulations, include the following:

•

•

•

•

•

•

the  federal  Anti-Kickback  Statute  prohibits,  among  other  things,  persons  and  entities  from  knowingly  and  willfully  soliciting,  offering, 
receiving or providing remuneration, directly or indirectly, in cash or in kind, to induce or reward, or in return for, either the referral of an 
individual for, or the purchase, order or recommendation of, any good or service, for which payment may be made under a federal healthcare 
program such as Medicare and Medicaid;

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

the  federal  Health  Insurance  Portability  and  Accountability  Act  of  1996  (“HIPAA”),  imposes  criminal  and  civil  liability  for,  among  other 
things,  executing  or  attempting  to  execute  a  scheme  to  defraud  any  healthcare  benefit  program  or  making  false  statements  relating  to 
healthcare matters;

HIPAA,  as  amended  by  the  Health  Information  Technology  for  Economic  and  Clinical  Health  Act  and  its  implementing  regulations,  also 
imposes  obligations,  including  mandatory  contractual  terms,  with  respect  to  safeguarding  the  privacy,  security  and  transmission  of 
individually identifiable health information;

the federal Physician Payments Sunshine Act requires applicable manufacturers of covered drugs, devices, biologics and medical supplies for 
which  payment  is  available  under  Medicare,  Medicaid  or  the  Children’s  Health  Insurance  Program,  with  specific  exceptions,  to  annually 
report  to  CMS  information  regarding  payments  and  other  transfers  of  value  to  physicians  and  teaching  hospitals  as  well  as  information 
regarding ownership and investment interests held by physicians and their immediate family members. The information was made publicly 
available on a searchable website in September 2014 and will be disclosed on an annual basis; and

analogous  state  and  foreign  laws  and  regulations,  such  as  state  anti-kickback  and  false  claims  laws,  may  apply  to  sales  or  marketing 
arrangements  and  claims  involving  healthcare  items  or  services  reimbursed  by  non-governmental  third-party  payors,  including  private 
insurers.

Some state laws require biotechnology companies to comply with the biotechnology industry’s voluntary compliance guidelines and the relevant 
compliance  guidance  promulgated  by  the  federal  government  and  may  require  drug  manufacturers  to  report  information  related  to  payments  and  other 
transfers of value to physicians and other healthcare providers or marketing expenditures. State and foreign laws also govern the privacy and security of 
health  information  in  some  circumstances,  many  of  which  differ  from  each  other  in  significant  ways  and  often  are  not  preempted  by  HIPAA,  thus 
complicating compliance efforts.

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

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Risks Related to Employee Matters, Managing Our Growth and Other Risks Related to Our Business

Our success is highly dependent on the services of our Chief Executive Officer, Dr. Robert Alexander, and our President and Chief Operating Officer, 
Dr. Adam Tomasi, and our ability to attract and retain highly skilled executive officers and employees.

To succeed, we must recruit, retain, manage and motivate qualified clinical, scientific, technical and management personnel, and we face significant 
competition for experienced personnel. We are highly dependent on the principal members of our management and scientific and medical staff, particularly 
our Chief Executive Officer, Dr. Robert Alexander, and our President and Chief Operating Officer, Dr. Adam Tomasi. If we do not succeed in attracting and 
retaining qualified personnel, particularly at the management level, it could adversely affect our ability to execute our business plan and harm our operating 
results.  In  particular,  the  loss  of  one  or  more  of  our  executive  officers,  including  Dr.  Alexander  or  Dr.  Tomasi,  could  be  detrimental  to  us  if  we  cannot 
recruit suitable replacements in a timely manner. The competition for qualified personnel in the biotechnology field is intense and as a result, we may be 
unable to continue to attract and retain qualified personnel necessary for the future success of our business. In addition to competition for personnel, the 
San Francisco Bay Area in particular is characterized by a high cost of living. We could in the future have difficulty attracting experienced personnel to our 
company and may be required to expend significant financial resources in our employee recruitment and retention efforts.

Many of the other biotechnology companies that we compete against for qualified personnel have greater financial and other resources, different risk 
profiles and a longer history in the industry than we do. They also may provide more diverse opportunities and better prospects for career advancement. 
Some of these characteristics may be more appealing to high-quality candidates than what we have to offer. If we are unable to continue to attract and 
retain high-quality personnel, the rate and success at which we can discover, develop and commercialize our product candidates will be limited and the 
potential for successfully growing our business will be harmed.

If we are unable to establish sales or marketing capabilities or enter into agreements with third-parties to sell or market our product candidates, we may 
not be able to successfully sell or market our product candidates that obtain regulatory approval.

We currently have a small commercial team which will need to be expanded substantially to support the marketing, sales and distribution of any of 
our product candidates that may be able to obtain regulatory approval. In order to commercialize any product candidates, we must build marketing, sales, 
distribution, managerial and other non-technical capabilities or make arrangements with third-parties to perform these services for each of the territories in 
which we may have approval to sell or market our product candidates. We may not be successful in accomplishing these required tasks.

Establishing  an  internal  sales  or  marketing  team  with  technical  expertise  and  supporting  distribution  capabilities  to  commercialize  our  product 
candidates will be expensive and time-consuming, and will require significant attention of our executive officers to manage. Any failure or delay in the 
development of our internal sales, marketing and distribution capabilities could adversely impact the commercialization of any of our product candidates 
that we obtain approval to market, if we do not have arrangements in place with third-parties to provide such services on our behalf. Alternatively, if we 
choose to collaborate, either globally or on a territory-by-territory basis, with third-parties that have direct sales forces and established distribution systems, 
either to augment our own sales force and distribution systems or in lieu of our own sales force and distribution systems, we will be required to negotiate 
and enter into arrangements with such third-parties relating to the proposed collaboration. If we are unable to enter into such arrangements when needed on 
acceptable terms, or at all, we may not be able to successfully commercialize any of our product candidates that receive regulatory approval or any such 
commercialization may experience delays or limitations. If we are unable to successfully commercialize our approved product candidates, either on our 
own or through collaborations with one or more third-parties, our future product revenue will suffer and we may incur significant additional losses.

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In order to successfully implement our plans and strategies, we will need to grow the size of our organization, and we may experience difficulties in 
managing this growth.

At December 31, 2021, we had 192 full-time employees, including 132 employees engaged in research and development. In order to successfully 
implement our development and commercialization plans and strategies, we expect to need additional managerial, operational, sales, marketing, financial 
and other personnel. Future growth would impose significant added responsibilities on members of management, including:

•

•

•

identifying, recruiting, integrating, maintaining and motivating additional employees;

managing our internal development efforts effectively, including the clinical and FDA review process for lirentelimab and any other future 
product candidates, while complying with any contractual obligations to contractors and other third-parties we may have; and

improving our operational, financial and management controls, reporting systems and procedures.

Our future financial performance and our ability to successfully develop and, if approved, commercialize lirentelimab and any other future product 
candidates will depend, in part, on our ability to effectively manage any future growth, and our management may also have to divert a disproportionate 
amount of its attention away from day-to-day activities in order to devote a substantial amount of time to managing these growth activities. In addition, if 
we reduce our workforce, as we did in early 2022, in order to reduce operating costs or for other reasons, the rate and success at which we can discover, 
develop and commercialize our product candidates may be limited and the potential for successfully growing our business may be harmed. 

We  currently  rely,  and  for  the  foreseeable  future  will  continue  to  rely,  in  substantial  part  on  certain  independent  organizations,  advisors  and 
consultants  to  provide  certain  services,  including  most  aspects  of  clinical  management  and  manufacturing.  We  cannot  assure  you  that  the  services  of 
independent  organizations,  advisors  and  consultants  will  continue  to  be  available  to  us  on  a  timely  basis  when  needed,  or  that  we  can  find  qualified 
replacements. In addition, if we are unable to effectively manage our outsourced activities or if the quality or accuracy of the services provided by third-
party  service  providers  is  compromised  for  any  reason,  our  clinical  trials  may  be  extended,  delayed  or  terminated,  and  we  may  not  be  able  to  obtain 
marketing approval of lirentelimab and any other future product candidates or otherwise advance our business. We cannot assure you that we will be able to 
manage our existing third-party service providers or find other competent outside contractors and consultants on economically reasonable terms, or at all.

If we are not able to effectively expand our organization by hiring new employees and/or engaging additional third-party service providers, we may 
not be able to successfully implement the tasks necessary to further develop and commercialize lirentelimab and any other future product candidates and, 
accordingly, may not achieve our research, development and commercialization goals.

Risks Related to Intellectual Property

If we are unable to obtain or protect intellectual property rights, we may not be able to compete effectively in our market.

Our  success  depends  in  significant  part  on  our  and  our  current  or  future  licensors’  ability  to  establish,  maintain  and  protect  patents  and  other 
intellectual property rights and operate without infringing the intellectual property rights of others. We have filed numerous patent applications both in the 
United States and in foreign jurisdictions to obtain patent rights to inventions we have developed. We have also licensed from third-parties rights to patent 
portfolios. Some of these licenses give us the right to prepare, file and prosecute patent applications and maintain and enforce patents we have licensed, and 
other licenses may not give us such rights.

The patent prosecution process is expensive and time-consuming, and we and our current or future licensors may not be able to prepare, file and 
prosecute  all  necessary  or  desirable  patent  applications  at  a  reasonable  cost  or  in  a  timely  manner.  It  is  also  possible  that  we  or  our  current  and  future 
licensors will fail to identify patentable aspects of inventions made in the course of development and commercialization activities before it is too late to 
obtain patent protection on them. Moreover, in some circumstances, we may not have the right to control the preparation, filing and prosecution of patent 
applications, or to maintain the patents, covering technology that we license from third-parties 

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and are reliant on our current and future licensors. Therefore, these patents and applications may not be prosecuted and enforced in a manner consistent 
with the best interests of our business. If our current or future licensors fail to establish, maintain or protect such patents and other intellectual property 
rights,  such  rights  may  be  reduced  or  eliminated.  If  our  current  and  future  licensors  are  not  fully  cooperative  or  disagree  with  us  as  to  the  prosecution, 
maintenance or enforcement of any patent rights, such patent rights could be compromised.

The patent position of biotechnology companies generally is highly uncertain, involves complex legal and factual questions and has in recent years 
been the subject of much litigation. As a result, the issuance, scope, validity, enforceability and commercial value of our and our current or future licensors’ 
patent rights are highly uncertain. Our and our current or future licensors’ pending and future patent applications may not result in patents being issued 
which  protect  our  technology  or  products,  in  whole  or  in  part,  or  which  effectively  prevent  others  from  commercializing  competitive  technologies  and 
products. The patent examination process may require us or our current and future licensors to narrow the scope of the claims of our or our current and 
future licensors’ pending and future patent applications, which may limit the scope of patent protection that may be obtained.

We cannot assure you that all of the potentially relevant prior art relating to our patents and patent applications has been found. If such prior art 
exists, it can invalidate a patent or prevent a patent from issuing from a pending patent application. Even if patents do successfully issue and even if such 
patents  cover  our  product  candidates,  third-parties  may  initiate  an  opposition,  interference,  re-examination,  post-grant  review,  inter  partes  review, 
nullification or derivation action in court or before patent offices, or similar proceedings challenging the validity, enforceability or scope of such patents, 
which may result in the patent claims being narrowed or invalidated. Our and our current or future licensors’ patent applications cannot be enforced against 
third-parties practicing the technology claimed in such applications unless and until a patent issues from such applications, and then only to the extent the 
issued claims cover the technology.

Because patent applications in the United States and most other countries are confidential for a period of time after filing, and some remain so until 
issued,  we  cannot  be  certain  that  we  or  our  current  and  future  licensors  were  the  first  to  file  any  patent  application  related  to  a  product  candidate. 
Furthermore,  if  third-parties  have  filed  such  patent  applications  on  or  before  March  15,  2013,  an  interference  proceeding  in  the  United  States  can  be 
initiated by such third-parties to determine who was the first to invent any of the subject matter covered by the patent claims of our applications. If third-
parties have filed such applications after March 15, 2013, a derivation proceeding in the United States can be initiated by such third-parties to determine 
whether our invention was derived from theirs. Even where we have a valid and enforceable patent, we may not be able to exclude others from practicing 
our invention where the other party can show that they used the invention in commerce before our filing date or the other party benefits from a compulsory 
license.  In  addition,  patents  have  a  limited  lifespan.  In  the  United  States,  if  all  maintenance  fees  are  timely  paid,  the  natural  expiration  of  a  patent  is 
generally 20 years from its earliest U.S. filing date. Various extensions may be available, but the life of a patent, and the protection it affords, is limited. 
Even  if  patents  covering  our  product  candidates  are  obtained,  once  the  patent  life  has  expired  for  a  product,  we  may  be  open  to  competition  from 
competitive  medications,  including  biosimilar  or  generic  medications.  For  example,  one  of  our  owned  patent  families  that  claims  one  of  the  product 
candidates will expire in 2035 in the United States and similar patent applications are pending in foreign jurisdictions with a projected expiration date in 
2034, at which time the underlying technology covered by such patents can be used by any third-party, including competitors. Although the patent term 
extensions under the Hatch-Waxman Act in the United States may be available to extend the patent term, we cannot provide any assurances that any such 
patent term extension will be obtained and, if so, for how long.

Due to the amount of time required for the development, testing and regulatory review of new product candidates, patents protecting such candidates 
might  expire  before  or  shortly  after  such  candidates  are  commercialized.  As  a  result,  our  owned  and  licensed  patent  portfolio  may  not  provide  us  with 
sufficient rights to exclude others from commercializing products similar or identical to ours. We expect to seek extensions of patent terms where these are 
available  in  any  countries  where  we  are  prosecuting  patents.  This  includes  in  the  United  States  under  the  Drug  Price  Competition  and  Patent  Term 
Restoration Act of 1984, which permits a patent term extension of up to five years beyond the expiration of the patent. However, the applicable authorities, 
including the FDA and the U.S. Patent and Trademark Office (“USPTO”) in the United States, and any equivalent foreign regulatory authority, may not 
agree  with  our  assessment  of  whether  such  extensions  are  available,  and  may  refuse  to  grant  extensions  to  our  patents,  or  may  grant  more  limited 
extensions than we request. If this occurs, our competitors may take advantage of our 

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investment in development and clinical trials by referencing our clinical and preclinical data and launch their product earlier than might otherwise be the 
case.

We may not be able to protect our intellectual property rights throughout the world.

Filing, prosecuting, enforcing and defending patents on product candidates in all countries throughout the world would be prohibitively expensive, 
and our or our current and future licensors’ intellectual property rights may not exist in some countries outside the United States or may be less extensive in 
some countries than in the United States. In addition, the laws of some foreign countries do not protect intellectual property rights to the same extent as 
federal and state laws in the United States. Consequently, we and our current and future licensors may not be able to prevent third-parties from practicing 
our and our current or future licensors’ inventions in all countries outside the United States, or from selling or importing products made using our and our 
current  or  future  licensors’  inventions  in  and  into  the  United  States  or  other  jurisdictions.  Competitors  may  use  our  and  our  current  or  future  licensors’ 
technologies  in  jurisdictions  where  we  have  not  obtained  patent  protection  to  develop  their  own  products  and,  further,  may  export  otherwise  infringing 
products to territories where we and our current and future licensors have patent protection, but enforcement is not as strong as that in the United States. 
These products may compete with our product candidates, and our and our current or future licensors’ patents or other intellectual property rights may not 
be effective or sufficient to prevent them from competing.

Many companies have encountered significant problems in protecting and defending intellectual property rights in foreign jurisdictions. The legal 
systems of certain countries, particularly certain developing countries, do not favor the enforcement of patents and other intellectual property protection, 
particularly those relating to biotechnology, which could make it difficult for us and our current and future licensors to stop the infringement of our and our 
current or future licensors’ patents or marketing of competing products in violation of our and our current or future licensors’ proprietary rights generally. 
Proceedings to enforce our and our current or future licensors’ patent rights in foreign jurisdictions could result in substantial costs and divert our and our 
current or future licensors’ efforts and attention from other aspects of our business, could put our and our current or future licensors’ patents at risk of being 
invalidated or interpreted narrowly and our and our current or future licensors’ patent applications at risk of not issuing and could provoke third-parties to 
assert claims against us or our current and future licensors. We or our current and future licensors may not prevail in any lawsuits that we or our current and 
future licensors initiate, and the damages or other remedies awarded, if any, may not be commercially meaningful.

Many countries have compulsory licensing laws under which a patent owner may be compelled to grant licenses to third-parties. In addition, many 
countries limit the enforceability of patents against government agencies or government contractors. In these countries, the patent owner may have limited 
remedies, which could materially diminish the value of such patent. If we or our current and future licensors are forced to grant a license to third-parties 
with respect to any patents relevant to our business, our competitive position may be impaired, and our business, financial condition, results of operations 
and prospects may be adversely affected.

Changes in patent law could diminish the value of patents in general, thereby impairing our ability to protect our product candidates.

Obtaining and enforcing patents in the biopharmaceutical industry involves both technological and legal complexity and is therefore costly, time-
consuming  and  inherently  uncertain.  Changes  in  either  the  patent  laws  or  interpretation  of  the  patent  laws  in  the  United  States  could  increase  the 
uncertainties and costs. Patent reform legislation in the United States and other countries, including the Leahy-Smith America Invents Act (“Leahy-Smith 
Act”), signed into law on September 16, 2011, could increase those uncertainties and costs surrounding the prosecution of our patent applications and the 
enforcement or defense of our issued patents. The Leahy-Smith Act includes a number of significant changes to U.S. patent law. These include provisions 
that affect the way patent applications are prosecuted, redefine prior art and provide more efficient and cost-effective avenues for competitors to challenge 
the validity of patents. These include allowing third-party submission of prior art to the USPTO during patent prosecution and additional procedures to 
attack the validity of a patent by USPTO administered post-grant proceedings, including post-grant review, inter partes review and derivation proceedings. 
After  March  15,  2013,  under  the  Leahy-Smith  Act,  the  United  States  transitioned  to  a  first  inventor  to  file  system  in  which,  assuming  that  the  other 
statutory requirements are met, the first inventor to file a patent application will be entitled to the patent on an invention regardless of whether a third-party 
was the first to invent the claimed invention. However, the Leahy-Smith Act and its implementation 

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could increase the uncertainties and costs surrounding the prosecution of our patent applications and the enforcement or defense of our issued patents, all of 
which could have a material adverse effect on our business, financial condition, results of operations and prospects.

The  U.S.  Supreme  Court  has  ruled  on  several  patent  cases  in  recent  years,  either  narrowing  the  scope  of  patent  protection  available  in  certain 
circumstances  or  weakening  the  rights  of  patent  owners  in  certain  situations.  Depending  on  future  actions  by  the  U.S.  Congress,  the  U.S.  courts,  the 
USPTO and the relevant law-making bodies in other countries, the laws and regulations governing patents could change in unpredictable ways that would 
weaken our ability to obtain new patents or to enforce our existing patents and patents that we might obtain in the future.

Obtaining  and  maintaining  our  patent  protection  depends  on  compliance  with  various  procedural,  document  submission,  fee  payment  and  other 
requirements  imposed  by  governmental  patent  agencies,  and  our  patent  protection  could  be  reduced  or  eliminated  for  non-compliance  with  these 
requirements.

Periodic maintenance and annuity fees on any issued patent are due to be paid to the USPTO and foreign patent agencies in several stages over the 
lifetime of the patent. The USPTO and various foreign governmental patent agencies require compliance with a number of procedural, documentary, fee 
payment and other similar provisions during the patent application process. While an inadvertent lapse can in many cases be cured by payment of a late fee 
or by other means in accordance with the applicable rules, there are situations in which noncompliance can result in abandonment or lapse of the patent or 
patent application, resulting in partial or complete loss of patent rights in the relevant jurisdiction. Non-compliance events that could result in abandonment 
or  lapse  of  a  patent  or  patent  application  include  failure  to  respond  to  official  actions  within  prescribed  time  limits,  non-payment  of  fees  and  failure  to 
properly legalize and submit formal documents. If we or our current and future licensors fail to maintain the patents and patent applications covering our 
product  candidates,  our  patent  protection  could  be  reduced  or  eliminated  and  our  competitors  might  be  better  able  to  enter  the  market  with  competing 
products.

If our trademark and tradenames are not adequately protected, then we may not be able to build name recognition in our markets and our business 
may be adversely affected.

We  cannot  assure  you  that  competitors  will  not  infringe  our  trademarks  or  that  we  will  have  adequate  resources  to  enforce  our  trademarks.  In 
addition, we do not own any registered trademarks for the mark “ALLAKOS.” We cannot assure you that any future trademark applications that we will 
file will be approved. During trademark registration proceedings, we may receive rejections and although we are given an opportunity to respond to those 
rejections, we may be unable to overcome such rejections. In addition, in proceedings before the USPTO and in proceedings before comparable agencies in 
many foreign jurisdictions, third-parties are given an opportunity to oppose pending trademark applications and to seek to cancel registered trademarks. 
Opposition or cancellation proceeding may be filed against our trademarks and our trademarks may not survive such proceedings, which may force us to 
rebrand our name.

If we breach the license agreements related to our product candidates, we could lose the ability to continue the development and commercialization of 
our product candidates.

Our commercial success depends upon our ability, and the ability of our current and future licensors, to develop, manufacture, market and sell our 
product candidates and use our and our current or future licensors’ wholly-owned technologies without infringing the proprietary rights of third-parties. A 
third-party may hold intellectual property, including patent rights that are important or necessary to the development of our products. As a result, we are a 
party to a number of technology licenses that are important to our business. For example, we have obtained an exclusive license under certain intellectual 
property related to Siglec-8 from The Johns Hopkins University to develop certain products and a non-exclusive license from BioWa and Lonza to develop 
and  commercialize  products  manufactured  in  a  particular  mammalian  host  cell  line.  If  we  fail  to  comply  with  the  obligations  under  these  agreements, 
including payment and diligence terms, our current and future licensors may have the right to terminate these agreements, in which event we may not be 
able to develop, manufacture, market or sell any product that is covered by these agreements or may face other penalties under the agreements. Such an 
occurrence  could  adversely  affect  the  value  of  the  product  candidate  being  developed  under  any  such  agreement.  Termination  of  these  agreements  or 
reduction or elimination of our rights under these agreements may result in our having to negotiate new or reinstated agreements, 

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which  may  not  be  available  to  us  on  equally  favorable  terms,  or  at  all,  or  cause  us  to  lose  our  rights  under  these  agreements,  including  our  rights  to 
intellectual property or technology important to our development programs.

Disputes may arise regarding intellectual property subject to a licensing agreement, including:

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the scope of rights granted under the license agreement and other interpretation-related issues;

the  extent  to  which  our  technology  and  processes  infringe  on  intellectual  property  of  the  licensor  that  is  not  subject  to  the  licensing 
agreement;

the sublicensing of patent and other rights under any collaboration relationships we might enter into in the future;

our diligence obligations under the license agreement and what activities satisfy those diligence obligations;

the inventorship and ownership of inventions and know-how resulting from the joint creation or use of intellectual property by our current 
and future licensors and us; and

the priority of invention of patented technology.

If  disputes  over  intellectual  property  that  we  have  licensed  prevent  or  impair  our  ability  to  maintain  our  current  licensing  arrangements  on 

acceptable terms, we may be unable to successfully develop and commercialize the affected product candidates.

Third-parties may initiate legal proceedings against us alleging that we infringe their intellectual property rights or we may initiate legal proceedings 
against  third-parties  to  challenge  the  validity  or  scope  of  intellectual  property  rights  controlled  by  third-parties,  the  outcome  of  which  would  be 
uncertain and could have an adverse effect on the success of our business.

Third-parties may initiate legal proceedings against us or our current and future licensors alleging that we or our current and future licensors infringe 
their intellectual property rights, or we or our current and future licensors may initiate legal proceedings against third-parties to challenge the validity or 
scope of intellectual property rights controlled by third-parties, including in oppositions, interferences, reexaminations, inter partes reviews or derivation 
proceedings in the United States or other jurisdictions. These proceedings can be expensive and time-consuming, and many of our or our current and future 
licensors’ adversaries in these proceedings may have the ability to dedicate substantially greater resources to prosecuting these legal actions than we or our 
current and future licensors.

Parties making claims against us may obtain injunctive or other equitable relief, which could effectively block our ability to further develop and 
commercialize one or more of our product candidates. Defense of these claims, regardless of their merit, would involve substantial litigation expense and 
would be a substantial diversion of management and employee resources from our business. An unfavorable outcome could require us or our current and 
future licensors to cease using the related technology or developing or commercializing our product candidates, or to attempt to license rights to it from the 
prevailing  party.  Our  business  could  be  harmed  if  the  prevailing  party  does  not  offer  us  or  our  current  and  future  licensors  a  license  on  commercially 
reasonable terms or at all. Even if we or our current and future licensors obtain a license, it may be non-exclusive, thereby giving our competitors access to 
the  same  technologies  licensed  to  us  or  our  current  and  future  licensors.  In  addition,  we  could  be  found  liable  for  monetary  damages,  including  treble 
damages and attorneys’ fees, if we are found to have willfully infringed a patent. A finding of infringement could prevent us from commercializing our 
product candidates or force us to cease some of our business operations, which could harm our business.

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

Many of our employees, including our senior management, were previously employed at other biopharmaceutical companies, including potential 
competitors.  Some  of  these  employees  executed  proprietary  rights,  non-disclosure  and/or  non-competition  agreements  in  connection  with  such  previous 
employment. Although we try to ensure that our employees do not use the proprietary information or know-how of others in their work for us, we may be 
subject to claims that we or these employees have used or disclosed confidential information or intellectual 

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property, including trade secrets or other proprietary information, of any such employee’s former employer. Litigation may be necessary to defend against 
these claims.

If we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or 
personnel or sustain damages. Such intellectual property rights could be awarded to a third-party, and we could be required to obtain a license from such 
third-party  to  commercialize  our  technology  or  products.  Such  a  license  may  not  be  available  on  commercially  reasonable  terms  or  at  all.  Even  if  we 
successfully prosecute or defend against such claims, litigation could result in substantial costs and distract management.

Our inability to protect our confidential information and trade secrets would harm our business and competitive position.

In addition to seeking patents for some of our technology and products, we also rely on trade secrets, including unpatented know-how, technology 
and other proprietary information, to maintain our competitive position. Trade secrets can be difficult to protect. We seek to protect these trade secrets, in 
part, by entering into non-disclosure and confidentiality agreements with parties who have access to them, such as our employees, contract manufacturers, 
consultants,  advisors  and  other  third-parties.  We  also  enter  into  confidentiality  and  invention  or  patent  assignment  agreements  with  our  employees  and 
consultants. Despite these efforts, any of the parties may breach the agreements and disclose our proprietary information, including our trade secrets, and 
we may not be able to obtain adequate remedies for such breaches. Misappropriation or unauthorized disclosure of our trade secrets could significantly 
affect our competitive position and may have a material adverse effect on our business. Enforcing a claim that a party illegally disclosed or misappropriated 
a trade secret is difficult, expensive and time-consuming, and the outcome is unpredictable. Some courts both within and outside the United States may be 
less  willing  or  unwilling  to  protect  trade  secrets.  Furthermore,  trade  secret  protection  does  not  prevent  competitors  from  independently  developing 
substantially equivalent information and techniques and we cannot guarantee that our competitors will not independently develop substantially equivalent 
information and techniques. If a competitor lawfully obtained or independently developed any of our trade secrets, we would have no right to prevent such 
competitor from using that technology or information to compete with us. Failure on our part to adequately protect our trade secrets and our confidential 
information would harm our business and our competitive position.

Risks Related to Our Dependence on Third-Parties

We rely on third-parties to conduct our clinical trials and those third-parties may not perform satisfactorily, including failing to meet deadlines for the 
completion of such trials, research and studies.

We do not have the ability to independently conduct our clinical trials. We currently rely on third-parties, such as CROs, clinical data management 
organizations, medical institutions and clinical investigators, to conduct our clinical trials of lirentelimab and expect to continue to rely upon third-parties to 
conduct additional clinical trials of lirentelimab and our other product candidates. Third-parties have a significant role in the conduct of our clinical trials 
and the subsequent collection and analysis of data. These third-parties are not our employees, and except for remedies available to us under our agreements, 
we have limited ability to control the amount or timing of resources that any such third-party will devote to our clinical trials. Some of these third-parties 
may terminate their engagements with us at any time. If we need to enter into alternative arrangements, it would delay our drug development activities.

Our reliance on these third-parties for research and development activities will reduce our control over these activities but will not relieve us of our 
regulatory responsibilities. For example, we will remain responsible for ensuring that each of our clinical trials is conducted in accordance with the general 
investigational plan and protocols for the trial. Moreover, the FDA requires us to comply with GCP standards, regulations for conducting, recording and 
reporting the results of clinical trials to assure that data and reported results are credible and accurate and that the rights, integrity and confidentiality of trial 
participants  are  protected.  The  EMA  also  requires  us  to  comply  with  similar  standards.  Regulatory  authorities  enforce  these  GCP  requirements  through 
periodic inspections of trial sponsors, principal investigators and trial sites. If we or any of our CROs fail to comply with applicable GCP requirements, the 
clinical data generated in our clinical trials may be deemed unreliable and the FDA, EMA or comparable foreign regulatory authorities may require us to 
perform additional clinical trials before approving our marketing applications. We cannot assure you that upon inspection by a given regulatory authority, 
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that  any  of  our  clinical  trials  comply  with  GCP  regulations.  In  addition,  our  clinical  trials  must  be  conducted  with  product  produced  under  cGMP 
regulations. Our failure to comply with these regulations may require us to repeat clinical trials, which would delay the marketing approval process. We 
also  are  required  to  register  certain  ongoing  clinical  trials  and  post  the  results  of  certain  completed  clinical  trials  on  a  government-sponsored  database, 
ClinicalTrials.gov, within certain timeframes. Failure to do so can result in fines, adverse publicity and civil and criminal sanctions.

The third-parties we rely on for these services may also have relationships with other entities, some of which may be our competitors. If these third-
parties  do  not  successfully  carry  out  their  contractual  duties,  meet  expected  deadlines  or  conduct  our  clinical  trials  in  accordance  with  regulatory 
requirements or our stated protocols, we will not be able to obtain, or may be delayed in obtaining, marketing approvals for our product candidates and will 
not be able to, or may be delayed in our efforts to, successfully commercialize our product candidates.

We contract with third-parties for the production of our product candidates for preclinical studies and, in the case of lirentelimab, our ongoing clinical 
trials, and expect to continue to do so for additional clinical trials and ultimately for commercialization. This reliance on third-parties increases the risk 
that we will not have sufficient quantities of our product candidates or drugs or such quantities at an acceptable cost, which could delay, prevent or 
impair our development or commercialization efforts.

We  do  not  currently  have  the  infrastructure  or  internal  capability  to  manufacture  supplies  of  our  product  candidates  for  use  in  development  and 
commercialization. We rely, and expect to continue to rely, on third-party manufacturers for the production of our product candidates for preclinical studies 
and  clinical  trials  under  the  guidance  of  members  of  our  organization.  In  the  case  of  lirentelimab,  we  have  previously  relied  on  a  single  third-party 
manufacturer  and  we  are  currently  in  the  process  of  developing  alternative  manufacturing  capabilities.  If  we  were  to  experience  an  unexpected  loss  of 
supply of lirentelimab, or any of our other product candidates, for any reason, whether as a result of manufacturing, supply or storage issues or otherwise, 
including  issues  related  to  the  COVID-19  global  pandemic,  we  could  experience  delays,  disruptions,  suspensions  or  terminations  of,  or  be  required  to 
restart or repeat, any pending or ongoing clinical trials.

We expect to continue to rely on third-party manufacturers for the commercial supply of any of our product candidates for which we may obtain 
marketing approval. We may be unable to maintain required agreements with third-party manufacturers or to do so on acceptable terms. Reliance on third-
party manufacturers entails additional risks, including:

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the possible failure of the third-party to manufacture our product candidate according to our schedule and scale, or at all, including if our 
third-party  contractors  give  greater  priority  to  the  supply  of  other  products  over  our  product  candidates  or  otherwise  do  not  satisfactorily 
perform according to the terms of the agreements between us and them;

the possible termination or nonrenewal of agreements by our third-party contractors at a time that is costly or inconvenient for us;

the possible breach by the third-party contractors of our agreements with them;

the failure of third-party contractors to comply with applicable regulatory requirements;

the possible failure of the third-party to manufacture our product candidates according to our specifications;

the possible mislabeling of clinical supplies, potentially resulting in the wrong dose amounts being supplied or active drug or placebo not 
being properly identified;

the possibility of clinical supplies not being delivered to clinical sites on time, leading to clinical trial interruptions, or of drug supplies not 
being distributed to commercial vendors in a timely manner, resulting in lost sales; and

the possible misappropriation of our proprietary information, including our trade secrets and know-how.

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

Our current and anticipated future dependence upon others for the manufacture of our product candidates or drugs may adversely affect our future 

profit margins and our ability to commercialize any drugs that receive marketing approval on a timely and competitive basis.

We may not gain the efficiencies we expect from further scale-up of manufacturing of lirentelimab, and our third-party manufacturers may be unable 
to successfully scale-up manufacturing in sufficient quality and quantity for lirentelimab or our other product candidates, which could delay or prevent 
the conducting of our clinical trials or the development or commercialization of our other product candidates.

Our  third-party  manufacturers  are  currently  manufacturing  lirentelimab  at  a  scale  that  is  sufficient  for  us  to  complete  our  planned  clinical  trials. 
However, we are in the process of increasing the batch scale to gain cost efficiencies. If our manufacturers are unable to scale-up the manufacturing of 
lirentelimab,  we  may  not  gain  such  cost  efficiencies  and  may  not  realize  the  benefits  that  would  typically  be  expected  from  further  scale-up  of 
manufacturing of lirentelimab.

In addition, in order to conduct clinical trials of any of our other product candidates, we may need to manufacture them in large quantities. Our 
third-party manufacturers, including Lonza, may be unable to successfully increase the manufacturing capacity for any of these product candidates in a 
timely  or  cost-effective  manner,  or  at  all.  In  addition,  quality  issues  may  arise  during  scale-up  activities.  If  our  third-party  manufacturers  are  unable  to 
successfully scale up the manufacture of our other product candidates in sufficient quality and quantity, the development, testing and clinical trials of that 
product  candidate  may  be  delayed  or  become  infeasible,  and  marketing  approval  or  commercial  launch  of  any  resulting  product  may  be  delayed  or  not 
obtained, which could significantly harm our business. 

Changes in methods of product candidate manufacturing or formulation may result in additional costs or delay.

As  product  candidates  progress  through  preclinical  and  late  stage  clinical  trials  to  marketing  approval  and  commercialization,  it  is  common  that 
various  aspects  of  the  development  program,  such  as  manufacturing  methods  and  formulation,  are  altered  along  the  way  in  an  effort  to  optimize  yield, 
manufacturing batch size, minimize costs and achieve consistent quality and results. Such changes carry the risk that they will not achieve these intended 
objectives. Any of these changes could cause our product candidates to perform differently and affect the results of planned clinical trials or other future 
clinical  trials  conducted  with  the  altered  materials.  This  could  delay  completion  of  clinical  trials,  require  the  conduct  of  bridging  clinical  trials  or  the 
repetition of one or more clinical trials, increase clinical trial costs, delay approval of our product candidates and jeopardize our ability to commercialize 
our product candidates and generate revenue.

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The  manufacture  of  biologics  is  complex  and  our  third-party  manufacturers  may  encounter  difficulties  in  production.  If  any  of  our  third-party 
manufacturers  encounter  such  difficulties,  our  ability  to  provide  adequate  supply  of  our  product  candidates  for  clinical  trials  or  our  products  for 
patients, if approved, could be delayed or prevented.

Manufacturing biologics, especially in large quantities, is complex and may require the use of innovative technologies to handle living cells. Each 
lot  of  an  approved  biologic  must  undergo  thorough  testing  for  identity,  strength,  quality,  purity  and  potency.  Manufacturing  biologics  requires  facilities 
specifically designed for and validated for this purpose, and sophisticated quality assurance and quality control procedures are necessary. Slight deviations 
anywhere  in  the  manufacturing  process,  including  filling,  labeling,  packaging,  storage  and  shipping  and  quality  control  and  testing,  may  result  in  lot 
failures,  product  recalls  or  spoilage.  If  our  current  manufacturing  locations  become  unavailable  at  their  anticipated  capacities  or  the  location  of  the 
manufacturing of lirentelimab or our other product candidates is changed for any reason, including for reasons related to the COVID-19 global pandemic, it 
could result in a delay or disruption to the manufacturing process or lead to difficulties that we did not experience at the original manufacturing locations. 
When  changes  are  made  to  the  manufacturing  process,  we  may  be  required  to  provide  preclinical  and  clinical  data  showing  the  comparable  identity, 
strength, quality, purity or potency of the products before and after such changes. If microbial, viral or other contaminations are discovered at the facilities 
of our manufacturer, such facilities may need to be closed for an extended period of time to investigate and remedy the contamination, which could delay 
clinical  trials  and  adversely  harm  our  business.  The  use  of  biologically  derived  ingredients  can  also  lead  to  allegations  of  harm,  including  infections  or 
allergic reactions, or closure of product facilities due to possible contamination. If our manufacturers are unable to produce sufficient quantities for clinical 
trials or for commercialization as a result of these challenges, our development and commercialization efforts would be impaired, which would have an 
adverse effect on our business, financial condition, results of operations and growth prospects.

If we decide to establish collaborations, but are not able to establish those collaborations, we may have to alter our development and commercialization 
plans.

Our  drug  development  programs  and  the  potential  commercialization  of  our  product  candidates  will  require  substantial  additional  cash  to  fund 
expenses. We may seek to selectively form collaborations to expand our capabilities, potentially accelerate research and development activities and provide 
for commercialization activities by third-parties.

We  would  face  significant  competition  in  seeking  appropriate  collaborators.  Whether  we  reach  a  definitive  agreement  for  a  collaboration  will 
depend, among other things, upon our assessment of the collaborator’s resources and expertise, the terms and conditions of the proposed collaboration and 
the proposed collaborator’s evaluation of a number of factors. Those factors may include the design or results of clinical trials, the likelihood of approval 
by  the  FDA  or  comparable  foreign  regulatory  authorities,  the  potential  market  for  the  subject  product  candidate,  the  costs  and  complexities  of 
manufacturing  and  delivering  such  product  candidate  to  patients,  the  potential  of  competing  drugs,  the  existence  of  uncertainty  with  respect  to  our 
ownership  of  intellectual  property  and  industry  and  market  conditions  generally.  The  potential  collaborator  may  also  consider  alternative  product 
candidates or technologies for similar indications that may be available to collaborate on and whether such a collaboration could be more attractive than the 
one with us for our product candidate.

Collaborations are complex and time-consuming to negotiate and document. In addition, there have been a significant number of recent business 
combinations among large pharmaceutical companies that have resulted in a reduced number of potential future collaborators. Even if we are successful in 
entering  into  a  collaboration,  the  terms  and  conditions  of  that  collaboration  may  restrict  us  from  entering  into  future  agreements  on  certain  terms  with 
potential collaborators.

If and when we seek to enter into collaborations, we may not be able to negotiate collaborations on a timely basis, on acceptable terms, or at all. If 
we are unable to do so, we may have to curtail the development of a product candidate, reduce or delay its development program or one or more of our 
other development programs, delay its potential commercialization or reduce the scope of any sales or marketing activities, or increase our expenditures 
and undertake development or commercialization activities at our own expense.

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Our employees may engage in misconduct or other improper activities, including noncompliance with regulatory standards and requirements.

We  are  exposed  to  the  risk  of  employee  fraud  or  other  misconduct.  Misconduct  by  employees  could  include  failures  to  comply  with  FDA 
regulations, provide accurate information to the FDA, comply with federal and state health care fraud and abuse laws and regulations, accurately report 
financial information or data or disclose unauthorized activities to us. In particular, sales, marketing and business arrangements in the health care industry 
are subject to extensive laws and regulations intended to prevent fraud, misconduct, kickbacks, self-dealing and other abusive practices. These laws and 
regulations may restrict or prohibit a wide range of pricing, discounting, marketing and promotion, sales commission, customer incentive programs and 
other business arrangements. Employee misconduct could also involve the improper use of information obtained in the course of clinical trials, which could 
result in regulatory sanctions and serious harm to our reputation. We have adopted a code of conduct, but it is not always possible to identify and deter 
employee misconduct, and the precautions we take to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or 
losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure to comply with these laws or regulations. If 
any such actions are instituted against us, and we are not successful in defending ourselves or asserting our rights, those actions could have a significant 
impact on our business, including the imposition of significant fines or other sanctions.

Risks Related to Ownership of Our Common Stock

The market price of our stock may continue to be volatile, which could result in substantial losses for investors.

The trading price of our common stock has been, and is likely to continue to be, highly volatile and subject to wide fluctuations in response to 
various factors, some of which we cannot control. We priced our initial public offering at $18.00 per share on July 19, 2018, and our common stock reached 
a high of $112.87 per share during the fourth quarter of 2021. As of February 23, 2022, the closing price of our common stock was $5.44. The trading price 
of our common stock could be subject to wide fluctuations in response to various factors, which in addition to the factors discussed in this “Risk Factors” 
section and elsewhere in this Annual Report on Form 10-K, include:

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the timing and results of preclinical studies and clinical trials of our product candidates or those of our competitors;

the success of competitive products or announcements by potential competitors of their product development efforts;

regulatory actions with respect to our products or our competitors’ products;

impacts and developments in the COVID-19 pandemic;

actual or anticipated changes in our growth rate relative to our competitors;

regulatory or legal developments in the United States and other countries;

developments or disputes concerning patent applications, issued patents or other proprietary rights;

the recruitment or departure of key scientific or management personnel;

announcements  by  us  or  our  competitors  of  significant  acquisitions,  strategic  collaborations,  joint  ventures,  collaborations  or  capital 
commitments;

actual or anticipated changes in estimates as to financial results, development timelines or recommendations by securities analysts;

fluctuations in the valuation of companies perceived by investors to be comparable to us;

market conditions in the pharmaceutical and biotechnology sector;

changes in the structure of healthcare payment systems; 

share price and volume fluctuations attributable to inconsistent trading volume levels of our shares;

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announcement or expectation of additional financing efforts;

sales of our common stock by us, our insiders or our other stockholders;

expiration of market stand-off or lock-up agreements; and

general economic, industry and market conditions.

In  addition,  the  stock  market  in  general,  and  pharmaceutical  and  biotechnology  companies  in  particular,  have  experienced  extreme  price  and 
volume  fluctuations  that  have  often  been  unrelated  or  disproportionate  to  the  operating  performance  of  these  companies,  including  in  response  to  the 
COVID-19 pandemic. Broad market and industry factors may negatively affect the market price of our common stock, regardless of our actual operating 
performance. The realization of any of the above risks or any of a broad range of other risks, including those described in this “Risk Factors” section, could 
have a dramatic and adverse impact on the market price of our common stock.

Our operating results may fluctuate significantly, which makes our future operating results difficult to predict and could cause our operating results to 
fall below expectations or our guidance.

Our quarterly and annual operating results may fluctuate significantly in the future, which makes it difficult for us to predict our future operating 
results. From time to time, we may enter into license or collaboration agreements or strategic partnerships with other companies that include development 
funding  and  significant  upfront  and  milestone  payments  and/or  royalties,  which  may  become  an  important  source  of  our  revenue.  These  upfront  and 
milestone payments may vary significantly from period to period and any such variance could cause a significant fluctuation in our operating results from 
one period to the next.

In addition, we measure compensation cost for stock-based awards made to employees at the grant date of the award, based on the fair value of the 
award, and recognize the cost as an expense over the employee’s requisite service period. As the variables that we use as a basis for valuing these awards 
change  over  time,  including  our  underlying  stock  price  and  stock  price  volatility,  the  magnitude  of  the  expense  that  we  must  recognize  may  vary 
significantly.

Furthermore, our operating results may fluctuate due to a variety of other factors, many of which are outside of our control and may be difficult 

to predict, including the following:

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delays or increased costs related to the COVID-19 global pandemic;

the  timing  and  cost  of,  and  level  of  investment  in,  research  and  development  activities  relating  to  our  current  and  any  future  product 
candidates, which will change from time to time;

our ability to enroll patients in clinical trials and the timing of enrollment;

the cost of manufacturing our current and any future product candidates, which may vary depending on FDA guidelines and requirements, 
the quantity of production and the terms of our agreements with manufacturers;

expenditures that we will or may incur to acquire or develop additional product candidates and technologies;

the timing and outcomes of clinical trials for lirentelimab and any of our future product candidates or competing product candidates;

the need to conduct unanticipated clinical trials or trials that are larger or more complex than anticipated;

competition from existing and potential future products that compete with lirentelimab and any of our future product candidates, and changes 
in the competitive landscape of our industry, including consolidation among our competitors or partners;

any delays in regulatory review or approval of lirentelimab or any of our future product candidates;

the level of demand for lirentelimab and any of our future product candidates, if approved, which may fluctuate significantly and be difficult 
to predict;

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the risk/benefit profile, cost and reimbursement policies with respect to our product candidates, if approved, and existing and potential future 
products that compete with lirentelimab and any of our future product candidates;

our ability to commercialize lirentelimab and any of our future product candidates, if approved, inside and outside of the United States, either 
independently or working with third parties;

our ability to establish and maintain collaborations, licensing or other arrangements;

our ability to adequately support future growth;

potential unforeseen business disruptions that increase our costs or expenses;

future accounting pronouncements or changes in our accounting policies; and

the changing and volatile global economic environment.

The  cumulative  effect  of  these  factors  could  result  in  large  fluctuations  and  unpredictability  in  our  quarterly  and  annual  operating  results.  As  a 
result, comparing our operating results on a period-to-period basis may not be meaningful. Investors should not rely on our past results as an indication of 
our future performance. This variability and unpredictability could also result in our failing to meet the expectations of industry or financial analysts or 
investors for any period. If our revenue or operating results fall below the expectations of analysts or investors or below any forecasts we may provide to 
the market, or if the forecasts we provide to the market are below the expectations of analysts or investors, the price of our common stock could decline 
substantially. Such a stock price decline could occur even when we have met any previously publicly stated guidance we may provide.

Raising additional capital may restrict our operations or require us to relinquish rights to our technologies or product candidates, and if we sell shares 
of our common stock in future financings, stockholders may experience immediate dilution and, as a result, our stock price may decline.

Until  such  time,  if  ever,  as  we  can  generate  substantial  product  revenues,  we  expect  to  finance  our  cash  needs  through  a  combination  of  equity 
offerings, debt financings, partnerships and marketing, distribution or licensing arrangements. We do not have any committed external source of funds. We 
may also from time to time issue additional shares of common stock at a discount from the then current trading price of our common stock. As a result, our 
stockholders would experience immediate dilution upon the purchase of any shares of our common stock sold at such discount. In addition, as opportunities 
present themselves, we may enter into financing or similar arrangements in the future, including the issuance of debt securities, preferred stock or common 
stock. If we issue common stock or securities convertible into common stock, our stockholders would experience additional dilution and, as a result, our 
stock  price  may  decline.  Debt  financing,  if  available,  may  involve  agreements  that  include  covenants  limiting  or  restricting  our  ability  to  take  specific 
actions, such as incurring additional debt, making capital expenditures or declaring dividends.

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

Our principal stockholders and management own a significant percentage of our stock and will be able to exert significant control over matters subject 
to stockholder approval.

As of December 31, 2021, our executive officers, directors, holders of 5% or more of our capital stock and their respective affiliates beneficially 
owned approximately 39.3% of our outstanding voting stock. As a result, this group of stockholders has the ability to significantly influence all matters 
requiring stockholder approval, including the election of directors, amendments of our organizational documents or approval of any merger, sale of assets 
or other major corporate transaction. This may prevent or discourage unsolicited acquisition proposals or offers for our common stock that you may feel are 
in your best interest as one of our stockholders. The interests of this group of stockholders may not always coincide with your interests or the interests of 
other stockholders and they may act in a 

77

 
manner that advances their best interests and not necessarily those of other stockholders, including seeking a premium value for their common stock, and 
might affect the prevailing market price for our common stock.

We are currently and may in the future be subject to securities litigation, which is expensive and could divert management attention.

The market price of our common stock may be volatile and, in the past, companies that have experienced volatility in the market price of their 
stock have been subject to securities class action litigation. We are currently and may in the future be the target of this type of litigation. For example, on 
March 10, 2020, a putative securities class action complaint captioned Kim v. Allakos et al., No. 20-cv-01720 (N.D. Cal.) was filed in the United States 
District Court for the Northern District of California against us, our Chief Executive Officer, Dr. Robert Alexander, and our former Chief Financial Officer, 
Mr.  Leo  Redmond.  The  complaint  asserts  claims  for  violations  of  Sections  10(b)  and  20(a)  of  the  Securities  Exchange  Act  of  1934  and  Rule  10b-5 
promulgated  thereunder  and  seeks  damages  based  on  alleged  material  misrepresentations  and  omissions  concerning  our  Phase  2  clinical  trials  of 
lirentelimab. The proposed class period is August 5, 2019, through December 17, 2019, inclusive. This or other securities litigation against us could result 
in substantial costs and divert our management's attention from other business concerns, which could seriously harm our business.

We have not paid and do not intend to pay dividends on our common stock so any returns will be limited to the value of our stock.

We  have  never  declared  or  paid  any  cash  dividends  on  our  common  stock.  We  currently  anticipate  that  we  will  retain  future  earnings  for  the 
development, operation and expansion of our business and do not anticipate declaring or paying any cash dividends for the foreseeable future. Any return 
to stockholders will therefore be limited to any appreciation in the value of their stock.

Provisions in our amended and restated certificate of incorporation and amended and restated bylaws and Delaware law might discourage, delay or 
prevent a change in control of our company or changes in our management and, therefore, depress the market price of our common stock.

Our amended and restated certificate of incorporation and amended and restated bylaws contain provisions that could depress the market price of 
our common stock by acting to discourage, delay or prevent a change in control of our company or changes in our management that the stockholders of our 
company may deem advantageous. These provisions, among other things:

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•

establish a classified board of directors so that not all members of our board are elected at one time;

permit only the board of directors to establish the number of directors and fill vacancies on the board;

provide that directors may only be removed “for cause” and only with the approval of two-thirds of our stockholders;

authorize the issuance of “blank check” preferred stock that our board could use to implement a stockholder rights plan (also known as a 
“poison pill”);

eliminate the ability of our stockholders to call special meetings of stockholders;

prohibit stockholder action by written consent, which requires all stockholder actions to be taken at a meeting of our stockholders;

prohibit cumulative voting;

authorize our board of directors to amend the bylaws;

establish  advance  notice  requirements  for  nominations  for  election  to  our  board  or  for  proposing  matters  that  can  be  acted  upon  by 
stockholders at annual stockholder meetings; and

require a super-majority vote of stockholders to amend some provisions described above.

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In addition, Section 203 of the General Corporation Law of the State of Delaware (“DGCL”), prohibits a publicly-held Delaware corporation 
from engaging in a business combination with an interested stockholder, generally a person which together with its affiliates owns, or within the last three 
years has owned, 15% of our voting stock, for a period of three years after the date of the transaction in which the person became an interested stockholder, 
unless the business combination is approved in a prescribed manner.

Any  provision  of  our  amended  and  restated  certificate  of  incorporation,  amended  and  restated  bylaws  or  Delaware  law  that  has  the  effect  of 
delaying or preventing a change in control could limit the opportunity for our stockholders to receive a premium for their shares of our capital stock and 
could also affect the price that some investors are willing to pay for our common stock.

Our amended and restated certificate of incorporation provides that the Court of Chancery of the State of Delaware and the federal district courts of 
the  United  States  of  America  will  be  the  exclusive  forums  for  substantially  all  disputes  between  us  and  our  stockholders,  which  could  limit  our 
stockholders’ ability to obtain a favorable judicial forum for disputes with us or our directors, officers or employees.

Our amended and restated certificate of incorporation provides that the Court of Chancery of the State of Delaware is the exclusive forum for:

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•

any derivative action or proceeding brought on our behalf;

any action asserting a claim of breach of fiduciary duty;

any action asserting a claim against us arising under the DGCL, our amended and restated certificate of incorporation or our amended and 
restated bylaws; and

any action asserting a claim against us that is governed by the internal-affairs doctrine.

Our amended and restated certificate of incorporation further provides that the federal district courts of the United States of America will be the 
exclusive forum for resolving any complaint asserting a cause of action arising under the Securities Act (such provision, the “Federal Forum Provision”). 
However,  on  December  19,  2018,  the  Delaware  Court  of  Chancery  issued  a  decision  in  Matthew  Sciabacucchi  v.  Matthew  B.  Salzberg  et  al.,  C.A.  No. 
2017-0931-JTL (Del. Ch.), finding that such provisions such as the Federal Forum Provision are not valid under Delaware law. In light of this decision of 
the Delaware Court of Chancery, we do not intend to enforce the federal forum provision in our amended and restated certificate of incorporation unless 
and until such time there is a final determination by the Delaware Supreme Court regarding the validity of such provisions. If the decision is not appealed 
or if the Delaware Supreme Court affirms the Delaware Chancery Court’s decision, then we will seek approval by our stockholders to amend our certificate 
of incorporation at our next regularly-scheduled annual meeting of stockholders to remove the Federal Forum Provision.

These exclusive-forum provisions may limit a stockholder’s ability to bring a claim in a judicial forum that it finds favorable for disputes with us or 
our directors, officers or other employees, which may discourage lawsuits against us and our directors, officers and other employees. If a court were to find 
either exclusive-forum provision in our amended and restated certificate of incorporation to be inapplicable or unenforceable in an action, we may incur 
additional costs associated with resolving the dispute in other jurisdictions, which could seriously harm our business. 

General Business Risks 

If we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incur costs that could 
have a material adverse effect on our business.

We  are  subject  to  numerous  environmental,  health  and  safety  laws  and  regulations,  including  those  governing  laboratory  procedures  and  the 
handling, use, storage, treatment and disposal of hazardous materials and wastes. Our operations involve the use of hazardous and flammable materials, 
including  chemicals  and  biological  materials.  Our  operations  also  produce  hazardous  waste  products.  We  generally  contract  with  third-parties  for  the 
disposal of these materials and wastes. We cannot eliminate the risk of contamination or injury from these materials. In the event of contamination or injury 
resulting from our use of hazardous materials, we could be held liable for any resulting 

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damages, and any liability could exceed our resources. We also could incur significant costs associated with civil or criminal fines and penalties.

Although we maintain workers’ compensation insurance to cover us for costs and expenses we may incur due to injuries to our employees resulting 
from  the  use  of  hazardous  materials,  this  insurance  may  not  provide  adequate  coverage  against  potential  liabilities.  We  do  not  maintain  insurance  for 
environmental liability or toxic tort claims that may be asserted against us in connection with our storage or disposal of hazardous and flammable materials, 
including chemicals and biological materials.

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

Our business activities may be subject to the Foreign Corrupt Practices Act (“FCPA”), the UK Bribery Act 2010 (“UK Bribery Act”), and other similar 
anti-bribery and anti-corruption laws of other countries in which we operate.

We have conducted and have ongoing studies in international locations, and may in the future initiate additional studies in countries other than the 
U.S. Our business activities may be subject to the FCPA, the UK Bribery Act and other similar anti-bribery or anti-corruption laws, regulations or rules of 
other  countries  in  which  we  operate.  The  FCPA  generally  prohibits  offering,  promising,  giving  or  authorizing  others  to  give  anything  of  value,  either 
directly or indirectly, to a non-U.S. government official in order to influence official action or otherwise obtain or retain business. The FCPA also requires 
public companies to make and keep books and records that accurately and fairly reflect the transactions of the corporation and to devise and maintain an 
adequate  system  of  internal  accounting  controls.  Our  business  is  heavily  regulated  and  therefore  involves  significant  interaction  with  public  officials, 
including officials of non-U.S. governments. Additionally, in many other countries, the health care providers who prescribe pharmaceuticals are employed 
by  their  government,  and  the  purchasers  of  pharmaceuticals  are  government  entities;  therefore,  our  dealings  with  these  prescribers  and  purchasers  are 
subject  to  regulation  under  the  FCPA.  Recently  the  SEC  and  Department  of  Justice  have  increased  their  FCPA  enforcement  activities  with  respect  to 
biotechnology and pharmaceutical companies. There is no certainty that all of our employees, agents or contractors, or those of our affiliates, will comply 
with all applicable laws and regulations, particularly given the high level of complexity of these laws. Violations of these laws and regulations could result 
in fines, criminal sanctions against us, our officers or our employees, the closing down of our facilities, requirements to obtain export licenses, cessation of 
business activities in sanctioned countries, implementation of compliance programs and prohibitions on the conduct of our business. Any such violations 
could  include  prohibitions  on  our  ability  to  offer  our  products  in  one  or  more  countries  and  could  materially  damage  our  reputation,  our  brand,  our 
international expansion efforts, our ability to attract and retain employees and our business, prospects, operating results and financial condition.

We may experience disruptions and delays or incur financial damages as a result of system failures or security breaches.

Despite  the  implementation  of  security  measures,  any  of  the  internal  computer  systems  belonging  to  us  or  our  third-party  service  providers  are 
vulnerable  to  damage  from  computer  viruses,  unauthorized  access,  natural  disasters,  terrorism,  war  and  telecommunication  and  electrical  failure.  Any 
system  failure,  accident  or  security  breach  that  causes  interruptions  in  our  own  or  in  third-party  service  providers’  operations  could  result  in  a  material 
disruption of our drug discovery and development programs. A system failure or security breach that causes 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 in order to recover or reproduce the lost 
data. In addition, to the extent that any disruption or security breach results in a loss or damage to our data or applications, or inappropriate disclosure of 
confidential or proprietary information, we may incur liability as a result, our drug discovery programs and competitive position may be adversely affected, 
and further development of our product candidates may be delayed. Any such disruption, failure or security breach could also cause us to incur additional 
costs to remedy the damages that arise from such disruption, failure or security breach.

Our insurance policies may not be adequate to compensate us for the potential losses arising from any such disruption, failure or security breach. In 

addition, such insurance may not be available to us in the future on 

80

 
economically reasonable terms, or at all. Further, our insurance may not cover all claims made against us and could have high deductibles in any event, and 
defending a suit, regardless of its merit, could be costly and divert management attention.

If we engage in future acquisitions or strategic partnerships, this may increase our capital requirements, dilute our stockholders, cause us to incur debt 
or assume contingent liabilities, and subject us to other risks.

We may evaluate various acquisition opportunities and strategic partnerships, including licensing or acquiring complementary products, intellectual 

property rights, technologies or businesses. Any potential acquisition or strategic partnership may entail numerous risks, including:

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•

•

•

increased operating expenses and cash requirements;

the assumption of additional indebtedness or contingent liabilities;

the issuance of our equity securities;

assimilation of operations, intellectual property and products of an acquired company, including difficulties associated with integrating new 
personnel;

the  diversion  of  our  management’s  attention  from  our  existing  product  programs  and  initiatives  in  pursuing  such  a  strategic  merger  or 
acquisition;

retention of key employees, the loss of key personnel and uncertainties in our ability to maintain key business relationships;

risks and uncertainties associated with the other party to such a transaction, including the prospects of that party and their existing products or 
product candidates and marketing approvals; and

our inability to generate revenue from acquired technology and/or products sufficient to meet our objectives in undertaking the acquisition or 
even to offset the associated acquisition and maintenance costs.

In  addition,  if  we  undertake  acquisitions,  we  may  issue  dilutive  securities,  assume  or  incur  debt  obligations,  incur  large  one-time  expenses  and 
acquire  intangible  assets  that  could  result  in  significant  future  amortization  expense.  Moreover,  we  may  not  be  able  to  locate  suitable  acquisition 
opportunities, and this inability could impair our ability to grow or obtain access to technology or products that may be important to the development of our 
business.

If securities or industry analysts do not publish research or reports about our business, or if they issue an adverse or misleading opinion regarding our 
stock, our stock price and trading volume could decline. 

The trading market for our common stock is influenced by the research and reports that industry or securities analysts publish about us or our 
business. If any of the analysts covering us issue an adverse or misleading opinion regarding us, our business model, our intellectual property or our stock 
performance, or if our operating results fail to meet the expectations of analysts, our stock price would likely decline. In addition, if one or more of these 
analysts cease coverage of us or fail to publish reports on us regularly, we could lose visibility in the financial markets, which in turn could cause our stock 
price or trading volume to decline.

Our disclosure controls and procedures may not prevent or detect all errors or acts of fraud. 

We are subject to the periodic reporting requirements of the Securities Exchange Act of 1934, as amended (“Exchange Act”). We designed our 
disclosure  controls  and  procedures  to  reasonably  assure  that  information  we  must  disclose  in  reports  we  file  or  submit  under  the  Exchange  Act  is 
accumulated and communicated to management, and recorded, processed, summarized and reported within the time periods specified in the rules and forms 
of the SEC. We believe that any disclosure controls and procedures or internal controls and procedures, no matter how well-conceived and operated, can 
provide only reasonable, not absolute, assurance that the objectives of the control system are met.

81

 
These inherent limitations include the facts that judgments in decision-making can be faulty and that breakdowns can occur because of simple 
error  or  mistake.  Additionally,  controls  can  be  circumvented  by  the  individual  acts  of  some  persons,  by  collusion  of  two  or  more  people  or  by  an 
unauthorized override of the controls. Accordingly, because of the inherent limitations in our control system, misstatements due to error or fraud may occur 
and not be detected.

Our operations are vulnerable to interruption by fire, earthquake, power loss, telecommunications failure, terrorist activity and other events beyond our 
control, which could harm our business.

Our  facility  is  located  in  a  seismically  active  region  and  in  a  state  which  also  experiences  large  scale  wildfires  from  time  to  time.  We  have  not 
undertaken  a  systematic  analysis  of  the  potential  consequences  to  our  business  and  financial  results  from  a  major  earthquake,  fire,  power  loss,  terrorist 
activity or other disasters and do not have a recovery plan for such disasters. In addition, we are in the process of constructing a new office and laboratory 
facility in San Carlos, California pursuant to a lease agreement we entered into in December 2019. We may encounter difficulties and delays in construction 
as  well  as  in  obtaining  necessary  validation,  permits,  licenses,  and  certifications  for  this  facility.  For  example,  as  circumstances  around  the  COVID-19 
pandemic  are  evolving,  government-imposed  quarantines  and  restrictions  may  require  us  to  temporarily  halt  construction  or  validation  activities. 
Furthermore, we may not be able to fully occupy this facility on our currently anticipated timeline, which could negatively impact our financial results 
given the fixed costs associated with the lease. If we are unable to complete construction in a timely and satisfactory manner, obtain the necessary permits, 
licenses,  certificates,  and  accreditations  or  fully  occupy  this  facility,  we  may  be  unable  to  meet  our  currently  anticipated  development  timelines  for  our 
product candidates, which would negatively impact our reputation, commercial plans and results of operations.

In addition, we do not carry sufficient insurance to compensate us for actual losses from interruption of our business that may occur, and any losses 
or damages incurred by us could harm our business. We maintain multiple copies of each of our antibody sequences and electronic data records, most of 
which we maintain at our headquarters. If our facility were impacted by a seismic event, we could lose all our antibody sequences, which would have an 
adverse effect on our ability to discover new targets.

Our ability to utilize our net operating loss carryforwards and certain other tax attributes may be limited.

As of December 31, 2021, we had gross U.S. federal and state net operating loss carryforwards of $715.5 million and $95.1 million, respectively. 
Federal net operating loss carryforwards of $653.6 million, which were generated after December 31, 2017, do not expire. The remaining $61.9 million of 
federal net operating loss carryforwards expire beginning in 2032. It is possible that we will not generate taxable income in time to use our net operating 
loss carryforwards before their expiration (if applicable) or at all. Under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended, if a 
corporation undergoes an “ownership change” (generally defined as a greater than 50 percentage points change (by value) in the ownership of its equity 
over a rolling three-year period), the corporation’s ability to use its pre-change net operating loss carryforwards and certain other pre-change tax attributes 
to  offset  its  post-change  income  and  taxes  may  be  limited.  We  may  have  experienced  such  ownership  changes  in  the  past,  and  we  may  experience 
ownership changes in the future as a result of shifts in our stock ownership, some of which are outside our control. Accordingly, our ability to utilize our 
net  operating  loss  carryforwards  and  certain  other  tax  attributes  could  be  limited  by  an  “ownership  change”  as  described  above,  which  could  result  in 
increased tax liability to our company.

Item 1B. Unresolved Staff Comments. 

None. 

Item 2. Properties. 

Our  corporate  headquarters  are  currently  located  in  Redwood  City,  California,  where  we  lease  25,136  square  feet  of  office,  research  and 

development and laboratory space pursuant to a lease agreement that expires on April 30, 2022. 

82

 
On  December  4,  2019,  we  entered  into  a  lease  agreement  for  approximately  98,000  square  feet  of  office  space  to  be  constructed  in  San  Carlos, 
California. These premises were delivered in November 2020, and we expect to move into this new headquarters in March 2022. The lease term will expire 
123 months on October 31, 2031. This lease agreement includes an option to extend the term for an additional period of five years and provides us a right 
of first refusal for certain additional office space.

We believe that our facilities will be sufficient for our needs over the next twelve months. We may need additional space as we expand our business 

and believe that additional space when needed, will be available on commercially reasonable terms.

Item 3. Legal Proceedings. 

From time to time, we may become involved in litigation or other legal proceedings. On March 10, 2020, a putative securities class action complaint 
captioned Kim v. Allakos et al., No. 20-cv-01720 (N.D. Cal.) was filed in the United States District Court for the Northern District of California against us, 
our Chief Executive Officer, Dr. Robert Alexander, and our former Chief Financial Officer, Mr. Leo Redmond. The complaint asserts claims for violations 
of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and Rule 10b-5 promulgated thereunder and seeks damages based on alleged material 
misrepresentations and omissions concerning its Phase 2 clinical trials of lirentelimab. The proposed class period is August 5, 2019, through December 17, 
2019, inclusive. On August 28, 2020, the plaintiff filed an amended complaint, adding as defendants Dr. Adam Tomasi, our President, Chief Operating 
Officer and then Chief Financial Officer, and Dr. Henrik Rasmussen, our then Chief Medical Officer. Defendants filed a motion to dismiss the lawsuit in 
November 2020, which is fully briefed and pending a decision from the Court. Given the early stage of this litigation matter, we cannot reasonably estimate 
a potential future loss or a range of potential future losses and have not recorded a contingent liability accrual as of December 31, 2021.

Item 4. Mine Safety Disclosures.

Not applicable.

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

Our common stock has been listed on the NASDAQ Global Select Market under the symbol “ALLK”. 

PART II

Holders of Common Stock

As of February 23, 2022, there were 20 holders of record of our common stock. Because many of our shares of common stock are held by brokers 
and other institutions on behalf of stockholders, we are unable to estimate the total number of beneficial owners of our common stock represented by these 
record holders.

Dividend Policy

We have never declared or paid any cash dividends on our common stock or any other securities. We anticipate that we will retain all available funds 
and any future earnings, if any, for use in the operation of our business and do not anticipate paying cash dividends in the foreseeable future. In addition, 
future debt instruments may materially restrict our ability to pay dividends on our common stock. Payment of future cash dividends, if any, will be at the 
discretion of the board of directors after taking into account various factors, including our financial condition, operating results, current and anticipated 
cash needs, the requirements of current or then-existing debt instruments and other factors the board of directors deems relevant.

Performance Graph

This graph below is not “soliciting material” or deemed “filed” with the SEC for purposes of Section 18 of the Exchange Act, or otherwise subject 
to  liabilities  under  that  Section,  and  shall  not  be  deemed  incorporated  by  reference  into  this  Annual  Report  on  Form  10-K  or  into  any  other  filing  of 
Allakos Inc. under the Securities Act, as amended, except to the extent that we specifically incorporate this information by reference therein, whether made 
before or after the date hereof and irrespective of any general incorporation language in any such filing.

The following graph compares the cumulative total return to stockholder return on our common stock relative to the cumulative total returns of the 
NASDAQ Composite Index and the NASDAQ Biotechnology Index. An investment of $100 is assumed to have been made in our common stock and each 
index  on  July  19,  2018  (the  first  day  of  trading  of  our  common  stock)  and  its  relative  performance  is  tracked  through  December  31,  2021.  Pursuant  to 
applicable Securities and Exchange Commission rules, all values assume reinvestment of the full amount of all dividends, however no dividends have been 
declared on our common stock to date. The stockholder returns shown on 

84

 
the graph below are based on historical results and are not indicative of future performance, and we do not make or endorse any predictions as to future 
stockholder returns.

COMPARISON OF CUMULATIVE TOTAL RETURN
among Allakos Inc., the NASDAQ Composite Index
and the NASDAQ Biotechnology Index

7/19/201
8

9/30/201
8

 $ 100.00   $ 143.97   $
   100.00     103.06    

6/30/201
9

3/31/201
9

12/31/201
8
167.26   $ 129.60   $ 138.66   $ 251.62   $
99.56     103.42     103.60    
85.24    

9/30/201
9

  100.00  

  103.09  

81.92  

94.65  

92.52  

84.54    

3/31/202
0

12/31/202
0

12/31/201
6/30/202
9/30/202
3/31/2020
9/30/202
9
0
0
1
1
8   $ 338.7
4   $ 448.00   $ 367.30   $ 273.1
5   $ 260.6
7   $ 229.9
305.15   $ 142.3
8   $
190.2
190.6
146.0
131.2
100.2
3    
6    
3    
8    
6    
116.51    
139.1
140.6
115.7
116.7
4    
5  
4    
0  

6/30/202
1

173.84    

168.85    

128.86  

129.57  

102.49  

91.96  

12/31/202
1

31.33  

206.30  

129.60  

Allakos Inc.

NASDAQ 
Composite
NASDAQ 
Biotechnolog
y

85

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Recent Sales of Unregistered Securities

Not applicable

Use of Proceeds from Registered Securities

Not applicable

 Issuer Purchases of Equity Securities

Not applicable

Item 6. [Reserved] 

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations. 

You should read the following discussion and analysis of our financial condition and results of operations together with our financial statements and 
the other financial information appearing elsewhere in this Annual Report on Form 10-K. These statements generally relate to future events or to our future 
financial  performance  and  involve  known  and  unknown  risks,  uncertainties  and  other  factors  which  may  cause  our  actual  results,  performance  or 
achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. The 
following  discussion  and  analysis  contain  forward-looking  statements  within  the  meaning  of  the  Private  Securities  Litigation  Reform  Act  of  1995.  Our 
actual results and the timing of events may differ materially from those discussed in our forward-looking statements as a result of various factors, including 
those discussed below and those discussed in the section entitled “Risk Factors” included in this Annual Report on Form 10-K. If we do update one or 
more  forward-looking  statements,  no  inference  should  be  drawn  that  we  will  make  additional  updates  with  respect  to  those  or  other  forward-looking 
statements. Additional information concerning these and other risks and uncertainties is contained in our other periodic filings with the SEC.

Forward-looking statements include, but are not limited to, statements about:

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•

•

•

•

•

•

•

•

•

•

•

risks related to the COVID-19 pandemic;

our  plans  and  ability  to  manufacture,  or  have  manufactured,  sufficient  quantities  of  lirentelimab  for  preclinical  studies  and  to  conduct 
clinical trials and to eventually commercialize the product, and our reliance on third parties in relation to the foregoing;

the impact that the adoption of new accounting pronouncements will have on our financial statements;

the ability of our clinical trials to demonstrate safety and efficacy of our product candidates, and other positive results;

the timing and focus of our future clinical trials, and the reporting of data from those trials;

our plans relating to commercializing lirentelimab, if approved, including the geographic areas of focus and sales strategy;

the size of the market opportunity for lirentelimab in each of the diseases we are targeting;

the number of diseases represented in the patient population enrolled in our clinical trials, and our ability to evaluate response to treatment 
of lirentelimab in diseases other than the primary indication in our clinical trials;

our estimates of the number of patients in the United States who suffer from the diseases we are targeting and the number of patients that will 
enroll in our clinical trials;

the beneficial characteristics, safety, efficacy and therapeutic effects of lirentelimab;

the  timing  or  likelihood  of  regulatory  filings  and  approvals,  including  our  expectation  to  seek  special  designations,  such  as  orphan  drug 
designation, for lirentelimab or our other product candidates for various diseases;

our ability to obtain and maintain regulatory approval of lirentelimab or our other product candidates;

our plans relating to the further development of lirentelimab and our other product candidates;

existing regulations and regulatory developments in the United States and other jurisdictions;

our plans and ability to obtain or protect intellectual property rights, including extensions of existing patent terms where available;

our continued reliance on third-parties to conduct additional clinical trials of lirentelimab and our other product candidates;

the need to hire additional personnel and our ability to attract and retain such personnel;

the accuracy of our estimates regarding expenses, future revenue, capital requirements and needs for additional financing;

87

 
•

•

•

our financial performance;

the sufficiency of our existing cash, cash equivalents and marketable securities to fund our future operating expenses and capital expenditure 
requirements; and

our anticipated uses of our existing cash, cash equivalents and investments in marketable securities.

These forward-looking statements are subject to a number of risks, uncertainties, and assumptions, including, but not limited to, those described in 
“Risk  Factors.”  In  some  cases,  you  can  identify  these  statements  by  terms  such  as  “anticipate,”  “believe,”  “could,”  “estimate,”  “expects,”  “intend,” 
“may,”  “plan,”  “potential,”  “predict,”  “project,”  “should,”  “will,”  “would”  or  the  negative  of  those  terms,  and  similar  expressions  that  convey 
uncertainty of future events or outcomes. These forward-looking statements reflect our beliefs and views with respect to future events and are based on 
estimates and assumptions as of the date of this Annual Report on Form 10-K and are subject to risks and uncertainties. We discuss many of these risks in 
greater detail in the section entitled “Risk Factors” included in Part I, Item 1A and elsewhere in this Report. Moreover, we operate in a very competitive 
and rapidly changing environment. New risks emerge from time to time. It is not possible to predict all risks, nor can we assess the impact of all factors on 
our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-
looking statements we may make. Given these uncertainties, you should not place undue reliance on these forward-looking statements. We qualify all of the 
forward-looking statements in this Annual Report on Form 10-K by these cautionary statements. Except as required by law, we assume no obligation to 
update these forward-looking statements publicly, or to update the reasons actual results could differ materially from those anticipated in any forward-
looking statements, whether as a result of new information, future events or otherwise.

Our discussion and analysis below are focused on our financial results and liquidity and capital resources for the years ended December 31, 2021 
and  2020,  including  year-over-year  comparisons  of  our  financial  performance  and  condition  for  these  years.  Discussion  and  analysis  of  the  year  ended 
December 31, 2019 specifically, as well as the year-over-year comparison of our financial performance and condition for the years ended December 31, 
2020 and 2019, are located in Part II, Item 7 - Management’s Discussion and Analysis of Financial Condition and Results of Operations in our Annual 
Report on Form 10-K for the year ended December 31, 2020, filed with the SEC on March 1, 2021.

Overview

We are a clinical stage biotechnology company developing therapeutics which target immunomodulatory receptors present on immune effector cells 
involved  in  allergy,  inflammatory  and  proliferative  diseases.  Our  most  advanced  antibodies  are  lirentelimab  (AK002)  and  AK006.  Lirentelimab  targets 
Siglec-8, an inhibitory receptor expressed selectively on eosinophils and mast cells. Lirentelimab has been studied in a number of human clinical studies 
and has shown the ability to deplete eosinophils inhibit mast cell activation, and improve patient reported symptoms. We are developing lirentelimab for the 
treatment  of  eosinophilic  gastritis/eosinophilic  duodenitis,  eosinophilic  esophagitis,  atopic  dermatitis,  chronic  spontaneous  urticaria  and  potentially 
additional indications. AK006 targets Siglec-6, an inhibitory receptor selectively expressed on mast cells. AK006 appears to have the potential to provide 
deeper  mast  cell  inhibition  than  lirentelimab  and,  in  addition  to  its  inhibitory  activity,  reduce  mast  cell  numbers.  We  plan  to  begin  human  studies  with 
AK006 in the first half of 2023. 

Lirentelimab selectively targets both mast cells and eosinophils, two types of white blood cells that are widely distributed in the body and play a 
central role in the inflammatory response. Inappropriately activated mast cells and eosinophils have been identified as key drivers in a number of severe 
diseases affecting the gastrointestinal tract, eyes, skin, lungs and other organs. Our initial focus is on eosinophilic gastrointestinal diseases which include 
eosinophilic esophagitis (“EoE”), eosinophilic gastritis (“EG”) as well as eosinophilic duodenitis (“EoD”) which has also been referred to as eosinophilic 
gastroenteritis.  In  addition,  lirentelimab  is  being  tested  in  atopic  dermatitis  and  chronic  spontaneous  urticaria  and  has  the  potential  to  treat  a  number  of 
other  severe  diseases.  To  date,  lirentelimab  completed  a  randomized,  double-blind,  placebo-controlled  Phase  2  study  (ENIGMA  1)  and  Phase  3  study 
(ENIGMA  2)  in  patients  with  EG  and/or  EoD,  a  Phase  2/3  study  in  patients  with  EoE  (KRYPTOS),  as  well  as  proof  of  concept  studies  in  chronic 
spontaneous urticaria, severe allergic conjunctivitis, and indolent systemic mastocytosis. Lirentelimab has received orphan disease status for EG, EoD, and 
EoE from the U.S. Food and Drug Administration (the “FDA”).

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The Phase 2 EG and/or EoD study with lirentelimab (ENIGMA 1) met all prespecified primary and secondary endpoints when compared to placebo 
and results were published in The New England Journal of Medicine. Additionally, patients in the ENIGMA 1 study with co-morbid EoE showed histologic 
and symptomatic improvement when treated with lirentelimab compared to placebo. More recently, topline data from Phase 3 ENIGMA 2 and Phase 2/3 
KRYPTOS studies of lirentelimab were announced in the fourth quarter of 2021. The ENIGMA 2 study met the histologic co-primary endpoint but missed 
the symptomatic co-primary endpoint when compared to placebo. Similarly, the KRYPTOS study met the histologic co-primary endpoint but missed the 
symptomatic co-primary endpoint when compared to placebo. Upon full analysis, we believe that the trials missed their symptomatic co-primary endpoints 
due  to  the  inclusion  of  mild  patients  and/or  patients  who  had  not  failed  standard  of  care.  In  the  more  severe  populations,  clear  signs  of  efficacy  were 
observed  in  both  EG/EoD  and  EoE  patients.  Based  on  these  findings,  we  plan  to  conduct  additional  studies  with  lirentelimab  in  these  indications  after 
discussions with the FDA

Despite the knowledge that mast cells and eosinophils drive many pathological conditions, there are no approved therapies that selectively target 
both  mast  cells  and  eosinophils.  Lirentelimab  binds  to  Siglec-8,  an  inhibitory  receptor  found  on  mast  cells  and  eosinophils,  which  represents  a  novel 
mechanism to selectively inhibit or deplete these important immune cells and thereby potentially resolve inflammation. We believe lirentelimab is the only 
Siglec-8 targeting antibody currently in clinical development.

Since our inception in 2012, we have devoted substantially all of our resources and efforts towards the research and development of our product 
candidates.  Our  lead  product  candidate,  lirentelimab,  a  monoclonal  antibody  targeting  Siglec-8,  entered  clinical  trials  in  2016.  In  addition  to  activities 
conducted internally at our facilities, we have utilized significant financial resources to engage contractors, consultants and other third parties to conduct 
various preclinical and clinical development activities on our behalf.

To  date,  we  have  not  had  any  products  approved  for  sale  and  have  not  generated  any  revenue  nor  been  profitable.  Further,  we  do  not  expect  to 
generate revenue from product sales until such time, if ever, that we are able to successfully complete the development and obtain marketing approval for 
one  of  our  product  candidates.  We  will  continue  to  require  additional  capital  to  develop  our  product  candidates  and  fund  operations  for  the  foreseeable 
future. We have incurred significant operating losses to date and expect to incur significant operating losses for the foreseeable future. Our net losses were 
$269.9 million and $153.5 million for the years ended December 31, 2021 and 2020, respectively. As of December 31, 2021, we had an accumulated deficit 
of $612.8 million.

In February 2022, we began implementing a reorganization plan (the “Reorganization Plan”) to reduce operating costs, contractual commitments 
and better align our workforce with the clinical development plans of our business. As a result, we entered into the Termination Agreement with Lonza and 
reduced our workforce by approximately 35%. While this will result in increased near-term costs, primarily in the first and second quarters of 2022, we 
believe  that  the  Reorganization  Plan  will  reduce  our  overall  spending  in  subsequent  quarters  subject  to  periodic  fluctuations  caused  by  the  timing  of 
ongoing manufacturing development efforts. Refer to Note 12 “Subsequent Events” of our financial statements for additional information. 

As of December 31, 2021, we had cash, cash equivalents and marketable securities of $424.2 million, which we believe will be sufficient to fund 

our planned operations for at least the next 12 months from the issuance of our financial statements.

In-Licensing Agreements

We have entered into a number of exclusive and nonexclusive, royalty bearing license agreements with third-parties for certain intellectual property. 
Under  the  terms  of  the  license  agreements  described  below,  we  are  obligated  to  pay  milestone  payments  upon  the  achievement  of  specified  clinical, 
regulatory and commercial milestones. Research and development expense associated with the Company’s milestone payments are recognized when such 
milestone  has  been  achieved.  Actual  amounts  due  under  the  license  agreements  vary  depending  on  factors  including,  but  not  limited  to,  the  number  of 
product candidates we develop and our ability to successfully develop and commercialize our product candidates covered under the respective agreements. 
In addition to milestone payments, we are also subject to future royalty payments based on sales of our product candidates covered under the agreements, 
as well as certain minimum annual royalty and commercial reservation fees. Because the achievement of milestones 

89

 
and  the  timing  and  extent  of  future  royalties  is  not  probable,  these  contingent  amounts  have  not  been  included  on  our  balance  sheets  or  as  part  of 
Contractual Obligations and Commitments discussion below.

We did not incur any milestone expense for the year ended December 31, 2021. We incurred $3.4 million of milestone expense for the year ended 
December 31, 2020 related to development milestones associated with the first patient dosed in our Phase 3 study with lirentelimab. Milestone payments 
are not creditable against royalties. As of December 31, 2021, we have not incurred any royalty liabilities related to our license agreements, as product sales 
have not yet commenced.

Exclusive License Agreement with The Johns Hopkins University

In  December  2013,  we  entered  into  a  license  agreement  with  JHU  for  a  worldwide  exclusive  license  to  develop,  use,  manufacture  and 
commercialize  covered  product  candidates  including  lirentelimab,  which  was  amended  in  September  2016.  Under  the  terms  of  the  agreement,  we  have 
made  upfront  and  milestone  payments  of  $0.7  million  through  December  31,  2021  and  we  may  be  required  to  make  aggregate  additional  milestone 
payments of up to $1.8 million. We also issued 88,887 shares of common stock as consideration under the JHU license agreement. In addition to milestone 
payments, we are also subject to low single-digit royalties to JHU based on future net sales of each licensed therapeutic product candidate by us and our 
affiliates and sublicensees, with up to a low six-digit dollar minimum annual royalty payment.

Non-exclusive License Agreement with BioWa Inc. and Lonza Sales AG

In  October  2013,  we  entered  into  a  tripartite  agreement  with  BioWa  and  Lonza  for  the  non-exclusive  worldwide  license  to  develop  and 
commercialize  product  candidates  including  lirentelimab  that  are  manufactured  using  a  technology  jointly  developed  and  owned  by  BioWa  and  Lonza. 
Under  the  terms  of  the  agreement,  we  have  made  milestone  payments  of  $3.4  million  through  December  31,  2021  and  we  may  be  required  to  make 
aggregate additional milestone payments of up to $38.0 million. In addition to milestone payments, we are also subject to minimum annual commercial 
license fees of $40,000 per year to BioWa until such time as BioWa receives royalty payments, as well as low single-digit royalties to BioWa and to Lonza. 
Royalties are based on future net sales by us and our affiliates and sublicensees.

Results of Operations

The following table summarizes our results of operations for the periods indicated (in thousands):

Operating expenses

Research and development
General and administrative
Total operating expenses

Loss from operations
Interest income
Other income (expense), net
Net loss
Unrealized gain (loss) on marketable securities
Comprehensive loss

Comparison of the Years Ended December 31, 2021 and 2020

Research and Development Expenses

2021

Year Ended December 31,
2020

2019

  $

  $

196,328     $
75,147    
271,475    
(271,475 )  
377    
1,238    
(269,860 )  
(161 )  
(270,021 )   $

  $

105,533  
51,524  
157,057    
(157,057 )  
4,313    
(736 )  
(153,480 )  
(129 )  
(153,609 )   $

61,858  
29,560  
91,418  
(91,418 )
6,201  
(155 )
(85,372 )
152  
(85,220 )

Research and development expenses consist primarily of discovery, development and manufacturing of our non-commercial products, clinical trial 
costs (including payments to contract research organizations, or “CROs”), salaries and other personnel costs, preclinical study fees, research supply costs, 
facility  and  equipment  costs  and  allocations  of  facilities  and  other  overhead  costs.  Amounts  incurred  in  connection  with  license  agreements,  including 
milestone payments, are also included in research and development expense.

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We expense research and development costs as incurred. We recognize costs for certain development activities, such as clinical trials, based on an 
evaluation of the progress to completion of specific tasks using data such as clinical site activations, patient enrollment or information provided to us by our 
clinical CROs and clinical investigative sites, along with analysis by our in-house clinical operations personnel. Advance payments for goods or services to 
be received in the future for use in research and development activities are deferred and capitalized as prepaid expenses, even when there is no alternative 
future use for the research and development. The capitalized amounts are expensed as the related goods are delivered or the services are performed.

Prior  to  the  regulatory  approval  of  our  product  candidates,  we  recognize  expenses  incurred  with  our  CDMOs  for  the  manufacture  of  product 
candidates that could potentially be available to support future commercial sales, if approved, in the period in which they have occurred. To date, we have 
not yet capitalized any costs to inventory as we are unable to determine if these costs will provide a future economic benefit, given the unapproved nature 
of our product candidates.

The successful development of our product candidates is highly uncertain. Accordingly, it is difficult to estimate the nature, timing and extent of 
costs necessary to complete the remainder of the development of our product candidates. We are also unable to predict when, if ever, we will be able to 
generate  revenue  from  our  product  candidates.  This  is  due  to  the  numerous  risks  and  uncertainties  associated  with  developing  drugs,  including  the 
uncertainty surrounding:

•

•

•

•

•

•

demonstrating sufficient safety and tolerability profiles of product candidates;

successful enrollment and completion of clinical trials;

requisite clearance and approvals from applicable regulatory authorities;

establishing and maintaining commercial manufacturing capabilities with CDMOs;

obtaining and maintaining protection of intellectual property; and

commercializing product candidates, if and when approved, alone or in collaboration with third-parties.

A change pertaining to any of these variables would significantly impact the timing and extent of costs incurred with respect to the development and 

commercialization of our product candidates.

External  costs  incurred  from  CDMOs,  clinical  CROs  and  clinical  investigative  sites  have  comprised  a  significant  portion  of  our  research  and 
development expenses since inception. We track these costs on a program-by-program basis following the advancement of a product candidate into clinical 
development.  Consulting  and  personnel-related  costs,  laboratory  supplies  and  non-capital  equipment  utilized  in  the  conduct  of  in-house  research,  in-
licensing fees and general overhead, are not tracked on a program-by-program basis, nor are they allocated, as they commonly benefit multiple projects, 
including those still in our pipeline.

The following table summarizes our research and development expenses for the periods indicated (in thousands):

Lirentelimab contract research and development costs
Consulting and personnel-related costs
Other unallocated research and development costs

Total

2021

Year Ended December 31,
2020

2019

  $

  $

117,621  
60,974  
17,733  
196,328  

  $

  $

55,322  
37,560  
12,651  
105,533  

  $

  $

30,806  
23,967  
7,085  
61,858  

Research and development expenses were $196.3 million for the year ended December 31, 2021 compared to $105.5 million for the year ended 
December  31,  2020,  an  increase  of  $90.8  million.  The  period-over-period  increase  in  research  and  development  expenses  is  primarily  driven  by  an 
additional  $62.3  million  of  lirentelimab  contract  research  and  development  costs  as  a  result  of  increased  spending  to  support  the  manufacturing  of 
lirentelimab and additional clinical trials costs, $23.4 million of consulting and personnel-related costs primarily associated with increased headcount and 
includes  $8.3  million  of  increased  stock-based  compensation  expense,  and  $5.1  million  increase  in  other  unallocated  research  and  development  costs 
primarily related to increased facilities and overhead costs. 

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We  anticipate  that  our  research  and  development  expenses  will  increase  significantly  during  the  first  and  second  quarters  of  2022  due  to  the 
Termination Agreement with Lonza as well as employment severance and retention related costs associated with the Reorganization Plan. We believe that 
the  Reorganization  Plan  will  reduce  our  overall  spending,  excluding  stock-based  compensation,    in  subsequent  quarters  subject  to  periodic  fluctuations 
caused by the timing of ongoing manufacturing development efforts. 

General and Administrative Expenses

General and administrative expenses consist of fees paid to consultants, salaries, benefits and other personnel-related costs, including stock-based 
compensation, for our personnel in executive, finance, accounting and other administrative functions, legal costs, fees paid for accounting and tax services, 
costs associated with pre-commercialization activities and facility costs not otherwise included in research and development expenses. Legal costs include 
general corporate and patent legal fees and related costs.

General  and  administrative  expenses  were  $75.1  million  for  the  year  ended  December  31,  2021  compared  to  $51.5  million  for  the  year  ended 
December 31, 2020, an increase of $23.6 million. The period-over-period increase in general and administrative expenses was primarily attributable to an 
increase  of  $16.2  million  in  increased  personnel-related  costs  due  to  increased  headcount  and  includes  an  increase  of  $9.1  million  in  stock-based 
compensation expense. Other period-over-period changes included increases to G&A outside spend of $4.0 million related to legal costs, accounting and 
financial service costs, and costs incurred by our early commercial development efforts. Finally, we incurred incremental facilities and other administrative 
costs of $3.4 million not otherwise allocated to research and development expenses.

We  anticipate  that  our  general  and  administrative  expenses  will  increase  during  the  first  quarter  of  2022  due  to  the  employment  severance  and 
retention related costs associated with the Reorganization Plan. We believe that the Reorganization Plan will reduce our overall spending, excluding stock-
based compensation, in subsequent quarters. Additionally, we expect to continue to incur costs associated with continuing to operate as a public company, 
including expenses related to maintaining compliance with the rules and regulations of the SEC, and those of any national securities exchange on which our 
securities  are  traded,  additional  insurance  premiums,  information  technology  and  facility  activities,  and  other  ancillary  administrative  and  professional 
services.

Interest Income

Interest income was $0.4 million for the year ended December 31, 2021 compared to $4.3 million for the year ended December 31, 2020, a decrease 

of $3.9 million. The year-over-year decrease is primarily attributable to lower interest rates and lower investment balances held during the current year.

Other Income (Expense), Net

Other income (expense), net, for the year ended December 31, 2021 reflected a gain of $1.2 million compared to a loss of $0.7 million for the year 
ended  December  31,  2020.  Other  income  (expense),  net,  for  the  year  ended  December  31,  2021  included  a  $1.9  million  gain  as  a  result  of  the  lease 
modification entered into in November 2021 which was partially offset by fluctuations in foreign currency rates. 

Liquidity and Capital Resources

Sources of Liquidity

As  of  December  31,  2021,  we  had  cash,  cash  equivalents  and  marketable  securities  of  $424.2  million.  Based  on  our  existing  business  plan,  we 
believe that our current cash, cash equivalents and marketable securities will be sufficient to fund our anticipated level of operations through at least the 
next 12 months from the issuance of our financial statements.

We  are  a  clinical  stage  biotechnology  company  with  a  limited  operating  history.  As  a  result  of  our  significant  research  and  development 

expenditures, we have generated net losses since our inception. We have financed our operations primarily through equity offerings. 

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July 2018 Initial Public Offering 

On July 23, 2018, we completed an IPO, selling 8,203,332 shares of common stock at $18.00 per share (the “July 2018 IPO”). Proceeds from our 
July  2018  IPO,  net  of  underwriting  discounts  and  commissions,  were  $137.3  million.  Concurrently  with  our  July  2018  IPO,  we  completed  a  private 
placement of 250,000 shares of common stock at $18.00 per share to an existing stockholder. Proceeds from this private placement were $4.5 million.

In connection with the completion of the July 2018 IPO, all then outstanding shares of convertible preferred stock converted into 30,971,627 shares 

of common stock. 

August 2019 Follow-On Offering

On August 9, 2019, we closed an underwritten public offering (the “August 2019 Offering”) under our shelf registration statement on Form S-3 (File 
No.  333-233018)  pursuant  to  which  we  sold  an  aggregate  of  5,227,272  shares  of  our  common  stock  at  a  public  offering  price  of  $77.00  per  share.  We 
received aggregate net proceeds of $377.5 million, after deducting the underwriting discounts and commissions and offering expenses.

November 2020 Follow-On Offering

On November 2, 2020, we closed an underwritten public offering (the “November 2020 Offering”) under our shelf registration statement on Form S-
3 (File No. 333-233018) pursuant to which we sold an aggregate of 3,506,098 shares of our common stock at a public offering price of $82.00 per share. 
We received aggregate net proceeds of $271.7 million, after deducting the underwriting discounts and commissions.

“At-the-Market” Equity Offering

On May 10, 2021, we entered into a Sales Agreement (the “Sales Agreement”) with Cowen and Company, LLC (“Cowen”). Pursuant to the terms of 

the Sales Agreement, we had the ability to sell, from time to time up to an aggregate of $400.0 million of our common stock through an “at-the-market” 
offering as defined in Rule 415 under the Securities Act of 1933, as amended. We agreed to pay Cowen a commission equal to 3.0% of the gross proceeds 
from the sale of shares of our common stock under the Sales Agreement and reimburse up to $60,000 of legal expenses incurred by Cowen.

We were not obligated to make any sales of shares of our common stock under the Sales Agreement. As of December 31, 2021, no shares of our 

common stock were sold under this Sales Agreement. The Sales Agreement was terminated effective February 24, 2022. 

Summary Cash Flows

The  following  table  summarizes  the  primary  sources  and  uses  of  our  cash,  cash  equivalents,  and  restricted  cash  for  the  periods  indicated  (in 

thousands):

Net cash used in operating activities
Net cash provided by (used in) investing activities
Net cash provided by financing activities

Net increase (decrease) in cash, cash equivalents and
   restricted cash

Comparison of the Years Ended December 31, 2021 and 2020

Cash Used in Operating Activities

2021

Year Ended December 31,
2020

2019

  $

  $

  $

(207,853 )
143,238  
10,260  

  $

(113,924 )
3,897  
278,837  

(54,355 )

  $

168,810  

  $

(63,012 )
(311,971 )
381,163  

6,180  

Net cash used in operating activities was $207.9 million for the year ended December 31, 2021, which was primarily attributable to our net loss of 
$269.9  million  adjusted  for  net  noncash  charges  of  $57.3  million  and  net  changes  in  operating  assets  and  liabilities  of  $4.7  million.  Noncash  charges 
included $50.8 million in stock-based compensation expense, $3.4 million in net amortization of premiums and discounts on marketable securities, $2.3 

93

 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
   
 
million in depreciation and amortization expense, $2.6 million in noncash lease expense and $1.9 million in gains from a lease modification.

Net cash used in operating activities was $113.9 million for the year ended December 31, 2020, which was primarily attributable to our net loss of 
$153.5  million  adjusted  for  net  noncash  charges  of  $1.4  million  and  net  changes  in  operating  assets  and  liabilities  of  $38.2  million.  Noncash  charges 
included $33.4 million in stock-based compensation expense, $2.4 million in net amortization of premiums and discounts on marketable securities, $1.5 
million in depreciation and amortization expense and $0.9 million in amortization of right-of-use asset.

Cash Used in Investing Activities

Net cash provided by investing activities was $143.2 million for the year ended December 31, 2021, which consisted of $564.0 million in proceeds 
from maturities of marketable securities, partially offset by $387.5 million for the purchases of marketable securities and $33.2 million for the purchases of 
property and equipment.

Net cash provided by investing activities was $3.9 million for the year ended December 31, 2020, which consisted of $546.8 million in proceeds 
from maturities of marketable securities, partially offset by $542.3 million for the purchases of marketable securities and $0.6 million for the purchases of 
property and equipment.

Cash Provided by Financing Activities

Net cash provided by financing activities was $10.3 million for the year ended December 31, 2021, which consisted primarily of $8.5 million in 

proceeds received from employees for the exercise of stock options and $1.8 million in proceeds from the issuance of common stock under the 2018 ESPP.

Net cash provided by financing activities was $278.8 million for the year ended December 31, 2020, which consisted primarily of $271.7 million in 
net proceeds from the issuance of common stock, $5.7 million in proceeds received from employees for the exercise of stock options and $1.5 million in 
proceeds from the issuance of common stock under the 2018 ESPP.

Funding Requirements

We will continue to require additional capital to develop our product candidates and fund operations for the foreseeable future. We may seek to raise 
funding  through  private  or  public  equity  or  debt  financings,  or  other  sources  such  as  strategic  collaborations.  Adequate  additional  funding  may  not  be 
available to us on acceptable terms or at all. Our failure to raise capital as and when needed could have a negative impact on our financial condition and our 
ability to pursue our business strategies.

The timing and amount of our capital expenditures will depend on many factors, including:

•

•

•

•

•

•

•

•

the number and scope of clinical indications and clinical trials we decide to pursue;

the scope and costs of manufacturing activities;

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

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

the cost and timing of establishing sales and marketing capabilities for product candidates receiving marketing approval, if any;

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

our efforts to enhance operational systems and our ability to attract, hire and retain qualified personnel, including personnel to support the 
development of our product candidates; and

the costs associated with being a public company.

94

 
If we are unable to raise additional funds when needed, we may be required to delay, reduce or terminate some or all of our development efforts. We 
may also be required to sell or license to others rights to our product candidates in certain territories or indications that we would prefer to develop and 
commercialize ourselves.

The issuance of additional equity securities may cause our stockholders to experience dilution. Future equity or debt financings may contain terms 
that are not favorable to us or our stockholders including debt instruments imposing covenants that restrict our operations and limit our ability to incur 
liens, issue additional debt, pay dividends, repurchase our common stock, make certain investments or engage in certain merger, consolidation, licensing or 
asset sale transactions.

Contractual Obligations and Commitments

The  following  table  outlines  our  contractual  obligations  and  commitments  at  December  31,  2021  (in  thousands)  and  does  not  incorporate  any 

cancellations or termination agreements entered into subsequent to December 31, 2021:

Operating lease obligations 
Purchase obligations 

(2)

(1)

Total

Total

77,664  
284,826  
362,490  

  $

  $

  $

  $

Less than
1 Year

Payments Due by Period
1-3
Years

3-5
Years

    More than 5

Years

7,445     $
161,787      
169,232     $

14,334     $
123,039      
137,373     $

15,208     $
—      
15,208     $

40,677  
—  
40,677  

(1)

(2)

Operating lease obligations represent future lease payments due under our two lease agreements. 
Purchase obligations represent noncancelable amounts due to counterparties under various master service agreements.

In  addition  to  the  amounts  included  in  the  table  above,  we  enter  into  contracts  in  the  normal  course  of  business  with  clinical  CROs,  clinical 
investigative sites and other counterparties assisting with our preclinical studies and clinical trials. Such contracts are generally cancellable, with varying 
provisions regarding termination. In the event of a contract being terminated, we would only be obligated for services received as of the effective date of 
the termination, along with cancellation fees, as applicable.

Approximately $231.2 million of the $284.8 million total noncancellable purchase obligations as of December 31, 2021 related to manufacturing 
services  agreements  with  Lonza  AG  or  affiliates  (such  agreements,  the  “MSAs”).  On  February  14,  2022  (the  “Effective  Date”),  we  entered  into  a 
termination  agreement  (the  “Termination  Agreement”)  with  Lonza  AG,  Lonza  Sales  Ltd  and  Lonza  Sales  AG  (collectively,  “Lonza”)  terminating  such 
MSAs. Lonza will continue to provide certain services to us, including completion of cGMP batches already underway and other services to assist with the 
transition  post-termination.  The  Termination  Agreement  provides  that  we  shall  pay  approximately  $136.1  million  (126  million  Swiss  Francs)  (the 
“Termination Amount”) to Lonza as a result of such termination, 95% of which is to be paid within 30 days after the Effective Date, and 5% of which is be 
paid within 30 days of the release of the remaining cGMP batches. If we fail to pay the first 95% of the Termination Amount to Lonza within 30 days of the 
Effective  Date,  Lonza  may  at  its  option  give  notice  to  us  that  the  Termination  Agreement  is  terminated.  The  Termination  Agreement  contains  mutual 
releases  by  all  parties  thereto,  for  all  claims  known  and  unknown,  relating  and  arising  out  of,  or  connected  with,  the  MSAs  and  the  subject  matter(s) 
thereof, subject to certain exceptions.

Off-Balance Sheet Arrangements

Since our inception, we have not entered into any off-balance sheet arrangements as defined in the rules and regulations of the SEC.

Critical Accounting Policies and Use of Estimates

Our management’s discussion and analysis of our financial condition and results of operations is based on our financial statements, which have been 
prepared  in  accordance  with  generally  accepted  accounting  principles  in  the  United  States  (“U.S.  GAAP”).  The  preparation  of  our  financial  statements 
requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities 
at the date of the financial statements, as well as the reported expenses incurred during the reporting periods. 

95

 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
   
   
   
 
 
 
   
 
 
Our estimates are based on our historical experience and on various other factors that we believe are reasonable under the circumstances, the results of 
which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results 
may differ from these estimates under different assumptions or conditions.

We believe that the accounting policies discussed below are critical to understanding our historical and future performance, as these policies relate to 

the more significant areas involving management’s judgments and estimates.

Accrued Contract Research and Development Expense

As part of our preparation of the financial statements, we are required to estimate our accrued expenses as of each balance sheet date. This process 
involves reviewing open contracts and purchase orders, as well as working with internal personnel to identify the existence and extent of services that have 
been performed on our behalf which have not yet been invoiced. We make estimates of our accrued expenses as of each balance sheet date based on facts 
and circumstances known to us at that time. We periodically confirm the accuracy of our estimates, recording adjustments, if necessary.

Estimates underlying accrued contract research and development expense primarily relate to our evaluation of the timing and extent of development 
and manufacturing services performed by our CDMOs, as well as research activities performed by CROs and clinical investigative sites activities on our 
behalf.  As  the  financial  terms  included  within  service  agreements  with  such  vendors  vary  from  contract  to  contract  and  often  include  uneven  payment 
flows,  our  evaluation  focuses  on  the  level  of  effort  and  resources  expended.  Accordingly,  the  calculation  of  accrued  contract  research  and  development 
expense  requires  us  to  analyze  a  significant  amount  of  inputs  and  data  from  multiple  internal  and  external  sources,  including  information  from 
communications with clinical operations and technical operations personnel.

Although  we  do  not  expect  our  estimates  to  be  materially  different  from  amounts  actually  incurred,  if  our  estimates  of  the  status  and  timing  of 
services performed differ from the actual status and timing of services performed, it could result in us reporting amounts that are higher or lower in any 
particular period. To date, there have been no material differences between our estimates of such expenses and the amounts actually incurred for the periods 
reported.

Operating Leases

We account for our leases in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 842, 
“Leases” (“ASC 842”). Right-of-use assets represent our right to use an underlying asset over the lease term and include any lease payments made prior to 
the lease commencement date and are reduced by lease incentives. Lease liabilities represent the present value of our total lease payments over the lease 
term, calculated using our incremental borrowing rate. In determining our incremental borrowing rate, we considered the term of the lease and our credit 
risk. We recognize options to extend a lease when it is reasonably certain that we will exercise such extension. We do not recognize options to terminate a 
lease when it is reasonably certain that we will not exercise such early termination options.

Stock-Based Compensation

We account for stock-based compensation expense resulting from stock-based awards granted to employees and nonemployees in accordance with 
ASC 718, Compensation—Stock Compensation, (“ASC 718”). Per ASC 718, we measure the fair value of stock-based awards on the date of grant and 
recognize  the  associated  compensation  expense,  net  of  impact  from  estimated  forfeitures,  over  the  requisite  service  period  on  a  straight-line  basis.  The 
vesting  period  of  the  stock-based  award  has  historically  served  as  the  requisite  service  period  for  the  respective  grants  to  our  employees,  nonemployee 
directors and consultants. At each subsequent reporting date, we are required to evaluate whether the achievement of any associated vesting conditions is 
probable and whether or not any such events have occurred that would have resulted in the acceleration of vesting.

Determining the amount of stock-based compensation expense to be recorded requires us to develop estimates of the fair value of stock options as of 

the date of grant. We estimate the fair value of each stock-based award using 

96

 
the Black-Scholes option-pricing model. The Black-Scholes option-pricing model uses highly subjective inputs such as the fair value of our common stock, 
as well as other assumptions including the expected volatility of our common stock, the expected term of the respective stock-based award, the risk-free 
interest rate for a period that approximates the expected term of the stock-based award being valued and the expected dividend yield on our common stock 
over the expected term.

Expected volatility. As we do not have sufficient trading history for our common stock, we have based our computation of expected volatility on the 
historical volatility of a representative group of public life science companies with similar characteristics to us, including company age and stage of 
product development. The historical volatility data is calculated based on a period of time commensurate with the expected term of the stock-based 
award being valued. We will continue to utilize this approach until a sufficient amount of historical information regarding the volatility of our own 
stock  price  becomes  available  or  until  other  relevant  circumstances  change,  such  as  our  assessment  that  our  identified  entities  are  no  longer 
appropriate  to  use  as  representative  companies.  In  the  latter  case,  more  suitable,  similar  entities  with  publicly  available  stock  prices  will  be 
incorporated in the calculation.

Expected term. In order to estimate the expected term of a stock-based award, we use the simplified method prescribed by SEC Staff Accounting 
Bulletin No. 107, Share-Based Payment, as we do not have sufficient historical exercise data to provide a reasonable basis upon which to estimate 
the expected term. Under this approach, the expected term is presumed to be the average of the contractual term (ten years) and the vesting term 
(generally four years) of the stock-based award. We have not historically experienced, nor do we expect there to be substantially different exercise 
or post-vesting termination behavior among our employees and directors.

Risk-free interest rate. The risk-free interest rate is based on publicly available yields of U.S. Treasury instruments with maturities consistent with 
the expected term of the stock-based award.

Expected dividend yield. The expected dividend yield is assumed to be zero as we have never paid dividends and have no current plans to pay any 
dividends on our common stock.

Income Taxes

We account for income taxes under the asset and liability method. Current income tax expense or benefit represents the amount of income taxes we 
expect to pay or have refunded in the current year. Our deferred income tax assets and liabilities are determined based on differences between financial 
statement reporting and tax basis accounting of assets and liabilities and net operating loss and credit carryforwards, which we measure using the enacted 
tax  rates  and  laws  that  will  be  in  effect  when  such  items  are  expected  to  reverse.  We  reduce  deferred  income  tax  assets,  as  necessary,  by  applying  a 
valuation allowance to the extent that we determined it is more likely than not that some or all of our tax benefits will not be realized.

We  account  for  uncertain  tax  positions  in  accordance  with  ASC  740-10,  Accounting  for  Uncertainty  in  Income  Taxes.  We  assess  all  material 
positions reflected in our income tax returns, including all significant uncertain positions, for all tax years that are subject to assessment or challenge by 
relevant  taxing  authorities.  Upon  determining  the  sustainability  of  our  positions,  we  measure  the  largest  amount  of  benefit  possessing  greater  than  fifty 
percent  likelihood  of  being  realized  upon  ultimate  settlement.  We  reassess  such  positions  at  each  balance  sheet  date  to  determine  whether  any  factors 
underlying the sustainability assertion have changed and whether or not the amount of the recognized tax benefit is still appropriate.

As of December 31, 2021, our gross deferred tax assets were $203.5 million. Due to our lack of earnings history and uncertainties surrounding our 
ability  to  generate  future  taxable  income,  we  have  offset  the  total  net  deferred  tax  assets  with  a  full  valuation  allowance.  The  deferred  tax  assets  were 
primarily comprised of federal and state tax net operating losses, (“NOLs”), which may be limited by certain rules governing changes in ownership, as 
defined in Section 382 of the Internal Revenue Code of 1986, as amended. Similar rules may apply under state tax laws. Our ability to use our remaining 
NOLs may be further limited if we experience future ownership changes.

Judgments concerning the recognition and measurement of our tax benefits, as well as limitations surrounding their realizability, might change as 

new information becomes available.

97

 
Recent Accounting Pronouncements

See  Note  2  to  our  financial  statements  for  recently  issued  accounting  pronouncements,  including  the  respective  effective  dates  of  adoption  and 

effects on our results of operations and financial condition.

Item 7A. Quantitative and Qualitative Disclosures About Market Risk. 

Interest Rate Sensitivity

We are exposed to market risk related to changes in interest rates. Our primary exposure to market risk is interest rate sensitivity, which is affected 
by  changes  in  the  general  level  of  U.S.  interest  rates,  particularly  because  our  investments,  including  cash  equivalents,  are  in  money  market  funds  that 
invest  in  U.S.  Treasury  obligations.  The  primary  objective  of  our  investment  activities  is  to  preserve  capital  to  fund  our  operations.  We  also  seek  to 
maximize income from our investments without assuming significant risk. Due to the short-term maturities and low credit risk profile of our balances held 
in money market funds, a hypothetical 10% change in interest rates would not have a material effect on the fair market value of our cash equivalents and 
marketable securities.

Foreign Currency Sensitivity

Our primary operations are transacted in U.S. Dollars, however, certain service agreements with third parties are denominated in currencies other 
than the U.S. Dollar, primarily the British Pound and Euro. As such, we are subject to foreign exchange risk and therefore, fluctuations in the value of the 
U.S. Dollar against the British Pound and Euro may impact the amounts reported for expenses and obligations incurred under such agreements. We do not 
currently  engage  in  any  hedging  activity  to  reduce  our  potential  exposure  to  currency  fluctuations,  although  we  may  choose  to  do  so  in  the  future.  A 
hypothetical 10% change in foreign exchange rates during any of the periods presented would not have had a material impact on our financial condition or 
results of operations.

98

 
Item 8. Financial Statements and Supplementary Data.

ALLAKOS INC.
INDEX TO FINANCIAL STATEMENTS

Report of Independent Registered Public Accounting Firm (PCAOB ID 42)

Audited Financial Statements: 

Balance Sheets 

Statements of Operations and Comprehensive Loss

Statements of Stockholders’ Equity

Statements of Cash Flows

Notes to Financial Statements

99

Page

100

102

103

104

105

106

 
 
 
  
 
 
  
 
  
 
  
 
  
 
  
 
 
Report of Independent Registered Public Accounting Firm

To the Stockholders and the Board of Directors of Allakos Inc.

Opinion on the Financial Statements

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

We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States)  (PCAOB),  the  Company's 
internal  control  over  financial  reporting  as  of  December  31,  2021,  based  on  criteria  established  in  Internal  Control-Integrated  Framework  issued  by  the 
Committee of Sponsoring Organizations of the Treadway Commission (2013 framework), and our report dated March 1, 2022 expressed an unqualified 
opinion thereon.

Basis for Opinion

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

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable 
assurance  about  whether  the  financial  statements  are  free  of  material  misstatement,  whether  due  to  error  or  fraud.  Our  audits  included  performing 
procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to 
those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits 
also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the 
financial statements. We believe that our audits provide a reasonable basis for our opinion.

Critical Audit Matter

The  critical  audit  matter  communicated  below  is  a  matter  arising  from  the  current  period  audit  of  the  financial  statements  that  was  communicated  or 
required to be communicated to the audit committee and that: (1) relates to accounts or disclosures that are material to the financial statements and (2) 
involved our especially challenging, subjective or complex judgments. The communication of the critical audit matter does not alter in any way our opinion 
on the financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical 
audit matter or on the accounts or disclosures to which it relates.

100

 
 
  
  
  
  
  
  
  
  
 
Accrued contract research and development expenses

Description of the 
Matter

As discussed in Note 2, accrued research and development expenses are recorded for estimated unpaid costs of research and 
development  activities  conducted  by  the  Company  and  its  third-party  service  providers,  which  include  the  conduct  of 
preclinical and clinical studies, and contract manufacturing activities. Accrued research and development expenses were $16.2 
million as of December 31, 2021 and include the estimated costs of accrued clinical investigative sites expenses incurred but 
not yet invoiced under agreements with investigative clinical trial sites that conduct research and development activities on 
behalf  of  the  Company  (“Accrued  Clinical  Investigative  Sites  Expenses”).  The  accrual  for  these  Accrued  Clinical 
Investigative  Site  Expenses  is  determined  after  consideration  of  several  factors,  including  estimates  of  services  completed. 
Auditing these Accrued Clinical Investigative Sites Expenses was complex due to the required analysis of extensive data in 
determining the estimated unpaid expenses. 

How We Addressed the 
Matter in Our Audit

We  obtained  an  understanding,  evaluated  the  design,  and  tested  the  operating  effectiveness  of  relevant  controls  over  the 
Company’s  determination  of  Accrued  Clinical  Investigative  Sites  Expenses,  including  controls  over  the  determination  of 
significant assumptions and the completeness and accuracy of the data used in determining these accrued costs.

Our audit procedures included, among others, testing the accuracy and completeness of the inputs used in management’s 
analysis to determine costs incurred. We verified that the accrued amounts were in accordance the terms and conditions of the 
underlying agreements and the information provided by third-party service providers. We also evaluated management’s 
estimates of the progress of the clinical trials by making direct inquiries of the Company’s personnel that oversee the clinical 
trials.

/s/ Ernst & Young LLP

We have served as the Company’s auditor since 2016.

Redwood City, California
March 1, 2022

101

 
 
 
 
 
ALLAKOS INC.
BALANCE SHEETS
(in thousands, except per share data)

Assets
Current assets:

Cash and cash equivalents
Investments in marketable securities
Prepaid expenses and other current assets

Total current assets
Property and equipment, net
Operating lease right-of-use assets
Other long-term assets
Total assets
Liabilities and stockholders’ equity
Current liabilities:

Accounts payable
Accrued expenses and other current liabilities

Total current liabilities

Operating lease liabilities, net of current portion

Total liabilities

Commitments and contingencies (Notes 6 and 7)
Stockholders’ equity:

Preferred stock, $0.001 par value per share; 20,000 shares 
   authorized as of December 31, 2021 and 2020; no 
   shares issued and outstanding as of December 31, 2021 and 2020
Common stock, $0.001 par value per share; 200,000 shares
   authorized as of December 31, 2021 and 2020; 54,622 and
   53,081 shares issued and outstanding as of December 31, 2021 
   and 2020, respectively
Additional paid-in capital
Accumulated other comprehensive gain (loss)
Accumulated deficit

Total stockholders’ equity
Total liabilities and stockholders’ equity

See accompanying notes to financial statements

102

December 31,

2021

2020

  $

152,822  
271,416    
27,343    
451,581    
43,100    
31,707    
8,436    
534,824     $

  $

13,692  
26,557    
40,249    
49,099    
89,348    

207,177  
451,820  
10,270  
669,267  
8,345  
39,731  
2,275  
719,618  

13,960  
8,490  
22,450  
42,773  
65,223  

—    

—  

54    
1,058,399    
(153 )  
(612,824 )  
445,476    
534,824     $

53  
997,298  
8  
(342,964 )
654,395  
719,618  

  $

  $

  $

  $

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ALLAKOS INC.
STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
(in thousands, except per share data)

Operating expenses

Research and development
General and administrative
Total operating expenses

Loss from operations
Interest income
Other income (expense), net
Net loss
Unrealized gain (loss) on marketable securities
Comprehensive loss
Net loss per common share:

Basic and diluted

Weighted-average number of common shares
   outstanding:

Basic and diluted

2021

Year Ended December 31,
2020

2019

  $

  $

  $

196,328     $
75,147    
271,475    
(271,475 )  
377    
1,238    
(269,860 )  
(161 )  
(270,021 )   $

105,533  
51,524  
157,057  
(157,057 )
4,313  
(736 )
(153,480 )
(129 )
(153,609 )

(5.01 )

  $

(3.10 )

  $

  $

  $

61,858  
29,560  
91,418  
(91,418 )
6,201  
(155 )
(85,372 )
152  
(85,220 )

(1.89 )

53,832  

49,492  

45,191  

See accompanying notes to financial statements

103

 
 
 
 
 
 
 
 
 
 
 
 
 
     
 
   
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
 
   
   
 
Balance as of December 31, 2018

Stock-based compensation expense
Issuance of common stock upon exercise of stock options
Issuance of common stock upon 2018 ESPP purchase
Issuance of common stock upon follow-on offering, net of
   offering costs of $24,975
Vesting of restricted common stock
Unrealized gain on marketable securities, net of tax
Net loss

Balance as of December 31, 2019

Stock-based compensation expense
Issuance of common stock upon exercise of stock options
Issuance of common stock upon 2018 ESPP purchase
Issuance of common stock upon follow-on offering, net of
   offering costs of $15,813
Issuance of common stock upon vesting of restricted 
   stock units
Unrealized loss on marketable securities
Net loss

Balance as of December 31, 2020

Stock-based compensation expense
Issuance of common stock upon exercise of stock options
Issuance of common stock upon 2018 ESPP purchase
Issuance of common stock upon vesting of restricted 
   stock units
Unrealized loss on marketable securities
Net loss

Balance as of December 31, 2021

ALLAKOS INC.
STATEMENTS OF STOCKHOLDERS’ EQUITY
(in thousands)

Common Stock

Shares

Amount

Additional
Paid-In
Capital

Accumulated 
Other 
Comprehensive 
Gain (Loss)

Accumulated
Deficit

Total
Stockholders’
Equity

42,117     $
—    
1,250  
74  

5,227  
—  
—  
—  
48,668     $
—    
700    
70    

42    $
—   
1  
—  

5  
—  
—  
—  
48    $
—   
1   
—   

288,079    $
15,764   
2,447  
1,190  

377,520  
20  
—  
—  
685,020    $
33,446   
5,695   
1,454   

3,506    

4   

271,683   

137    
—    
—    
53,081     $
—    
1,227    
29    

285    
—    
—    
54,622     $

—   
—   
—   
53    $
—   
1   
—   

—   
—   
—   
54    $

—   
—   
—   

997,298    $
50,842   
8,491   
1,768   

—   
—   
—   

1,058,399    $

(15 )  $
—    
—  
—  

—  
—  
152  
—  
137     $
—    
—    
—    

—    

—    
(129 ) 
—    
8     $

—    
—    
—    

—    
(161 ) 
—    
(153 )  $

(104,112 )  $

—    
—    
—    

—    
—    
—    
(85,372 ) 
(189,484 )  $

—    
—    
—    

—    

—    
—    
(153,480 ) 
(342,964 )  $

—    
—    
—    

—    
—    
(269,860 ) 
(612,824 )  $

183,994  
15,764  
2,448  
1,190  

377,525  
20  
152  
(85,372 )
495,721  
33,446  
5,696  
1,454  

271,687  

—  
(129 )
(153,480 )
654,395  
50,842  
8,492  
1,768  

—  
(161 )
(269,860 )
445,476  

See accompanying notes to financial statements

104

 
 
 
 
  
  
   
   
 
 
 
   
  
 
  
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ALLAKOS INC.
STATEMENTS OF CASH FLOWS
(in thousands)

Cash flows from operating activities

Net loss
Adjustments to reconcile net loss to net cash used in operating activities:

Stock-based compensation
Net amortization of premiums and discounts on marketable securities
Depreciation and amortization
Noncash lease expense
Gain on lease modification
Loss on disposal of property and equipment

Changes in operating assets and liabilities:

Prepaid expenses and other current assets
Other long-term assets
Accounts payable
Accrued expenses and other current liabilities
Operating lease liabilities, net of current portion

Net cash used in operating activities

Cash flows from investing activities
Purchases of marketable securities
Proceeds from maturities of marketable securities
Purchases of property and equipment

Net cash provided by (used in) investing activities

Cash flows from financing activities

Proceeds from issuance of common stock, net of issuance costs
Proceeds from exercise of stock options, net of repurchases
Proceeds from issuance of common stock under 2018 ESPP

Net cash provided by financing activities

Net increase (decrease) in cash, cash equivalents and 
  restricted cash

Cash, cash equivalents and restricted cash, beginning of period
Cash, cash equivalents and restricted cash, end of period

Supplemental disclosures

Right-of-use assets obtained in exchange for lease obligations
Vesting of restricted common stock subject to repurchase
Property and equipment purchased but unpaid

2021

Year Ended December 31,
2020

2019

  $

(269,860 )   $

(153,480 )   $

(85,372 )

50,842    
3,389    
2,310    
2,570    
(1,873 )  
46    

(16,678 )  
(6,161 )  
(232 )  
13,594    
14,200    
(207,853 )  

(387,541 )  
564,000    
(33,221 )  
143,238    

—  
8,492    
1,768    
10,260    

33,446    
2,358    
1,545    
794    
—    
—    

(7,601 )  
—    
7,644    
900    
470    
(113,924 )  

(542,273 )  
546,800    
(630 )  
3,897    

271,687  

5,696    
1,454    
278,837    

(54,355 )  
209,452    
155,097     $

200     $
—     $
3,890     $

168,810    
40,642    
209,452     $

34,750  
—  
353  

  $
  $
  $

  $

  $
  $
  $

15,764  
(2,664 )
1,508  
275  
—  
—  

463  
(564 )
3,571  
4,077  
(70 )
(63,012 )

(541,701 )
230,500  
(770 )
(311,971 )

377,525  
2,448  
1,190  
381,163  

6,180  
34,462  
40,642  

6,050  
20  
—  

See accompanying notes to financial statements

105

 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
ALLAKOS INC.
NOTES TO FINANCIAL STATEMENTS

1. Organization and Business

Allakos Inc. (“Allakos” or the “Company”) was incorporated in the state of Delaware in March 2012. Allakos is a clinical stage biopharmaceutical 
company focused on the development of lirentelimab for the treatment of eosinophil and mast cell related diseases. The Company’s primary activities to 
date have included establishing its facilities, recruiting personnel, conducting research and development of its product candidates and raising capital. The 
Company’s operations are located in Redwood City, California. 

Liquidity Matters

Since  inception,  the  Company  has  incurred  net  losses  and  negative  cash  flows  from  operations.  During  the  year  ended  December  31,  2021,  the 
Company incurred a net loss of $269.9 million and used $207.9 million of cash in operations. As of December 31, 2021, the Company had an accumulated 
deficit  of  $612.8 million  and  does  not  expect  to  experience  positive  cash  flows  from  operating  activities  in  the  foreseeable  future.  The  Company  has 
financed its operations to date primarily through the sale of common stock. Management expects to incur additional operating losses in the future as the 
Company continues to further develop, seek regulatory approval for and, if approved, commence commercialization of its product candidates. 

Due  to  the  clinical  study  results  released  in  December  2021,  our  Board  of  Directors  approved  in  February  2022  plans  to  reduce  our  contractual 
commitments with Lonza and a reorganization plan (the “Reorganization Plan”) to reduce operating costs and better align our workforce with the clinical 
development  plans  of  our  business.  Refer  to  Note  12  “Subsequent  Events”  for  additional  information.  The  Company  had  $424.2 million  of  cash,  cash 
equivalents and marketable securities at December 31, 2021. 

Management believes that this amount is sufficient to fund the Company’s operations for at least the next 12 months from the issuance date of these 

financial statements.

2. Summary of Significant Accounting Policies

Basis of Presentation

The  financial  statements  have  been  prepared  in  accordance  with  United  States  generally  accepted  accounting  principles  (“U.S.  GAAP”).  The 
preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts and 
disclosures reported in the financial statements and accompanying notes. 

Use of Estimates

Management uses significant judgment when making estimates related to common stock valuation and related stock-based compensation expense, 
accrued research and development expense, and lease related assets and liabilities. Management bases its estimates on historical experience and on various 
other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying 
values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates under different assumptions 
or conditions, and those differences could be material to the financial position and results of operations.

Concentration of Credit Risk and Other Risks and Uncertainties

Financial  instruments  that  potentially  subject  the  Company  to  credit  risk  principally  consist  of  cash,  cash  equivalents  and  marketable  securities. 
These financial instruments are held in accounts at a single financial institution that management believes possesses high credit quality. Amounts on deposit 
with this financial institution have and will continue to exceed federally-insured limits. The Company has not experienced any losses on its cash deposits. 
Additionally, the Company’s investment policy limits its investments to certain types of securities issued by the United States government and its agencies. 

106

 
The Company is subject to a number of risks similar to that of other early-stage biopharmaceutical companies, including, but not limited to, the need 
to obtain adequate additional funding, possible failure of current or future clinical trials, its reliance on third-parties to conduct its clinical trials, the need to 
obtain regulatory and marketing approvals for its product candidates, competitive developments, the need to successfully commercialize and gain market 
acceptance of the Company’s product candidates, its right to develop and commercialize its product candidates pursuant to the terms and conditions of the 
licenses  granted  to  the  Company,  protection  of  proprietary  technology,  the  ability  to  make  milestone,  royalty  or  other  payments  due  under  licensing 
agreements,  and  the  need  to  secure  and  maintain  adequate  manufacturing  arrangements  with  third-parties.  If  the  Company  does  not  successfully 
commercialize or partner its product candidates, it will be unable to generate product revenue or achieve profitability.

Cash, Cash Equivalents and Restricted Cash

The  Company  considers  all  highly  liquid  investments  with  original  maturities  of  three  months  or  less  from  the  date  of  purchase  to  be  cash 
equivalents. The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the Company’s balance sheets and 
which, in aggregate, represent the amounts reported in the statements of cash flows (in thousands):

Cash and cash equivalents
Restricted cash

Total

  $

  $

2021

152,822     $
2,275    
155,097     $

December 31,
2020

207,177  
2,275  
209,452  

  $

  $

2019

38,367  
2,275  
40,642  

Restricted  cash  at  December  31,  2021  represents  $2.3  million  of  security  deposits  for  the  lease  of  the  Company’s  facilities  in  Redwood  City, 
California  and  San  Carlos,  California.  Both  security  deposits  are  in  the  form  of  letters  of  credit  secured  by  restricted  cash.  Restricted  cash  amounts  are 
included within other long-term assets on the Company’s balance sheets.

Marketable Securities

The  Company  invests  in  marketable  securities,  primarily  securities  issued  by  the  United  States  government  and  its  agencies.  The  Company’s 
marketable  securities  are  considered  available-for-sale  and  are  classified  as  current  assets  even  when  the  stated  maturities  of  the  underlying  securities 
exceed one year from the date of the current balance sheet being reported. This classification reflects management’s ability and intent to utilize proceeds 
from the sale of such investments to fund ongoing operations. Unrealized gains and losses are excluded from earnings and are reported as a component of 
accumulated other comprehensive gain. The cost of securities sold is determined using the specific-identification method. Interest earned and adjustments 
for the amortization of premiums and discounts on investments are included in interest income, net, on the statements of operations and comprehensive 
loss. Realized gains and losses and declines in fair value judged to be other than temporary, if any, on investments in marketable securities are included in 
other expense, net, on the statements of operations and comprehensive loss.

Fair Value Measurements

The  Company  accounts  for  fair  value  of  its  financial  instruments  in  accordance  with  Financial  Accounting  Standards  Board  (the  “FASB”) 
Accounting Standards Codification (“ASC”) Topic No. 820, Fair Value Measurements  (“ASC  820”).  ASC  820  establishes  a  common  definition  for  fair 
value, establishes a framework for measuring fair value and expands disclosures about such fair value measurements. Additionally, ASC 820 defines fair 
value  as  the  price  that  would  be  received  to  sell  an  asset  or  paid  to  transfer  a  liability  in  an  orderly  transaction  between  market  participants  at  the 
measurement date.

The  Company  measures  fair  value  based  on  a  three-level  hierarchy  of  inputs,  of  which  the  first  two  are  considered  observable  and  the  last 
unobservable.  Unobservable  inputs  reflect  the  Company’s  own  assumptions  about  current  market  conditions.  The  three-level  hierarchy  of  inputs  is  as 
follows:

Level 1 – Quoted prices in active markets for identical assets or liabilities.

107

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted 
prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of 
the assets or liabilities.

Level 3 – Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of assets or liabilities.

To the extent that the valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value 
requires more judgment. Accordingly, the degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in 
Level  3.  A  financial  instrument’s  level  within  the  fair  value  hierarchy  is  based  on  the  lowest  level  of  any  input  that  is  significant  to  the  fair  value 
measurement.

The  carrying  amounts  reflected  in  the  Company’s  balance  sheets  for  cash  and  cash  equivalents,  prepaid  expenses  and  other  current  assets,  other 
long-term  assets,  accounts  payable,  and  accrued  expenses  and  other  current  liabilities  approximate  fair  value,  due  to  their  short-term  nature.  The 
Company’s investments in marketable securities are measured at fair value in accordance with the levels above.

Property and Equipment, Net 

Property  and  equipment  are  stated  at  cost,  net  of  accumulated  depreciation.  Depreciation  is  computed  using  the  straight-line  method  over  the 
estimated useful lives of the assets. Generally, the useful lives of laboratory equipment are five years, furniture and office equipment are three to five years, 
and leasehold improvements property and equipment are the shorter of the remaining lease term or the estimated life of the assets. 

Any  resulting  gains  or  losses  on  dispositions  of  property  and  equipment  are  included  as  a  component  of  other  income  (expense),  net,  within  the 
Company’s  statements  of  operations  and  comprehensive  loss.  Repair  and  maintenance  costs  that  do  not  significantly  add  value  to  the  property  and 
equipment, or prolong its life, are charged to operating expense as incurred.

Operating Leases

The  Company  accounts  for  its  leases  in  accordance  with  Financial  Accounting  Standards  Board  (“FASB”)  Accounting  Standards  Codification 
(“ASC”) 842, “Leases” (“ASC 842”). Right-of-use assets represent the Company’s right to use an underlying asset over the lease term and include any 
lease payments made prior to the lease commencement date and are reduced by lease incentives. Lease liabilities represent the present value of the total 
lease payments over the lease term, calculated using the Company’s incremental borrowing rate. In determining the Company’s incremental borrowing rate, 
consideration is given to the term of the lease and the Company’s credit risk. The Company recognizes options to extend a lease when it is reasonably 
certain  that  it  will  exercise  such  extension.  The  Company  does  not  recognize  options  to  terminate  a  lease  when  it  is  reasonably  certain  that  it  will  not 
exercise such early termination options. Lease expense is recognized on a straight-line basis over the expected lease term.

Accrued Research and Development Expense

Service agreements with contract development and manufacturing organizations (“CDMOs”), clinical contract research organizations (“CROs”) and 
clinical investigative sites comprise a significant component of the Company’s research and development activities. External costs for these vendors are 
recognized as the services are incurred. The Company accrues for expenses resulting from obligations under agreements with its third-parties for which the 
timing of payments does not match the periods over which the materials or services are provided to the Company. Accruals are recorded based on estimates 
of services received and efforts expended pursuant to agreements established with CDMOs, clinical CROs, clinical investigative sites and other outside 
service providers. These estimates are typically based on contracted amounts applied to the proportion of work performed and determined through analysis 
with internal personnel and external service providers as to the progress or stage of completion of the services. 

The Company makes judgements and estimates in determining the accrual balance in each reporting period. In the event advance payments are made 
to a CDMO, clinical CRO, clinical investigative site or other outside service provider, the payments are recorded within prepaid expenses and other current 
assets  and  subsequently  recognized  as  research  and  development  expense  when  the  associated  services  have  been  performed.  As  actual  costs  become 
known, 

108

 
the Company adjusts its liabilities and assets. Inputs, such as the extent of services received and the duration of services to be performed, may vary from 
the Company’s estimates, which will result in adjustments to research and development expense in future periods. Changes in these estimates that result in 
material changes to the Company’s accruals could materially affect the Company’s results of operations. The Company’s historical estimates have not been 
materially different from actual amounts recorded.

Research and Development Expense

Research  and  development  costs  are  expensed  as  incurred.  Research  and  development  costs  include,  among  others,  consulting  costs,  salaries, 
benefits, travel, stock-based compensation, laboratory supplies and other non-capital equipment utilized for in-house research, allocation of facilities and 
overhead  costs  and  external  costs  paid  to  third-parties  that  conduct  research  and  development  activities  on  the  Company’s  behalf.  Amounts  incurred  in 
connection with license agreements, including milestone payments, are also included in research and development expense.

Advance payments for goods or services to be rendered in the future for use in research and development activities are deferred and included in 

prepaid expenses and other current assets. The deferred amounts are expensed as the related goods are delivered or the services are performed. 

Segments 

Operating  segments  are  defined  as  components  of  an  entity  about  which  separate  discrete  information  is  available  for  evaluation  by  the  chief 
operating decision maker or decision-making group, in deciding how to allocate resources and in assessing performance. The Company’s chief operating 
decision maker, its Chief Executive Officer, views its operations and manages its business in one operating segment operating exclusively in the United 
States.

Patent Costs 

The Company expenses patent application and related legal costs as incurred and classifies such costs as general and administrative expenses in the 

statements of operations and comprehensive loss.

Stock-Based Compensation 

The Company accounts for its stock-based compensation in accordance with FASB ASC Topic 718, Compensation—Stock Compensation (“ASC 
718”). ASC 718 requires all stock-based awards issued to employees and nonemployees to be recognized as expense in the statements of operations and 
comprehensive loss based on their grant date fair values. Stock-based awards issued to nonemployee consultants are accounted for based on the fair value 
of  services  to  be  received  or  of  the  intrinsic  value  of  equity  instruments  to  be  issued,  whichever  is  more  reliably  measured.  The  measurement  date  for 
awards issued to nonemployee consultants is the date of grant.

For purposes of determining the estimated fair value of stock options granted to employees and nonemployees, the Company uses the Black-Scholes 
option  pricing  model.  The  Black-Scholes  option  pricing  model  requires  the  input  of  certain  assumptions  that  involve  judgment,  for  which  changes  can 
materially affect the resulting estimates of fair value. The assumptions used to determine the fair value of stock options granted were as follows: 

Expected volatility – As there is insufficient trading history for the Company’s common stock, the Company has based its computation of expected 
volatility on the historical volatility of a representative group of public companies with similar characteristics to the Company, including stage of 
product  development  and  life  science  industry  focus.  The  historical  volatility  is  calculated  based  on  a  period  of  time  commensurate  with  the 
expected term assumption. 

Expected  term  –  The  Company  determines  the  expected  term  in  accordance  with  the  “simplified  method”  described  by  SEC  Staff  Accounting 
Bulletin No. 107, Share-Based Payment, as it does not have sufficient historical exercise data to provide a reasonable basis upon which to estimate 
the expected term. 

Risk-free interest rate – The Company bases the risk-free interest rate on United States Treasury securities with terms consistent to the expected term 
of the stock option being valued. 

109

 
Expected dividends – The expected dividend yield is assumed to be zero as the Company has never paid dividends and has no current plans to pay 
any dividends on its common stock. 

The fair value of restricted stock units (“RSUs”) is determined using the quoted market price of the Company’s common stock on the date of grant. 

The Company uses historical data to estimate pre-vesting forfeitures and records stock-based compensation expense only for those awards expected 
to  vest.  To  the  extent  that  actual  forfeitures  differ  from  estimates,  the  difference  is  recorded  as  a  cumulative  adjustment  in  the  period  the  estimate  are 
revised. The Company expenses the fair value of its stock-based compensation awards to employees and nonemployees on a straight-line basis over the 
requisite service period, which is generally the vesting period.

The Company recognizes the stock-based compensation expense related to performance-based stock awards or performance-based RSUs ("PSUs") 
if the performance targets are deemed probable of being achieved. The vesting of PSUs requires that certain performance conditions are achieved during 
the performance period and is subject to the employee’s continued service requirements. 

Income Taxes

We account for income taxes under the asset and liability method. Current income tax expense or benefit represents the amount of income taxes we 
expect to pay or have refunded in the current year. Our deferred income tax assets and liabilities are determined based on differences between financial 
statement reporting and tax basis accounting of assets and liabilities and net operating loss and credit carryforwards, which we measure using the enacted 
tax  rates  and  laws  that  will  be  in  effect  when  such  items  are  expected  to  reverse.  We  reduce  deferred  income  tax  assets,  as  necessary,  by  applying  a 
valuation allowance to the extent that we determined it is more likely than not that some or all of our tax benefits will not be realized.

We  account  for  uncertain  tax  positions  in  accordance  with  ASC  740-10,  Accounting  for  Uncertainty  in  Income  Taxes.  We  assess  all  material 
positions reflected in our income tax returns, including all significant uncertain positions, for all tax years that are subject to assessment or challenge by 
relevant  taxing  authorities.  Upon  determining  the  sustainability  of  our  positions,  we  measure  the  largest  amount  of  benefit  possessing  greater  than  fifty 
percent  likelihood  of  being  realized  upon  ultimate  settlement.  We  reassess  such  positions  at  each  balance  sheet  date  to  determine  whether  any  factors 
underlying the sustainability assertion have changed and whether or not the amount of the recognized tax benefit is still appropriate.

Comprehensive Loss

Comprehensive loss is defined as the change in stockholders’ equity during a period from transactions and other events and circumstances from non-
owner sources. The difference between net loss and comprehensive loss for the years ended December 31, 2021, 2020 and 2019 are a result of unrealized 
gains and losses on the Company’s investments in marketable securities included in current assets on the balance sheets.

Net Loss per Share

The Company calculates basic net loss per share by dividing the net loss attributable to common stockholders by the weighted-average shares of 
common  stock  outstanding  during  the  period.  The  Company  calculates  diluted  net  loss  per  share  after  giving  consideration  to  all  potentially  dilutive 
securities outstanding during the period using the treasury-stock and if-converted methods, except where the effect of including such securities would be 
anti-dilutive. Because the Company has reported net losses since inception, the effect from potentially dilutive securities would have been anti-dilutive and 
therefore has been excluded from the calculation of diluted net loss per share.

110

 
Basic and diluted net loss per share was calculated as follows (in thousands, except per share data):

Numerator:
Net loss
Denominator:

Weighted-average shares of common stock
   outstanding, basic and diluted
Net loss per share, basic and diluted

Year Ended December 31,

2021

2020

2019

(269,860 )   $

(153,480 )

  $

(85,372 )

53,832    

(5.01 )   $

49,492  
(3.10 )

  $

45,191  
(1.89 )

  $

  $

The following table sets forth the potentially dilutive securities that have been excluded from the calculation of diluted net loss per share due to their 

anti-dilutive effect for the periods indicated (in thousands):

Options to purchase common stock
Unvested restricted stock units
Unvested performance stock unit
Shares issuable under employee stock purchase plans

Total

Foreign Currency Transactions 

2021

Year Ended December 31,
2020

2019

5,530    
1,506    
113    
118    
7,267    

6,616    
1,161    
—    
14    
7,791    

7,148  
542  
—  
31  
7,721  

The Company is party to multiple contract manufacturing and clinical research agreements for which services to be performed are denominated in 
foreign  currencies  other  than  the  United  States  Dollar.  The  Company  records  gains  and  losses  attributable  to  fluctuations  in  foreign  currencies  as  a 
component of other income (expense), net, on the statements of operations and comprehensive loss. 

Recently Issued and Adopted Accounting Pronouncements

The  Company  has  reviewed  recently  issued  accounting  pronouncements  and  concluded  they  are  either  not  applicable  to  the  business  or  that  no 

material effect is expected on the Financial Statements as a result of future adoption. 

3. Fair Value Measurements

The Company measures and reports certain financial instruments as assets and liabilities at fair value on a recurring basis. The Company’s financial 

assets measured at fair value on a recurring basis were as follows (in thousands):

Cash equivalents

Money market funds

Total cash equivalents
Short-term marketable securities

U.S. treasuries

Total short-term marketable securities

Total cash equivalents and short-term 
   marketable securities

Level 1

Level 2

Level 3

Total

December 31, 2021

  $

150,781     $
150,781  

271,416  
271,416  

—     $
—  

—  
—  

—     $
—  

—  
—  

  $

422,197     $

—     $

—     $

150,781  
150,781  

271,416  
271,416  

422,197  

111

 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
 
 
     
   
 
   
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
     
   
 
 
 
 
   
   
   
 
   
 
     
   
 
   
 
 
   
   
   
 
 
   
   
   
 
Cash equivalents

Money market funds

Total cash equivalents
Short-term marketable securities

U.S. treasuries

Total short-term marketable securities

Total cash equivalents and short-term
   marketable securities

Level 1

Level 2

Level 3

Total

December 31, 2020

  $

205,408     $
205,408  

451,820  
451,820  

—     $
—  

—  
—  

—     $
—  

—  
—  

  $

657,228     $

—     $

—     $

205,408  
205,408  

451,820  
451,820  

657,228  

The Company evaluates transfers between levels at the end of each reporting period. There were no transfers of assets or liabilities between levels 

during the years ended December 31, 2021 and 2020.

4. Marketable Securities

All marketable securities were considered available-for-sale at December 31, 2021 and 2020. The amortized cost, gross unrealized holding gains or 

losses, and fair value of the Company’s marketable securities by major security type are summarized in the table below (in thousands):

Available-for-sale securities

U.S. treasuries classified as investments

Total

Available-for-sale securities

U.S. treasuries classified as investments

Total

Amortized
Cost Basis

Unrealized
Gains

Unrealized
Losses

Fair
Value

December 31, 2021

  $
  $

  $
  $

271,570     $
271,570     $

2     $
2     $

(156 )   $
(156 )   $

271,416  
271,416  

Amortized
Cost Basis

Unrealized
Gains

Unrealized
Losses

Fair
Value

December 31, 2020

451,812     $
451,812     $

26     $
26     $

(18 )   $
(18 )   $

451,820  
451,820  

The amortized cost of available-for-sale securities is adjusted for amortization of premiums and accretion of discounts to maturity. As of December 
31, 2021 and 2020, the aggregate fair value of securities held by the Company in an unrealized loss position for less than twelve months was $241.4 million 
and $91.4 million, respectively. All of these securities had remaining maturities of less than one year. The Company has the intent and ability to hold such 
securities until recovery and has determined that there has been no material change to their credit risk. As a result, the Company determined it did not hold 
any investments with a credit loss at December 31, 2021 and 2020.

There were no material realized gains or losses recognized on the sale or maturity of available-for-sale securities during the years ended December 

31, 2021, 2020 and 2019, and as a result, there were no material reclassifications out of accumulated other comprehensive gain (loss) for the same periods.

112

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
 
 
   
   
   
 
   
 
     
   
 
   
 
 
   
   
   
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
 
5. Balance Sheet Components and Supplemental Disclosures

Property and Equipment, Net

Property and equipment, net, consisted of the following (in thousands):

Laboratory equipment
Furniture and office equipment
Leasehold improvements
Construction-in-progress

Less accumulated depreciation
Property and equipment, net

December 31,

2021

2020

4,676     $
1,947  
4,581  
37,704  
48,908  
(5,808 )
43,100     $

4,236  
1,784  
4,581  
1,325  
11,926  
(3,581 )
8,345  

  $

  $

Depreciation and amortization expense for the years ended December 31, 2021, 2020 and 2019 was $2.3 million, $1.5 million and $1.5  million, 
respectively. The increase in construction-in-progress assets in 2021 primarily relate to tenant improvements at the Company’s new corporate headquarters 
and is expected to be completed and put into service during the first quarter of 2022.

Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):

Accrued contract research and development expense
Accrued compensation and benefits expense
Current portion of operating lease liabilities
Other current liabilities

Total

6. Leases

Operating Leases 

December 31,

2021

2020

  $

  $

16,215  
3,172    
2,316    
4,854    
26,557  

  $

  $

4,697  
3,214  
492  
87  
8,490  

The Company’s lease obligations primarily relate to leased office and laboratory space under noncancelable operating leases. In accordance with 
ASC 842, the Company has performed an evaluation of its other contracts with vendors and has determined that, except for the leases described below, 
none of its other contracts contain a lease. 

2018 Redwood City Lease 

In January 2018,  the  Company  entered  into  an  operating  lease  agreement  for  approximately  25,000  square  feet  of  office  and  laboratory  space  in 
Redwood City, California (the “2018 Redwood City Lease”). The contractual term of the 2018 Redwood City Lease was 10.75 years beginning from the 
substantial completion and delivery of the premises, which occurred in November 2018, and originally terminating in July 2029. 

The 2018 Redwood City Lease includes monthly base rent amounts escalating over the term of the lease. In addition, the lessor provided for a tenant 
improvement  allowance  ("TIA")  up  to  $1.4  million,  which  was  fully  utilized.  The  TIA  was  recorded  as  leasehold  improvements,  with  offsetting 
adjustments recorded to the associated operating lease right of use asset included on the balance sheets as of December 31, 2021 and 2020. 

In November 2021, the Company entered into a lease termination agreement (the “Termination Agreement”) with respect to the 2018 Redwood City 
Lease. Pursuant to the Termination Agreement, the 2018 Redwood City Lease will be terminated effective April 30, 2022. The Company accounted for this 
change in lease term as a modification of the original lease. As a result of the modification, the operating right-of-use asset and lease liability were 

113

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
   
  
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
remeasured. As of December 31, 2021, the remaining lease liability of $0.6 million was recognized on the balance sheet. There is no remaining right-of-use 
asset as of December 31, 2021. The Company recognized $1.9 million as gain on lease modifications in the fourth quarter of 2021, which is included in 
other income (expense), net on the statements of operations and comprehensive loss.

In  connection  with  the  early  termination  and  upon  satisfaction  of  certain  conditions  including  the  delivery  of  certain  equipment  and  other  assets 

related to the building, the landlord agreed to pay to the Company $1.1 million. 

2019 San Carlos Lease 

In December 2019, the Company entered into an additional operating lease agreement for approximately 98,000 square feet of office and laboratory 
space in San Carlos, California (the “2019 San Carlos Lease”). The contractual term of the 2019 San Carlos Lease is 10.25 years from August 2021 until 
October 2031. The 2019 San Carlos Lease provides rent abatements and includes a one-time option to extend the lease term for five years. This option to 
extend  the  lease  term  was  not  determined  to  be  reasonably  certain  and  therefore  has  not  been  included  in  the  Company’s  calculation  of  the  associated 
operating lease liability under ASC 842.

The 2019 San Carlos Lease includes monthly base rent amounts escalating over the term of the lease. In addition, the lessor provided for a TIA of 

up to $14.7 million, which is expected to be fully utilized and are recorded in lease obligations.

The Company utilized its incremental borrowing rate to calculate the present value of the lease payments for the 2019 San Carlos Lease based on 
information available on November 1, 2020, the lease commencement date for accounting purposes, which was the date the Company was deemed to have 
obtained  control  of  the  premises.  Calculation  of  the  operating  lease  liability  also  included  estimated  future  TIA  reimbursements  that  had  not  yet  been 
received  as  of  the  lease  commencement  date.  TIA  reimbursements  received  subsequent  to  lease  commencement  date  are  recorded  as  reductions  to  the 
operating lease liability.

Classification of Operating Leases 

The 2018 Redwood City Lease and the 2019 San Carlos Lease required security deposits of $0.8 million and $1.5 million, respectively, which the 
Company satisfied by establishing letters of credit secured by restricted cash. Restricted cash related to the Company’s lease agreements are recorded in 
other long-term assets on the Company’s balance sheets.

Classification of the Company’s operating lease liabilities included in the Company’s balance sheets at December 31, 2021 and 2020 was as follows 

(in thousands):

Operating lease liabilities

Current portion included in accrued expenses and
   other current liabilities
Operating lease liabilities, net of current portion

Total operating lease liabilities

December 31,

2021

2020

  $

  $

2,316     $
49,099    
51,415     $

492  
42,773  
43,265  

The components of lease costs, which are included in operating expenses in the Company’s statements of operations and comprehensive loss were as 

follows (in thousands):

Operating lease costs
Variable costs

Total lease costs

Year ended December 31,

2021

2020

$

$

6,676  
1,663  
8,339  

  $

  $

2,087  
364  
2,451  

Variable costs included in the table above represent amounts the Company pays related to property taxes, insurance, maintenance and repair costs. 

114

 
 
 
 
 
 
 
 
 
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
Cash  paid  for  amounts  included  in  the  measurement  of  the  Company’s  operating  lease  liabilities  and  presented  within  cash  used  in  operating 

activities in the statements of cash flows was $1.7 million, $1.2 million and $0.5 million for the years ended December 31, 2021, 2020 and 2019.

Cash  received  for  amounts  related  to  tenant  improvement  allowances  from  lessors  was  $12.9  million,  $0.2  million  and  $0  million  for  the  years 

ended December 31, 2021, 2020 and 2019, respectively.

Operating Lease Obligations 

Future  lease  payments  required  under  operating  leases  included  on  the  Company’s  balance  sheet  at  December  31,  2021  are  as  follows  (in 

thousands):

Fiscal Year Ending December 31,
2022
2023
2024
2025
2026
Thereafter

Total future lease payments

Less:

Present value adjustment
Present value of future lease incentives

Operating lease liabilities

  $

  $

7,445  
7,061  
7,273  
7,492  
7,716  
40,677  
77,664  

25,276  
973  
51,415  

Operating  lease  liabilities  are  based  on  the  net  present  value  of  the  remaining  lease  payments  over  the  remaining  lease  term.  In  determining  the 
present value of lease payments, the Company used its incremental borrowing rate based on the information available at the lease commencement date. As 
of December 31, 2021, the weighted-average remaining lease term of the Company’s leases was 9.8 years and the weighted-average discount rate used to 
determine the operating lease liabilities included on the balance sheet was 8.5%.

As  of  December  31,  2021,  the  Company  has  not  been  party  to  any  lease  agreements  containing  material  residual  value  guarantees  or  material 

restrictive covenants.

7. Commitments and Contingencies

As  of  December  31,  2021,  the  Company  had  $284.8  million  noncancelable  purchase  commitments  under  various  master  service  agreements 

primarily relating to our contract development and manufacturing organizations (“CDMOs”). Refer to Note 12 “Subsequent Events” for additional details.

Additionally, we enter into contracts in the normal course of business with clinical contract research organizations (“CROs”), clinical investigative 
sites  and  other  counterparties  assisting  with  our  preclinical  studies  and  clinical  trials.  Such  contracts  are  generally  cancellable,  with  varying  provisions 
regarding  termination.  In  the  event  of  a  contract  being  terminated,  we  would  only  be  obligated  for  services  received  as  of  the  effective  date  of  the 
termination, along with cancellation fees, as applicable. 

In-Licensing Agreements

The Company has entered into exclusive and non-exclusive, royalty bearing license agreements with third-parties for certain intellectual property. 
Under the terms of the license agreements, the Company is obligated to pay milestone payments upon the achievement of specified clinical, regulatory and 
commercial milestones. Research and development expense associated with the Company’s milestone payments are recognized when such milestone has 
been  achieved.  Actual  amounts  due  under  the  license  agreements  will  vary  depending  on  factors  including,  but  not  limited  to,  the  number  of  products 
developed and the Company’s ability to further develop and commercialize the licensed products. The Company is also subject to future royalty payments 
based on sales of the licensed products. In-licensing payments to third-parties for milestones are recognized as research and development expense in the 
period of achievement.

115

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
The Company did not recognize any milestone expense for the years ended December 31, 2021 and 2019. The Company recognized $3.4 million of 
milestone expense for the year ended December 31, 2020 related to development milestones associated with the first patient dosed in the Company’s Phase 
3 study with lirentelimab. Milestone payments are not creditable against royalties. As of December 31, 2021, the Company has not incurred any royalty 
liabilities related to its license agreements, as product sales have not yet commenced.

Exclusive License Agreement with The Johns Hopkins University

In December 2013, the Company entered into a license agreement with The Johns Hopkins University (“JHU”) for a worldwide exclusive license to 
develop, use, manufacture and commercialize covered product candidates including lirentelimab, which was amended in September 30, 2016. Under the 
terms of the agreement, the Company has made upfront and milestone payments of $0.7 million through December 31, 2021 and may be required to make 
aggregate additional milestone payments of up to $1.8 million. The Company also issued 88,887 shares of common stock as consideration under the JHU 
license  agreement.  In  addition  to  milestone  payments,  the  Company  is  also  subject  to  single-digit  royalties  to  JHU  based  on  future  net  sales  of  each 
licensed  therapeutic  product  candidate  by  the  Company  and  its  affiliates  and  sublicensees,  with  up  to  a  low  six-digit  dollar  minimum  annual  royalty 
payment.

Non-exclusive License Agreement with BioWa Inc. and Lonza Sales AG

In  October  2013,  the  Company  entered  into  a  tripartite  agreement  with  BioWa  Inc.  (“BioWa”),  and  Lonza  Sales  AG  (“Lonza”),  for  the  non-
exclusive  worldwide  license  to  develop  and  commercialize  product  candidates  including  lirentelimab  that  are  manufactured  using  a  technology  jointly 
developed  and  owned  by  BioWa  and  Lonza.  Under  the  terms  of  the  agreement,  the  Company  has  made  milestone  payments  of  $3.4  million  through 
December 31, 2020 and may be required to make aggregate additional milestone payments of up to $38.0 million. In addition to milestone payments, the 
Company is also subject to minimum annual commercial license fees of $40,000 per year to BioWa until such time as BioWa receives royalty payments, as 
well as low single-digit royalties to BioWa and to Lonza. Royalties are based on future net sales by the Company and its affiliates and sublicensees.

Indemnification Agreements

The  Company  has  entered  into  indemnification  agreements  with  certain  directors  and  officers  that  require  the  Company,  among  other  things,  to 
indemnify them against certain liabilities that may arise by reason of their status or service as directors or officers. To date, no such matters have arisen and 
the  Company  does  not  believe  that  the  outcome  of  any  claims  under  indemnification  arrangements  will  have  a  material  adverse  effect  on  its  financial 
positions, results of operations or cash flows. Accordingly, the Company has not recorded a liability related to such indemnifications at December 31, 2021.

Legal Contingencies

On March 10, 2020, a putative securities class action complaint captioned Kim v. Allakos et al., No. 20-cv-01720 (N.D. Cal.) was filed in the United 
States District Court for the Northern District of California against the Company, its Chief Executive Officer, Dr. Robert Alexander, and its former Chief 
Financial Officer, Mr. Leo Redmond. The complaint asserts claims for violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and 
Rule 10b-5 promulgated thereunder and seeks damages based on alleged material misrepresentations and omissions concerning its Phase 2 clinical trials of 
lirentelimab.  The  proposed  class  period  is  August  5,  2019,  through  December  17,  2019,  inclusive.  On  August  28,  2020,  the  plaintiff  filed  an  amended 
complaint,  adding  as  defendants  Adam  Tomasi,  the  Company’s  President  and  Chief  Operating  Officer,  and  Henrik  Rasmussen,  the  Company’s  former 
Chief Medical Officer. Given the early stage of this litigation matter, the Company cannot reasonably estimate a potential future loss or a range of potential 
future losses, if any, and has not recorded a contingent liability accrual as of December 31, 2021.

8. Stockholders’ Equity

The Company’s amended and restated certificate of incorporation filed on July 23, 2018 authorizes the issuance of a total of 220,000,000 shares of 

stock. Of these shares, 200,000,000 are designated as common stock and 20,000,000 are designated as preferred stock.

116

 
Common Stock

There were 54,622,363 shares of common stock issued and outstanding at December 31, 2021. Common shares reserved for future issuance upon 

the exercise, issuance or conversion of the respective equity instruments are as follows (in thousands):

Exercise of common stock options outstanding
Shares reserved for issuance under equity incentive plans
Vesting of restricted stock units
Shares reserved for issuance under employee stock purchase plans

Total

December 31,

2021

2020

5,530    
7,154    
1,506    
1,766  
15,956    

6,616  
5,271  
1,161  
1,265  
14,313  

Common stockholders are entitled to dividends if and when declared by the Board of Directors subject to the prior rights of preferred stockholders. 

As of December 31, 2021, no dividends on common stock had been declared by the Board of Directors.

Preferred Stock

There were no shares of preferred stock issued and outstanding at December 31, 2021.

9. Stock-Based Compensation

Total stock-based compensation expense recognized is as follows (in thousands): 

Research and development
General and administrative

Total

2021

Year Ended December 31,
2020

2019

  $

  $

19,872  
30,970  
50,842  

  $

  $

11,583  
21,863  
33,446  

  $

  $

5,351  
10,413  
15,764  

No income tax benefits for stock-based compensation expense have been recognized for the years ended December 31, 2021, 2020 and 2019 as a 

result of the Company’s full valuation allowance applied to net deferred tax assets and net operating loss carryforwards. 

Equity Incentive Plans 

In July 2018, the Board of Directors adopted the 2018 Equity Incentive Plan (the “2018 Plan”). The 2018 Plan provides for the grant of incentive 
stock options, non-statutory stock options, restricted stock awards, restricted stock units (“RSUs”), stock appreciation rights, performance-based awards 
("PSUs") and other stock-based awards. The number of shares of common stock that may be issued under the 2018 Plan will automatically increase on 
each January 1, beginning with the fiscal year ending December 31, 2019, equal to the least of (i) 5,000,000 shares, (ii) 5% of the outstanding shares of 
common stock as of the last day of the preceding fiscal year and (iii) such other amount as the Board of Directors may determine. Stock options and RSUs 
granted under the 2018 Plan generally vest over four years and expire no more than 10 years from the date of grant.

Following  the  IPO  and  upon  the  effectiveness  of  the  2018  Plan,  the  Company’s  2012  Equity  Incentive  Plan,  as  amended,  (the  “2012  Plan”), 
terminated and no further awards will be granted thereunder. All outstanding awards under the 2012 Plan will continue to be governed by their existing 
terms.  Any  shares  subject  to  awards  granted  under  the  2012  Plan  that,  on  or  after  the  termination  of  the  2012  Plan,  expire  or  terminate  and  shares 
previously issued pursuant to awards granted under the 2012 Plan that, on or after the termination of the 2012 Plan, are forfeited or repurchased by the 
Company will be transferred into the 2018 Plan. As of December 31, 2021, the maximum number of shares that may be added to the 2018 Plan pursuant to 
the preceding clause is 3,587,158 shares.

117

 
 
 
 
 
 
 
 
 
 
   
 
   
 
   
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
Prior to its termination, the 2012 Plan provided for the grant of stock options, stock appreciation rights, restricted stock and restricted stock units to 
employees, directors and consultants. Stock options granted under the 2012 Plan generally vest over four years and expire no more than 10 years from the 
date of grant.

As of December 31, 2021, the number of shares available for issuance under the 2018 Plan was 7,040,500.

Stock Options

Stock option activity under the 2018 Plan and the 2012 Plan during the year ended December 31, 2021 is summarized as follows (in thousands, 

except per share data): 

Balance at December 31, 2020

Authorized
Granted
Exercised
Forfeited

Balance at December 31, 2021
Options exercisable
Options vested and expected to vest

Options
Outstanding

Weighted-
Average
Exercise
Price

Weighted-
Average
Remaining
Years

6,616     $
—    
375     $
(1,228 )   $
(233 )   $
5,530     $
4,625     $
5,514     $

15.53    

94.89    
6.92    
46.54    
21.51    
13.12    
21.34    

Aggregate
Intrinsic
Value

7.1     $

823,532  

6.3     $
5.9     $
6.3     $

25,750  
25,251  
25,749  

The following weighted-average assumptions were used to calculate the fair value of stock options granted during the periods indicated:

Risk-free interest rate
Expected volatility
Expected dividend yield
Expected term (in years)

2021

Year Ended December 31,
2020

2019

1.01 %    
70.40 %    
—  
6.00  

0.50 %    
70.78 %    
—  
5.95  

1.91 %
67.22 %
—  
6.01  

The weighted-average fair value of options granted during the years ended December 31, 2021, 2020 and 2019 was $59.00, $51.59 and $28.66 per 

share, respectively.

The aggregate fair value of stock options that vested during the years ended December 31, 2021, 2020 and 2019 was $17.1 million, $18.0 million 

and $12.6 million, respectively.

The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the 
Company’s common stock for those stock options that had exercise prices lower than the fair value of the Company’s common stock. Following the IPO, 
the aggregate intrinsic value represents the value of the Company’s closing stock price on the last trading day of the year in excess of the weighted-average 
exercise price multiplied by the number of options outstanding or exercisable. The aggregate intrinsic value of stock options exercised during the years 
ended December 31, 2021, 2020 and 2019 was $109.2 million, $62.2 million and $55.8 million, respectively.

As of December 31, 2021, total unrecognized stock-based compensation expense relating to unvested stock options was $30.6 million. This amount 

is expected to be recognized over a weighted-average period of 2.6 years. 

Restricted Stock Awards

The 2012 Plan allows for the issuance of restricted common stock and early exercise of unvested stock options in exchange for restricted common 
stock. Unvested shares of restricted common stock are subject to repurchase by the Company at the original issuance price in the event of the employee’s 
termination, either voluntarily or involuntarily. Consideration received for unvested stock-based awards is initially recorded as a liability and subsequently 
reclassified into stockholders’ deficit as the related awards vest. 

118

 
 
 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
   
 
 
 
 
 
 
     
 
   
   
   
 
   
   
   
 
   
   
   
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
 
There were no unvested shares of restricted common stock at December 31, 2021 and 2020. The fair value of restricted common stock that vested 

during the years ended December 31, 2021, 2020 and 2019 was $0, $0 and $20,000, respectively.

Time-based Restricted Stock Units

Each time-based restricted stock unit (“RSU”) represents one equivalent share of our common stock to be awarded after satisfying the applicable 
continued service-based vesting criteria over a specified period. The fair value for these RSUs is based on the closing price of our common stock on the 
date of grant. The RSUs do not entitle participants to the rights of holders of common stock, such as voting rights, until the shares are issued. RSUs that are 
expected to vest are net of estimated future forfeitures.

RSU activity under the 2018 Plan is summarized as follows (in thousands, except per share data): 

Balance at December 31, 2020

Granted
Vested
Forfeited

Balance at December 31, 2021

Number
of Shares

Weighted-
Average
Grant Date
Fair Value

1,161     $
833     $
(285 )   $
(203 )   $
1,506     $

102.24  
84.80  
100.11  
101.12  
93.14  

The  weighted-average  fair  value  of  RSUs  granted  during  the  year  ended  December  31,  2021,  2020  and  2019  was  $84.80, $106.56  and  $93.67, 

respectively. 

As of December 31, 2021, total unrecognized stock-based compensation expense relating to unvested RSUs was $130.0 million and the weighted-

average remaining vesting period was 3.2 years.

The aggregate intrinsic value of RSUs is calculated as the closing price per share of the Company’s common stock on the last trading day of the 
fiscal period, multiplied by the number of RSUs expected to vest as of December 31, 2021. As of December 31, 2021, the aggregate intrinsic value of 
RSUs was $14.7 million.

Performance-based Restricted Stock Units

During the year ended December 31, 2021, the Compensation Committee of the Board of Directors approved awards of restricted stock units with 
performance-based vesting (“PSUs”) from the 2018 Plan to certain executive officers. Each PSU represents one equivalent share of our common stock to 
be awarded upon vesting at the end of the performance periods, if specific performance goals set by the Compensation Committee of the Board of Directors 
are achieved. No PSUs will vest if the performance goals are not met. The fair value of these PSUs is based on the closing price of our common stock on 
the  date  of  grant.  The  Company  assesses  the  probability  of  achieving  the  performance  goals  on  a  quarterly  basis.  Changes  in  our  assessment  of  the 
probability  results  in  adjustments  to  stock-based  compensation,  which  may  include  either  a  cumulative  catch-up  of  expense  or  a  reduction  of  expense 
depending on whether the likelihood of vesting has increased or decreased, that is recognized in the period such determination is made. The PSUs do not 
entitle participants to the rights of holders of common stock, such as voting rights, until the shares are issued. PSUs that are expected to vest are net of 
estimated future forfeitures.

The following table summarizes the PSUs activity for the year ended December 31, 2021 (in thousands, except per share data):

Balance at December 31, 2020

Granted

Balance at December 31, 2021

119

Number
of Shares

Weighted-
Average
Grant Date
Fair Value

—     $
113     $
113     $

—  
79.60  
76.60  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  The  Company  did  not  grant  any  stock  options  or  awards  with  performance-based  or  market-based  vesting  conditions  during  the  years  ended 
December 31, 2020 and 2019. As of December 31, 2021, the vesting of the PSUs was not deemed probable. Accordingly, no stock-based compensation 
expense  related  to  these  awards  has  been  recognized  during  the  year  ended  December  31,  2021.  As  of  December  31,  2021,  total  unrecognized 
compensation expense relating to PSUs was $9.0 million over a weighted-average period of 2.2 years and the aggregate intrinsic value of PSUs was $1.1 
million.

Employee Stock Purchase Plan

In  July  2018,  the  Company’s  Board  of  Directors  and  stockholders  approved  the  2018  Employee  Stock  Purchase  Plan  (the  “2018  ESPP”).  The 
number of shares of common stock that may be issued under the 2018 ESPP shall automatically increase on each January 1, beginning with the fiscal year 
ending  December  31,  2019,  equal  to  the  least  of  (i)  1,000,000  shares,  (ii)  1%  of  the  outstanding  shares  of  common  stock  as  of  the  last  day  of  the 
immediately preceding fiscal year and (iii) such other amount determined by the 2018 ESPP administrator. As of December 31, 2021, the number of shares 
available for issuance under the 2018 ESPP was 1,765,958.

Under the 2018 ESPP, employees may purchase shares of the Company’s common stock at a price per share equal to 85% of the lower of the fair 
market  value  of  the  common  stock  on  the  first  trading  day  of  the  offering  period  or  on  the  exercise  date.  The  2018  ESPP  provides  for  consecutive, 
overlapping 24-month offering periods, each of which will include purchase periods. The first offering period commenced on July 18, 2018. 

During the year ended December 31, 2021, 2020 and 2019, stock-based compensation related to the 2018 ESPP was $1.2 million, $0.9 million and 

$0.7 million, respectively.

The following weighted-average assumptions were used to calculate the fair value of ESPP shares during the periods indicated: 

Risk-free interest rate
Expected volatility
Expected dividend yield
Expected term (in years)

2021

Year Ended December 31,
2020

2019

0.11 %  
68.40 %  
—  
1.20  

0.58 %    
61.80 %    
—  
1.20  

2.37 %
64.26 %
—  
1.22  

As of December 31, 2021, total unrecognized compensation expense relating to shares to be purchased under the 2018 ESPP was $1.5 million over a 

weighted-average period of 1.3 years. 

10. Income Taxes 

The Company’s deferred income tax assets include operating losses and tax credit carryforwards, as well as certain temporary differences between 

the carrying amounts of assets and liabilities for financial reporting purposes 

120

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
and the  amounts  used  for  income  tax  purposes.  Total  deferred  income  tax  assets,  net  of  valuation  allowance,  at  December  31,  2021  and  2020  were  as 
follows (in thousands):

Deferred tax assets

Net operating loss carryforwards
Research and development credits
Accruals and reserves
Stock-based compensation
Lease liability

Gross deferred tax assets

Less: valuation allowance
Deferred tax assets, net of valuation allowance
Deferred tax liabilities

Fixed and intangible assets
Right-of-use asset

Gross deferred tax liabilities

Net deferred tax assets

December 31,

2021

2020

157,277     $
33,341    
3,889    
4,932    
10,854    
210,293  
(203,516 )  
6,777    

84  
6,693  
6,777  

—     $

87,124  
18,139  
1,368  
5,661  
9,151  
121,443  
(112,680 )
8,763  

360  
8,403  
8,763  
—  

  $

  $

Management has evaluated the positive and negative evidence surrounding the realizability of its deferred tax assets and has determined that it is 
more likely than not that the Company will not recognize the benefits of its federal and state deferred tax assets, and as a result, a valuation allowance of 
$203.5 million and $112.7 million has been established at December 31, 2021 and 2020, respectively. The change in the valuation allowance was $90.8 
million and $52.8 million for the years ended December 31, 2021 and 2020, respectively. The Company has incurred net operating losses (“NOL”) since 
inception. As of December 31, 2021, the Company had federal and state NOL carryforwards of $715.5 million and $95.1 million, respectively. Federal 
NOL  carryforwards  of  $653.6  million,  which  were  generated  after  December  31,  2017,  do  not  expire.  The  remaining  $61.9  million  of  Federal  NOL 
carryforwards expire beginning in 2032. As of December 31, 2021, the Company had federal and California research and other tax credit carryforwards of 
$38.4 million and $8.0 million, respectively. The federal tax credits expire beginning in 2033. The California tax credits can be carried forward indefinitely.

The  Internal  Revenue  Code  of  1986,  as  amended  (the  “Code”),  provides  for  a  limitation  of  the  annual  use  of  net  operating  losses  and  other  tax 
attributes  (such  as  research  and  development  tax  credit  carryforwards)  following  certain  ownership  changes  defined  by  the  Code  that  could  limit  the 
Company’s ability to utilize these carryforwards in the future. The Company may have experienced or may in the future experience ownership changes, as 
defined by the Code and may not be able to take full advantage of these carryforwards for federal or state income tax purposes.

The effective tax rate for the years ended December 31, 2021 and 2020 is different from the federal statutory rate primarily due to the valuation 
allowance  against  deferred  tax  assets  as  a  result  of  insufficient  income.  The  Company’s  effective  tax  rate  differs  from  the  federal  statutory  tax  rate  as 
follows:

Federal statutory tax rate
Change in deferred tax asset valuation allowance
State taxes, net of federal benefit
Research and development tax credits
Stock-based compensation
Other
Effective tax rate

121

Year Ended December 31,

2021

2020

21.0 %  
(33.7 )%  
1.9 %  
5.2 %  
6.9 %  
(1.3 )%  
— %  

21.0 %
(34.4 )%
0.8 %
5.6 %
6.9 %
0.1 %
— %

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
     
   
 
 
   
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Uncertain Tax Positions

The Company accounts for its uncertain tax positions in accordance with FASB ASC Topic No. 740-10, Accounting for Uncertainty in Income Taxes 
(“ASC 740-10”). Per ASC 740-10, the Company determines its uncertain tax positions based on a determination of whether and how much of a tax benefit 
taken by the Company in its tax filings is more likely than not to be sustained upon examination by the relevant income tax authorities.

A reconciliation of the beginning and ending amount of unrecognized benefits is as follows (in thousands):

Balance at the beginning of the year

Increase related to current year tax positions
Increase related to prior year tax positions

Balance at the end of the year

Year Ended December 31,

2021

2020

  $

  $

6,932     $
5,345  
(324 )  
11,953     $

3,545  
3,387  
—  
6,932  

The  entire  amount  of  the  unrecognized  tax  benefits  would  not  impact  the  Company’s  effective  tax  rate  if  recognized.  During  the  years  ended 
December 31, 2021 and 2020, the Company did not recognize accrued interest and penalties related to unrecognized tax benefits. The Company does not 
anticipate that the amount of existing unrecognized tax benefits will significantly increase or decrease during the next twelve months.

The  Company  files  income  tax  returns  in  the  U.S.  federal  and  multiple  state  tax  jurisdictions.  The  federal  and  state  income  tax  returns  from 

inception to December 31, 2021 remain subject to examination.

During the third quarter of 2020, the U.S. Internal Revenue Service (“IRS”) commenced an examination of the Company’s federal corporate income 
tax return for the year ended December 31, 2018. The Company believes that it has adequately provided for any adjustments that may result from the IRS 
examination, however, the outcome of tax examinations cannot be predicted with certainty. The examination was not yet completed as of December 31, 
2021.

It is the Company’s policy to include penalties and interest expense related to income taxes as a component of the income tax provision as necessary. 
Management  determined  that  no  accrual  for  interest  and  penalties  was  required  at  December  31,  2021  and  2020.  Since  the  Company  is  in  a  loss 
carryforward  position,  it  is  generally  subject  to  examination  by  the  U.S.  federal,  state  and  local  income  tax  authorities  for  all  tax  years  in  which  a  loss 
carryforward is available.

11. Defined Contribution Plans

In January 2018, the Company established a defined contribution plan under Section 401(k) of the Internal Revenue Code (the “401(k) plan”). The 
401(k) plan covers all employees who meet defined minimum age and service requirements. Employee contributions are voluntary and are determined on 
an individual basis, limited to the maximum amount allowable under U.S. federal tax regulations. The Company makes matching contributions of up to 4% 
of the eligible employees’ compensation to the 401(k) plan. During the years ended December 31, 2021, 2020 and 2019, the Company made contributions 
to the 401(k) plan of $0.7 million, $0.7 million and $0.5 million, respectively.

12. Subsequent Events

In February 2022, we began implementing a reorganization plan to reduce operating costs, contractual commitments and better align our workforce 

with the clinical development plans of our business (the "Reorganization Plan").

Vendor Termination Agreement

Approximately $231.2 million of the $284.8 million total noncancellable purchase obligations as of December 31, related to various manufacturing 
services agreements with Lonza AG or affiliates (such agreements, the “MSAs”) On February 14, 2022 (the “Effective Date”), the Company entered into a 
termination agreement (the “Termination 

122

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
Agreement”) with Lonza AG, Lonza Sales Ltd and Lonza Sales AG (collectively, “Lonza”) regarding all outstanding manufacturing service agreements. 
Lonza  will  continue  to  provide  certain  services  to  us,  including  completion  of  cGMP  batches  already  underway  and  other  services  to  assist  with  the 
transition post-termination. The Termination Agreement provides that the Company shall pay approximately $136.1 million (126 million Swiss Francs) (the 
“Termination Amount”) to Lonza as a result of such termination, 95% of which is to be paid within 30 days after the Effective Date, and 5% of which is be 
paid within 30 days of the release of the remaining cGMP batches. If the Company fails to pay the first 95% of the Termination Amount to Lonza within 30 
days of the Effective Date, Lonza may at its option give notice to the Company that the Termination Agreement is terminated. The Termination Agreement 
contains mutual releases by all parties thereto, for all claims known and unknown, relating and arising out of, or connected with, the MSAs and the subject 
matter(s) thereof, subject to certain exceptions.

In addition, Lonza held or had placed orders for raw materials to be used in the course of services Lonza was to provide to the Company. Pursuant to 
the  Termination  Agreement,  the  cost  of  such  raw  materials  is  included  in  the  Termination  Amount.  Although  the  Company  will  hold  title  to  such  raw 
materials and may repurpose where possible, the recoverable value, if any, is currently not estimable. 

As the agreement was terminated on February 14, 2022, there was no impact of the termination agreement to the financial statements for the year 
ended December 31, 2021. The Company is still evaluating the impact of the termination agreement to our 2022 financial statements including the total 
amount and value, if any, of raw materials and its ability to utilize or repurpose such materials and the total value of services remaining to be rendered. 
However, the Company expects that the termination will result in a charge to our financial statements in amounts totaling up to $137 million during 2022.

Employment Related Subsequent Events

Under  the  plan,  the  Company  is  reducing  its  workforce  by  approximately  35%.  Impacted  employees  received  notice  that  their  positions  will  be 
eliminated on February 16, 2022. At the time of departure from the Company, impacted employees are eligible to receive severance benefits and Company 
funded COBRA premiums, contingent upon an impacted employee’s execution (and non-revocation) of a customary separation agreement, which includes 
a general release of claims against the Company.

In connection with the Reorganization Plan, the Company estimates that it will incur aggregate restructuring charges of approximately $5.3 million, 
which will be recognized primarily in the first quarter of 2022, related to severance payments and other employee-related separation costs. The Company 
may  also  incur  additional  costs  not  currently  contemplated  due  to  events  that  may  occur  as  a  result  of,  or  that  are  associated  with,  the  reduction  in 
workforce.

In addition, the Board determined that it is in the best interests of the Company and its stockholder to put in place arrangements designed to provide 
that the Company will have the continued dedication and commitment of those employees, including executives, determined to be key to the planned go-
forward operations. The Board approved, and management has implemented a retention program for employees staying with the company and includes 
cash retention bonuses totaling approximately $3 million for certain retained employees and grants of RSUs totaling 8.2 million awards in aggregate to all 
employees. Half of these RSUs are time-based RSUs with four-year vesting and half are performance-based with full vesting in the event that the Company 
achieves all primary endpoints in any of its Phase 2/3 clinical studies other than the Phase 3 Eosinophilic Duodenitis study expected to readout data in Q3 
2022.

Item 9. Changes in and Disagreements With Accountants on Accounting and Financial Disclosure.

None. 

123

 
  
Item 9A. Controls and Procedures. 

Evaluation of Disclosure Controls and Procedures

Our  management,  with  the  participation  of  our  Chief  Executive  Officer  and  our  President,  Chief  Operating  Officer  and  Chief  Financial  Officer, 
evaluated the effectiveness of our disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) of the Exchange Act. Disclosure controls 
and  procedures  include,  without  limitation,  controls  and  procedures  designed  to  ensure  that  information  required  to  be  disclosed  by  a  company  in  the 
reports that it files or submits under the Exchange Act is accumulated and communicated to management, including our principal executive and principal 
financial  officers,  as  appropriate  to  allow  timely  decisions  regarding  required  disclosure.  Based  on  this  evaluation,  our  Chief  Executive  Officer  and 
President,  Chief  Operating  Officer  and  Chief  Financial  Officer  concluded  that  the  design  and  operation  of  our  disclosure  controls  and  procedures  were 
effective at the reasonable assurance level as of December 31, 2021.

Management’s Annual Report on Internal Control over Financial Reporting

Our  management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over  financial  reporting,  as  such  term  is  defined  in 
Exchange  Act  Rules  13a-15(f)  and  15d-15(f).  Internal  control  over  financial  reporting  includes  those  policies  and  procedures  that  (i)  pertain  to  the 
maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and  dispositions  of  our  assets;  (ii)  provide  reasonable 
assurance that transactions are recorded as necessary to permit preparation of the financial statements in accordance with generally accepted accounting 
principles, and that receipts and expenditures are being made only in accordance with authorizations of our management and directors; and (iii) provide 
reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of our assets that could have a material effect 
on the financial statements.

Our  management,  with  the  participation  of  our  principal  executive  officer  and  principal  financial  officer,  conducted  an  evaluation  of  the 
effectiveness of our internal control over financial reporting based on criteria established in the Internal Control–Integrated Framework (2013) issued by 
the Committee of Sponsoring Organizations of the Treadway Commission. Based on this evaluation, our management concluded that our internal controls 
over financial reporting were effective as of December 31, 2021.

The  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December  31,  2021  has  also  been  audited  by  Ernst  &  Young  LLP,  an 

independent registered public accounting firm, as stated in its report included in this Annual Report on Form 10-K.

Inherent Limitations on the Effectiveness of Internal Control

Management  recognizes  that  any  controls  and  procedures,  no  matter  how  well  designed  and  operated,  can  provide  only  reasonable  assurance  of 

achieving their objectives, and management necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and procedures.

Changes in Internal Control over Financial Reporting

There was no change in our internal control over financial reporting identified in connection with the evaluation required by Rule 13a-15(d) and 
15d-15(d) of the Exchange Act that occurred during the fourth quarter of the year ended December 31, 2021 that has materially affected, or is reasonably 
likely to materially affect, our internal control over financial reporting.

124

 
 
Report of Independent Registered Public Accounting Firm

To the Stockholders and the Board of Directors of Allakos Inc.

Opinion on Internal Control Over Financial Reporting

We  have  audited  Allakos  Inc.  ‘s  internal  control  over  financial  reporting  as  of  December  31,  2021,  based  on  criteria  established  in  Internal  Control—
Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) (the COSO criteria). In our 
opinion, Allakos Inc. maintained, in all material respects, effective internal control over financial reporting as of December 31, 2021, based on the COSO 
criteria. 

We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States)  (“PCAOB”),  the  balance 
sheets of the Company as of December 31, 2021 and 2020, the related statements of operations and comprehensive loss, statements of stockholders' equity 
and cash flows for each of the three years in the period ended December 31, 2021, and the related notes and our report dated March 1, 2022 expressed an 
unqualified opinion thereon. 

Basis for Opinion

The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of 
internal control over financial reporting included in the accompanying Management's Annual Report on Internal Control Over Financial Reporting. Our 
responsibility  is  to  express  an  opinion  on  the  Company’s  internal  control  over  financial  reporting  based  on  our  audit.  We  are  a  public  accounting  firm 
registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the 
applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. 

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable 
assurance about whether effective internal control over financial reporting was maintained in all material respects. 

Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, testing and 
evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered 
necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. 

Definition and Limitations of Internal Control Over Financial Reporting

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting 
and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control 
over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly 
reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit 
preparation  of  financial  statements  in  accordance  with  generally  accepted  accounting  principles,  and  that  receipts  and  expenditures  of  the  company  are 
being  made  only  in  accordance  with  authorizations  of  management  and  directors  of  the  company;  and  (3)  provide  reasonable  assurance  regarding 
prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial 
statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of 
effectiveness  to  future  periods  are  subject  to  the  risk  that  controls  may  become  inadequate  because  of  changes  in  conditions,  or  that  the  degree  of 
compliance with the policies or procedures may deteriorate.

/s/ Ernst & Young LLP

Redwood City, California
March 1, 2022

125

 
 
 
Item 9B. Other Information. 

This disclosure set forth below is provided in lieu of a separate Form 8-K filing pursuant to Item 1.02 of Form 8-K.

The Sales Agreement, dated May 10, 2021, between the Company and Cowen and Company, LLC was terminated effective February 24, 2022.

The disclosure set forth below is provided in lieu of a separate Form 8-K filing pursuant to Item 5.02 of Form 8-K.

On  February  25,  2022,  the  Board  of  Directors  (the  “Board”)  of  Allakos  Inc.  (“Allakos”  or  the  “Company”)  approved  a  grant  of  (1)  1,058,646 
restricted  stock  units  (“RSUs”)  to  Dr.  Robert  Alexander,  our  Chief  Executive  Officer,  (2)  475,216  RSUs  to  H.  Baird  Radford,  III,  our  Chief  Financial 
Officer, (3) 688,120 RSUs to Dr. Adam Tomasi, our President and Chief Operating Officer, and (4) 280,980 RSUs to Mark Asbury, our Chief Legal Officer 
and General Counsel, effective as of February 25, 2022 (the “Grant Date”). Each individual’s RSU grant vests as follows:

•

•

50% of such individual’s RSUs are subject to time-based vesting, with 25% of these time-based RSUs vesting on March 1, 2023, and the 
remainder vesting in 12 equal installments on each three-month anniversary of the Grant Date thereafter; and 

50% of such individual’s RSUs are subject to performance-based vesting, with all of these performance-based RSUs vesting upon the first 
completion of any of the Company’s Phase 2 or Phase 3 studies of lirentelimab (other than the Company’s eosinophilic duodenitis-only study, 
which was commenced in 2021), provided that the study meets its primary endpoints.

Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.

Not applicable.

126

 
PART III

Item 10. Directors, Executive Officers and Corporate Governance. 

The information required under this item is incorporated herein by reference to our definitive proxy statement pursuant to regulation 14A, or the 
Proxy Statement, which proxy statement is expected to be filed with Securities and Exchange Commission not later than 120 days after the close of our 
fiscal year ended December 31, 2021.

Item 11. Executive Compensation. 

The information required by this item will be set forth in the Proxy Statement and is incorporated herein by reference.

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

The information required by this item will be set forth in the Proxy Statement and is incorporated herein by reference.

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

The information required by this item will be set forth in the Proxy Statement and is incorporated herein by reference.

Item 14. Principal Accounting Fees and Services. 

The information required by this item will be set forth in the Proxy Statement and is incorporated herein by reference.

127

 
Item 15. Exhibits, Financial Statement Schedules. 

(a)

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

(1)

Financial Statements 

PART IV

See Index to Financial Statements included in Part II Item 8 of this Annual Report on Form 10-K

(2)

Financial Statement Schedules

All schedules are omitted because they are not applicable or the required information is shown in the financial statements or notes thereto.

(3)

List of Exhibits required by Item 601 of Regulation S-K

Exhibit
Number

Description

3.1

3.2

4.1

4.2

4.3

10.1+

10.2+

10.3+

10.4+

10.5+

10.6+

10.7+

10.8+

  Amended and Restated Certificate of Incorporation of the 

Registrant.

   Amended and Restated Bylaws of the Registrant.
  Amended and Restated Investors’ Rights Agreement among the 
Registrant and certain of its stockholders, dated November 30, 
2017.

  Specimen common stock certificate of the Registrant.
  Description of Securities Registered Pursuant to Section 12 of 

the Securities Exchange Act of 1934.

  Form of Indemnification Agreement between the Registrant and 

each of its directors and executive officers.

  2012 Equity Incentive Plan, as amended, and forms of 

agreement thereunder. 

  2018 Equity Incentive Plan and forms of agreements thereunder.  
  2018 Employee Stock Purchase Plan.
  Employment Letter between the Registrant and Robert 

Alexander, Ph.D.

  Employment Letter between the Registrant and Adam Tomasi, 

Ph.D.

  Employment Letter between the Registrant and Henrik 

Rasmussen, M.D., Ph.D.

  Employment Letter between the Registrant and Harlan Baird 

Radford, III.

10.9+

10.10+

10.11+

  Executive Incentive Compensation Plan.
  Outside Director Compensation Policy.
  Amended and Restated Outside Director Compensation Policy.

128

Incorporated by Reference

File No.

  Number

Filing Date

Filed 
Herewith

Form  

8-K  

001-38582

8-K  
S-1/A  

001-38582

333-225836

  S-1/A  

333-225836

3.1

3.2

4.1

4.2

7/24/2018

7/24/2018

6/22/2018

7/09/2018

X

S-1

S-1

333-225836

10.1+

6/22/2018

333-225836

10.2+

6/22/2018

S-1/A  
S-1/A  
S-1/A  

333-225836

333-225836

333-225836

10.3+

10.4

10.5+

7/09/2018

7/09/2018

7/09/2018

S-1/A  

333-225836

10.6+

7/09/2018

S-1/A  

333-225836

10.7+

7/09/2018

10-Q  

S-1
S-1/A  
10-Q  

10.1

5/10/2021

333-225836

333-225836

10.9+
  10.10+  

10.2+

6/22/2018

7/09/2018

5/11/2020

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.12+

10.13

10.14

10.15#

10.16#

10.17#

10.18#

10.19#

10.20

10.21

23.1

31.1

31.2

32.1*

32.2*

  Change in Control and Severance Policy.
  Lease Agreement between the Registrant and Westport Office 

Park, LLC, dated January 4, 2018, as amended.

  Lease Agreement between the Registrant and ARE-San 

Francisco No. 63, LLC, dated December 4, 2019.

  Non-exclusive License Agreement between the Registrant, 
BioWa, Inc. and Lonza Sales AG, dated October 31, 2013.

  Amended and Restated Exclusive License Agreement between 

the Registrant and the Johns Hopkins University, dated 
September 30, 2016.

  Commercial Supply Agreement between the Registrant and 

Lonza Sales AG, dated April 7, 2020.

  Commercial Supply Agreement between the Registrant and 

Lonza Sales AG, dated December 18, 2020.

  Termination Agreement between the Registrant and Lonza AG 

and affiliates thereof, dated February 14, 2022.

  Sales Agreement between the Registrant and Cowen and 

Company, LLC, dated May 10, 2021.

  Notice of Termination of Sales Agreement between the 

Registrant and Cowen and Company, LLC, dated February 24, 
2022.

  Consent of Independent Registered Public Accounting Firm.

   Certification of Principal Executive Officer Pursuant to Rules 
13a-14(a) and 15d-14(a) under the Securities Exchange Act of 
1934, as Adopted Pursuant to Section 302 of the Sarbanes-
Oxley Act of 2002.

   Certification of Principal Financial Officer Pursuant to Rules 

13a-14(a) and 15d-14(a) under the Securities Exchange Act of 
1934, as Adopted Pursuant to Section 302 of the Sarbanes-
Oxley Act of 2002.

   Certification of Principal Executive Officer Pursuant to 18 

U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the 
Sarbanes-Oxley Act of 2002.

   Certification of Principal Financial Officer Pursuant to 18 

U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the 
Sarbanes-Oxley Act of 2002.

129

S-1/A  

333-225836

10.11+  

7/09/2018

S-1

333-225836

10.12

6/22/2018

10-K  

10.13

2/25/2020

S-1/A  

333-225836

10.14#

7/17/2018

S-1/A  

333-225836

10.15#

7/17/2018

10-Q  

10-K  

10.1#

5/11/2020

10.19#

3/1/2021

8-K  

1.1

5/10/2021

X

X

X

X

X

X

X

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
101.INS

  Inline XBRL Instance Document - the instance document does 
not appear in the Interactive Data File because its XBRL tags 
are embedded within the Inline XBRL document.

101.SCH

  Inline XBRL Taxonomy Extension Schema Document

101.CAL

101.DEF

  Inline XBRL Taxonomy Extension Calculation Linkbase 

Document

  Inline XBRL Taxonomy Extension Definition Linkbase 

Document

101.LAB

  Inline XBRL Taxonomy Extension Label Linkbase Document

101.PRE

  Inline XBRL Taxonomy Extension Presentation Linkbase 

Document

104

  Cover Page Interactive Data File (formatted in Inline XBRL)

X

X

X

X

X

X

* Furnished herewith.
+ Indicated management contract or compensatory plan.
#  Portions  of  this  exhibit  (indicated  by  asterisks)  have  been  omitted  pursuant  to  a  request  for  confidential  treatment  and  this  exhibit  has  been  filed 
separately with the SEC.

Item 16. Form 10-K Summary

None.

130

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, as amended, the Registrant has duly caused this Report 

to be signed on its behalf by the undersigned, thereunto duly authorized.

SIGNATURES

Date: March 1, 2022

ALLAKOS INC.

By:

/s/ Robert Alexander
Robert Alexander, Ph.D.
Chief Executive Officer
(Principal Executive Officer)

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, this Report has been signed below by the following persons on 

behalf of the Registrant in the capacities and on the dates indicated.

Name

/s/ Robert Alexander
Robert Alexander, Ph.D.

/s/ H. Baird Radford, III
H. Baird Radford, III

/s/ Daniel Janney
Daniel Janney

/s/ Robert E. Andreatta
Robert E. Andreatta

/s/ Steven P. James
Steven P. James

/s/ John McKearn
John McKearn, Ph.D.

/s/ Paul Walker
Paul Walker

Title

  Chief Executive Officer and Director
  (Principal Executive Officer)

  Chief Financial Officer
  (Principal Financial and Accounting Officer)

  Chair of the Board

  Director

  Director

  Director

  Director

131

Date

March 1, 2022

March 1, 2022

March 1, 2022

March 1, 2022

March 1, 2022

March 1, 2022

March 1, 2022

 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
     
     
 
 
 
 
 
 
DESCRIPTION OF SECURITIES
REGISTERED PURSUANT TO SECTION 12 OF 
THE SECURITIES EXCHANGE ACT OF 1934

Exhibit 4.3

As of December 31, 2021, Allakos Inc. (the “Company”, “our”, “us”, or “we”) had one class of securities registered under Section 12 of the Securities 
Exchange Act of 1934, as amended (the “Exchange Act”): common stock, par value $0.001 per share. The Company’s common stock is listed on The 
Nasdaq Global Select Market under the trading symbol “ALLK”.

DESCRIPTION OF CAPITAL STOCK

The following is a description of our capital stock and certain provisions of our amended and restated certificate of incorporation and amended and restated 
bylaws. The following description may not contain all of the information that is important to you. To understand the material terms of our common stock, 
you should read our amended and restated certificate of incorporation and amended and restated bylaws, copies of which have been filed with the Securities 
and Exchange Commission (“SEC”).

Authorized Capital Stock 

The Company’s authorized capital stock consists of 200,000,000 shares of common stock, par value $0.001 and 20,000,000 shares of preferred stock, par 
value $0.001 per share. As of December 31, 2021, we had 54,622,363 shares of our common stock issued and outstanding and no shares of preferred stock 
issued and outstanding. 

Common Stock

Fully Paid and Nonassessable

All of the outstanding shares of the Company’s common stock are fully paid and nonassessable.

Voting Rights 

Each holder of common stock is entitled to one vote for each share on all matters submitted to a vote of the stockholders, including the election of directors. 
Our certificate of incorporation and bylaws do not provide for cumulative voting rights. Because of this, the holders of a plurality of the shares of common 
stock entitled to vote in any election of directors can elect all of the directors standing for election, if they should so choose. With respect to matters other 
than the election of directors, at any meeting of the stockholders at which a quorum is present or represented, the affirmative vote of a majority of the 
voting power of the shares present in person or represented by proxy at such meeting and entitled to vote on the subject matter shall be the act of the 
stockholders, except as otherwise required by law. The holders of a majority of the stock issued and outstanding and entitled to vote, present in person or 
represented by proxy, shall constitute a quorum for the transaction of business at all meetings of the stockholders. 

Dividend Rights

Subject to preferences that may be applicable to any then-outstanding preferred stock, holders of our common stock are entitled to receive dividends, if any, 
as may be declared from time to time by our board of directors out of legally available funds. 

Right to Receive Liquidation Distributions

In the event of our liquidation, dissolution or winding up, holders of our common stock will be entitled to share ratably in the net assets legally available for 
distribution to stockholders after the payment of all of our debts and other liabilities and the satisfaction of any liquidation preference granted to the holders 
of any then-outstanding shares of preferred stock. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Rights and Preferences 

Holders of our common stock have no preemptive, conversion, subscription or other rights, and there are no redemption or sinking fund provisions 
applicable to our common stock. The rights, preferences and privileges of the holders of our common stock are subject to and may be adversely affected by 
the rights of the holders of shares of any series of preferred stock that we may designate in the future. 

DESCRIPTION OF PREFERRED STOCK

Our board of directors has the authority, without further action by the stockholders, to issue up to 20,000,000 shares of preferred stock in one or more series 
and to fix the rights, preferences, privileges and restrictions thereof. These rights, preferences and privileges could include dividend rights, conversion 
rights, voting rights, redemption rights, liquidation preferences, sinking fund terms and the number of shares constituting any series or the designation of 
such series, any or all of which may be greater than the rights of our common stock. The issuance of preferred stock could adversely affect the voting 
power of holders of our common stock and the likelihood that such holders will receive dividend payments and payments upon liquidation. In addition, the 
issuance of preferred stock could have the effect of delaying, deferring or preventing change in our control or other corporate action. No shares of preferred 
stock are outstanding.

ANTI-TAKEOVER EFFECTS OF CERTAIN PROVISIONS OF DELAWARE LAW, OUR AMENDED AND RESTATED CERTIFICATE OF 
INCORPORATION AND OUR AMENDED AND RESTATED BYLAWS

Certain provisions of Delaware law and certain provisions in our amended and restated certificate of incorporation and amended and restated bylaws 
summarized below may be deemed to have an anti-takeover effect and may delay, deter or prevent a tender offer or takeover attempt that a stockholder 
might consider to be in its best interests, including attempts that might result in a premium being paid over the market price for the shares held by 
stockholders. 

Preferred Stock 

Our amended and restated certificate of incorporation contains provisions that permit our board of directors to issue, without any further vote or action by 
the stockholders, shares of preferred stock in one or more series and, with respect to each such series, to fix the number of shares constituting the series and 
the designation of the series, the voting rights (if any) of the shares of the series and the powers, preferences or relative, participation, optional and other 
special rights, if any, and any qualifications, limitations or restrictions, of the shares of such series. 

Classified Board 

Our amended and restated certificate of incorporation provides that our board of directors is divided into three classes, designated Class I, Class II and 
Class III. Each class is an equal number of directors, as nearly as possible, consisting of one-third of the total number of directors constituting the entire 
board of directors. The term of the Class I directors will terminate on the date of the 2022 annual meeting, the term of the Class II directors shall terminate 
on the date of the 2023 annual meeting and the term of the Class III directors shall terminate on the date of the 2024 annual meeting. At each annual 
meeting of stockholders, successors to the class of directors whose term expires at that annual meeting will be elected for a three-year term. 

Removal of Directors 

Our amended and restated certificate of incorporation provides that stockholders may only remove a director for cause by a vote of no less than a majority 
of the shares present in person or by proxy at the meeting and entitled to vote. 

Director Vacancies 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our amended and restated certificate of incorporation authorizes only our board of directors to fill vacant directorships. 

No Cumulative Voting 

Our amended and restated certificate of incorporation provides that stockholders do not have the right to cumulate votes in the election of directors. 

Special Meetings of Stockholders 

Our amended and restated certificate of incorporation and amended and restated bylaws provide that, except as otherwise required by law, special meetings 
of the stockholders may be called only by an officer at the request of a majority of our board of directors, by the Chair of our board of directors or by our 
Chief Executive Officer. 

Advance Notice Procedures for Director Nominations 

Our bylaws provide that stockholders seeking to nominate candidates for election as directors at an annual or special meeting of stockholders must provide 
timely notice thereof in writing. To be timely, a stockholder’s notice generally will have to be delivered to and received at our principal executive offices 
before notice of the meeting is issued by the secretary of the company, with such notice being served not less than 90 nor more than 120 days before the 
meeting. Although the amended and restated bylaws do not give the board of directors the power to approve or disapprove stockholder nominations of 
candidates to be elected at an annual meeting, the amended and restated bylaws may have the effect of precluding the conduct of certain business at a 
meeting if the proper procedures are not followed or may discourage or deter a potential acquirer from conducting a solicitation of proxies to elect its own 
slate of directors or otherwise attempting to obtain control of the company. 

Action by Written Consent 

Our amended and restated certificate of incorporation and amended and restated bylaws provide that any action to be taken by the stockholders must be 
effected at a duly called annual or special meeting of stockholders and may not be effected by written consent. 

Amending our Certificate of Incorporation and Bylaws 

Our amended and restated certificate of incorporation may be amended or altered in any manner provided by the Delaware General Corporation Law 
(“DGCL”). Our amended and restated bylaws may be adopted, amended, altered or repealed by stockholders only upon approval of at least majority of the 
voting power of all the then outstanding shares of the common stock, except for any amendment of the above provisions, which would require the approval 
of a two-thirds majority of our then outstanding common stock. Our amended and restated certificate of incorporation provides that our bylaws may be 
amended, altered or repealed by the board of directors. 

Authorized but Unissued Shares 

Our authorized but unissued shares of common stock and preferred stock will be available for future issuances without stockholder approval, except as 
required by the listing standards of NASDAQ, and could be utilized for a variety of corporate purposes, including future offerings to raise additional 
capital, acquisitions and employee benefit plans. The existence of authorized but unissued and unreserved common stock and preferred stock could render 
more difficult or discourage an attempt to obtain control of the company by means of a proxy contest, tender offer, merger or otherwise. 

Exclusive Jurisdiction 

Our amended and restated certificate of incorporation provides that, unless we consent to the selection of an alternative forum, the Court of Chancery of the 
State of Delaware shall be the sole and exclusive forum for any derivative action or proceeding brought on our behalf, any action asserting a claim of 
breach of fiduciary duty, any action asserting a claim arising pursuant to the DGCL, any action regarding our amended and restated certificate of 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
incorporation or our amended and restated bylaws, or any action asserting a claim against us that is governed by the internal affairs doctrine. Our amended 
and restated certificate of incorporation provides further that the federal district courts of the United States of America is the exclusive forum for resolving 
any complaint asserting a cause of action arising under the Securities Act. However, it is possible that a court could find our forum selection provisions to 
be inapplicable or unenforceable.

LISTING

Our common stock is listed on the NASDAQ under the symbol “ALLK.” 

 
 
 
 
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS ([***]), 
HAS BEEN OMITTED BECAUSE THE INFORMATION IS NOT MATERIAL AND IS THE TYPE OF INFORMATION 
THAT THE REGISTRANT TREATS AS PRIVATE OR CONFIDENTIAL.

Exhibit 10.19

DATED

14 February 2022

TERMINATION WIND-DOWN AND SETTLEMENT AGREEMENT

among

Lonza AG

and

Lonza Sales AG

and

Allakos Inc.

 
 
 
 
 
 
CONTENTS

____________________________________________________________

CLAUSE

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

Definitions and interpretation

Effect of this Termination Agreement

Payment

Raw Materials.

Release

Agreement not to sue

Costs and Taxes

Warranties and authority

Indemnities

No admission

Severability

Entire Agreement / Construction

Confidentiality

Governing law

Jurisdiction

Contracts (Rights of Third Parties) Act 1999; No Third-Party Beneficiaries

Co-operation

Counterparts

Variation

EXHIBITS

Exhibit A -- On-Going Services

1

3

3

4

5

5

6

7

7

8

8

8

8

9

9

10

10

10

10

10

 
 
 
 
 
This Termination Wind-Down and Settlement Agreement (this “Termination Agreement”) is dated 14th February 2022 (“Effective Date”)

Parties

(1)  Lonza AG, Münchensteinerstrasse 38, CH-4002 Basel, Switzerland (“Lonza AG”)

(2)  Lonza Sales AG, Münchensteinerstrasse 38, CH-4002 Basel, Switzerland (“Lonza Sales AG” also referred to as Lonza Sales Ltd.) and, 

collectively with Lonza AG, “Lonza”)

(3)  Allakos Inc., 975 Island Drive, Suite 201, Redwood City, CA 94065 (“Allakos”)

Lonza and Allakos collectively the “parties” and each a “party.”

Stipulations

Each of the Parties stipulates and agrees to the following:

(A)  Allakos and Lonza are parties to certain MSAs (as defined below) pursuant to which Allakos has committed to purchase, and Lonza has 
agreed to manufacture and supply, certain minimum amounts of materials, as more fully specified therein (the “Obligations”).

(B)  Each  party  has  duly  performed  all  of  its  obligations  under  the  MSAs,  and  is  ready,  willing  and  able  to  continue  to  perform  for  the 

remainder of the term of each of the MSAs.

(C)  Allakos desires to terminate and wind-down the MSAs for business and economic reasons of Allakos.

(D)  If Allakos were to cancel all of the various Batches and Services under the MSA as permitted by the MSAs, the resulting Cancellation 
Fees  and other amounts owned to Lonza under the MSAs would be an amount substantially in excess of the Termination Amount 
(the “Aggregate Cancellation Amount”).

(E)  Lonza  has  agreed  to  consent  to  the  wind-down  and  early  termination  of  the  MSAs  by  Allakos  in  exchange  for  an  immediate  and 
indefeasible payment upon the terms set forth herein, and Allakos has agreed to make such payment in exchange for a relief from 
any further or additional liability of Allakos to Lonza under the MSAs.

(F)  Allakos acknowledges that this Termination Agreement and its performance provides substantial value and benefits to Allakos insofar as 
the  early  and  orderly  termination  of  the  MSAs  relieves  Allakos  of  future  payment  obligations  to  Lonza  in  amounts  materially 
greater than the Termination Amount. 

(G)  The Parties have therefore agreed to terms for the full and final settlement on a binding basis as set forth in this Termination Agreement.

Agreed terms

2

 
 
 
1.  Definitions and interpretation

In  this  Termination  Agreement,  unless  the  context  otherwise  requires,  the  following  words  and  expressions  have  the  following 
meanings: 

  MSAs: collectively, the following manufacturing and other services agreements, including all Binding Orders, Forecasts, Project Plans, 
SOWs, and other documents and/or agreements issued, executed, and/or agreed upon under and/or pursuant thereto, and all exhibits, 
appendices, and attachments to any of the foregoing (as all have been amended through the Effective Date):

a)  Development and Manufacturing Services Agreement dated 01Oct2013 (the “1K DMSA”);

b)  BLA Services and Manufacturing Services Agreement dated 01Dec17 (the “BLA Agreement”);

c)  2k Development and Manufacturing Services Agreement dated 01Nov2019 (the “2k DMSA”);

d)  1k Commercial Supply Agreement dated 02Apr2020 (the “1k CSA”); and

e)  2k Commercial Supply Agreement dated 27Nov2020 (the “2k CSA”).

Related Parties: a party’s direct and indirect parents, subsidiaries, affiliates, predecessors, successors, assigns, and/or transferees, and 

each of their respective employees, principals, agents, officers, directors, and/or other representatives.

Other capitalised terms shall have the meaning given in the relevant MSA.

2.  Effect of this Termination Agreement 

2.1  The parties hereby agree that upon its execution this Termination Agreement shall immediately be fully and effectively binding on each 

of them.

2.2  Each  MSA  shall  terminate  as  of  the  Effective  Date.    Such  terminations  are  via  mutual  agreement  of  the  parties,  and  not  due  to  any  
party’s breach.  Notwithstanding the foregoing but subject to clause 2.4, Lonza shall continue to perform and provide the Services 
as detailed in Exhibit A (the “On-Going Services”), including Release of three (3) subcutaneous cGMP Batches manufactured in 
2022 under the 1K DMSA (collectively, the “SC Batches”), in each case, pursuant to the terms of the applicable MSA (as if such 
MSA was not terminated solely with respect to such On-Going Services until completion of such On-Going Services).

2.3  All Parties shall take such steps concerning termination as are required by each of the MSAs.

2.4  Other than terms related to fees, expenses, and costs (including Cancellation Fees) and the payment of any of foregoing (which terms 

are fully superseded by this Termination Agreement) 

3

 
 
 
 
the terms of each MSA that are to survive termination as per the terms of each applicable MSA shall survive termination of such 
MSA. 

3.  Payment

3.1  In exchange for termination of the MSAs, the releases, and the other agreements herein, as well as in full payments for: (i) all amounts 
paid  or  payable  under  the  MSAs  (including  amounts  that  would  be  invoiced  and/or  otherwise  payable  after  the  Effective  Date), 
including amounts for all Raw Materials (including the Allakos Raw Materials) and all Raw Materials Fees, Cell Bank Storage fees, 
and  amounts  due  with  respect  to  any  subcontractor  and/or  external  laboratories,  and  (ii)  performance  and  completion  of  the  On-
Going  Services,  Allakos  will  pay  Lonza  an  aggregate  amount  of  one  hundred  and  twenty-six  million  Swiss  Francs 
(CHF126,000,000) (the “Termination Amount”).

3.2  Allakos will pay Lonza ninety-five percent (95%) of the Termination Amount within thirty (30) days after the Effective Date.

3.3  Allakos will pay Lonza the remaining five percent (5%) of the Termination Amount within thirty (30) days after Release of the last of 

the SC Batches.

3.4  All such payments of the Termination Amount will be payable by way of bank transfer as follows:

(a)  To Lonza AG: fifty point nine percent (50.9%) of the Termination Amount to the following account:

Credit Suisse AG, PO Box, CH-8071, Zurich, Switzerland

BIC (Swift)

IBAN

Account

[***]

[***]

[***]

(b)  To Lonza Sales AG: forty-nine point one percent (49.1%) of the Termination Amount to the following account:

Credit Suisse AG, PO Box, CH-8071, Zurich, Switzerland

BIC (Swift)

IBAN

Account

[***]

[***]

[***]

4

 
 
 
 
3.5  Interest shall accrue and be payable by Allakos on any part of the Termination Amount that is not paid in accordance with clause 3.2 or 

3.3, as applicable, at the rate of 2% per annum above the Swiss Average Rate Overnight (SARON).

3.6  Notwithstanding clause 3.2 in the event Allakos shall fail to pay the first ninety-five percent (95%) of the Termination Amount within 
thirty (30) days following the Effective Date, Lonza may at its option give notice to Allakos that this Termination Agreement is 
terminated, null and void.

3.7  Lonza’s  agreement  to  the  terms  and  conditions  of  this  Termination  Agreement  is  expressly  predicated  and  conditioned  upon  the  
Termination  Amount  being  a  final  and  indefeasible  payment.    In  the  event  Lonza  is  required  to  return  any  portion  of  the 
Termination  Amount  for  any  reason,  including  without  limitation  a  “clawback”  action  brought  by  or  on  behalf  of  a  bankruptcy 
estate,  Lonza  shall  be  entitled  to  assert  the  full  amount  of  the  Aggregate  Cancellation  Amount  (offset  only  by  the  portion  of  the 
Termination Amount, if any, that Lonza retains), and may assert the Aggregate Cancellation Amount as a counterclaim or right of 
offset in any such action.

4.  Raw Materials.

As of the Effective Date, Lonza holds and/or has placed orders for Raw Materials purchased for use with Services that were to be 
provided to Allakos (collectively, the “Allakos Raw Materials”).  For clarity, Lonza will not seek separate payment for the amount 
owed  by  Allakos  for  such  Allakos  Raw  Materials  (including  any  Raw  Materials  Fees),  since  the  Parties  have  agreed  that  the 
Termination  Amount  as  defined  in  clause  3.1  includes  the  Parties’  negotiated  settlement  on  all  matters  under  the  MSAs.    Upon 
payment of the amount in clause 3.2 (95% of the Termination Amount), title to and risk of loss of the Allakos Raw Materials shall 
transfer to Allakos (and/or, if Lonza has not yet received title to any such Allakos Raw Material as of such payment, title to such 
Allakos Raw Material will automatically transfer to Allakos immediately after Lonza takes title thereto).  Following the Effective 
Date, Allakos and Lonza shall cooperate in good faith to make an orderly disposition of the Allakos Raw Materials as  agreed by 
Allakos and Lonza, recognising that (a) the Allakos Raw Materials includes Raw Materials unique to Allakos that Lonza cannot 
repurpose  or  sell  to  other  Lonza  customers  and  (b)  Lonza  cannot  re-sell  or  re-allocate  certain  other  Allakos  Raw  Materials  to 
Lonza’s  other  customers  since  Lonza  has  already  separately  purchased  the  required  raw  materials  for  those  other  customers’ 
campaigns.

5.  Release

5.1  Subject to clause 3.7, this Termination Agreement is in full and final settlement of, and each party, on behalf of itself and its Related 
Parties, hereby releases and forever discharges, each other party and each other party’s Related Parties from all and/or any actions, 
claims,  rights,  demands,  liabilities,  damages,  losses,  covenants,  obligations,  agreements,  promises,  complaints,  suits,  causes  of 
action,  costs,  expenses,  debts,  and  set-offs  of  any  kind  and/or  nature,  including  without  limitation  claims  for  penalties,  general 
damages,  direct  and  indirect,  incidental  and  consequential  damages,  exemplary,  punitive,  compensatory  and  special  damages, 
equitable relief, and 

5

 
 
attorneys’  fees,  in  any  jurisdiction  worldwide,  whether  accrued  or  unaccrued,  suspected  or  unsuspected,  asserted  or  unasserted, 
foreseen or unforeseen, fixed or contingent, liquidated or unliquidated (collectively, Claims), that it and/or its Related Parties ever 
had, may have, and/or hereafter can, shall, and/or may have against the other party and/or any of its Related Parties arising out of 
and/or connected with, subject to clauses 2.4 and 5.2 hereof, the MSAs and the subject matters(s) thereof (collectively the Released 
Claims), provided, however, that the release by Lonza and its Related Parties of Allakos and its Related Parties shall be effective 
only upon the passage of 96 days from the date of completion of payment in full of the Termination Amount without Allakos having 
commenced or become the subject of a bankruptcy case (e.g., a case under title 11 of the United States Code) before the expiration 
of such period.

5.2  No Release of Payments Due Under this Termination Agreement or for On-Going Services:  The Parties hereby expressly acknowledge 
that they are not, by this Termination Agreement, releasing any claims that arise under the terms of this Termination Agreement or 
Lonza’s performance of (or failure to perform) the On-Going Services, and/or the breach of such terms or performance obligations 
(including, but not limited to, any failure by Allakos and/or Lonza to make any of the payments due hereunder).

5.3  Each party affirms that it has not filed with any governmental agency and/or court any type of action and/or report against any other 
party, and currently knows of no existing act and/or omission by the other party that may constitute a claim and/or liability excluded 
from the release in Clause 5.1.

6.  Agreement not to sue 

6.1  Each party agrees, on behalf of itself and on behalf of its Related Parties, not to sue, commence, voluntarily aid in any way, prosecute 
and/or  cause  to  be  commenced  and/or  prosecuted  against  the  other  party  and/or  its  Related  Parties  any  action,  suit  and/or  other 
proceeding concerning the Released Claims, in this jurisdiction and/or any other.

6.2  Clause  5  and  clause  6.1  shall  not  apply  to,  and  the  Released  Claims  shall  not  include,  any  claims  in  respect  of  any  breach  of  this 

Termination Agreement or Lonza’s performance of (or failure to perform) the On-Going Services.

7.  Costs and Taxes

7.1  The parties shall each bear their own legal costs in relation to the negotiation and documentation of this Termination Agreement.

7.2  Each  party  shall  be  solely  responsible  for,  and  is  legally  bound  to  make  payment  of,  any  taxes  determined  to  be  due  and  owing  
(including penalties and interest related thereto) by it to any national, federal, state, local, and/or regional taxing authority as a result 
of its receipt of any payment hereunder. Each party agrees to indemnify and hold the paying party harmless in the 

6

 
 
event that any governmental taxing authority asserts against the paying party any claim for unpaid taxes, failure to withhold taxes, 
penalties, and/or interest based upon the payment of any amount hereto to such recipient party.

7.3  This clause 7 supersedes and overrides any and all previous agreements between the parties in relation to this Termination Agreement 

(including the implementation of all matters provided by this Termination Agreement).

8.  Warranties and authority 

8.1  Each party warrants and represents that it has not sold, transferred, assigned, and/or otherwise disposed of its interest in the Released 

Claims.

8.2  Each party warrants and represents to the other with respect to itself that it has the full right, power, and authority to execute, deliver, 

and perform this Termination Agreement.

8.3  Each  party  warrants  and  represents  that  it  has  received  independent  legal  advice  with  respect  to  the  advisability  of  executing  this  
Termination  Agreement.    The  Parties  further  acknowledge  they  have  been  fully  advised  by  their  attorneys  with  respect  to  their 
rights and obligations under this Termination Agreement and understand those rights and obligations.  The Parties also acknowledge 
that, before execution of this Termination Agreement, they and/or their legal counsel have had an adequate opportunity to make any 
investigation and/or inquiries deemed necessary and/or desirable with respect to the subject matter of this Termination Agreement.  

8.4  Except as set forth above, each of the Parties represents, warrants, and agrees that in executing this Termination Agreement it has relied 
solely on the statements expressly set forth herein.  Each of the Parties further represents, warrants, and agrees that in executing this 
Termination Agreement it has placed no reliance whatsoever on any statement, representation, and/or promise of any other Party, 
and/or any other person or entity, not expressly set forth herein, and/or upon the failure of any other Party and/or any other person 
and/or entity to make any statement, representation or disclosure of anything whatsoever.

9. 

Indemnities 

Each party hereby indemnifies and holds harmless, and shall keep indemnified and held harmless, the other party against all Claims 
in respect of any of the Released Claims which it and/or its Related Parties and/or any of them may bring against the other party 
and/or its Related Parties or any of them.

10.  No admission 

This Termination Agreement is entered into in connection with the compromise of matters between and/or among the parties and in 
the light of other considerations. It is not, and shall not 

7

 
 
be  represented  and/or  construed  by  the  parties  as,  an  admission  of  liability  and/or  wrongdoing  on  the  part  of  either  party  to  this 
Termination Agreement and/or any other person or entity.

11.  Severability 

If any provision and/or part-provision of this Termination Agreement is or becomes invalid, illegal, and/or unenforceable, it shall be 
deemed modified to the minimum extent necessary to make it valid, legal, and enforceable. If such modification is not possible, the 
relevant provision and/or part-provision shall be deemed deleted, provided, however, that in the event that the terms and conditions 
of  this  Termination  Agreement  are  materially  altered,  the  parties  will,  in  good  faith,  renegotiate  the  terms  and  conditions  of  this 
Termination Agreement to reasonably replace such invalid and/or unenforceable provisions in light of the intent of this Termination 
Agreement.  Any modification to and/or deletion of a provision and/or part-provision under this clause shall not affect the validity 
and enforceability of the rest of this Termination Agreement.

12.  Entire Agreement / Construction

12.1 Subject to clause 12.3, this Termination Agreement constitutes the entire agreement between the parties and supersedes and extinguishes 
all  previous  agreements,  promises,  assurances,  warranties,  representations,  and  understandings  between  them,  whether  written  or 
oral, relating to its subject matter.

12.2 Each party agrees that it shall have no remedies in respect of any statement, representation, assurance, and/or warranty (whether made 
innocently  or  negligently)  that  is  not  set  out  in  this  Termination  Agreement.  Each  party  agrees  that  it  shall  have  no  claim  for 
innocent and/or negligent misrepresentation based on any statement in this Termination Agreement.

12.3 For clarity, this Termination Agreement does not terminate, amend, and/or modify any agreement between and/or among any of parties 
other  than  the  MSAs,  including,  without  limitation,  the  Non-Exclusive  License  Agreement,  dated  31Oct2013,  among  Allakos, 
Lonza Sales AG, and the other party thereto, and the Siglec-8 GS Cell Line Agreement, dated 8Oct2018, among Allakos and Lonza 
Sales AG.

12.4 Neither this Termination Agreement, nor any provision herein, shall be deemed to have been prepared or drafted by any particular party 
or construed against any party on the ground that such party drafted this Termination Agreement or any provision thereof.  The term 
“including” as used in this Termination Agreement is used to list items by way of example and shall not be deemed to constitute a 
limitation of any term or provision contained herein. Further, the parties also acknowledge that the terms and conditions set forth in 
this Termination Agreement are fair, adequate, reasonable, and proper, and that this Termination Agreement is the result of arms-
length negotiations between the parties.

8

 
 
13.  Confidentiality 

The terms of this Termination Agreement, and the substance of all negotiations in connection with it, are confidential to the parties 
and  their  advisers,  who  shall  not  disclose  them  to,  and/or  otherwise  communicate  them  to,  any  third  party  without  the  written 
consent of the other party other than:

(a) 

to the parties’ respective auditors, insurers, and lawyers on terms which preserve confidentiality; and

(b)  pursuant to an order of a court of competent jurisdiction, and/or pursuant to any proper order and/or demand made by any 
competent authority and/or body where they are under a legal and/or regulatory obligation to make such a disclosure; and

(c)  pursuant  to  any  express  requirement  under  the  rules  of  any  listing  authority  and/or  stock  exchange  on  which  a  party’s 

shares and/or those of any of its Group Companies are subject; and

(d)  as far as necessary to implement and enforce any of the terms of this Termination Agreement.

For the avoidance of doubt, nothing in this 913 prevents the parties from making a disclosure to a regulator regarding any alleged 
misconduct,  wrongdoing,  and/or  serious  breach  of  regulatory  requirements,  and/or  making  a  disclosure  to  any  law  enforcement 
agency  regarding  an  alleged  criminal  offence  and/or  co-operating  with  any  law  enforcement  agency  regarding  a  criminal 
investigation and/or prosecution.

14.  Governing law

This Termination Agreement and any dispute and/or claim (including non-contractual disputes and/or claims) arising out of and/or 
in connection with it and/or its subject matter and/or formation shall be governed by and construed in accordance with the internal 
laws of the State of New York, without regard to its choice of law provisions.

15.  Jurisdiction

Each party irrevocably agrees that the courts of the State of New York shall have non-exclusive jurisdiction to settle any dispute 
and/or  claim  (including  non-contractual  disputes  and/or  claims)  arising  out  of  and/or  in  connection  with  this  Termination 
Agreement and/or its subject matter and/or formation.

9

 
 
16.  Contracts (Rights of Third Parties) Act 1999; No Third-Party Beneficiaries

The parties agree that the terms of this Termination Agreement are not enforceable by any third party under the Contracts (Rights of 
Third Parties) Act 1999, and that no third party is an intended beneficiaries of this Termination Agreement.

17.  Co-operation 

The  parties  shall  deliver  and/or  cause  to  be  delivered  such  instruments  and  other  documents  at  such  times  and  places  as  are 
reasonably necessary and/or desirable, and shall take any other action reasonably requested by the other party for the purpose of 
putting this Termination Agreement into effect.

18.  Counterparts 

18.1 This Termination Agreement may be executed in any number of counterparts, each of which shall constitute a duplicate original, but all 
the  counterparts  shall  together  constitute  the  one  agreement.  For  the  purposes  of  completion,  signatures  by  the  parties’  legal 
advisers shall be binding.

18.2 Transmission of an executed counterpart of this Termination Agreement (but for the avoidance of doubt not just a signature page) by 
email  in  PDF  and/or  other  agreed  format)  shall  take  effect  as  the  transmission  of  an  executed  “wet  ink”  counterpart  of  this 
Termination Agreement. 

18.3 No counterpart shall be effective until each party has provided to the others at least one executed counterpart. 

19.  Variation 

No  variation  of  this  Termination  Agreement  shall  be  effective  unless  it  is  in  writing  and  signed  by  the  parties  (and/or  their 
authorised representatives).

This Termination Agreement has been entered into on the date stated at the beginning of it.

10

 
 
 
 
IN  WITNESS  WHEREOF,  each  of  the  Parties  hereto  has  caused  this  Termination  Agreement  to  be  executed  by  its  duly 

authorized representative effective as of the date written above.

LONZA AG

LONZA SALES AG

By:

By:

/s/ Daniel Blaettler
Name: Daniel Blaettler
Title: General Counsel Corporate

/s/ Michael Stanek
Name: Michael Stanek
Title: General Counsel, EMEA

By:

By:

/s/ Daniel Blaettler
Name: Daniel Blaettler
Title: General Counsel Corporate

/s/ Jennifer Cannon
Name: Jennifer Cannon
Title: Head of Mammalian

ALLAKOS INC.

By: /s/ Robert Alexander
Name: Robert Alexander
Title: Chief Executive Officer

ALLAKOS INC.

By: /s/ Adam Tomasi
Name: Adam Tomasi
Title: President and Chief Operating Officer

Initials by ALLAKOS INC:

  M.A._____ 

B.R.______

Legal 

Finance

11

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit A

On-Going Services

(cid:0)  Three (3) SC Batches:  Manufacture and Release of Three (3) subcutaneous cGMP Batches manufactured in 2022 under the 

1K DMSA

(cid:0)  Other Identified On-Going Services:

Services

Stage #

SOW #

Agreement

Completion of timepoints testing of 
ongoing SC DS and DP Stability Studies 

Completion of HCP testing at Lonza for 
Clinical/PPQ runs at Fujifilm

Execute Siglec-8 Assay Agreement to 
transfer cell banks for Eurofins testing 

64, 

67 and 100

71, 

78, 

88 and 98, 

93, 

101

7 

TBC

1K DMSA

1K CSA

TBC

92, 

105, 

106, 

118, 

156, 

161, 

168 

434

No signed stage at the 
moment. Stage 170 
has now been 
assigned in the tracker 
as reference

Completion of Potelligent Cell line 
creation for Allakos to generate process-
specific HCP reagent

335

87

BLA Agreement

12

 
 
 
 
Completion of Lonza activities needed to 
support DS and DP stability testing such 
as stability of primary reference, 
requalification of assay reference, and 
annual verification of potency assays

60, 

75, 

253, 

320, 

331, 

334, 

261 

Initial contract,

98,

53 and 85,

74,

86,

86,

35, 49, 63, 70

BLA Agreement and 1K 
DMSA

Finalize and transmit study reports from 
completed  MSS and Poros 
Chromatography Cleaning Verification 
Study at Manufacturing Scale (“Blank 
Run”) - Post PPQ testing

Finalize and transmit study reports from 
completed  MSS and POROS XS 
Chromatography Resins Lifetime Studies 
at Manufacturing Scale-Post PPQ batch 
testing 

293, 294

54

BLA Agreement

291, 292

54, 

BLA Agreement

Lonza to ship MCB/WCB, DS/in process 
samples from Slough/Visp to Allakos 
designated sites

N/A

N/A

(cid:0)  Replacement Batches:  For any above described On-Going Service that includes the manufacture of a cGMP Batch, the applicable 
On-Going  Service  includes,  for  clarity,  Release  and  acceptance  of  such  Batches  and,  if  requested  by  Allakos,  provision  of  a 
replacement Batch by Lonza for any rejected Batches if and as set forth the applicable MSA (such as if the Failed Batch was a 
Lonza Responsibility).  If, for any such failed cGMP Batch, Lonza is not required to provide a replacement Batch pursuant to the 
terms  of  the  applicable  MSA  (such  as  for  a  failed  Batch  not  caused  by  a  Lonza  Responsibility),  then,  upon  Allakos’s  request, 
Lonza shall negotiate in good faith with Allakos for the provisions of a replacement cGMP Batch upon commercially reasonable 
terms.  For any such replacement Batch, if possible, Lonza shall use manufacturing slots for Services that would have otherwise 
have been used for Allakos’s Product but for termination of the MSA pursuant to this Termination Agreement.

13

 
 
 
 
(cid:0) 

BLA  Support:    Lonza  shall  provide  Allakos  with  reasonably  requested  data,  information,  documentation,  and  support  in 
connection with Allakos’s seeking and/or obtaining Approval(s) (including BLA(s)) for the Products, provided that the obligation 
to provide such support (other than to deliver then-existing data, information, and documentation) will continue only for a period 
of twelve (12) months after the Effective Date.

(cid:0)  Winddown Generally:  In addition to the above Services, for a period of twelve (12) months after the Effective Date, Lonza shall 
provide Allakos with reasonable assistance in winding down currently in-process Services, which may include, without limitation, 
transferring  relevant  data  and  information  related  to  completed  Services  and  On-Going  Services  to  Allakos  and/or  relevant 
Regulatory Authorities and/or other Governmental Authorities.

14

 
 
NOTICE OF TERMINATION

Exhibit 10.21

February 24, 2022

From: 

 Allakos, Inc.

975 Island Drive, Suite 201
Redwood City, California 94065

To:   Cowen and Company, LLC 
599 Lexington Avenue 
New York, New York 10022 
Attention: General Counsel

Attention: Bradley Friedman, General Counsel

Re:  Notice of Termination of Sales Agreement, dated as of May 10, 2021

Ladies and Gentlemen, 

Reference is made to that certain Sales Agreement, dated as of May 10, 2021 (the “Sales Agreement”), by and among 
Allakos, Inc. (the “Company”) and Cowen and Company, LLC (“Cowen”). Capitalized terms used but not defined herein shall 
have the meanings ascribed to such terms in the Sales Agreement.

Pursuant to Section 11(c) of the Sales Agreement, the Company hereby provides written notice (this “Notice”) of 

termination of the Sales Agreement, with such termination to be effective as of the date first written above (the “Termination 
Date”). As of the Termination Date, all rights and obligations of the Company and Cowen under the Sales Agreement shall 
terminate with the exception of those provisions or terms which by their terms survive the termination of the Sales Agreement.

Notwithstanding anything to the contrary contained therein, Cowen hereby expressly agrees to waive the ten (10) days’ 

notice requirement set forth in Section 11(c) of the Sales Agreement.

Except as specifically provided herein, nothing in this Notice is intended to, nor shall it, modify the Sales Agreement in 

any manner. 

This Notice and any claim, controversy or dispute arising under or related to this Notice shall be governed by and 

construed in accordance with the laws of the State of New York.

This Notice may be signed in one or more counterparts, each of which shall constitute an original and all of which 
together shall constitute one and the same agreement.  Delivery of an executed counterpart of a signature page to this letter 
agreement by facsimile or other electronic 

 
 
 
 
 
 
 
   
 
 
 
 
 
 
  
 
 
 
transmission shall be effective as delivery of a manually signed counterpart. The words “execution,” “signed,” “signature,” 
“delivery,” and words of like import in or relating to this Notice hereby shall be deemed to include Electronic Signatures (as 
defined below), deliveries or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or 
enforceability as a manually executed signature, physical delivery thereof or the use of a paper-based recordkeeping system, as 
the case may be. “Electronic Signatures” means any electronic symbol or process attached to, or associated with, any contract or 
other record and adopted by a person with the intent to sign, authenticate or accept such contract or record.

[Signature Pages Follow]

 
 
 
 
 
 
Very truly yours,

Allakos, Inc.

By:  /s/ Mark Asbury 
Name: Mark Asbury
Title:   Chief Legal Officer, General Counsel and 

Secretary

[Signature Page (Termination Notice to Sales Agreement)]

 
 
 
 
 
 
 
Agreed and Accepted:

Cowen and Company, LLC

By: /s/ Michael Murphy
Name:  Michael Murphy
Title:  Managing Director

[Signature Page (Termination Notice to Sales Agreement)]

 
 
 
 
  
 
 
 
Consent of Independent Registered Public Accounting Firm

Exhibit 23.1

We consent to the incorporation by reference in the Registration Statements:

(1) Registration  Statements  (Form  S-8  No.  333-226247,  333-231276,  333-236631,  333-253701,  333-262749)  pertaining  to  the  2018  Equity 

Incentive Plan, the 2018 Employee Stock Purchase Plan and the amended 2012 Equity Incentive Plan of Allakos Inc., and 

(2) Registration Statement (Form S-3 No. 333-233018) of Allakos Inc., 

of our reports dated March 1, 2022, with respect to the financial statements of Allakos Inc. and the effectiveness of internal control over financial reporting 
of Allakos Inc., included in this Annual Report (Form 10-K) for the year ended December 31, 2021.

/s/ Ernst & Young LLP 

Redwood City, California 
March 1, 2022

 
CERTIFICATION PURSUANT TO
RULES 13a-14(a) AND 15d-14(a) UNDER THE SECURITIES EXCHANGE ACT OF 1934,
AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

Exhibit 31.1

I, Robert Alexander, certify that:

1.

2.

3.

4.

I have reviewed this Annual Report on Form 10-K of Allakos Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the 
statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this 
report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 
financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-
15(f)) for the registrant and have:

(a)

(b)

(c)

(d)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to 
ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those 
entities, particularly during the period in which this report is being prepared;

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our 
supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for 
external purposes in accordance with generally accepted accounting principles;

Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the 
effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent 
fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to 
materially affect, the registrant's internal control over financial reporting; and

5.

The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the 
registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

(a)

(b)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are 
reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal 
control over financial reporting.

Date: March 1, 2022

By:

/s/ Robert Alexander
Robert Alexander
President and Chief Executive Officer
(Principal Executive Officer)

 
 
 
 
  
  
  
  
  
  
  
 
 
CERTIFICATION PURSUANT TO
RULES 13a-14(a) AND 15d-14(a) UNDER THE SECURITIES EXCHANGE ACT OF 1934,
AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

Exhibit 31.2

I, H. Baird Radford, III, certify that:

1.

2.

3.

4.

I have reviewed this Annual Report on Form 10-K of Allakos Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the 
statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this 
report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 
financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-
15(f)) for the registrant and have:

(a)

(b)

(c)

(d)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to 
ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those 
entities, particularly during the period in which this report is being prepared;

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our 
supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for 
external purposes in accordance with generally accepted accounting principles;

Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the 
effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent 
fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to 
materially affect, the registrant's internal control over financial reporting; and

5.

The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the 
registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

(a)

(b)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are 
reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal 
control over financial reporting.

Date: March 1, 2022

By:

/s/ H. Baird Radford, III
H. Baird Radford, III
Chief Financial Officer
(Principal Financial and Accounting Officer)

 
 
 
 
  
  
  
  
  
  
  
 
 
Exhibit 32.1

CERTIFICATION OF PRINCIPAL EXECUTIVE OFFICER PURSUANT TO
18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Annual Report of Allakos Inc. (the “Company”) on Form 10-K for the year ended December 31, 2021 as filed with the 
Securities and Exchange Commission on the date hereof (the “Report”), I hereby certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to 
Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1)

(2)

The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the 
Company.

Date: March 1, 2022

By:

/s/ Robert Alexander
Robert Alexander
President and Chief Executive Officer
(Principal Executive Officer)

 
 
  
  
  
  
  
  
  
 
 
Exhibit 32.2

CERTIFICATION OF PRINCIPAL FINANCIAL OFFICER PURSUANT TO
18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Annual Report of Allakos Inc. (the “Company”) on Form 10-K for the year ended December 31, 2021 as filed with the 
Securities and Exchange Commission on the date hereof (the “Report”), I hereby certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to 
Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1)

(2)

The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the 
Company.

Date: March 1, 2022

By:

/s/ H. Baird Radford, III
H. Baird Radford, III
Chief Financial Officer
(Principal Financial and Accounting Officer)