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Allakos Inc.

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FY2023 Annual Report · Allakos Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-K

(Mark One)

☒

☐

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

For the fiscal year ended December 31, 2023
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)

825 Industrial Road, Suite 500
San Carlos, California
(Address of principal executive offices)

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

94070
(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.  ☐

If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction of an error to 
previously issued financial statements. ☐

Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant’s executive 
officers during the relevant recovery period pursuant to §240.10D-1(b). ☐

Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). YES ☐ NO ☒

The aggregate market value of the common stock held by non-affiliates of the Registrant based on the closing price of the Registrant’s Common Stock on the Nasdaq Global Select Market as of 
June 30, 2023 was $287.5 million. 

The number of shares of Registrant’s Common Stock outstanding as of February 29, 2024 was 87,873,995. 

Portions of the Registrant’s Definitive Proxy Statement relating to the registrant’s 2024 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  2023  fiscal  year  ended 
December 31, 2023. 

 
 
 
 
 
 
 
 
 
 
   
 
Table of Contents

Business
Risk Factors
Unresolved Staff Comments
Cybersecurity
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

PART I
Item 1.
Item 1A.
Item 1B.
Item 1C.
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.

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SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

This Annual Report on Form 10-K, or Annual Report, contains forward-looking statements within the meaning of the Private Securities Litigation 
Reform Act of 1995. All statements other than statements of historical facts contained in this Annual Report, including statements regarding our future 
results of operations and financial position, business strategy, development plans, ongoing and planned future preclinical studies and clinical trials, future 
results of ongoing and planned clinical trials, expected research and development costs, regulatory strategy, timing and likelihood of success, as well as 
plans and objectives of management for future operations, are forward-looking statements. In some cases, investors can identify forward-looking statements 
by  terms  such  as  “may,”  “will,”  “should,”  “would,”  “expect,”  “plan,”  “anticipate,”  “could,”  “intend,”  “target,”  “project,”  “contemplate,”  “believe,” 
“estimate,” “predict,” “potential,” or “continue” or the negative of these terms or other similar expressions. Forward-looking statements contained in this 
Annual Report include, but are not limited to, statements about:

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our plans to develop, manufacture and commercialize AK006 and our other product candidates, including our targeted clinical indications, 
intellectual property strategy, sales and marketing objectives and infrastructure capabilities;

the timing, focus and clinical indications of our preclinical studies and clinical trials, and the reporting of data from those trials;

the ability of our clinical trials to demonstrate safety and efficacy of our product candidates, and other positive results;

the expected patient enrollment in our clinical trials;

the impact that the adoption of new accounting pronouncements will have on our financial statements;

the beneficial characteristics, safety, efficacy and therapeutic effects of AK006 or our other product candidates;

the timing or likelihood of regulatory filings and approvals, including our expectation to seek special designations, such as orphan drug 
designation, for AK006 or our other product candidates for various diseases;

our ability to obtain and maintain regulatory approval of AK006 or our other product candidates;

our continued reliance on third-parties to manufacture our product candidates and conduct additional clinical trials of AK006;

our ability to obtain, maintain, or negotiate favorable terms of any collaboration, partnership, licensing or other arrangements that may be 
necessary or desirable to develop, manufacture or commercialize AK006 and our other product candidates; 

our intentions with respect to future sales and marketing plans;

the total reduction in force related to our 2024 Reorganization Plan;

the need to hire additional personnel and our ability to attract and retain such personnel;

the need for additional financing, and our ability to obtain such financing on terms that are favorable to the Company and its stockholders;

our expectations regarding financial performance, including revenues, expenses and net losses, and impacts from our reorganization plans 
and manufacturing development efforts of the foregoing;

the sufficiency of our existing cash, cash equivalents and marketable securities to fund our future operating expenses and capital expenditure 
requirements; 

the costs associated with being a public company; and

our anticipated uses of our existing cash, cash equivalents and marketable securities.

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We have based these forward-looking statements largely on our current expectations and projections about our business, the industry in which we 
operate and financial trends that we believe may affect our business, financial condition, results of operations and prospects, and these forward-looking 
statements are not guarantees of future performance or development. These forward-looking statements speak only as of the date of this Annual Report and 
are subject to a number of risks, uncertainties and assumptions described in the section titled “Risk Factors” included in Part I, Item 1A and elsewhere in 
this Annual Report. Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, 
investors  should  not  rely  on  these  forward-looking  statements  as  predictions  of  future  events.  The  events  and  circumstances  reflected  in  our  forward-
looking statements may not be achieved or occur and actual results could differ materially from those projected in the forward-looking statements. Except 
as required by applicable law, we do not plan to publicly update or revise any forward-looking statements contained herein, whether as a result of any new 
information, future events or otherwise. 

In addition, statements that “we believe” and similar statements reflect our beliefs and opinions on the relevant subject. These statements are based 
upon information available to us as of the date of this Annual Report, and while we believe such information forms a reasonable basis for such statements, 
such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or 
review of, all potentially available relevant information. These statements are inherently uncertain and investors are cautioned not to unduly rely upon these 
statements. 

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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  allergic,  inflammatory  and  proliferative  diseases.  Activating  inhibitory  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 cells’ ability to identify and kill proliferative cells. Our 
most advanced product candidate, AK006, is currently in a Phase 1 clinical trial. 

AK006 targets Siglec-6, an inhibitory receptor expressed selectively on mast cells, a type of white blood cell that is widely distributed in the body 
and plays a central role in the inflammatory response. Binding of AK006 to Siglec-6 is designed to activate the native inhibitory function of the receptor 
which  in  turn  reduces  mast  cell  activation.  In  preclinical  studies,  AK006  inhibited  multiple  modes  of  mast  cell  activation,  including  immunoglobulin  E 
(“IgE”), interleukin-33 (“IL-33”), tyrosine kinase receptor (“KIT”), complement component 5a (“C5a”), and mass-related G protein-coupled receptor-X2 
(“MRGPR-X2”), resulting in the deep suppression of mast cell activation. In addition to mast cell inhibition, AK006 reduced human tissue mast cells via 
antibody-dependent cellular phagocytosis (“ADCP”) in the presence of activated macrophages. 

CSU  is  an  inflammatory  skin  disease  believed  to  be  caused  by  the  inappropriate  activation  of  mast  cells  via  IgE-dependent  and  IgE-independent 
pathways in the skin. Symptoms of CSU include frequent and unpredictable eruption of hives, severe itching and swelling. First-line treatment consists of 
H1 antihistamine medication; however, a significant number of patients do not receive adequate benefit from such medication even at up to four times the 
labeled dose. In the United States, it is estimated that there are approximately 800,000 adults with moderate-to-severe CSU whose disease is refractory to 
antihistamines. There is only one FDA approved therapy for patients who are refractory to antihistamines, omalizumab, which binds IgE. Because AK006 
inhibits  both  IgE-dependent  and  IgE-independent  modes  of  mast  cell  activation,  it  has  the  potential  to  treat  a  broad  CSU  population  or  show  greater 
symptom improvement.

In the third quarter of 2023, we began dosing healthy volunteers in a randomized, double-blind, placebo-controlled Phase 1 study of AK006.  The 
Phase 1 study of AK006 consists of single ascending dose (“SAD”) and multiple ascending dose (“MAD”) cohorts in healthy volunteers, as well as well as 
a cohort in patients with CSU who will be administered AK006 via intravenous infusion. AK006 has been well-tolerated to date and has completed the 
SAD portion of the study. We expect to report SAD and MAD safety, pharmacokinetics (“PK”) and pharmacodynamic (“PD”) results in the second quarter 
of 2024. 

As part of the Phase 1 study, we plan to collect skin biopsies from healthy volunteers dosed with AK006 which will allow us to determine the amount 
of AK006 that is bound to the Siglec-6 receptor on skin mast cells (also known as the receptor occupancy). Given that CSU is believed to be caused by 
inappropriately activated skin mast cells, this information will allow us to assess AK006’s ability to reach the pathogenic cell type in the target tissue and to 
determine  whether  AK006  is  achieving  receptor  occupancy  levels  consistent  with  the  levels  required  for  inhibition  in  preclinical  studies.  Following  the 
SAD and MAD portions of the Phase 1 AK006 study in healthy volunteers, we plan to initiate a randomized, double-blind, placebo-controlled cohort of 
patients with CSU. We expect data from the CSU cohort to be available at year end 2024.

We have also developed a formulation of AK006 for subcutaneous (“SC”) administration.  As part of the Phase 1 study, we are administering SC 
AK006 to a cohort of healthy volunteers. We expect to report SC AK006 safety, PK, and PD data, including bioavailability as well as Siglec-6 receptor 
occupancy  in  skin  biopsy  samples,  during  the  third  quarter  of  2024.    Pending  positive  data  from  the  SC  cohort,  we  plan  to  use  the  SC  formulation  in 
subsequent AK006 clinical trials. 

We  had  also  been  developing  lirentelimab  (AK002)  and,  in  conjunction  with  the  Phase  2  lirentelimab  results  in  atopic  dermatitis  and  chronic 
spontaneous urticaria, we announced in January 2024 that we no longer plan to pursue further development of lirentelimab. Accordingly, we implemented a 
reorganization plan to reduce operating costs and better align our workforce with our current clinical development plans focusing on AK006 (the “2024 

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Reorganization Plan”). Lirentelimab had been administered in more than 1,000 patients, with approximately 500 patients exposed for six months or more. 
Lirentelimab had generally been well tolerated with no long-term safety findings to date. 

Understanding the Foundation of Our Approach

Background on Mast Cells and Siglec-6

Mast  cells  are  involved  in  many  inflammatory  conditions  and  therefore  represent  attractive  drug  targets.  Mast  cells  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 in the center of multiple aspects of the inflammatory response.

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 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.

Mast cells produce a broad range of inflammatory mediators including vasoactive amines, bioactive lipids, proteases, cytokines and chemokines and 
express many immunologically important cell surface receptors. As a result, mast cells are involved in both innate and adaptive immune responses and 
participate  in  both  acute  and  chronic  inflammation.  Because  of  the  inflammatory  mediators  they  release  and  their  ability  to  recruit  and  activate  other 
immune cells through expression of chemokines and cytokines, mast cells are believed to drive symptoms in a number of diseases.

Agents targeting mast cell receptors or secretion products have shown utility in the treatment of a number of diseases including chronic urticaria, 
atopic  dermatitis,  severe  asthma,  chronic  rhinosinusitis,  eosinophilic  gastrointestinal  diseases,  and  indolent  systemic  mastocytosis,  highlighting  the 
pathogenic roles of mast cells.

Siglec-6 is an inhibitory receptor that our research shows is selectively expressed on mast cells. Because Siglec-6 is expressed in high abundance on 
mast  cells,  it  presents  a  novel  way  to  selectively  target  this  important  immune  cell.  As  an  inhibitory  receptor,  the  natural  function  of  Siglec-6  is  to 
counteract activating signals within mast cells that lead to an inflammatory response. As a result, agonist antibodies that target Siglec-6, such as AK006, 
have the potential to inhibit multiple modes of mast cell activation and to reduce the secretion of the broad range of inflammatory mediators secreted by 
mast cells. By targeting Siglec-6, we are seeking to produce drugs with advantages over agents that target a single mast cell secretion product or activation 
pathway.

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

Mast cells 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-4 and IL-13 and viruses through Toll-Like Receptors. In response to these and 
other  activating  signals,  mast  cells  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.

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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  are  the  key  cause  of  tissue  damage  and  contribute  to  tissue  fibrosis.  Mast  cell  secretions  are  toxic  to 
surrounding cells and break down tissues, resulting in fibrosis and tissue remodeling.

Mast  cells  drive  inflammation  by  signaling  to  other  cells  of  the  immune  system.  Mast  cells  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, 

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IL-13, MCP-1, CCL2, CCL3, CCL5, CCL17, TGFa, TGFb and 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 1. Mast Cell Functions

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

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

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 found on the surface of mature mast cells. 
The physiological function of Siglec-6 is to provide an inhibitory signal to mast cells thereby reducing or preventing mast cell activation. Siglec-6 exerts 
these effects through an intracellular immunoreceptor tyrosine-based inhibitory motif (“ITIM”).

ITIM  bearing  receptors  antagonize  activating  receptors  and  consequently  have  important  roles  in  regulating  the  immune  system.  The  inhibitory 
function is derived from the ability of the ITIMs to recruit SH2 domain-containing phosphatases which work to oppose activating signals driven by kinase 
signaling cascades. Disrupting kinase signaling cascades has been a successful strategy for treating inflammatory diseases as evidenced by approved drugs 
which  target  JAK,  KIT,  BTK,  SYK,  and  others.  However,  often  these  kinase  signaling  pathways  are  active  in  multiple  cell  types,  which  can  result  in 
unintended  side  effects  when  disrupted.  In  contrast,  targeting  the  ITIM  signaling  cascade  (via  Siglec-6)  has  the  potential  to  counteract  a  broad  array  of 
activating signals, including IgE, IL-33, MRGPR-X2, and KIT, which could allow for the treatment of multiple mast cell-driven diseases.

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Figure 2. AK006 Triggers Potent Inhibition of Mast Cells 

AK006 Binds to Siglec-6

AK006 was designed to take advantage of the selective expression pattern and inhibitory function of Siglec-6, an inhibitory receptor found on mast 
cells. AK006 is a humanized IgG1 monoclonal antibody which activates the inhibitory receptor Siglec-6. AK006 is directed to an extracellular epitope of 
the  Siglec-6  receptor  that  was  identified  for  its  ability  to  generate  strong  inhibitory  signals  to  mast  cells.  Furthermore,  AK006  was  engineered  to  have 
higher cell surface residence time which may increase mast cell inhibition. In preclinical studies, AK006 inhibited multiple modes of mast cell activation, 
including IgE, IL-33, KIT, C5a, and MRGPR-X2, resulting in the broad suppression of inflammation. In addition to mast cell inhibition, AK006 reduced 
human tissue mast cells via ADCP phagocytosis in the presence of activated macrophages.

Our Strategy

AK006  has  shown  activity  in  preclinical  studies  including  a  broad  array  of  animal  disease  models  of  mast  cell  diseases.  We  have  prioritized  our 
AK006  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:

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•

Evaluate AK006 in healthy volunteers. AK006 is currently being evaluated in a Phase 1 SAD and MAD study in healthy volunteers. The 
study  is  designed  to  assess  safety,  PK  and  PD  of  AK006.  As  part  of  the  phase  1  study,  we  plan  to  collect  skin  biopsies  from  healthy 
volunteers dosed with AK006 which will allow us to look at the amount of AK006 that is bound to the Siglec-6 receptor on skin mast cells 
(also  known  as  the  receptor  occupancy).  Given  that  CSU  is  believed  to  be  caused  by  inappropriately  activated  skin  mast  cells,  this 
information will allow us to assess AK006’s ability to reach the pathogenic cell type in the target tissue and to determine whether AK006 is 
achieving receptor occupancy levels consistent with the levels required for inhibition in preclinical studies. We expect to report data from the 
Phase 1 SAD and MAD portions of the study in the second quarter of 2024.

Obtain Proof of Concept (“POC”) with AK006 in CSU and other mast cell driven conditions. Allakos plans to test AK006 in a randomized, 
double-blind, placebo-controlled cohort of patients with chronic spontaneous urticaria (“CSU”). We expect data from the CSU cohort to be 
available at year end 2024. Chronic spontaneous urticaria is an inflammatory skin disease believed to be caused by the inappropriate 

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•

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activation  of  mast  cells  in  the  skin.  We  believe  there  is  a  need  for  additional  treatments  for  patients  with  CSU  that  are  refractory  to 
antihistamines. In addition, in 2024 we plan to initiate a clinical study with AK006 in an additional mast cell driven condition. 

Develop Subcutaneous formulation of AK006. We have also developed a formulation of AK006 for SC administration.  As part of the Phase 
1 study, we are administering SC AK006 to a cohort of healthy volunteers. We expect to report SC AK006 safety, PK, and PD data, including 
bioavailability as well as Siglec-6 receptor occupancy in skin biopsy samples, during the third quarter of 2024.  Pending positive data from 
the SC cohort, Allakos plans to use the SC formulation in subsequent AK006 clinical development.

Build therapeutic pipeline. Our research is focused on immunomodulatory receptors present on immune effector cells involved in allergic, 
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  the  function  of  the  receptors  could  restore  the  immune  cells’  ability  to  identify  and  kill 
proliferative  cells.  Following  this  approach,  we  have  developed  AK006  and  have  research  programs  directed  at  other  immunomodulatory 
targets.

AK006 Clinical Development

We  are  developing  AK006  for  the  treatment  of  CSU  and  potentially  other  indications.  AK006  has  completed  extensive  preclinical  testing  and,  in 
these studies, we have demonstrated that binding of AK006 to Siglec-6 inhibits multiple modes of mast cell activation, including IgE, IL-33, KIT, C5a, and 
MRGPR-X2,  resulting  in  the  deep  suppression  of  mast  cell  activation.  In  addition  to  mast  cell  inhibition,  AK006  reduced  human  tissue  mast  cells  via 
ADCP in the presence of activated macrophages. AK006 is currently being evaluated in a Phase 1 study in healthy volunteers and we plan to initiate a 
Phase 1 cohort in patients with CSU.

In the third quarter of 2023, we began dosing healthy volunteers in a randomized, double-blind, placebo-controlled Phase 1 study of AK006.  The 
Phase 1 study of AK006 consists of SAD and MAD cohorts in healthy volunteers as well as a cohort in patients with CSU who will be administered AK006 
via  intravenous  infusion.  We  expect  to  report  SAD  and  MAD  safety,  PK  and  PD  results  in  the  second  quarter  of  2024.    Additional  key  measurements 
include Siglec-6 receptor occupancy data in skin biopsies. Following the SAD and MAD portions of the Phase 1 AK006 study in healthy volunteers, we 
plan to initiate a randomized, double-blind, placebo-controlled cohort of patients with CSU. We expect data from the CSU cohort to be available at year end 
2024.

Allakos  has  also  developed  a  formulation  of  AK006  for  SC  administration.    As  part  of  the  randomized,  double-blind,  placebo-controlled  Phase  1 
study, we initiated a cohort in healthy volunteers who will be administered AK006 via SC formulation. We expect to report SC AK006 safety, PK, and PD 
results, including bioavailability as well as Siglec-6 receptor occupancy in skin biopsy samples, during the third quarter of 2024.  Pending success in the SC 
cohort, we plan to use the SC formulation in all subsequent AK006 clinical development. 

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Figure 3. AK006 Phase 1 Study Design

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. 
The most common forms of CU are chronic spontaneous urticaria (“CSU”), cholinergic urticaria and symptomatic dermatographism. 

Urticaria  symptoms  are  caused  by  the  inappropriate  activation  of  mast  cells  via  IgE-dependent  and  IgE-independent  pathways  in  the  skin.    IgE-
dependent mast cell activation has been identified as a pathogenic driver of urticaria and agents which target this pathway have demonstrated therapeutic 
activity. More recently, mast cell activation through MRGPR-X2, an IgE independent mast cell activation pathway, has been implicated in urticaria disease 
pathogenesis.  In urticaria, agents that target both IgE-dependent and IgE-independent modes of mast cell activation have the potential to work in a broader 
patient population or show greater symptom improvement.

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. 

In  the  United  States,  it  is  estimated  that  there  are  approximately  800,000  adults  with  moderate-to-severe  CSU  whose  disease  is  refractory  to 

antihistamines. There is only one FDA approved therapy, omalizumab, with low (<10%) usage for these patients.

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, 

8

 
 
 
 
 
 
 
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  CSU  patients  who  remain  symptomatic  despite  antihistamine  treatment,  the  only  currently 
approved  treatment  is  Xolair  (omalizumab),  a  monoclonal  anti-IgE  antibody.  Unfortunately,  approximately  60%  of  CSU  patients  continue  to  have 
symptoms despite treatment with Xolair.

AK006 Preclinical Data

AK006  targets  Siglec-6,  an  inhibitory  receptor  expressed  selectively  on  mast  cells.  Binding  of  AK006  to  Siglec-6  activates  the  native  inhibitory 
function of the receptor which in turn reduces mast cell activation. In preclinical studies, AK006 inhibited multiple modes of mast cell activation, including 
IgE,  IL-33,  KIT,  C5a,  and  MRGPR-X2,  resulting  in  the  broad  suppression  of  inflammation.  In  addition  to  mast  cell  inhibition,  AK006  reduced  human 
tissue mast cells via ADCP. AK006 appears to have the potential to provide deeper mast cell inhibition than lirentelimab and, in addition to its inhibitory 
activity, to reduce mast cell numbers. 

AK006 induces potent IgE mast cell inhibition in ex vivo human tissue

Activation of skin mast cells through the IgE receptor has been identified as contributing to the pathogenesis of CSU and other mast cell driven 
conditions. To evaluate AK006’s ability to inhibit IgE activation of mast cells, we developed an IgE-mediated mast cell activation assay in human tissue. In 
this assay, mast cells are activated via high affinity IgE receptor, FceRI, using an agonistic anti-FceRI antibody and mast cell activation is evaluated by 
examining  CD63  expression  using  flow  cytometry.  CD63  is  an  activation  marker  found  on  mast  cell  granules,  high  levels  indicate  that  mast  cells  are 
actively degranulating. AK006 was able to provide near complete levels of inhibition in this preclinical experiment. 

Figure 4. IgE-Mediated Mast Cell Activation in Human Tissue

AK006 inhibits systemic anaphylaxis in vivo

AK006 has been shown to inhibit mast cell activation in vivo using a systemic anaphylaxis mouse model. Administration of an anti-FceRI antibody, 
to  activate  mast  cells,  induces  systemic  anaphylaxis  in  humanized  mice.  AK006  +  anti-FceRI  treated  mice  demonstrated  inhibition  of  an  anaphylactic 
response  compared  to  isotype  control  +  anti-FceRI  treated  mice  that  experienced  an  anaphylactic  response.  Moreover,  AK006  treated  mice  displayed 
reduced levels of mast cell-derived mediators, including active tryptase, chymase and histamine. The data suggest that AK006 can inhibit IgE activation of 
mast cells in vivo as well as in vitro.

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Figure 5. AK006 Protects Against Systemic Anaphylaxis in Humanized Mice

AK006 reduces MRGPR-X2 activation in skin inflammation model

AK006 has also been shown to inhibit MRGPR-X2 activation of mast cells in vivo.  In a MRGPR-X2-mediated skin inflammation model, Siglec-6 
transgenic mice or Siglec-8 transgenic mice were dosed with AK006, lirentelimab or an isotype. Mice were then injected intradermally with a substance 
(LL37)  that  activates  MRGPR-X2,  twice  a  day,  for  two  days.  This  MRGPR-X2-mediated  mast  cell  activation  in  mice  induced  erythema,  as  well  as 
monocyte, and eosinophil infiltration. This data further demonstrates that treatment with AK006, but not lirentelimab, significantly reduces MRGPR-X2-
mediated skin inflammation.

Figure 6. AK006 Reduces MRGPR-X2-Induced Skin Inflammation

AK006 inhibits KIT-mediated mast cell activation in vivo

AK006 also has been shown 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. 

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Figure 7. 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 the number of human tissue mast cells in the presence of activated macrophages relative to an isotype control mAb (“ISO”). This data 
suggests AK006 has unique activity that reduces mast cells via ADCP in the presence of activated effector cells, such as macrophages. 

Figure 8. 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.

AK006 is currently being evaluated in a Phase 1 study in healthy volunteers and we plan to initiate a Phase 1 cohort in patients with CSU.  We 

expect data from the CSU cohort to be available at year end 2024.

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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. 

Prior Clinical Programs with Lirentelimab

Lirentelimab  has  been  administered  to  more  than  1,000  patients,  and  approximately  500  patients  have  been  exposed  for  six  months  or  more. 
Lirentelimab has generally been well-tolerated in each of our clinical trials and has consistently demonstrated high levels of eosinophil depletion in blood 
and tissue. Lirentelimab showed activity in open label clinical studies in chronic urticaria, severe allergic conjunctivitis and indolent systemic mastocytosis. 
Moreover,  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. The ENIGMA 2, KRYPTOS and EoDyssey studies each met the histologic 
co-primary endpoint of those studies but did not meet the symptomatic co-primary endpoint when compared to placebo.  More recently, the ATLAS and 
MAVERICK  studies  did  not  meet  their  primary  endpoints.  Due  to  the  negative  results  in  the  recent  clinical  studies,  we  have  halted  lirentelimab 
development efforts.

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, and governmental agencies, as well as 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 specifically targets Siglec-6. The 

competition we may face with respect to each of the indications we are targeting with AK006 includes:

•

Chronic Spontaneous Urticaria - Xolair (Roche and Novartis) is the only drug currently approved by the FDA for the treatment of CSU. 
Companies  conducting  studies  in  chronic  spontaneous  urticaria  include:  Novartis  (remibrutinib),  Sanofi  (rilzabrutinib),  Regeneron 
(dupilumab), and Celldex (barzolvolimab).

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 

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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 preclinical testing and in compliance with 
cGMP requirements for clinical trials under our guidance. In the case of AK006, 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,
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.

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.

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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 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  multiple  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;

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.

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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.

Prior to beginning the first clinical trial with a product candidate in the United States, the sponsor must submit an IND to the FDA. An IND is a 
request for authorization from the FDA to administer an investigational new drug product to humans. The central focus of an IND submission is on the 
general investigational plan and the protocol(s) for clinical studies. The IND also includes results of animal and in vitro studies assessing the toxicology, 
pharmacokinetics,  pharmacology,  and  pharmacodynamic  characteristics  of  the  product;  chemistry,  manufacturing,  and  controls  information;  and  any 
available human data or literature to support the use of the investigational product. Some long-term preclinical testing, such as animal tests of reproductive 
adverse events and carcinogenicity, may continue after the IND submission is complete. An IND must become effective before human clinical trials may 
begin. The IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA, within the 30-day time period, raises safety concerns or 
questions about the proposed clinical trial. In such a case, the IND may be placed on clinical hold and the IND sponsor and the FDA must resolve any 
outstanding concerns or questions before the clinical trial can begin. Submission of an IND therefore may or may not result in FDA authorization to begin a 
clinical trial. 

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.

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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.  Since  the  start  of  the  COVID-19  pandemic,  the  FDA  has  issued  various  COVID-19-related  guidance  documents  for  sponsors  and 
manufacturers. President Biden ended the COVID-19 national and public health emergencies on May 11, 2023. The full impact of the termination of the 
public health emergencies on FDA and other regulatory policies and operations are unclear.

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 or BLA 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 2024, the 
user fee for an application requiring clinical data, such as an NDA or BLA, is approximately $4 million. PDUFA also imposes an annual program fee for 
human drugs and biologics of about $0.42 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.

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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, 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.

If regulatory approval of a product is granted, such approval will be granted for particular indications and may entail limitations on the indicated 
uses for which such product may be marketed. For example, the FDA may approve the NDA with a Risk Evaluation and Mitigation Strategy (REMS) to 
ensure the benefits of the product outweigh its risks. A REMS is a safety strategy to manage a known or potential serious risk associated with a medicine 
and to enable patients to have continued access to such medicines by managing their safe use. It 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. The FDA also may offer 
conditional  approval  subject  to,  among  other  things,  changes  to  proposed  labeling  or  the  development  of  adequate  controls  and  specifications.  Once 
approved, the FDA may withdraw the product approval if compliance with pre- and post-marketing requirements is not maintained or if problems occur 
after  the  product  reaches  the  marketplace.  The  FDA  may  also  require  one  or  more  Phase  4  post-market  studies  and  surveillance  to  further  assess  and 
monitor the product’s safety and effectiveness after commercialization and may limit further marketing of the product based on the results of these post-
marketing studies. In addition, new government requirements, including those resulting from new legislation, may be established, or the FDA’s policies 
may change, which could impact the timeline for regulatory approval or otherwise impact ongoing development programs.

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.

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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.

In response to the court decision in Catalyst Pharms., Inc. v. Becerra, 14 F.4th 1299 (11th Cir. 2021), in January 2023, the FDA published a notice in 
the  Federal  Register  to  clarify  that  while  the  agency  complies  with  the  court’s  order  in  Catalyst,  FDA  intends  to  continue  to  apply  its  longstanding 
interpretation of the regulations to matters outside of the scope of the Catalyst  order  –  that  is,  the  agency  will  continue  tying  the  scope  of  orphan-drug 
exclusivity to the uses or indications for which a drug is approved, which permits other sponsors to obtain approval of a drug for new uses or indications 
within the same orphan designated disease or condition that have not yet been approved. It is unclear how future litigation, legislation, agency decisions, 
and administrative actions will impact the scope of the orphan drug exclusivity.

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.

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 

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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.  Further,  the  Food  and  Drug  Omnibus  Reform  Act  made  several  changes  to  the  FDA’s  authorities  and  its  regulatory  framework, 
including,  among  other  changes,  reforms  to  the  accelerated  approval  pathway,  such  as  requiring  the  FDA  to  specify  conditions  for  post-approval  study 
requirements and setting forth procedures for the FDA to withdraw a product on an expedited basis for non-compliance with post-approval requirements.

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.

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:

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•

•

•

•

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  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 

20

 
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.

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

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•

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.

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 

22

 
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.

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.

23

 
On  January  31,  2022,  the  Clinical  Trials  Regulation  (“CTR”)  went  into  application,  which  aims  to  harmonize  the  submission,  assessment  and 
supervision processes for clinical trials in the European Union. The CTR also provided a new Clinical Trials Information System (“CTIS”), which provides
a single entry point for sponsors and regulators of clinical trials and a public searchable database for certain clinical trial information.

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 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 

24

 
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 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.

Moreover,  there  has  recently  been  heightened  governmental  scrutiny  over  the  manner  in  which  drug  manufacturers  set  prices  for  their  marketed 
products,  which  has  resulted  in  several  Congressional  inquiries  and  proposed  and  enacted  federal  and  state  legislation  designed  to,  among  other  things, 
bring more transparency to product pricing, review the relationship between pricing and manufacturer patient programs, and reform government program 
reimbursement methodologies for drug products. Under the American Rescue Plan Act of 2021, effective January 1, 2024, the statutory cap on Medicaid 
Drug Rebate Program rebates that manufacturers pay to state Medicaid programs will be eliminated. Elimination of this cap may require pharmaceutical 
manufacturers  to  pay  more  in  rebates  than  it  receives  on  the  sale  of  products,  which  could  have  a  material  impact  on  our  business.  In  August  2022, 
Congress passed the Inflation Reduction Act of 2022  (the “Inflation Reduction Act”), which includes prescription drug provisions that have significant
implications for the pharmaceutical industry and Medicare beneficiaries, including allowing the federal government to negotiate a maximum fair price for 
certain high-priced single source Medicare drugs, imposing penalties and excise tax for manufacturers that fail to comply with the drug price negotiation 
requirements, requiring inflation rebates for all Medicare Part B and Part D drugs, with limited exceptions, if their drug prices increase faster than inflation, 
and  redesigning  Medicare  Part  D  to  reduce  out-of-pocket  prescription  drug  costs  for  beneficiaries,  among  other  changes.  Various  industry  stakeholders, 
including certain pharmaceutical companies and the 

25

 
Pharmaceutical  Research  and  Manufacturers  of  America  have  initiated  lawsuits  against  the  federal  government  asserting  that  the  price  negotiation 
provisions  of  the  IRA  are  unconstitutional.  The  impact  of  these  judicial  challenges,  legislative,  executive,  and  administrative  actions  and  any  future 
healthcare measures and agency rules implemented by the government on us and the pharmaceutical industry as a whole is unclear. The implementation of 
cost containment measures, including the prescription drug provisions under the Inflation Reduction Act, as well as other healthcare reforms may prevent 
us from being able to generate revenue, attain profitability, or commercialize our product candidates if approved. Complying with any new legislation and 
regulatory changes could be time-intensive and expensive, resulting in a material adverse effect on our business.

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  (the  “Board”)  engages
regularly with management on human capital matters. As of December 31, 2023, we had 131 full-time employees, 98 of whom were engaged in research 
and  development  activities.  We  are  proud  to  have  a  well-balanced  and  diverse  group  of  employees  and  believe  that  our  current  workforce  structure
demonstrates our commitment to diversity in all aspects of our business. We note that more than half of our employees as of December 31, 2023, identified 
as  non-Caucasian  and  more  than  half  as  female.  We  also  know  that  diversity  is  vital  at  every  level,  including  the  Board.  None  of  our  employees  are 
represented  by  a  labor  union  or  covered  under  a  collective  bargaining  agreement.  Due  to  unfavorable  clinical  trial  results,  we  have  undergone  two 
reorganization plans which significantly decreased our workforce over the past two years.  We are mindful of the impact this has on retaining, hiring and 
motivating employees and have taken various steps to try to mitigate the negative effects of the workforce reductions, including a variety of activities to 
foster career development, team building, and increased communication throughout the organization. Despite these setbacks, we consider our relationship 
with our employees to be strong based on engagement scores, employee comments and turnover commensurate with that experienced in our industry.

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 

26

 
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 the COVID-19 pandemic. 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 
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. In 2022, we focused on collecting internal 
and external insights to inform decision-making on work models that would align with how employees will work in the current environment, including 
working  from  home,  fully  on-site,  or  in  a  hybrid  fashion,  which  has  evolved  as  a  result  of  the  COVID-19  pandemic.  In  2023,  our  focus  was  on  the 
implementation  and  sustained  success  of  the  new  work  models,  including  on-site  engagement  activities  that  reinforce  our  differentiating  culture  and 
facilitate cross-team networking, collaboration, and innovation. We will continue to monitor recommendations from local and national health authorities 
and respond accordingly.

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. 

January 2024 Reorganization

Due  to  the  clinical  trial  results  released  in  January  2024,  our  Board  approved  a  reorganization  plan  (the  “2024  Reorganization  Plan”)  to  reduce 
operating costs and better align our workforce with the new clinical development plans of our business. Under the 2024 Reorganization Plan, our workforce 
will  be  reduced  by  approximately  50%  primarily  during  the  first  quarter  of  2024.  The  management  team  and  the  Board  developed  severance  packages 
appropriate  to  the  market  conditions  for  similar  situations  and  companies.  Impacted  employees  are  eligible  to  receive  severance  benefits  and  Company 
funded COBRA premiums.

Facilities

Our  corporate  headquarters  are  located  in  San  Carlos,  California,  where  we  lease  approximately  96,000  square  feet  of  office,  research  and 
development  and  laboratory  space.  The  lease  term  will  expire  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 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.

27

 
Legal Proceedings

For  information  on  our  legal  proceedings,  see  the  section  entitled  “Item  3,  Legal Proceedings”,  in  this  Annual  Report  on  Form  10-K  (“Annual 

Report”). 

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  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 covering 
anti-Siglec-6 antibodies, such as AK006, and uses thereof, as of December 31, 2023, contains one U.S. patent application and one pending PCT application. 
These  applications,  with  projected  expiration  dates  in  2042,  are  solely  owned  by  us  and  are  drawn  to  the  active  component  of  AK006,  an  anti-Siglec-6 
antibody, pharmaceutical compositions comprising AK006, and methods for treatment of specified diseases using antibodies to Siglec-6.

We have also filed patent applications with claims pending relating to antibodies in preclinical development and methods for treating cancer and 

immune disorders with these antibodies.

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  (“USPTO”)  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.

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  AK006,  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.

28

 
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, 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 Section 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.

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,  including  our  financial  statements  and  the 
related notes and the section entitled “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.

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.

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

•

•

•

Our business may be adversely affected by health epidemics, such as the coronavirus outbreak.

We are dependent on the success of our lead product candidate, AK006, which is currently in early clinical development. If we are unable to 
obtain approval for and commercialize AK006 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.

29

 
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.

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.

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

Our  business  may  become  subject  to  economic,  political,  regulatory  and  other  risks  associated  with  international  operations  directly  or 
indirectly. A variety of risks associated with marketing our product candidates internationally could materially adversely affect our business.

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, Dr. Adam Tomasi, 
and our ability to attract and retain other 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 attain commercial success through the sale and marketing of our product candidates that obtain regulatory 
approval. 

In order to successfully implement our long-term plans and strategies, we will need to increase the number of employees in our organization, 
and we may experience difficulties in managing this employee 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 AK006, our ongoing 
clinical trial, 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 scaling-up of manufacturing of AK006, and our third-party manufacturers may be unable to 
successfully  scale-up  manufacturing  in  sufficient  quality  and  quantity  for  AK006  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.

Changes in methods of product candidate manufacturing or formulation may result in additional costs, delays or have unintended impacts to 
the development of our product candidates.

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Risks Related to Ownership of Our Common Stock

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•

•

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.

We have been and may in the future be subject to securities litigation, which is expensive and could divert management attention from other 
business concerns.

General Business Risks

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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.

Failure to comply with anti-bribery and anti-corruption laws and anti-money laundering laws, and similar laws, could subject us to penalties 
and other adverse consequences.

We are subject to various governmental export control and trade sanctions laws and regulations that could impair our ability to compete in 
international markets or subject us to liability if we violate these controls. 

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

The other factors discussed under “Risk Factors”.

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  former  product  candidate.  All  of  our  product  candidates  currently 
under  development,  other  than  AK006,  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 January 2024, we announced that both our ATLAS clinical trial and our MAVERICK clinical trial failed to meet their 
primary endpoints. As a result of the results announced in January 2024, we implemented the 2024 Reorganization Plan to better align our resources with 
our development strategy focused on AK006. 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 

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net losses were $185.7 million and $320.0 million for the years ended December 31, 2023 and 2022, respectively. As of December 31, 2023, we had an 
accumulated  deficit  of  $1,118.5  million.  We  have  devoted  substantially  all  of  our  resources  and  efforts  to  research  and  development.  Our  lead  product 
candidate, AK006, is in early 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 our manufacturing and clinical activities, 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 AK006 and 
any  other  product  candidates  remains  uncertain.  For  example,  in  January  2024  we  announced  that  both  our  ATLAS  clinical  trial  and  our  MAVERICK 
clinical trial failed to meet their primary endpoints, and 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  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:

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successful and timely completion of preclinical and clinical development of our lead product candidate, AK006, and any other future product 
candidates;

timely receipt of marketing approvals for AK006 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  AK006  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  AK006  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.

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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,  AK006  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 significant 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 need to 
reevaluate our operating plan and 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, 2023, we had $170.8 million in cash, cash equivalents and marketable securities. We filed: (i) on August 4, 2022, a prospectus 
supplement to our shelf registration statement on Form S-3 (File No. 333-265085) that covers the offering, issuance and sale of up to $75.0 million of our 
common stock from time to time through an “at-the-market” program under the Securities Act of 1933, as amended, and (ii) on September 19, 2022, a 
prospectus  supplement  to  such  shelf  registration  statement  that  covered  the  offering,  issuance  and  sale  of  29,882,000  shares  of  our  common  stock,  at  a 
public offering price of $5.02 per share. We received aggregate net proceeds of $140.6 million, after deducting the underwriting commissions and offering 
expenses from the September 19, 2022 follow-on offering and as of December 31, 2023 received aggregate net proceeds of $1.0 million under the “at-the-
market” program. We believe that our existing cash, cash equivalents and 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 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  marketable  securities  to  fund  our  development  of  AK006  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  AK006  and  any  other  product  candidates  will  require  a 
significant amount of capital. Our existing cash, cash equivalents and marketable securities will not be sufficient to fund all of the actions that are necessary 
to complete the development and commercial approval of AK006 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.  Additionally,  our  ability  to  raise  additional  capital  may  be  adversely  impacted  by  potential  worsening  of  global  economic 
conditions and volatility of financial markets in the United States and worldwide. 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, such as the coronavirus outbreak.

The COVID-19 pandemic had an adverse impact on our operations and supply chains and COVID-19, or other health epidemics, may further disrupt 

our operations, supply chains or those of our contractors, and increase our 

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expenses.  We  and  our  contractors  experienced  and  may  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, the U.S. federal government may, among other things, require domestic 
industries to provide essential goods and services needed for the national defense, and it used the Defense Production Act in the context of the COVID-19 
pandemic to divert supplies and materials to vaccine producers. For example, one of our suppliers informed us that, due to their obligation to prioritize 
other products or customers pursuant to the Defense Production Act, they were 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 did not cause delays in our overall timeline for clinical trials or regulatory 
filings, it is possible that similar 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  health  epidemics,  which  could  impact  our  proposed  timeline  for  developing  and 
commercializing AK006 and adversely impact our business, financial condition and results of operations. 

In addition, the spread of COVID-19 disrupted the United States’ healthcare and healthcare regulatory systems; accordingly, COVID-19 or health 
epidemics may 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 COVID-19 outbreaks or other health epidemics. Site initiation and patient 
enrollment  may  be  delayed,  for  example,  due  to  factors  including  prioritization  of  hospital  resources  toward  COVID-19  patients,  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 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. Health epidemics 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. Health epidemics 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 our operations are impacted from COVID-19 or health epidemics, 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  including  COVID-19,  could  adversely  impact  our  business.  Although  we  are  continuing  to 
monitor and assess the effects of public health conditions on our business, the ultimate impact of health epidemics is highly uncertain and subject to change. 

We are dependent on the success of our lead product candidate, AK006, which is currently in early clinical development. If we are unable to obtain 
approval for and commercialize AK006 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 AK006, our lead product candidate. AK006 is in the early-stage of clinical development and we are investing the majority of our efforts and 
financial  resources  in  the  research  and  development  of  AK006.  Our  ability  to  develop  AK006  remains  uncertain,  especially  given  that  we  have  not  yet 
completed the Phase 1 trial for AK006. For example, in January 2024, we announced that both our ATLAS clinical trial and our MAVERICK clinical trial 
with  lirentelimab  failed  to  meet  their  primary  endpoints.  Similarly,  in  December  2021,  we  announced  that  our  phase  3  ENIGMA  study  and  KRYPTOS 
study failed to meet their patient reported symptomatic co-primary endpoints. AK006 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. We are not permitted to market or promote 

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AK006 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 AK006 will depend on several factors, including the following:

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initiation and timely completion of our clinical trials of AK006;

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 health pandemics;

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 AK006 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;

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 

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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 health epidemics;

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. 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.

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 contract research organizations (“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

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•

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

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 product candidates approved for sale and we cannot guarantee that we will ever have marketable product candidates. Clinical 
failure  can  occur  at  any  stage  of  clinical  development  and  has  been  experienced  by  companies  pursuing  approval  in  the  indications  that  we  are,  or  are 
contemplating, developing. 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 AK006 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.

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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 REMS, if any, which may 
not be required of alternative treatments and competitor products;

the potential and perceived advantages of product candidates over alternative treatments, including standard of care treatment regimes;

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.  Intravenous  and  subcutaneous 
drugs are less convenient for patients than some other methods of administration, such as an orally delivered drug. The SAD and MAD cohorts in healthy 
volunteers,  as  well  as  well  as  a  cohort  in  patients  with  CSU,  was  administered  AK006  via  intravenous  infusion  and  we  plan  to  administer  AK006 
subcutaneously in future clinical trials.

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 AK006 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 AK006 and any other future product candidates may be limited or may not be 
amenable to treatment with AK006 and 

38

 
any other products, if and when approved. Even if we obtain significant market share for AK006 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  AK006  into  clinical  development  and  through  to 
regulatory  approval  and  commercialization.  Our  other  product  candidates  are  at  even  earlier  stages  of  development  than  AK006  and  may  fail  in 
development or suffer delays that adversely affect their commercial viability.

AK006  is  in  early  clinical  development  and  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  AK006.  The  success  of  any  product  candidates  we  may  develop  will  depend  on  many  factors, 
including, among other things, the following:

•

•

•

•

•

•

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

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 product candidates 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 CMS. 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  product  does  not  assure  that  other  payors  will  also  provide  coverage  for  the  product.  As  a  result,  the 
coverage determination process is often time-consuming and costly. This process will require 

39

 
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 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 Siglec-6. The competition 
we may face with respect to the indications we are targeting with AK006 includes, without limitation, Roche, Novartis, Regeneron, Celldex and Gossamer 
Bio for CU. 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 

40

 
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 AK006 for a limited number of 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  developing  AK006  for  a  limited  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  products  or  profitable  market  opportunities.  Our  spending  on  current  and  future  research  and 
development activities for specific indications may not yield any commercially viable product candidates. 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,  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 

41

 
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;

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.

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.  Significant  regulatory  hurdles  remain, 
both near term and long term, before AK006 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.

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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 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  public  health  concerns,  staffing 
shortages,  government  shutdowns  and  furloughs,  or  other  disruptions  to  FDA’s  normal  operations.  Examples  of  changes  in  regulations  include  future 
legislation or administrative action, or changes in FDA policy during the period of product development, clinical trial requirements 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.

If 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 

43

 
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  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 clinical trial 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  (“GCPs”)  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 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 

44

 
ongoing regulatory requirements. These requirements include submissions of safety and other post-marketing information and reports, registration, as well 
as continued compliance with cGMPs and 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.

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.

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. 

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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.

In response to the court decision in Catalyst Pharms., Inc. v. Becerra, 14 F.4th 1299 (11th Cir. 2021), in January 2023, the FDA published a notice in 
the  Federal  Register  to  clarify  that  while  the  agency  complies  with  the  court’s  order  in  Catalyst,  FDA  intends  to  continue  to  apply  its  longstanding 
interpretation of the regulations to matters outside of the scope of the Catalyst  order  –  that  is,  the  agency  will  continue  tying  the  scope  of  orphan-drug 
exclusivity to the uses or indications for which a drug is approved, which permits other sponsors to obtain approval of a drug for new uses or indications 
within the same orphan designated disease or condition that have not yet been approved. It is unclear how future litigation, legislation, agency decisions, 
and administrative actions will impact the scope of the orphan drug exclusivity.

Although  we  may  seek  a  breakthrough  therapy  designation  for  AK006  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 AK006 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 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.

The Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the 
“ACA”) substantially changed the way healthcare is financed by both the government and private insurers, and continues to significantly impact the U.S. 
pharmaceutical industry. In January 2013, President Obama signed into law the American Taxpayer Relief Act of 2012, which, among other things, 

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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. Since the enactment of the ACA, there have been judicial and Congressional challenges to certain aspects of the ACA. 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 will remain in effect through 2032, unless Congress takes additional action. 

There  has  been  heightened  governmental  scrutiny  recently  over  the  manner  in  which  drug  manufacturers  set  prices  for  their  marketed  products, 
which has resulted in several Congressional inquiries and proposed and enacted federal and state legislation designed to, among other things, bring more 
transparency  to  product  pricing,  review  the  relationship  between  pricing  and  manufacturer  patient  programs,  and  reform  government  program 
reimbursement  methodologies  for  drug  products.  Under  the  American  Rescue  Plan  Act  of  2021,  the  statutory  cap  on  Medicaid  Drug  Rebate  Program 
rebates that manufacturers pay to state Medicaid programs was eliminated. Elimination of this cap may require pharmaceutical manufacturers to pay more 
in rebates than they receive on the sale of products, which could have a material impact on our business. In August 2022, Congress passed the Inflation 
Reduction Act, which includes prescription drug provisions that have significant implications for the pharmaceutical industry and Medicare beneficiaries, 
including allowing the federal government to negotiate a maximum fair price for certain high-priced single source Medicare drugs, imposing penalties and 
excise tax for manufacturers that fail to comply with the drug price negotiation requirements, requiring inflation rebates for all Medicare Part B and Part D 
drugs, with limited exceptions, if their drug prices increase faster than inflation, and redesigning Medicare Part D to reduce out-of-pocket prescription drug 
costs for beneficiaries, among other changes. Various industry stakeholders, including certain pharmaceutical companies and the Pharmaceutical Research 
and  Manufacturers  of  America  have  initiated  lawsuits  against  the  federal  government  asserting  that  the  price  negotiation  provisions  of  the  IRA  are 
unconstitutional. The impact of these judicial challenges, legislative, executive, and administrative actions and any future healthcare measures and agency 
rules  implemented  by  the  government  on  us  and  the  pharmaceutical  industry  as  a  whole  is  unclear.  The  implementation  of  cost  containment  measures, 
including  the  prescription  drug  provisions  under  the  Inflation  Reduction  Act,  as  well  as  or  other  healthcare  reforms  may  prevent  us  from  being  able  to 
generate revenue, attain profitability, or commercialize our product candidates if approved.

At  the  state  level,  legislatures  are  increasingly  passing  legislation  and  implementing  regulations  designed  to  control  pharmaceutical  and  biologic 
product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and 
transparency  measures,  and  in  some  cases,  designed  to  encourage  importation  from  other  countries  and  bulk  purchasing.  For  example,  FDA  recently 
authorized the state of Florida to import certain prescription drugs from Canada for a period of two years to help reduce drug costs, provided that Florida’s 
Agency for Health Care Administration meets the requirements set forth by the FDA. Other states may follow Florida. Legally mandated price controls on 
payment amounts by third-party payors or other restrictions on coverage or access could harm our business, results of operations, financial condition and 
prospects. In addition, regional healthcare authorities and individual hospitals are increasingly using bidding procedures to determine what pharmaceutical 
products  and  which  suppliers  will  be  included  in  their  prescription  drug  and  other  healthcare  programs.  This  could  reduce  the  ultimate  demand  for  our 
product candidates that we successfully commercialize or put pressure on our product pricing.

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. Further, if the Supreme Court reverses or curtails the Chevron doctrine, which gives deference 
to regulatory agencies in litigation against FDA and other agencies, more companies may bring lawsuits against FDA to challenge longstanding decisions 
and policies of FDA, which could undermine FDA’s authority, lead to uncertainties in the industry, and disrupt FDA’s normal operations, which could delay 
FDA’s review of our marketing applications.

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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 
used and otherwise processed 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 protected health information 
governed by the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 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 and Enforcement Act 
(the  “CPRA”),  which  amends  and  expands  the  CCPA,  and  creates  a  new  California  privacy  regulatory  authority,  was  passed  via  ballot  initiative  in 
November 2020 and became effective in most material respects on January 1, 2023. Numerous other states have proposed, and in certain cases enacted, 
new  legislation  relating  to  privacy  and  security.  For  example,  Washington  has  enacted  the  My  Health,  My  Data  Act,  which  includes  a  private  right  of 
action. Additionally, numerous other states, including Virginia, Colorado, Utah, Connecticut, Iowa, Indiana, Tennessee, Florida, Texas, Oregon, Delaware, 
and  Montana,  have  enacted  laws  addressing  privacy  and  security  that  impose  obligations  similar  to  those  of  the  CCPA  and  CPRA.  More  generally,  the 
CCPA and CPRA have prompted proposals for new federal and state privacy legislation that, if enacted, could increase our potential liability, increase our 
compliance costs, require us to modify our policies and practices, and adversely affect our business.

We  may  also  be  subject  to  or  affected  by  federal,  state  and  foreign  laws,  regulations  and  regulatory  guidance  governing  the  collection,  use, 
disclosure, security, transfer, storage and other processing 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. We also may be or may be asserted to be subject to additional obligations 
relating to these matters, including industry standards. The global legislative and regulatory landscapes for privacy, data protection and information security 
matters continue 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, impose additional costs, and cause it to be necessary or appropriate for us to modify our policies or practices, which 
we may be unable to do on commercial reasonable terms or at all. 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 (EU 2016/679) (the “GDPR”), and the United Kingdom has 
adopted its General Data Protection Regulation (the “UK GDPR”), which introduced strict requirements for processing personal data. The GDPR and UK 
GDPR have increased 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 otherwise process information about them. The processing of 
sensitive personal data, such as information about health conditions, entails heightened compliance burdens under the GDPR and the UK GDPR and is a 
topic  of  active  interest  among  foreign  regulators.  In  addition,  the  GDPR  and  the  UK  GDPR  provide  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 under the GDPR (or £17.5 million under the UK 
GDPR). Numerous other jurisdictions have proposed or enacted legislation that is similar to the GDPR and the UK GDPR. Significant effort and expense 
are required in order to address the GDPR’s and the UK GDPR’s restrictions and obligations. Moreover, the requirements under the GDPR and UK 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  or  otherwise  more  burdensome  than  under  current  requirements.  For 
example, in July 2020, the Court of Justice of the European Union invalidated the EU-U.S. 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. This has increased the complexity of transferring 
personal data across borders and may require us to review and amend our mechanisms relating to cross-border data transfer. It is also possible that laws, 
regulations, and other actual or asserted obligations relating to privacy, data protection or information security may be interpreted and applied in manners 
that  are,  or  are  alleged  to  be,  inconsistent  with  our  practices.  Any  failure  or  perceived  failure  by  us  to  comply  with  federal,  state,  or  foreign  laws,  self-
regulatory 

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standards,  contractual  obligations  or  other  actual  or  asserted  obligations  relating  to  privacy,  data  protection  or  cybersecurity  could  result  in  negative 
publicity, harm to our reputation, diversion of management time and effort, proceedings against us by governmental entities or others, and fines, penalties 
and  other  liabilities.  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 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:

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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;

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  made  to  covered  recipients,  including  physicians  (defined  to 
include  doctors,  dentists,  optometrists,  podiatrists  and  chiropractors),  certain  non-physician  healthcare  professionals  (such  as  nurse 
practitioners  and  physician  assistants,  among  others),  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.

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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.

Our business may become subject to economic, political, regulatory and other risks associated with international operations directly or indirectly. A 
variety of risks associated with marketing our product candidates internationally could materially adversely affect our business.

Our business is subject to risks associated with business operations we conduct internationally, as well as indirect impacts from our relationships 
with collaborators, partners, or contractors who conduct business internationally. We may seek regulatory approval of our product candidates outside of the 
United States and, accordingly, we expect that we will be subject to additional risks related to operating in foreign countries if we obtain the necessary 
approvals, including:

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differing regulatory requirements and reimbursement regimes in foreign countries, including changes in existing regulatory requirements and 
implementation of new regulatory requirements or policies that impact our clinical development and business operations in foreign countries;

foreign regulatory authorities may disagree with the design, implementation or results of our clinical trials or our interpretation of data from 
preclinical studies or clinical trials;

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

unexpected changes in tariffs, trade barriers, price and exchange controls and other regulatory requirements;

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

compliance with tax, employment, immigration and labor laws for employees living or traveling abroad;

foreign taxes, including withholding of payroll taxes;

foreign  currency  fluctuations,  which  could  result  in  increased  operating  expenses  and  reduced  revenue,  and  other  obligations  incident  to 
doing business in another country;

difficulties staffing and managing foreign operations;

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

potential liability under the FCPA or comparable foreign regulations;

challenges  enforcing  our  contractual  and  intellectual  property  rights,  especially  in  those  foreign  countries  that  do  not  respect  and  protect 
intellectual property rights to the same extent as the United States;

impact  of  the  COVID-19  pandemic  or  other  public  health  concerns  on  our  ability  to  produce  our  product  candidates  and  conduct  clinical 
trials in foreign countries;

production  or  supply  shortages  or  other  disruptions  resulting  from  any  events  affecting  raw  material  supply  or  manufacturing  capabilities 
abroad, including, but not limited to, impacts due to the ongoing 

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Ukraine-Russia war, addition of certain suppliers or companies to the Unverified List or other export restrictions or sanctions that can impact 
the supply chain, our business, or business operations of our suppliers, contractors or partners; and

•

business interruptions resulting from geo-political actions, national security concerns, trade restrictions, wars, such as the ongoing Ukraine-
Russia and Israel-Hamas wars, other regional or geo-political conflicts, and terrorism.

These  and  other  risks  associated  with  our  international  operations  may  materially  adversely  affect  our  ability  to  attain  or  maintain  profitable 
operations.  Further,  there  is  currently  significant  uncertainty  about  the  future  relationship  between  the  United  States  and  various  other  countries,  most 
significantly China, with respect to trade policies, treaties, tariffs, taxes, and other limitations on cross-border operations. The U.S. government has made 
and continues to make significant additional changes in U.S. trade policy and may continue to take future actions that could negatively impact U.S. trade.  
For  example,  legislation  has  been  introduced  in  Congress  to  limit  certain  U.S.  biotechnology  companies  from  using  equipment  or  services  produced  or 
provided by select Chinese biotechnology companies, and others in Congress have advocated for the use of existing executive branch authorities to limit 
those Chinese service providers’ ability to engage in business in the U.S. We cannot predict what actions may ultimately be taken with respect to trade 
relations between the United States and China or other countries, what products and services may be subject to such actions or what actions may be taken 
by  the  other  countries  in  retaliation.  If  we  are  unable  to  obtain  or  use  services  from  existing  service  providers  or  become  unable  to  export  or  sell  our 
products  to  any  of  our  customers  or  service  providers,  our  business,  liquidity,  financial  condition,  and/or  results  of  operations  would  be  materially  and 
adversely affected.

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, Dr. Adam Tomasi, and our 
ability to attract and retain other 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, Dr. Adam Tomasi. If we do not succeed in attracting and retaining other 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  are  able  to  offer.  Additionally,  we  have  announced  two 
reorganization  plans  within  the  past  24  months,  which  significantly  decreased  our  workforce.    These  actions  may  impact  our  ability  to  retain,  hire,  or 
motivate employees. 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.

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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 attain commercial success through the sale and marketing of 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 and as a result our 
commercialization efforts may be adversely impacted.

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.

In order to successfully implement our long-term plans and strategies, we will need to increase the number of employees in our organization, and we 
may experience difficulties in managing this employee growth.

In order to successfully implement our long-term 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  AK006  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  AK006  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 business-related 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 the first quarter of 2024 and 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  be  assured  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 AK006 and any other future product candidates or otherwise advance our business. We cannot be assured that we will be able to 
manage our existing third-party 

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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  AK006  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 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 

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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 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  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.

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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 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 

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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. 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, 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:

•

•

•

•

•

•

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.

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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  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.

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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 trial of AK006, and we expect to continue to rely upon third-parties to 
conduct additional clinical trials of AK006 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, 
such regulatory authority will determine 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 AK006, our ongoing clinical trial, 
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. If we were to experience an unexpected loss of supply of AK006 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 
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 

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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.

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 scaling-up manufacturing of AK006, and our third-party manufacturers may be unable to successfully 
scale-up manufacturing in sufficient quality and quantity for AK006 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 AK006 at a scale that is sufficient for us to complete our planned clinical trials.

However, in order to conduct larger clinical trials with AK006 or with any of our other product candidates, we may need to manufacture them in 
large quantities. Our third-party manufacturers 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 

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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,  delays  or  have  unintended  impacts  to  the 
development of our product candidates.

As product candidates progress through preclinical studies and 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  or  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, if approved, and generate revenue.

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 AK006 or our other product candidates is changed for any reason, 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, 

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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.

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 March 8, 2024, the closing price of our common stock was $1.43. 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, 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;

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

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

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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;

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 and ongoing economic uncertainty resulting from the war in Ukraine and conflict in the Middle East, inflationary pressures and rising 
interest  rates.  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.

An impairment in the carrying value of long-lived assets could negatively affect our consolidated results of operations and net worth.  We have 
substantial  amounts  of  long-lived  assets,  including  right-of-use  assets,  property  and  equipment,  which  are  subject  to  impairment  analysis  and  review. 
Identifying and assessing whether impairment indicators exist, or if events or significant changes in market conditions  have occurred, requires significant 
judgment. Any significant change in market conditions, including a sustained decline in our stock price, that indicate a reduction in carrying value, may 
give rise to impairment in the period that the change becomes known. We also continually evaluate whether events or circumstances have occurred that 
indicate the remaining estimated useful lives of our long-lived assets may warrant revision or whether the remaining balance of prepaid or other assets may 
not be recoverable.  Any of the above actions could result in impairment charges which could substantially affect our reported earnings in the periods such 
charges are recorded.

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.

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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 pandemic or other public health concerns;

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 AK006 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 AK006 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 AK006 or any of our future product candidates;

the level of demand for AK006 and any of our future product candidates, if approved, which may fluctuate significantly and be difficult to 
predict;

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 AK006 and any of our future product candidates;

our ability to commercialize AK006 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 variety of means, including 

equity offerings and potentially through debt financings, partnerships and 

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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, 2023, our executive officers, directors, holders of 5% or more of our capital stock and their respective affiliates beneficially 
owned approximately 41.7% 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  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 have been 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 have been 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 asserted claims for violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and Rule 10b-5 promulgated 
thereunder  and  sought  damages  based  on  alleged  material  misrepresentations  and  omissions  concerning  our  Phase  2  clinical  trials  of  lirentelimab.  The 
complaint, as amended, was dismissed and we consider this matter closed. That said, 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.

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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”;

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.

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 or proceeding asserting a claim of breach of a fiduciary duty owed by any of our directors, officers, or other employees to us or 
our stockholders;

any  action  or  proceeding  asserting  a  claim  arising  pursuant  to  any  provision  of  the  DGCL,  our  amended  and  restated  certificate  of 
incorporation or our amended and restated bylaws; or

any action or proceeding asserting a claim governed by the internal-affairs doctrine.

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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.

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 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.

Failure to comply with anti-bribery and anti-corruption laws and anti-money laundering laws, and similar laws, could subject us to penalties and other 
adverse consequences.

We have conducted and have ongoing studies in international locations, and may in the future initiate additional studies and conduct other activities 
in countries other than the U.S. Our business activities are subject to the FCPA, the U.S. domestic bribery statute contained in 18 U.S.C. § 201 the UK 
Bribery  Act  and  other  similar  anti-bribery  or  anti-corruption  laws  and  anti-money  laundering  laws,  regulations  or  rules  of  other  countries  in  which  we 
operate.  Anti-corruption  and  anti-bribery  laws  generally  prohibit  companies,  their  employees,  agents,  representatives,  business  partners,  and  third-party 
intermediaries from offering, promising, giving or authorizing others to give improper payments or benefits to recipients in the public or private sector. 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  and  compliance  procedures  designed  to  prevent  violations  of  anti-corruption  and  anti-
bribery laws. 

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 enforcement under the FCPA. Recently 
the  SEC  and  Department  of  Justice  have  increased  their  FCPA  enforcement  activities  with  respect  to  biotechnology  and  pharmaceutical  companies.  We 
sometimes leverage third parties to conduct our business and act on our behalf 

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outside  of  the  United  States.  We,  our  employees,  agents,  representatives,  business  partners  and  third-party  intermediaries  may  have  direct  or  indirect 
interactions with officials and employees of government agencies or state-owned or affiliated entities and we may be held liable for the corrupt or other 
illegal  activities  of  these  employees,  agents,  representatives,  business  partners  or  third-party  intermediaries  even  if  we  do  not  explicitly  authorize  such 
activities.

While  we  have  policies  and  procedures  to  address  compliance  with  such  laws,  we  cannot  assure  you  that  all  of  our  employees,  agents, 
representatives,  business  parties  and  third-party  intermediaries  will  comply  with  our  policies  and  procedures  and  applicable  laws  and  regulations, 
particularly given the high level of complexity of these laws. 

Any  allegations  or  violations  of  these  laws  and  regulations  could  result  in  whistleblower  complaints,  investigations,  prosecutions,  settlements, 
enforcement actions, fines, severe criminal and civil sanctions, damages, adverse media coverage, loss of export privileges, or suspension or debarment 
from government contracts all of which 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.  Responding  to  any  investigation  or  action  will  likely  result  in  a 
materially significant diversion of management’s attention and resources and significant defense costs and other professional fees. 

We  are  subject  to  various  governmental  export  control  and  trade  sanctions  laws  and  regulations  that  could  impair  our  ability  to  compete  in 
international markets or subject us to liability if we violate these controls. 

In some cases, our products are subject to export control laws and regulations, including the Export Administration Regulations administered by the 
U.S.  Department  of  Commerce,  and  our  activities  may  be  subject  to  trade  and  economic  sanctions,  including  those  administered  by  the  United  States 
Department of the Treasury’s Office of Foreign Assets Control, or OFAC, (collectively, “Trade Controls”). As such, a license may be required to export or 
re-export our products, or provide related services, to certain countries and end-users, and for certain end-uses. The process for obtaining necessary licenses 
may be time-consuming or unsuccessful, potentially causing delays in sales or losses of sales opportunities and these licenses may not be issued.

Trade Controls are complex and dynamic regimes and monitoring and ensuring compliance can be challenging. Any failure to comply could subject 
us to both civil and criminal penalties, including substantial fines, possible incarceration of responsible individuals for willful violations, possible loss of 
our export or import privileges, and reputational harm. Although we have no knowledge that our activities have resulted in violations of Trade Controls, 
any failure by us or our partners to comply with applicable laws and regulations would have negative consequences for us, including reputational harm, 
government investigations, and penalties.

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

We  rely  on  both  internal  information  technology  systems  and  networks,  and  those  of  third  parties,  to  transmit,  store,  and  otherwise  process 
information in connection with our business activities. We are increasingly dependent on our technology systems to operate our business, and our ability to 
effectively manage our business depends on the security, reliability and adequacy of our systems, networks, and data, and those for our CROs and other 
third-party service providers. Despite the implementation of security measures, the computer systems used by us or our third-party service providers are 
vulnerable  to  damage,  disruption,  outages,  and  interruptions  from  computer  viruses,  ransomware  and  other  malicious  code,  denial  of  service  and  other 
cyberattacks, supply chain attacks, hacking and other means of obtaining unauthorized access, employee and service provider error or malfeasance, natural 
disasters, terrorism, war and telecommunication and electrical failure and other means to affect service reliability and threaten data confidentiality, integrity 
and  availability.  Any  system  failure,  accident  or  security  breach  or  incident  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 or incident that leads 
to the loss, unavailability or corruption 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 affected data. In addition, any disruption or security breach or incident may result in 
the  unavailability  or  loss  of  or  damage  to  our  data  or  applications,  or  inappropriate  use,  acquisition,  disclosure  or  other  processing  of  confidential  or 
proprietary information and loss of intellectual property. Should any of these occur, we may incur liability as a result, our drug 

67

 
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 or incident could also cause us to incur additional costs to address the disruption, failure, breach or incident and to 
remedy the damages that arise from such disruption, failure or security breach or incident. We and our third-party service providers may face difficulties or 
delays in identifying or responding to any disruption, failure, security breach or incident, and may find it necessary or appropriate to incur substantial costs 
in an effort to improve the protection of our data and information technology infrastructure, whether in response to an actual or suspected security breach or 
incident or otherwise. Many of our employees work and access systems remotely, which increases the risk of security breaches and incidents. Geopolitical
tensions and conflicts, such as the ongoing Russia-Ukraine war may also create heightened risks of cyberattacks and other incidents.

While we have invested, and continue to invest, in the protection of our data and information technology infrastructure, there can be no assurance 
that our efforts will prevent service interruptions, prevent or identify vulnerabilities or security breaches in or incidents impacting our systems or those of 
our third-party service providers, or prevent or identify other security breaches, incidents, or other compromises or events that lead to the loss or destruction 
of,  or  unauthorized  access  to,  or  use,  disclosure  or  other  processing  of  data  we  or  our  service  providers  process  or  maintain.  Any  actual  or  perceived 
security breach or incident may result in claims, demands and proceedings initiated by governmental actors or others, and financial, legal, business and 
reputational harm to us, including potential fines, penalties, and other damages and liabilities. Any such event may have a material adverse impact on our 
business, prospects, operating results and financial condition. Our insurance policies may not be adequate to compensate us for the potential losses arising 
from  any  such  disruption,  failure  or  security  breach  or  incident.  In  addition,  such  insurance  may  not  be  available  to  us  in  the  future  on  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:

•

•

•

•

•

•

•

•

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.

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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.

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 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, 2023, we had gross U.S. federal and state net operating loss carryforwards of $893.7 million and $847.2 million, respectively. 
Federal net operating loss carryforwards of $831.8 million, which were generated after December 31, 2017, do not expire. The remaining $61.8 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 by 
certain stockholders 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 had one or more 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 severely limited or eliminated by an “ownership change” as described 
above, which could result in increased tax liability to our company or reduced value of our deferred tax assets.

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Changes in tax laws or in their implementation or interpretation may adversely affect our financial condition, results of operations, and cash flows.

We are subject to income and non-income taxes in various jurisdictions. Tax laws, regulations and administrative practices in these jurisdictions may 
be subject to significant change, with or without advance notice. For example, the United States enacted the Tax Cuts and Jobs Act of 2017, which, starting 
from January 1, 2022, eliminates the option to deduct research and development expenditures currently and instead requires taxpayers to amortize them 
over  five  or  fifteen  years.  More  recently,  the  United  States  enacted  the  Inflation  Reduction  Act,  which,  among  other  provisions,  imposes  a  one-percent 
excise  tax  on  certain  stock  buybacks  by  U.S.  publicly-traded  corporations  on  or  after  January  1,  2023.  In  addition,  the  Organization  for  Economic 
Cooperation and Development proposed implementing a global minimum tax of 15%, which is being adopted or considered by many jurisdictions. Changes 
in tax laws, regulations, or rulings, changes in interpretations of existing laws and regulations, or changes in accounting principles could negatively and 
materially affect our financial position, cash flows, and results of operations.

Item 1B. Unresolved Staff Comments. 

None. 

Item 1C. Cybersecurity.

Risk Management and Strategy

We have established policies and processes for assessing, identifying, and managing material risk from cybersecurity threats, and have integrated 
these  processes  into  our  overall  risk  management  systems  and  processes.  We  routinely  assess  material  risks  from  cybersecurity  threats,  including  any 
potential unauthorized occurrence on or conducted through our information systems that may result in adverse effects on the confidentiality, integrity, or 
availability of our information systems or any information residing therein.

We  conduct  periodic  risk  assessments  to  identify  cybersecurity  threats,  as  well  as  assessments  in  the  event  of  a  material  change  in  our  business 
practices that may affect information systems that are vulnerable to such cybersecurity threats.  These risk assessments include identification of reasonably 
foreseeable  internal  and  external  risks,  the  likelihood  and  potential  damage  that  could  result  from  such  risks,  and  the  sufficiency  of  existing  policies, 
procedures, systems, and safeguards in place to manage such risks. 

Following these risk assessments, we re-design, implement, and maintain reasonable safeguards to minimize identified risks; reasonably address any 
identified gaps in existing safeguards; and regularly monitor the effectiveness of our safeguards. We devote internal and external resources and designate 
high-level  personnel,  including  our  Chief  Financial  Officer,  who  reports  to  our  Chief  Executive  Officer,  to  manage  the  risk  assessment  and  mitigation 
process.  

As part of our overall risk management system, we monitor and test our safeguards and train our employees on these safeguards, in collaboration 

with human resources, IT, and management.  Personnel at all levels and departments are made aware of our cybersecurity policies through trainings.

We  engage  consultants  or  other  third  parties  in  connection  with  our  risk  assessment  processes.  These  service  providers  assist  us  to  design  and 

implement our cybersecurity policies and procedures, as well as to monitor and test our safeguards.

We  have  not  encountered  cybersecurity  challenges  that  have  materially  impaired  our  operations  or  financial  standing.  For  additional  information 
regarding  whether  any  risks  from  cybersecurity  threats,  including  as  a  result  of  any  previous  cybersecurity  incidents,  have  materially  affected  or  are 
reasonably likely to materially affect our company, including our business strategy, results of operations, or financial condition, please refer to Item 1A, 
“Risk Factors,” in this Annual Report, including the risk factors entitled “We may experience disruptions and delays or incur financial damages as a result 
of system failures or security breaches or incidents” and “If we fail to comply with 

70

 
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”.

Governance

One of the key functions of our Board is informed oversight of our risk management process, including risks from cybersecurity threats. Our Board 
is  responsible  for  monitoring  and  assessing  strategic  risk  exposure,  and  our  executive  officers  are  responsible  for  the  day-to-day  management  of  the 
material risks we face. Our Board administers its cybersecurity risk oversight function directly as a whole, as well as through the audit committee. 

Our Chief Financial Officer, in conjunction with our information security team and third-party consultants, is primarily responsible to assess and 

manage our material risks from cybersecurity threats.

Our Chief Financial Officer oversees our cybersecurity policies and processes, including those described in “Risk Management and Strategy” above. 
The cybersecurity risk management program includes tools and activities to prevent, detect, and analyze current and emerging cybersecurity threats, and 
plans and strategies to address threats and incidents.

Our  Chief  Financial  Officer  provides  briefings  to  the  audit  committee  regarding  our  company’s  cybersecurity  risks  and  activities,  including  any 
recent cybersecurity incidents and related responses, cybersecurity systems testing, activities of third parties, and the like. In addition, our Chief Financial 
Officer provides briefings of any significant cybersecurity matters to the Board as well as an annual update of cybersecurity risks and activities.

Item 2. Properties. 

Our corporate headquarters are currently located in San Carlos, California, where we lease approximately 96,000 square feet of office, research and 

development and laboratory space pursuant to a lease agreement that expires on October 31, 2031. 

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 legal proceedings or be subject to claims arising in the ordinary course of our business. We are not 
currently a party to any litigation or legal proceedings that, in the opinion of our management, are likely to have a material adverse effect on our business. 
Regardless of outcome, such proceedings or claims can have an adverse impact on us because of defense and settlement costs, diversion of resources and 
other factors, and there can be no assurances that favorable outcomes will be obtained.

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 March 1, 2024, there were 12 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 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 deems relevant.

Performance Graph

As a “smaller reporting company” as defined by Item 10 of Regulation S-K, we are not required to provide this information.

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. 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. Please also see the section 
titled “Special Note Regarding Forward-Looking Statements.”

Overview

We are a clinical stage biotechnology company developing therapeutics which target immunomodulatory receptors present on immune effector cells 
involved  in  allergic,  inflammatory  and  proliferative  diseases.  Activating  inhibitory  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 cells’ ability to identify and kill proliferative cells. Our 
most advanced product candidate, AK006, is currently in a Phase 1 clinical trial. 

AK006 has shown activity in preclinical studies including a broad array of animal disease models of mast cell diseases. We have prioritized our 
AK006  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:

•

•

•

•

Evaluate AK006 in healthy volunteers. AK006 is currently being evaluated in a Phase 1 SAD and MAD study in healthy volunteers. The 
study  is  designed  to  assess  safety,  PK  and  PD  of  AK006.  As  part  of  the  phase  1  study,  we  plan  to  collect  skin  biopsies  from  healthy 
volunteers dosed with AK006 which will allow us to look at the amount of AK006 that is bound to the Siglec-6 receptor on skin mast cells 
(also  known  as  the  receptor  occupancy).  Given  that  CSU  is  believed  to  be  caused  by  inappropriately  activated  skin  mast  cells,  this 
information will allow us to assess AK006’s ability to reach the pathogenic cell type in the target tissue and to determine whether AK006 is 
achieving receptor occupancy levels consistent with the levels required for inhibition in preclinical studies. We expect to report data from the 
Phase 1 SAD and MAD portions of the study in the second quarter of 2024. 

Obtain  POC  with  AK006  in  CSU  and  other  mast  cell  driven  conditions.  Allakos  plans  to  test  AK006  in  a  randomized,  double-blind, 
placebo-controlled cohort of patients with CSU. We expect data from the CSU cohort to be available at year end 2024. Chronic spontaneous 
urticaria is an inflammatory skin disease believed to be caused by the inappropriate activation of mast cells in the skin. We believe there is a 
need for additional treatments for patients with CSU that are refractory to antihistamines. In addition, in 2024 we plan to initiate a clinical 
study with AK006 in an additional mast cell driven condition. 

Develop Subcutaneous formulation of AK006. We have also developed a formulation of AK006 for SC administration.  As part of the Phase 
1 study, we are administering SC AK006 to a cohort of healthy volunteers. We expect to report SC AK006 safety, PK, and PD data, including 
bioavailability as well as Siglec-6 receptor occupancy in skin biopsy samples, during the third quarter of 2024.  Pending positive data from 
the SC cohort, Allakos plans to use the SC formulation in subsequent AK006 clinical development. 

Build therapeutic pipeline. Our research is focused on immunomodulatory receptors present on immune effector cells involved in allergic, 
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 the function of the receptors could 

73

 
restore  the  immune  cells’  ability  to  identify  and  kill  proliferative  cells.  Following  this  approach,  we  have  developed  AK006  and  have 
research programs directed at other immunomodulatory targets.

AK006 targets Siglec-6, an inhibitory receptor expressed selectively on mast cells, a type of white blood cell that is widely distributed in the body 
and plays a central role in the inflammatory response. Binding of AK006 to Siglec-6 activates the native inhibitory function of the receptor which in turn 
reduces mast cell activation. In preclinical studies, AK006 inhibited multiple modes of mast cell activation, including IgE, IL-33, KIT, C5a, and MRGPR-
X2, resulting in the deep suppression of mast cell activation. In addition to mast cell inhibition, AK006 reduced human tissue mast cells via ADCP in the 
presence of activated macrophages. AK006 is currently being evaluated in a Phase 1 study in healthy volunteers and Allakos plans to initiate a randomized, 
double-blind, placebo-controlled cohort of patients with CSU. We expect data from the CSU cohort to be available at year end 2024.

Chronic spontaneous urticaria is an inflammatory skin disease believed to be caused by the inappropriate activation of mast cells via IgE-dependent 
and IgE-independent pathways in the skin. Symptoms of chronic spontaneous urticaria include frequent and unpredictable eruption of hives, severe itching 
and swelling. First-line treatment consists of H1 antihistamine medication; however, a significant number of patients do not receive adequate benefit even 
at up to four times the labeled dose. In the United States, it is estimated that there are 800 thousand adults with moderate-to-severe CSU whose disease is 
refractory  to  antihistamines.  There  is  only  one  FDA  approved  therapy  for  patients  who  are  refractory  to  antihistamines,  omalizumab,  which  binds  IgE. 
Because AK006, inhibits both IgE-dependent and IgE-independent modes of mast cell activation, it has the potential to treat a broad CSU population or 
show greater symptom improvement.

In the third quarter of 2023 Allakos began dosing healthy volunteers in a randomized, double-blind, placebo-controlled Phase 1 study of AK006. 
The  Phase  1  study  of  AK006  consists  of  SAD  and  MAD  cohorts  in  healthy  volunteers  as  well  as  well  as  a  cohort  in  patients  with  CSU  who  will  be 
administered AK006 via intravenous infusion. We expect to report SAD and MAD safety, PK and PD results in the second quarter of 2024. 

As part of the Phase 1 study, we plan to collect skin biopsies from healthy volunteers dosed with AK006 which will allow us to look at the amount 
of AK006 that is bound to the Siglec-6 receptor on skin mast cells (also known as the receptor occupancy). Given that CSU is believed to be caused by 
inappropriately activated skin mast cells, this information will allow us to assess AK006’s ability to reach the pathogenic cell type in the target tissue and to 
confirm that AK006 is achieving receptor occupancy levels consistent with the levels required for inhibition in preclinical experiments. Following the SAD 
and MAD portions of the Phase 1 AK006 study in healthy volunteers, Allakos plans to initiate a randomized, double-blind, placebo-controlled cohort of 
patients with CSU. We expect data from the CSU cohort to be available at year end 2024.

We have also developed a formulation of AK006 for SC administration. As part of the Phase 1 study, we are administering SC AK006 to a cohort of 
healthy  volunteers.  We  expect  to  report  SC  AK006  safety,  PK,  and  PD  results,  including  bioavailability  as  well  as  Siglec-6  receptor  occupancy  in  skin 
biopsy  samples,  during  the  third  quarter  of  2024.  Pending  positive  data  from  the  SC  cohort,  we  plan  to  use  the  SC  formulation  in  subsequent  AK006 
clinical development.

We  had  also  been  developing  lirentelimab  (AK002)  and,  in  conjunction  with  the  Phase  2  lirentelimab  results  in  atopic  dermatitis  and  chronic 
spontaneous  urticaria,  we  announced  on  January  16,  2024  that  we  no  longer  plan  to  pursue  further  development  of  lirentelimab.  Lirentelimab  has  been 
administered  in  more  than  1,000  patients,  and  with  approximately  500  patients  exposed  for  six  months  or  more.    Lirentelimab  has  generally  been  well 
tolerated with no long-term safety findings to date.

Since our inception in 2012, we have devoted substantially all of our resources and efforts towards the research and development of our product 
candidates. 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 

74

 
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 $185.7 million and $320.0 million for 
the years ended December 31, 2023 and 2022, respectively. As of December 31, 2023, we had an accumulated deficit of $1,118.5 million.

In January 2024, we began implementing the 2024 Reorganization Plan to reduce operating costs and better align our workforce with our current 
clinical  development  plans  of  our  business.  Accordingly,  we  decided  to  halt  lirentelimab-related  activities  across  clinical,  manufacturing,  research  and 
administrative functions. As a result, we will reduce our workforce by approximately 50%. While this will result in increased near-term costs, primarily in 
the  first  and  second  quarters  of  2024,  we  believe  that  the  2024  Reorganization  Plan  will  reduce  our  overall  spending  in  subsequent  quarters  subject  to 
periodic fluctuations caused by the timing of ongoing manufacturing development efforts and the timing of future clinical trials. Further, we test long-lived 
assets  for  impairment  if  changes  in  circumstances  or  the  occurrence  of  events  suggest  impairment  exists.  Any  significant  change  in  market  conditions, 
including  a  sustained  decline  in  our  stock  price,  that  indicate  a  reduction  in  carrying  value  may  give  rise  to  impairment  in  the  period  that  the  change 
becomes known. Such factors could result in significant additional non-cash charges including impairment of long-lived assets and accelerated depreciation 
for assets that have shortened expected asset lives.

As of December 31, 2023, we had cash, cash equivalents and marketable securities of $170.8 million, which we believe will be sufficient to fund our 
planned operations for at least the next 12 months from the issuance of our audited financial statements included elsewhere in this Annual Report on Form 
10-K.

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

Year Ended December 31,

2023

2022

150,908     $
45,148    
196,056    
(196,056 )  
10,347    
8    
(185,701 )  
334    
(185,367 )   $

265,081  
57,348  
322,429  
(322,429 )
3,673  
(1,196 )
(319,952 )
(131 )
(320,083 )

  $

  $

Comparison of the Years Ended December 31, 2023 and 2022

We classify operating expenses into two categories: (i) research and development and (ii) general and administrative.

Research and Development Expenses

Research and development expenses represent the following costs incurred by us for the discovery, development and manufacturing of our product 

candidates:

•

•

•

consultant  and  personnel-related  costs  including  consulting  fees,  employee  salaries  and  benefits,  travel  and  stock-based  compensation 
expense;

costs incurred to conduct nonclinical research and development activities;

costs incurred under service agreements with clinical contract research organizations (“CROs”) and clinical investigative sites to conduct our 
clinical studies;

75

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•

•

•

•

costs incurred under service agreements with contract development and manufacturing organizations (“CDMOs”) for the manufacture and fill 
finish of our product candidates, as well as any costs required to cancel any related purchase obligations;

costs related to in-house research and development activities conducted at our facilities including laboratory supplies, non-capital laboratory 
equipment and depreciation of capital laboratory equipment and leasehold improvements;

costs incurred under exclusive and non-exclusive license agreements with third-parties; and

allocated  facility  and  other  costs  including  the  rent  and  maintenance  of  our  facilities,  insurance  premiums,  depreciation  of  shared-use 
leasehold improvements and general office supplies.

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. However, consulting and personnel-related costs, laboratory supplies and non-capital equipment utilized in the conduct of in-house research, 
in-licensing fees, various pre-clinical research costs 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.

We anticipate that our research and development expenses will fluctuate from quarter-to-quarter in the future, primarily driven by the timing of costs 
associated  with  the  manufacturing  of  our  product  candidates,  as  well  as  the  timing  of  future  clinical  trials.  We  expect  the  first  half  of  2024  to  include 
significant  expenses  relating  to  lirentelimab,  as  we  incur  closeout  costs,  employee  severance,  and  other  costs  resulting  from  the  decision  to  halt 
development of lirentelimab.

76

 
The following table summarizes our research and development expenses for the periods indicated (in thousands):

Contract clinical and manufacturing costs
Consulting, professional and personnel-related costs
Other unallocated research and development costs

Total

Year Ended December 31,

2023

2022

  $

  $

70,240  
53,509  
27,159  
150,908  

  $

  $

181,975  
56,527  
26,579  
265,081  

Research  and  development  expenses  were  $150.9  million  for  the  year  ended  December  31,  2023  compared  to  $265.1  million  for  the  year  ended 

December 31, 2022, a decrease of $114.2 million primarily due to decreases in contract clinical and manufacturing costs.

Contract clinical and manufacturing costs decreased by $111.7 million in fiscal 2023 compared to the prior year largely due to $134.5 million in 
costs recognized in fiscal 2022 associated with the manufacturing termination agreement entered into during the first quarter of 2022, as well as a decrease 
of approximately $3.6 million in clinical related costs, offset by a $26.4 million increase in other manufacturing spending. 

Consulting, professional and personnel-related costs decreased by $3.0 million in fiscal 2023 compared to the prior year resulting from cost saving 
measures  implemented  during  the  first  quarter  of  2022  including  reduced  headcount  and  offset  by  a  $0.2  million  increase  in  stock-based  compensation 
expense.

Other unallocated research and development costs increased $0.6 million in fiscal 2023 compared to the prior year primarily due to increased pre-

clinical research activities.

We anticipate that our research and development expenses will decrease significantly in 2024 due to the cost cutting measures associated with the 
2024 Reorganization Plan resulting from our decision to halt lirentelimab development. We believe that the majority of the costs associated with the 2024 
Reorganization Plan and lirentelimab close out costs will be incurred during the first half of 2024, but that these cost cutting efforts will reduce our overall 
spending, excluding stock-based compensation, in subsequent quarters subject to periodic fluctuations caused by the timing of manufacturing development 
and clinical trial activities.

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  $45.1  million  for  the  year  ended  December  31,  2023  compared  to  $57.3  million  for  the  year  ended 
December 31, 2022, a decrease of $12.2 million. The period-over-period decrease in general and administrative expenses was primarily attributable to cost 
reduction efforts initiated in the first quarter of 2022 which helped drive an $8.7 million decrease in employee compensation costs as well as a $3.5 million 
decrease in professional and other administrative expenses. Employee compensation costs in fiscal 2023 included a $2.1 million decrease in stock-based 
compensation expense as compared to the prior year.

We anticipate that our general and administrative expenses will decrease in 2024 following the employment severance related costs associated with 
the  2024  Reorganization  Plan.  We  believe  that  the  2024  Reorganization  Plan  will  reduce  our  overall  spending,  excluding  stock-based  compensation,  in 
subsequent  quarters.  Additionally,  we  expect  to  continue  to  incur  costs  associated  with  operating  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.

77

 
 
 
 
 
 
 
   
 
 
 
   
 
 
   
 
Interest Income

Interest  income  was  $10.3  million  for  the  year  ended  December  31,  2023,  compared  to  $3.7  million  for  the  year  ended  December  31,  2022,  an 

increase of $6.7 million. The year-over-year increase is primarily attributable to higher interest rates.

Other Income (Expense), Net

Other income, net, for the year ended December 31, 2023 was immaterial, compared to a $1.2 million loss for the year ended December 31, 2022, 

primarily due to foreign exchange losses incurred in fiscal 2022.

Liquidity and Capital Resources

Sources of Liquidity

As  of  December  31,  2023,  we  had  cash,  cash  equivalents  and  marketable  securities  of  $170.8  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 audited financial statements included elsewhere in this Annual Report on Form 10-K.

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. 

In May 2022, we filed a shelf registration statement on Form S-3 (File No. 3333-265085) with the SEC pursuant to which we may, from time to 
time, sell up to an aggregate of $250.0 million of our common stock. On May 31, 2022, the registration statement was declared effective by the SEC, which 
allows us to access the capital markets for the three-year period following this effective date. Our September 2022 equity offering and our outstanding “at-
the-market” offering program were offered under this Form S-3. Further details of these programs are included below.

Additionally, in November 2023, we filed a shelf registration statement on Form S-3 (File No. 333-275517) with the SEC pursuant to which we may, 
from time to time, sell up to an aggregate of $250.0 million of our common stock. On November 24, 2023, the registration statement was declared effective 
by the SEC, which allows us to access the capital markets for the three-year period following this effective date.

September 2022 Offering

On September 21, 2022, we closed an underwritten registered direct offering (the “September 2022 Offering”) under our shelf registration statement 
on Form S-3 (File No. 333-265085) pursuant to which we sold an aggregate of 29,882,000 shares of our common stock at an offering price of $5.02 per 
share. We received aggregate net proceeds of $140.6 million, after deducting the underwriting commissions and offering expenses.

“At-the-Market” Equity Offerings

On August 4, 2022, we entered into a sales agreement (the “2022 Sales Agreement”) with Cowen and Company, LLC (“Cowen”). Pursuant to the 

2022 Sales Agreement we may sell, from time to time up to an aggregate of $75.0 million in gross sales proceeds of our common stock through an “at-the-
market” offering (“ATM Offering”). We will pay Cowen a commission equal to 3.0% of the gross proceeds from the sale of shares of our common stock 
under the 2022 Sales Agreement. The $75.0 million of common stock that may be offered, issued and sold in the ATM Offering is included in the $250.0 
million of securities that may be offered, issued and sold by us under our registration statement on Form S-3 (File No. 333-265085). We expect to use the 
net proceeds from sales under the 2022 Sales Agreement for general corporate purposes.

During the year ended December 31, 2023, we sold 0.1 million shares of our common stock at an average price of $7.20 per share through our ATM 

Offering, resulting in proceeds of $1.0 million net of commissions, with all sales occurring during the first quarter of 2023. Under our current ATM 
Offering program, $74.0 million of common stock remain available for future sales as of December 31, 2023; however, we are not obligated to make any 
sales under this program.

78

 
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 investing activities
Net cash provided by financing activities

Net decrease in cash, cash equivalents and
   restricted cash

Comparison of the Years Ended December 31, 2023 and 2022 

Cash Used in Operating Activities

Year Ended December 31,

2023

2022

  $

  $

(116,480 )
93,175  
2,528  

  $

(20,777 )

  $

(279,971 )
71,681  
141,882  

(66,408 )

Net cash used in operating activities was $116.5 million for the year ended December 31, 2023, which was primarily attributed to our net loss of 
$185.7  million  adjusted  for  net  noncash  charges  of  $43.6  million  and  net  changes  in  operating  assets  and  liabilities  of  $25.6  million.  Noncash  charges 
included $41.2 million in stock-based compensation expense, $6.1 million in depreciation and amortization expense, $1.5 million in noncash lease expense 
and were offset by $5.3 million in net accretion of premium and discounts on marketable securities.

Net cash used in operating activities was $280.0 million for the year ended December 31, 2022, which was primarily attributable to our net loss of 
$320.0  million  adjusted  for  net  noncash  charges  of  $53.7  million  and  net  changes  in  operating  assets  and  liabilities  of  $13.8  million.  Noncash  charges 
included $43.2 million in stock-based compensation expense, $7.1 million in depreciation and amortization expense, $2.9 million in noncash lease expense 
and $0.6 million in net amortization of premium and discounts on marketable securities.

Cash Provided by Investing Activities

Net cash provided by investing activities was $93.2 million for the year ended December 31, 2023, which consisted of $263.0 million in proceeds 
from maturities of marketable securities, partially offset by $169.2 million in purchases of marketable securities and $0.6 million in purchases of property 
and equipment.

Net cash provided by investing activities was $71.7 million for the year ended December 31, 2022, which consisted of $287.0 million in proceeds 
from maturities of marketable securities, $20.0 million in proceeds from the sale of marketable securities and $1.2 million in proceeds from the sale of 
property and equipment, partially offset by $228.1 million in purchases of marketable securities and $8.3 million in purchases of property and equipment.

Cash Provided by Financing Activities

Net  cash  provided  by  financing  activities  was  $2.5  million  for  the  year  ended  December  31,  2023,  which  consisted  primarily  of  $1.0  million  in 
proceeds from the issuance of common stock under our ATM Offering program, $0.9 million in proceeds from the issuance of common stock under the
2018 ESPP and $0.7 million in proceeds from employees for the exercise of stock options.

Net cash provided by financing activities was $141.9 million for the year ended December 31, 2022, which consisted primarily of $140.6 million in 
proceeds from the issuance of common stock pursuant to the September 2022 Offering, $0.9 million in proceeds from employees for the exercise of stock 
options and $0.4 million in proceeds from the issuance of common stock under the 2018 ESPP.

Funding Requirements

As of December 31, 2023, we had cash, cash equivalents and marketable securities, excluding restricted cash, of $170.8 million, which we believe 
will  be  sufficient  to  fund  our  planned  operations  for  at  least  the  next  12  months  from  the  issuance  date  of  our  audited  financial  statements  included 
elsewhere  in  this  Annual  Report  on  Form  10-K.  We  will  continue  to  require  additional  capital  to  develop  our  product  candidates,  achieve  commercial 
approval and fund operations for the foreseeable future. We intend to seek and have sought to raise funding from time to time 

79

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
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, and if successful, the cost and time necessary to bring product 
candidates to market;

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.

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,  2023  (in  millions)  and  does  not  incorporate  any 

cancellations or termination agreements entered into subsequent to December 31, 2023:

Operating lease obligations 
Purchase obligations 

(2)

(1)

Total

Total

61.8  
6.0  
67.8  

  $

  $

  $

  $

Less than
1 Year

Payments Due by Period
1-3
Years

3-5
Years

  More than 5

Years

7.4  
6.0  
13.4  

  $

  $

14.8  
—  
14.8  

  $

  $

15.7  
—  
15.7  

  $

  $

23.9  
—  
23.9  

(1)

(2)

Operating lease obligations represent future lease payments due primarily under our corporate facility lease agreement. 
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.

80

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
 
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. 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 

81

 
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 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.

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.

Effects of Inflation

Inflation  generally  affects  us  by  increasing  our  cost  of  labor  and  research  and  development  contracts.  We  do  not  believe  that  inflation  has  had  a 

material effect on our financial results during the periods presented.

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.

82

 
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

83

Page

84

86

87

88

89

90

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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, 2023 and 2022, the related statements of operations 
and  comprehensive  loss,  stockholders'  equity  and  cash  flows  for  each  of  the  two  years  in  the  period  ended  December  31,  2023,  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, 2023 and 2022, and the results of its operations and its cash flows for each of the two years in the period ended December 
31, 2023, in conformity with U.S. generally accepted accounting principles. 

Basis for Opinion

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

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable 
assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor 
were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of 
internal  control  over  financial  reporting  but  not  for  the  purpose  of  expressing  an  opinion  on  the  effectiveness  of  the  Company's  internal  control  over 
financial reporting. Accordingly, we express no such opinion. 

Our  audits  included  performing  procedures  to  assess  the  risks  of  material  misstatement  of  the  financial  statements,  whether  due  to  error  or  fraud,  and 
performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in 
the  financial  statements.  Our  audits  also  included  evaluating  the  accounting  principles  used  and  significant  estimates  made  by  management,  as  well  as 
evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion. 

Critical Audit Matter

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

84

 
 
 
 
 
 
 
 
 
 
 
Accrued Clinical Investigative Sites 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  contract  research  and  development  expenses 
were  $22.3  million  as  of  December  31,  2023,  which  includes  the  estimated  accrued  clinical  investigative  sites  expenses 
incurred  but  not  invoiced  under  agreements  with  investigative  clinical  trial  sites  that  conduct  clinical  studies  (“Accrued 
Clinical Investigative Sites Expenses”). The accrual for these Accrued Clinical Investigative Site Expenses includes 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 expenses incurred but not invoiced. 

How We Addressed the 
Matter in Our Audit

We obtained an understanding of the Company’s process to determine Accrued Clinical Investigative Sites Expenses. Our audit 
procedures included testing the accuracy and completeness of the inputs used in management’s analysis to determine expenses
incurred but not invoiced and making direct inquiries of the Company's personnel that oversee the clinical trials. Further, we 
verified the accrued expenses incurred but not invoiced to the underlying agreements and the information provided by third-
party service providers.

/s/ Ernst & Young LLP

We have served as the Company’s auditor since 2016.

San Mateo, California

March 14, 2024

85

 
 
 
 
  
 
 
 
ALLAKOS INC.
BALANCE SHEETS
(in thousands, except per share data)

Assets
Current assets:

Cash and cash equivalents
Investments
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 (Note 7)
Stockholders’ equity:

Preferred stock, $0.001 par value per share; 20,000 shares 
   authorized as of December 31, 2023 and 2022; no 
   shares issued and outstanding as of December 31, 2023 and 2022
Common stock, $0.001 par value per share; 200,000 shares
   authorized as of December 31, 2023 and 2022; 87,750 and
   85,387 shares issued and outstanding as of December 31, 2023
   and 2022, respectively
Additional paid-in capital
Accumulated other comprehensive income (loss)
Accumulated deficit

Total stockholders’ equity
Total liabilities and stockholders’ equity

See accompanying notes to financial statements

86

  $

  $

  $

December 31,

2023

2022

  $

66,440  
104,354    
9,095    
179,889    
33,369    
24,136    
6,216    
243,610     $

  $

1,764  
34,814    
36,578    
38,215    
74,793    

87,217  
192,569  
29,057  
308,843  
39,144  
30,225  
8,208  
386,420  

4,832  
25,206  
30,038  
45,949  
75,987  

—    

—  

88    
1,287,156    
50    
(1,118,477 )  
168,817    
243,610     $

85  
1,243,408  
(284 )
(932,776 )
310,433  
386,420  

  $

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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

  $

  $

  $

Year Ended December 31,

2023

2022

150,908     $
45,148    
196,056    
(196,056 )  
10,347    
8    
(185,701 )  
334    
(185,367 )   $

265,081  
57,348  
322,429  
(322,429 )
3,673  
(1,196 )
(319,952 )
(131 )
(320,083 )

(2.14 )

  $

(5.06 )

86,798  

63,284  

See accompanying notes to financial statements

87

 
 
 
 
 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
   
 
   
 
 
   
 
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

Balance as of December 31, 2021

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 $9,417
Issuance of common stock upon vesting of restricted 
   stock units
Unrealized gain (loss) on marketable securities
Net loss

Balance as of December 31, 2022

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 ATM offering
Issuance of common stock upon vesting of restricted 
   stock units
Unrealized gain (loss) on marketable securities
Net loss

Balance as of December 31, 2023

54,622  
—  
464  
104  

29,882  

315  
—  
—  
85,387  
—  
206  
281  
142  

1,734  
—  
—  
87,750  

  $

  $

  $

54  
—  
1  
—  

30  

—  
—  
—  
85  
—  
—  
—  
—  

3  
—  
—  
88  

  $

  $

1,058,399  
43,158  
852  
438  

140,561  

—  
—  
—  
1,243,408  
41,223  
673  
865  
990  

  $

(153 )   $

—  
—  
—  

—  

—  
(131 )  
—  
(284 )   $
—  
—  
—  
—  

  $

(612,824 )   $
—  
—  
—  

—  

—  
—  

(319,952 )  
(932,776 )   $
—  
—  
—  
—  

—  
—  

445,476  
43,158  
853  
438  

140,591  

—  
(131 )
(319,952 )
310,433  
41,223  
673  
865  
990  

—  
334  
(185,701 )
168,817  

(3 )  
—  
—  
1,287,156  

  $

  $

—  
334  
—  
50  

(185,701 )  
(1,118,477 )   $

  $

See accompanying notes to financial statements

88

 
 
 
 
   
   
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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 (accretion) 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
Proceeds from sale of marketable securities
Purchases of property and equipment
Proceeds from sale of property and equipment
Net cash provided by 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
Noncash adjustments to right-of-use assets
Changes of property and equipment in accounts payable and accruals

See accompanying notes to financial statements

89

Year Ended December 31,

2023

2022

  $

(185,701 )   $

(319,952 )

41,223  
(5,250 )  
6,141  
1,491  
—  
3  

19,994  
1,992  
(2,845 )  
9,907  
(3,435 )  
(116,480 )  

(169,233 )  
263,000  
—  
(592 )  
—  
93,175  

990  
673  
865  
2,528  

(20,777 )  
88,689  
67,912  

  $

665  

  $
(5,307 )   $
(223 )   $

43,158  
588  
7,071  
2,904  
—  
28  

(2,431 )
(574 )
(8,765 )
1,152  
(3,150 )
(279,971 )

(228,144 )
287,000  
19,989  
(8,333 )
1,169  
71,681  

140,591  
853  
438  
141,882  

(66,408 )
155,097  
88,689  

1,422  
—  
(4,021 )

  $

  $
  $
  $

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
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  developing  therapeutics  which  target  immunomodulatory  receptors  present  on  immune  effector  cells  involved  in  allergic, 
inflammatory and proliferative diseases. Our most advanced product candidate is AK006 which targets mast cells. Inappropriately activated mast cells have 
been identified as key drivers in a number of severe diseases affecting the gastrointestinal tract, eyes, skin, lungs and other organs. 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 San Carlos, California. 

Liquidity Matters

Since  inception,  the  Company  has  incurred  net  losses  and  negative  cash  flows  from  operations.  During  the  year  ended  December  31,  2023,  the 
Company incurred a net loss of $185.7 million and used $116.5 million of cash in operations. As of December 31, 2023, the Company had an accumulated 
deficit  of  $1,118.5 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 January 2024, our Board of Directors approved a reorganization plan to reduce operating costs and better 
align our workforce with our current clinical development plans of our business (the “2024 Reorganization Plan”). Refer to Note 12 “Subsequent Events” 
for additional details. 

The Company had $170.8 million of cash, cash equivalents and marketable securities at December 31, 2023. 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  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. 

90

 
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 in other long-term assets

Total

December 31,

2023

2022

  $

  $

66,440     $
1,472    
67,912     $

87,217  
1,472  
88,689  

Restricted cash at December 31, 2023 represents $1.5 million of security deposits for the lease of the Company’s facility in San Carlos, California. 

The security deposit is in the form of a letter of credit secured by restricted cash and is recorded in other long-term assets on the Company's balance sheets.

Investments

The Company invests in marketable securities, primarily securities issued by the U.S. government and its agencies. The Company’s investments 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  (loss).  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 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.

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.

91

 
 
 
 
 
 
 
 
 
 
 
 
 
 
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  and  capitalized  software  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 or other long-term assets, as appropriate, and subsequently recognized as research and development expense when the associated services have been 
performed. As actual costs become known, 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 

92

 
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.  Costs  to  terminate 
commitments  with  third-party  suppliers  performing  research  and  development  activities  and  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 or other long-term assets, as appropriate. 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 our stock as well as 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. 

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. 

93

 
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

The  Company  accounts  for  income  taxes  under  the  asset  and  liability  method.  Current  income  tax  expense  or  benefit  represents  the  amount  of 
income taxes the Company expects to pay or have refunded in the current year. The Company’s 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  it  measures  using  the  enacted  tax  rates  and  laws  that  will  be  in  effect  when  such  items  are  expected  to  reverse.  The  Company  reduces  deferred 
income tax assets, as necessary, by applying a valuation allowance to the extent that it determined it is more likely than not that some or all of our tax 
benefits will not be realized.

The Company accounts for uncertain tax positions in accordance with ASC 740-10, Accounting for Uncertainty in Income Taxes. The Company 
assesses  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 its positions, the Company measures the largest amount of 
benefit possessing greater than fifty percent likelihood of being realized upon ultimate settlement. The Company reassesses 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, 2023 and 2022 are a result of unrealized gains 
and losses on the Company’s investments in marketable securities included in current assets on the Company's 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. 

The Company’s weighted-average shares of common stock outstanding increased from 63.3 million shares of common stock outstanding during the 
year ended December 31, 2022 to 86.8 million shares of common stock outstanding during the year ended December 31, 2023 primarily as a result of the 
29.9 million shares sold as part of an underwritten registered direct offering closed on September 21, 2022 (the “September 2022 Offering”). Refer to Note 
8 “Stockholders’ Equity” for additional details related to the offering.

94

 
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,

2023

2022

 $

(185,701 )   $

(319,952 )

 $

86,798    

(2.14 )   $

63,284  
(5.06 )

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 

Year Ended December 31,

2023

2022

7,968    
5,621    
2,845    
127    
16,561    

5,423  
4,478  
3,276  
135  
13,312  

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

In  December  2023,  the  FASB  issued  ASU  2023-09,  Income  Taxes  (Topic  740):  Improvements  to  Income  Tax  Disclosures.  This  ASU  requires 
entities to expand its existing income tax disclosures, specifically related to the rate reconciliation and income taxes paid. This authoritative guidance will 
be effective for us in fiscal year 2025, with early adoption permitted. The Company is currently evaluating the impact of the ASU, but does not expect any
material impacts upon 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
U.S. government agency bonds

Total short-term marketable securities

Total cash equivalents and short-term 
   marketable securities

Level 1

Level 2

Level 3

Total

December 31, 2023

  $

67,070     $
67,070  

96,705  
7,649  
104,354  

—     $
—  

—  
—  
—  

—     $
—  

67,070  
67,070  

—  
—  
—  

96,705  
7,649  
104,354  

  $

171,424     $

—     $

—     $

171,424  

95

 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
     
   
  
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
   
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
   
 
 
 
 
   
   
   
 
   
 
   
 
   
 
   
 
 
   
   
   
 
 
   
   
   
 
 
   
   
   
 
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, 2022

  $

86,270     $
86,270  

192,569  
192,569  

—     $
—  

—  
—  

—     $
—  

86,270  
86,270  

—  
—  

192,569  
192,569  

  $

278,839     $

—     $

—     $

278,839  

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, 2023 and 2022.

4. Investments

All investments were considered available-for-sale at December 31, 2023 and 2022. The amortized cost, gross unrealized holding gains or losses, 

and fair value of the Company’s investments by major security type are summarized in the table below (in thousands):

Available-for-sale securities

U.S. treasuries classified as investments
U.S. government agency bonds

Total available-for-sale securities

Available-for-sale securities

U.S. treasuries classified as investments
Total available-for-sale securities

Amortized
Cost Basis

December 31, 2023

Unrealized
Gains

Unrealized
Losses

Fair
Value

  $

  $

96,688     $
7,652  
104,340     $

39     $
—  
39     $

(22 )   $
(3 )    
(25 )   $

96,705  
7,649  
104,354  

Amortized
Cost Basis

December 31, 2022

Unrealized
Gains

Unrealized
Losses

Fair
Value

  $
  $

192,853     $
192,853     $

3     $
3     $

(287 )   $
(287 )   $

192,569  
192,569  

The amortized cost of available-for-sale securities is adjusted for amortization of premiums and accretion of discounts to maturity. As of December 
31, 2023 and 2022, the aggregate fair value of securities held by the Company in an unrealized loss position for less than twelve months was $53.7 million 
and $162.6 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, 2023 and 2022.

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, 2023 and 2022, and as a result, there were no material reclassifications out of accumulated other comprehensive gain (loss) for the same periods.

96

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
 
 
   
   
   
 
   
 
     
   
 
   
 
 
   
   
   
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
   
 
5. Balance Sheet Components and Supplemental Disclosures

Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consisted of the following (in thousands):

Prepaid clinical expenses
Prepaid manufacturing expenses
Other prepaid expenses or current assets

Total

December 31,

2023

2022

1,092  
3,877    
4,126    
9,095  

  $

  $

1,741  
21,998  
5,318  
29,057  

  $

  $

The decrease in prepaid manufacturing expenses from December 31, 2022 to December 31, 2023 is primarily due to the timing of manufacturing 

activities relating to lirentelimab.

Property and Equipment, Net

Property and equipment, net, consisted of the following (in thousands):

Laboratory equipment
Furniture and office equipment
Leasehold improvements
Capitalized software
Construction-in-progress or pending installation

Less accumulated depreciation
Property and equipment, net

December 31,

2023

2022

  $

  $

6,993     $
3,947  
32,386  
4,382  
69  
47,777  
(14,408 )
33,369     $

6,473  
3,947  
32,457  
4,112  
422  
47,411  
(8,267 )
39,144  

Depreciation  expense  for  the  years  ended  December  31,  2023  and  2022  was  $6.1 million, and $7.1  million,  respectively.  During  the  year  ended 
December  31,  2022,  gross  fixed  assets  of  $5.8  million  with  accumulated  depreciation  of  $4.6  million  were  disposed  of  or  sold  for  $1.2  million  in 
conjunction with exiting the Redwood City facility.

Other Long-Term Assets

Other long-term assets were $6.2 million and $8.2 million as of December 31, 2023 and 2022, respectively. Other long-term assets at December 31, 
2023 and 2022 included $0.8 million and $6.6 million, respectively, in advance payments to CDMOs for development and manufacturing services expected 
to be provided more than one year from the balance sheet date. Other long-term assets as of December 31, 2023 additionally includes $3.9 million of tax 
credit receivables classified as long-term.

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

97

December 31,

2023

2022

  $

22,262  
8,674    
3,250    
628    

34,814  

  $

13,950  
7,039  
3,161  
1,056  
25,206  

  $

  $

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
6. Leases

Operating Leases 

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. 

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 $14.4 million, which was fully utilized and are recorded in lease obligations.

On March 27, 2023, the Company entered into an amendment for the 2019 San Carlos Lease, whereby rentable square feet was adjusted to 95,692 
square feet and lease payments were reduced by approximately 2.5% per month, effective from January 1, 2022 through the end of the lease term. The 
Company accounted for these changes as a modification under ASC 842 and the operating right-of-use asset and lease liability were remeasured during the 
first quarter of 2023 utilizing an estimated incremental borrowing rate of 10.5%. Our estimated incremental borrowing rate was based on our estimated rate
of interest for a fully collateralized borrowing over a similar term as the remaining lease payments while incorporating our credit risk. As a result of the 
modification, the right-of-use asset and lease liability decreased by approximately $5.6 million. No gain or loss was recognized upon the modification.

Classification of Operating Leases 

The 2019 San Carlos Lease required security deposits of $1.5  million,  which  the  Company  satisfied  by  establishing  letters  of  credit  secured  by 
restricted cash. As of December 31, 2023 and 2022, a security deposit of $1.5 million for the 2019 San Carlos Lease was recorded as restricted cash 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, 2023 and 2022 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,

2023

2022

  $

  $

3,250     $
38,215    
41,465     $

3,161  
45,949  
49,110  

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,

2023

2022

  $

  $

5,806     $
3,627  
9,433     $

5,886  
3,007  
8,893  

98

 
 
 
 
 
 
 
 
 
 
 
     
   
 
 
 
 
 
 
 
 
 
 
   
 
  
  
 
Variable costs included in the table above represent amounts the Company pays related to property taxes, insurance, maintenance and repair costs. 

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 $6.7 million and $6.8 million for the years ended December 31, 2023 and 2022.

Cash received for amounts related to tenant improvement allowances from lessors was $0.3 million and $1.3 million for the years ended December

31, 2023 and 2022, respectively.

Operating Lease Obligations 

Future lease payments required under operating leases included on the Company’s balance sheet at December 31, 2023 are as follows (in thousands):

Fiscal Year Ending December 31,
2024
2025
2026
2027
2028
Thereafter

Total future lease payments

Less:

Present value adjustment

Operating lease liabilities

  $

  $

7,441  
7,287  
7,506  
7,731  
7,963  
23,871  
61,799  

20,334  
41,465  

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, 2023, the weighted-average remaining lease term of the Company’s leases was 7.8 years and the weighted-average discount rate used to 
determine the operating lease liabilities included on the balance sheet was 10.5%.

As  of  December  31,  2023,  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,  2023,  the  Company’s  commitments  include  an  estimated  $6.0  million  of  noncancellable  purchase  commitments,  including 

commitments with contract manufacturers for which the Company has not received the goods or services. 

Additionally,  the  Company  enters  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,  the  Company  would  only  be  obligated  for  services  received  as  of  the  effective  date  of  the 
termination, along with cancellation fees, as applicable.

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, 2023.

99

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
8. Stockholders’ Equity

September 2022 Offering

On September 21, 2022, the Company closed an underwritten registered direct offering (the “September 2022 Offering”) under its shelf registration 
statement  on  Form  S-3  (File  No.  333-265085),  supplemented  by  a  prospectus  supplement  filed  with  the  SEC  on  September  19,  2022  pursuant  to  Rule 
424(b)  under  the  Securities  Act  of  1933,  as  amended.  In  connection  with  the  September  2022  Offering,  the  Company  sold  an  aggregate  of  29,882,000 
shares of our common stock, par value $0.001 per share, at an offering price of $5.02 per share. Aggregate net proceeds were approximately $140.6 million, 
after deducting the underwriting commissions and estimated offering expenses.

“At-the-Market” Equity Offerings

On  August  4,  2022,  the  Company  entered  into  a  sales  agreement  (the  “2022  Sales  Agreement”)  with  Cowen  and  Company,  LLC  (“Cowen”). 
Pursuant to Sales Agreement, the Company may sell, from time to time, up to an aggregate of $75.0 million in gross sales proceeds of its common stock 
through an “at-the-market” offering (“ATM Offering”) as defined under the Securities Act of 1933. The Company will pay a commission equal to 3% of the 
gross proceeds from the sale of shares of its common stock under the Sales Agreement. The $75.0 million of common stock that may be offered, issued and 
sold  in  the  ATM  Offering  is  included  in  the  $250.0  million  of  securities  that  may  be  offered,  issued  and  sold  by  the  Company  under  its  registration 
statement  on  Form  S-3  (File  No.  333-265085).  The  Company  expects  to  use  the  net  proceeds  from  sales  under  the  2022  Sales  Agreement  for  general 
corporate purposes.

During the year ended December 31, 2023, the Company sold 0.1 million shares of its common stock at an average price of $7.20 per share through 
its ATM Offering, resulting in proceeds of $1.0 million net of commissions, with all sales occurring during the first quarter of 2023. Under its current ATM 
Offering program, $74.0 million of common stock remain available for future sales as of December 31, 2023; however, the Company is not obligated to 
make any sales under this program.

9. Stock-Based Compensation

Total stock-based compensation expense recognized is as follows (in thousands): 

Research and development
General and administrative

Total

Year Ended December 31,

2023

2022

  $

  $

17,599  
23,624  
41,223  

  $

  $

17,399  
25,759  
43,158  

No income tax benefits for stock-based compensation expense have been recognized for the years ended December 31, 2023 and 2022, 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 

100

 
 
 
 
 
 
 
 
 
 
 
 
   
 
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, 2023, the maximum number of shares that may be added to the 2018 Plan pursuant to the preceding 
clause is 2,546,977 shares.

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, 2023, the number of shares available for issuance under the 2018 Plan was 2,036,811.

Stock Options

Stock option activity under the 2018 Plan and the 2012 Plan during the year ended December 31, 2023 is summarized as follows (in thousands, 

except per share data): 

Balance at December 31, 2022

Granted
Exercised
Expired
Forfeited

Balance at December 31, 2023

Options exercisable

Options vested and expected to vest

Options
Outstanding

Weighted-
Average
Exercise
Price

Weighted-
Average
Remaining
Years

5,423     $
3,458     $
(206 )   $
(267 )   $
(440 )   $
7,968     $
4,216     $
7,776     $

15.41      
5.79      
3.26      
48.35      
7.99      

10.85      

13.62      

10.95      

Aggregate
Intrinsic
Value

6.4  

  $

22,657  

6.9     $

5.0  

  $

6.9  

  $

3,168  

3,165  

3,168  

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)

Year Ended December 31,

2023

2022

3.88 % 
99.96 % 
—    
5.96    

2.95 %
75.94 %
—  
5.84  

The  weighted-average  fair  value  of  options  granted  during  the  years  ended  December  31,  2023  and  2022  was  $4.61  and  $2.76  per  share, 

respectively.

The  aggregate  fair  value  of  stock  options  that  vested  during  the  years  ended  December  31,  2023  and  2022  was  $6.7  million  and  $15.2  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.  The  aggregate 
intrinsic value of stock options exercised during the years ended December 31, 2023 and 2022 was $0.1 million and $1.8 million, respectively.

As of December 31, 2023, total unrecognized stock-based compensation expense relating to unvested stock options was $16.9 million. This amount 

is expected to be recognized over a weighted-average period of 2.4 years. 

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 

101

 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
  
   
   
  
   
   
  
   
   
  
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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, 2022

Granted
Vested
Forfeited

Balance at December 31, 2023

Number
of Shares

Weighted-
Average
Grant Date
Fair Value

4,478     $
3,860     $
(1,734 )   $
(983 )   $
5,621     $

16.90  
6.52  
18.29  
12.23  

10.16  

The weighted-average fair value of RSUs granted during the years ended December 31, 2023 and 2022 was $6.52 and $5.38, respectively. 

As of December 31, 2023, total unrecognized stock-based compensation expense relating to unvested RSUs was $48.4 million and the weighted-

average remaining vesting period was 2.3 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,  2023.  As  of  December  31,  2023,  the  aggregate  intrinsic  value  of 
RSUs was $15.3 million.

Performance-based Restricted Stock Units

During the year ended December 31, 2023, no restricted stock units with performance-based vesting (“PSUs”) from the 2018 Plan were granted, 
however, 2.8 million PSUs were outstanding as of December 31, 2023. 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  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, 2023 (in thousands, except per share data):

Balance at December 31, 2022

Granted
Forfeited

Balance at December 31, 2023

Number
of Shares

3,276     $
—     $
(431 )   $
2,845     $

Weighted-
Average
Grant Date
Fair Value

6.21  
—  
5.58  

6.30  

No  stock-based  compensation  expense  related  to  the  PSUs  has  been  recognized  during  the  years  ended  December  31,  2023  and  2022  as  the 
achievement of the performance conditions were not deemed probable and the remaining vesting period is undeterminable. As of December 31, 2023, total 
unrecognized compensation expense relating to PSUs was $17.9 million and the aggregate intrinsic value of PSUs at December 31, 2023 was $7.8 million.

102

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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, 2023, the number of shares 
available for issuance under the 2018 ESPP was 2,781,902.

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  years  ended  December  31,  2023  and  2022,  stock-based  compensation  related  to  the  2018  ESPP  was  $0.8  million  and  $0.8  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)

Year Ended December 31,

2023

2022

5.14 % 
127.37 % 
—    
1.32    

2.20 %
75.83 %
—  
1.67  

As of December 31, 2023, total unrecognized compensation expense relating to shares to be purchased under the 2018 ESPP was $0.3 million and 

the weighted-average remaining vesting period was 1.1 years. 

10. Income Taxes 

The  Company  is  subject  to  income  taxes  in  the  United  States  and  certain  states  in  which  it  operates,  and  it  uses  estimates  in  determining  its 
provisions for income taxes. Significant management judgement is required in determining the Company's provision for income taxes, deferred tax assets 
and liabilities and valuation allowances recorded against net deferred tax assets in accordance with U.S. GAAP. These estimates and judgements occur in 
the  calculation  of  tax  credits,  benefits,  and  deductions,  and  in  the  calculation  of  certain  tax  assets  and  liabilities,  which  arise  from  certain  temporary 
differences  between  the  carrying  amounts  of  assets  and  liabilities  for  financial  reporting  purposes  and  the  amounts  used  for  income  tax  purposes. 
Significant changes to these estimates may result in an increase or decrease to the Company's tax provision in the current or subsequent period. 

The Internal Revenue Code of 1986, as amended (the “Code”), provides for a limitation of the annual use of net operating losses (“NOLs”) 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  had  one  or  more  ownership  changes  in  the  past,  and  it  may 
experience ownership changes in the future. Accordingly, the Company's ability to utilize its NOLs and certain other tax attributes could be severely limited 
or eliminated.

103

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total deferred income tax assets, net of valuation allowance, at December 31, 2023 and 2022 were as follows (in thousands):

Deferred tax assets

Net operating loss carryforwards
Capitalized research expenditures
Research and development credits
Accruals and reserves
Stock-based compensation
Lease liability
Fixed and intangible assets
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,

2023

2022

  $

247,208     $
65,677    
42,347    
8,182    
5,519    
11,314    
295    

380,542  
(373,957 )  
6,585    

—  
6,585  
6,585  

  $

—     $

225,924  
48,767  
35,906  
6,839  
6,341  
13,403  
—  
337,180  
(328,553 )
8,627  

378  
8,249  
8,627  
—  

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 
$374.0 million and $328.6 million has been established at December 31, 2023 and 2022, respectively. The change in the valuation allowance was $45.4 
million  and  $125.0  million  for  the  years  ended  December  31,  2023  and  2022,  respectively.  The  Company  has  incurred  NOL  since  inception.  As  of 
December 31, 2023, the Company had federal and state NOL carryforwards of $893.7 million and $847.2 million, respectively. Federal NOL carryforwards 
of $831.8  million,  which  were  generated  after  December  31,  2017,  do  not  expire.  The  remaining  $61.8  million  of  Federal  NOL  carryforwards  expire 
beginning in 2032. As of December 31, 2023, the Company had federal and California research and other tax credit carryforwards of $48.1 million and 
$11.2 million, respectively. The federal tax credits expire beginning in 2033. The California tax credits can be carried forward indefinitely.

In accordance with the Tax Cuts and Jobs Act of 2017, research and experimental expenditures are required to be capitalized beginning in 2022 and 

amortized over a period of 5 years for domestic expenses and 15 years for foreign expenses.

The effective tax rate for the years ended December 31, 2023 and 2022 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

104

Year Ended December 31,

2023

2022

21.0 %   
(24.5 )%   
5.3 %   
3.1 %   
(0.7 )%   
(4.2 )%   
—  %   

21.0 %
(39.1 )%
20.3 %
0.6 %
(0.1 )%
(2.7 )%
—  %

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
     
   
 
 
   
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
 
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
Decrease related to prior year tax positions

Balance at the end of the year

Year Ended December 31,

2023

2022

13,175     $
1,736  
101  
—    
15,012     $

11,953  
2,317  
—  
(1,095 )
13,175  

  $

  $

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, 2023 and 2022, 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 U.S. Internal Revenue Service (“IRS”) examined the Company’s federal corporate income tax return for the year ended December 31, 2018. 
The examination was completed in April 2022 and did not require any material adjustments. The federal and state income tax returns from inception to 
December 31, 2023 remain subject to examination.

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,  2023  and  2022.  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, 2023 and 2022, the Company made contributions to the 
401(k) plan of $1.0 million and $1.0 million, respectively.

12. Subsequent Events

On January 16, 2024, the Company announced that due to unfavorable clinical trial results associated with the use of lirentelimab in its Phase 2 
atopic dermatitis and Phase 2b chronic spontaneous urticaria trials, that the Company will halt lirentelimab-related activities across clinical, manufacturing, 
research and administrative functions. Accordingly, the Company’s Board of Directors approved the 2024 Reorganization Plan to reduce operating costs 
and better align our workforce with the new clinical development plans of our business. Under the 2024 Reorganization Plan, the Company’s workforce 
will be reduced by approximately 50% primarily during the first quarter of 2024.

The  Company  expects  to  record  approximately  $4  million  in  severance  costs  during  the  first  quarter  of  2024  associated  with  the  workforce 

reduction.

105

 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
 
Item 9. Changes in and Disagreements With Accountants on Accounting and Financial Disclosure.

None. 

Item 9A. Controls and Procedures. 

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our Chief Executive 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 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, 2023.

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, 2023.

Attestation Report of the Registered Public Accounting Firm

This  Annual  Report  does  not  include  an  attestation  report  of  our  registered  public  accounting  firm  regarding  our  internal  control  over  financial 
reporting. Management's report was not subject to attestation by our registered public accounting firm pursuant to Section 404(b) of the Sarbanes-Oxley 
Act of 2002, as amended, which permits us to provide only management’s report in this Annual Report.

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. 
In  addition,  the  design  of  any  system  of  controls  is  based  in  part  upon  certain  assumptions  about  the  likelihood  of  future  events,  and  there  can  be  no 
assurance  that  any  design  will  succeed  in  achieving  its  stated  goals  under  all  potential  future  conditions.  Over  time,  controls  may  become  inadequate 
because of changes in conditions, or the degree of compliance with policies or procedures may deteriorate. Because of the inherent limitations in a cost-
effective control system, misstatements due to error or fraud may occur and not be detected.

106

 
 
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 
Rule  15d-15(d)  of  the  Exchange  Act  that  occurred  during  the  fourth  quarter  of  the  year  ended  December  31,  2023  that  has  materially  affected,  or  is 
reasonably likely to materially affect, our internal control over financial reporting.

Item 9B. Other Information. 

During our last fiscal quarter, no director or officer, as defined in Rule 16a-1(f), adopted or terminated a “Rule 10b5-1 trading arrangement”  or  a 

“non-Rule 10b5-1 trading arrangement,” each as defined in Regulation S-K Item 408.

Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.

Not applicable.

107

 
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, 2023.

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 Accountant Fees and Services. 

The information required by this item will be set forth in the Proxy Statement and is incorporated herein by reference.

108

 
PART IV

Item 15. Exhibits, Financial Statement Schedules. 

(a)

The following documents are filed as part of this Annual Report:

(1)

Financial Statements 

See Index to Financial Statements included in Part II, Item 8 of this Annual Report.

(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

3.1

3.2

4.1

4.2

Description

Form  

File No.

  Number

Filing Date

Filed 
Herewith

Incorporated by Reference

  Amended and Restated Certificate of Incorporation of the 

8-K  

001-38582

Registrant.

  Amended and Restated Bylaws of the Registrant.

8-K  

001-38582

  Specimen common stock certificate of the Registrant.

  S-1/A  

333-225836

  Description of Securities Registered Pursuant to Section 12 of 

10-K  

001-38582

the Securities Exchange Act of 1934.

3.1

3.1

4.2

4.3

7/24/2018

8/21/2023

7/9/2018

3/1/2022

10.1+

  Form of Indemnification Agreement between the Registrant and 

each of its directors and executive officers.

10.2+

  2012 Equity Incentive Plan, as amended, and forms of 

agreement thereunder. 

S-1

S-1

333-225836

10.1

6/22/2018

333-225836

10.2

6/22/2018

10.3+

10.4+

10.5+

  2018 Equity Incentive Plan and forms of agreements thereunder.  

S-1/A  

333-225836

  2018 Employee Stock Purchase Plan.

  Employment Letter between the Registrant and Robert 

Alexander, Ph.D.

S-1/A  

333-225836

S-1/A  

333-225836

10.6+

  Employment Letter between the Registrant and Adam Tomasi, 

S-1/A  

333-225836

10.3

10.4

10.5

10.6

7/9/2018

7/9/2018

7/9/2018

7/9/2018

Ph.D.

10.7+

  Employment Letter between the Registrant and Harlan Baird 

10-Q  

001-38582

10.1

5/10/2021

10.8+

10.9+

10.10+

10.11a

10.11b

Radford, III.

  Executive Incentive Compensation Plan.

  Outside Director Compensation Policy.

  Change in Control and Severance Policy.

  Lease Agreement between the Registrant and ARE-San 

Francisco No. 63, LLC, dated December 4, 2019.

  First Amendment to Lease Agreement between the Registrant 
and ARE-San Francisco No. 63, LLC, dated November 15, 
2022.

S-1

333-225836

10-Q  

001-38582

S-1/A  

333-225836

10-K  

001-38582

10.9

10.1

10.11

10.13

6/22/2018

8/9/2023

7/9/2018

2/25/2020

10-Q  

001-35852

10.1

5/9/2023

109

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.11c

  Second Amendment to Lease Agreement between the Registrant 
and ARE-San Francisco No. 63, LLC, dated March 27, 2023.

10-Q  

001-35852

10.2

5/9/2023

10.12#

  Termination Agreement between the Registrant and Lonza AG 

10-K  

001-38582

10.19

3/1/2022

and affiliates thereof, dated February 14, 2022.

10.13

  Master Development Services Agreement between the 

10-Q  

001-38582

10.1

5/6/2022

Registrant and Samsung Biologics Co., Ltd., dated March 31, 
2022.

10.14

  Sales Agreement between the Registrant and Cowen and 

8-K  

001-38582

1.1

8/5/2022

Company, LLC, dated August 4, 2022.

10.15#

  Master Services Agreement, dated November 1, 2020, by and 

10-Q  

001-38582

10.1

8/4/2022

among Fujifilm Diosynth Biotechnologies UK Limited, Fujifilm 
Diosynth Biotechnologies Texas, LLC, Fujifilm Diosynth 
Biotechnologies U.S.A., Inc. and Biogen (Denmark) 
Manufacturing APS – a Fujifilm Diosynth Biotechnologies 
Group Company.

  Consent of Independent Registered Public Accounting Firm.

  Power of Attorney (reference is made to the signature page 

hereto).

  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.

23.1

24.1

31.1

31.2

  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.

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.

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.

97.1

  Compensation Recovery Policy.

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

  Inline XBRL Taxonomy Extension Calculation Linkbase 

Document

110

X

X

X

X

X

X

X

X

X

X

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
101.DEF

  Inline XBRL Taxonomy Extension Definition Linkbase 

Document

101.LAB

  Inline XBRL Taxonomy Extension Label Linkbase Document

101.PRE

  Inline XBRL Taxonomy Extension Presentation Linkbase 

Document

104

  Cover Page Interactive Data File (formatted in Inline XBRL and 

contained in Exhibit 101)

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.

111

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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 14, 2024

ALLAKOS INC.

By:

/s/ Robert Alexander
Robert Alexander, Ph.D.
Chief Executive Officer
(Principal Executive Officer)

POWER OF ATTORNEY

KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Robert Alexander and 
H. Baird Radford, III as his or her true and lawful attorneys-in-fact and agents, with full power of substitution and substitution, for him or her and in his or 
her name, place, and stead, in any and all capacities (including his or her capacity as a director and/or officer of Allakos Inc.) to sign any or all amendments 
to this Annual Report on Form 10-K, and to file the same, with all exhibits thereto, and all other documents in connection therewith, with the Securities and 
Exchange Commission, granting unto said attorneys-in-fact and agents, and each of them, full power and authority to do and perform each and every act 
and thing requisite and necessary to be done in and about the premises, as fully to all intents and purposes as they, he or she might or could do in person, 
hereby ratifying and confirming all that said attorney-in-fact and agents or any of them, or their, his, or her substitute or substitutes, may lawfully do or 
cause to be done by virtue hereof.

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/ Neil Graham
Neil Graham, M.D.

/s/ Steven P. James
Steven P. James

/s/ Amy L. Ladd
Amy L. Ladd, M.D.

/s/ Rand Sutherland
Rand Sutherland, M.D.

/s/ Dolca Thomas
Dolca Thomas, M.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 of Directors

  Director

  Director

  Director

  Director

  Director

  Director

  Director

112

Date

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consent of Independent Registered Public Accounting Firm

Exhibit 23.1

We consent to the incorporation by reference in the following Registration Statements:

(1)

Registration  Statements  (Form  S-8  No.  333-226247,  333-231276,  333-236631,  333-253701,  333-262749,  333-269134  and  333-276392) 
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 Statements (Form S-3 No.333-265085 and 333-275517) of Allakos Inc.,

of our report dated March 14, 2024, with respect to the financial statements of Allakos Inc., included in this Annual Report (Form 10-K) of Allakos Inc. for 
the year ended December 31, 2023.

/s/ Ernst & Young LLP 

San Mateo, California 
March 14, 2024

 
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 14, 2024

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 14, 2024

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, 2023 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 14, 2024

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, 2023 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 14, 2024

By:

/s/ H. Baird Radford, III
H. Baird Radford, III
Chief Financial Officer
(Principal Financial and Accounting Officer)

 
 
 
 
 
 
 
 
 
 
 
ALLAKOS INC.

COMPENSATION RECOVERY POLICY

Exhibit 97.1

(Adopted and approved on August 17, 2023 and effecve as of December 1, 2023)

Allakos Inc. (the “Company”) is commied to strong corporate governance. As part of this commitment, the Company’s Board 
of  Directors  (the  “Board”)  has  adopted  this  clawback  policy  called  the  Compensaon  Recovery  Policy  (the  “Policy”).  The  Policy  is 
intended to further the Company’s pay-for-performance philosophy and to comply with applicable law by providing for the reasonably 
prompt recovery of certain incenve-based compensaon received by Execuve Officers in the event of an Accounng Restatement. 

Capitalized  terms  used  in  the  Policy  are  defined  below,  and  the  definions  have  substanve  impact  on  its  applicaon  so 
reviewing  them  carefully  is  important  to  your  understanding.    The  applicaon  of  the  Policy  to  Execuve  Officers  is  not  discreonary, 
except to the limited extent provided below, and applies without regard to whether an Execuve Officer was at fault.

The  Policy  is  intended  to  comply  with,  and  will  be  interpreted  in  a  manner  consistent  with,  Secon  10D  of  the  Securies 
Exchange  Act  of  1934  (the  “Exchange  Act”),  with  Exchange  Act  Rule  10D-1  and  with  the  lisng  standards  of  the  naonal  securies 
exchange  (the  “Exchange”)  on  which  the  securies  of  the  Company  are  listed,  including  any  interpreve  guidance  provided  by  the 
Exchange. 

Persons Covered by the Policy

The  Policy  is  binding  and  enforceable  against  all  Execuve  Officers.  “Execuve Officer”  means  each  individual  who  is  or  was 
ever designated as an “officer” by the Board in accordance with Exchange Act Rule 16a-1(f). Each Execuve Officer will be required to 
sign and return to the Company an acknowledgement that such Execuve Officer will be bound by the terms and comply with the Policy. 
The failure to obtain such acknowledgement will have no impact on the applicability or enforceability of the Policy.

Administraon of the Policy

The  Compensaon  Commiee  (the  “Commiee”)  of  the  Board  has  full  delegated  authority  to  administer  the  Policy.  The 
Commiee is authorized to interpret and construe the Policy and to make all determinaons necessary, appropriate, or advisable for the 
administraon of the Policy. In addion, if determined in the discreon of the Board, the Policy may be administered by the independent 
members of the Board or another commiee of the Board made up of independent members of the Board, in which case all references 
to the Commiee will be deemed to refer to the independent members of the Board or the other Board commiee. All determinaons 
of the Commiee will be final and binding and will be given the maximum deference permied by law.

Accounng Restatements Requiring Applicaon of the Policy

If the Company is required to prepare an accounng restatement due to the material noncompliance of the Company with any 
financial  reporng  requirement  under  the  securies  laws,  including  any  required  accounng  restatement  to  correct  an  error  in 
previously issued financial statements that is material to the previously issued financial statements, or that would result in a material 
misstatement if the error were corrected 

 
 
in the current period or le uncorrected in the current period (an “Accounng Restatement”), then the Commiee must determine the 
Excess Compensaon, if any, that must be recovered. The Company’s obligaon to recover Excess Compensaon is not dependent on if 
or when the restated financial statements are filed.

Compensaon Covered by the Policy

The Policy applies to certain Incenve-Based Compensaon that is Received on or aer October 2, 2023 (the “Effecve Date”), 
during  the  Covered  Period  while  the  Company  has  a  class  of  securies  listed  on  a  naonal  securies  exchange.  The  Incenve-Based 
Compensaon is considered “Clawback Eligible Incenve-Based Compensaon” if the Incenve-Based Compensaon is Received by a 
person aer such person became an Execuve Officer and the person served as an Execuve Officer at any me during the performance 
period to which the Incenve-Based Compensaon applies. The ”Excess Compensaon” that is subject to recovery under the Policy is 
the  amount  of  Clawback  Eligible  Incenve-Based  Compensaon  that  exceeds  the  amount  of  Clawback  Eligible  Incenve-Based 
Compensaon  that  otherwise  would  have  been  Received  had  such  Clawback  Eligible  Incenve-Based  Compensaon  been  determined 
based on the restated amounts (this is referred to in the lisngs standards as “erroneously awarded incenve-based compensaon”).

To determine the amount of Excess Compensaon for Incenve-Based Compensaon based on stock price or total shareholder 
return, where it is not subject to mathemacal recalculaon directly from the informaon in an Accounng Restatement, the amount 
must be based on a reasonable esmate of the effect of the Accounng Restatement on the stock price or total shareholder return upon 
which  the  Incenve-Based  Compensaon  was  Received  and  the  Company  must  maintain  documentaon  of  the  determinaon  of  that 
reasonable esmate and provide the documentaon to the Exchange.

“Incenve-Based Compensaon” means any compensaon that is granted, earned, or vested based wholly or in part upon the 
aainment of a Financial Reporng Measure. For the avoidance of doubt, no compensaon that is potenally subject to recovery under 
the Policy will be earned unl the Company’s right to recover under the Policy has lapsed.

The following items of compensaon are not Incenve-Based Compensaon under the Policy: salaries, bonuses paid solely at 
the discreon of the Compensaon Commiee or Board that are not paid from a bonus pool that is determined by sasfying a Financial 
Reporng Measure, bonuses paid solely upon sasfying one or more subjecve standards and/or compleon of a specified employment 
period,  non-equity  incenve  plan  awards  earned  solely  upon  sasfying  one  or  more  strategic  measures  or  operaonal  measures,  and 
equity  awards  for  which  the  grant  is  not  conngent  upon  achieving  any  Financial  Reporng  Measure  performance  goal  and  vesng  is 
conngent solely upon compleon of a specified employment period (e.g., me-based vesng equity awards) and/or aaining one or 
more non-Financial Reporng Measures

“Financial Reporng Measures” are measures that are determined and presented in accordance with the accounng principles 
used in preparing the Company’s financial statements, and any measures that are derived wholly or in part from such measures. Stock 
price and total shareholder return are also Financial Reporng Measures. A Financial Reporng Measure need not be presented within 
the financial statements or included in a filing with the Securies and Exchange Commission. 

Incenve-Based  Compensaon  is  “Received”  under  the  Policy  in  the  Company’s  fiscal  period  during  which  the  Financial 
Reporng Measure specified in the Incenve-Based Compensaon award is aained, even if the payment, vesng, selement or grant of 
the  Incenve-Based  Compensaon  occurs  aer  the  end  of  that  period.  For  the  avoidance  of  doubt,  the  Policy  does  not  apply  to 
Incenve-Based Compensaon for which the Financial Reporng Measure is aained prior to the Effecve Date.

-2-

 
“Covered Period” means the three completed fiscal years immediately preceding the Accounng Restatement Determinaon 

Date. In addion, Covered Period can include certain transion periods resulng from a change in the Company’s fiscal year. 

“Accounng  Restatement  Determinaon  Date”  means  the  earliest  to  occur  of:  (a)  the  date  the  Board,  a  commiee  of  the 
Board,  or  one  or  more  of  the  officers  of  the  Company  authorized  to  take  such  acon  if  Board  acon  is  not  required,  concludes,  or 
reasonably  should  have  concluded,  that  the  Company  is  required  to  prepare  an  Accounng  Restatement;  and  (b)  the  date  a  court, 
regulator, or other legally authorized body directs the Company to prepare an Accounng Restatement.

Repayment of Excess Compensaon

The  Company  must  recover  Excess  Compensaon  reasonably  promptly  and  Execuve  Officers  are  required  to  repay  Excess 
Compensaon  to  the  Company.  Subject  to  applicable  law,  the  Company  may  recover  Excess  Compensaon  by  requiring  the  Execuve 
Officer to repay such amount to the Company by direct payment to the Company or such other means or combinaon of means as the 
Commiee determines to be appropriate (these determinaons do not need to be idencal as to each Execuve Officer). These means 
may include:

(a)

(b)

(c)

(d)

(e)

requiring reimbursement of cash Incenve-Based Compensaon previously paid; 

seeking  recovery  of  any  gain  realized  on  the  vesng,  exercise,  selement,  sale,  transfer,  or  other  disposion  of  any 
equity-based awards; 

offseng  the  amount  to  be  recovered  from  any  unpaid  or  future  compensaon  to  be  paid  by  the  Company  or  any 
affiliate of the Company to the Execuve Officer; 

cancelling outstanding vested or unvested equity awards; and/or 

taking any other remedial and recovery acon permied by law, as determined by the Commiee. 

The repayment of Excess Compensaon must be made by an Execuve Officer notwithstanding any Execuve Officer’s belief 
(whether or not legimate) that the Excess Compensaon had been previously earned under applicable law and therefore is not subject 
to clawback. 

In addion to its rights to recovery under the Policy, the Company or any affiliate of the Company may take any legal acons it 
determines  appropriate  to  enforce  an  Execuve  Officer’s  obligaons  to  the  Company  or  to  discipline  an  Execuve  Officer,  including 
(without limitaon) terminaon of employment, instuon of civil proceedings, reporng of misconduct to appropriate governmental 
authories,  reducon  of  future  compensaon  opportunies  or  change  in  role.  The  decision  to  take  any  acons  described  in  the 
preceding sentence will not be subject to the approval of the Commiee and can be made by the Board, any commiee of the Board, or 
any duly authorized officer of the Company or of any applicable affiliate of the Company.

Limited Excepons to the Policy

The Company must recover Excess Compensaon in accordance with the Policy except to the limited extent that the condions 
of  Exchange  Act  Rule  10D-1(b)(1)(iv)  and  the  Exchange  lisng  standards  are  met,  and  the  Commiee  has  made  a  determinaon  that 
recovery of the Excess Compensaon would be impraccable.

-3-

 
Other Important Informaon in the Policy

The  Policy  is  in  addion  to  the  requirements  of  Secon  304  of  the  Sarbanes-Oxley  Act  of  2002  that  are  applicable  to  the 
Company’s  Chief  Execuve  Officer  and  Chief  Financial  Officer,  as  well  as  any  other  applicable  laws,  regulatory  requirements,  or  rules.  
With  the  excepon  of  any  compensaon  that  is  Received  prior  to  the  Effecve  Date,  which  compensaon  will  remain  subject  to  any 
clawback or other compensaon recovery policy previously adopted by the Company, the Policy supersedes in full all of the clawback or 
other compensaon recovery policies of the Company that were in effect prior to the Effecve Date to the extent those policies were 
applicable to Execuve Officers and the operave porons of those policies will have no further force or effect on or aer the Effecve 
Date.

Notwithstanding  the  terms  of  any  of  the  Company’s  organizaonal  documents  (including,  but  not  limited  to,  the  Company’s 
bylaws), any corporate policy or any contract (including, but not limited to, any indemnificaon agreement), neither the Company nor 
any affiliate of the Company will indemnify or provide advancement for any Execuve Officer against any loss of Excess Compensaon. 
Neither the Company nor any affiliate of the Company will pay for or reimburse insurance premiums for an insurance policy that covers 
potenal recovery obligaons. In the event that pursuant to this Policy the Company is required to recover Excess Compensaon from an 
Execuve Officer who is no longer an employee, the Company will be entled to seek recovery in order to comply with applicable law,
regardless of the terms of any release of claims or separaon agreement such individual may have signed. 

The Commiee or Board may review and modify the Policy from me to me.

If any provision of the Policy or the applicaon of any such provision to any Execuve Officer is adjudicated to be invalid, illegal 
or  unenforceable  in  any  respect,  such  invalidity,  illegality  or  unenforceability  will  not  affect  any  other  provisions  of  the  Policy  or  the 
applicaon of such provision to another Execuve Officer, and the invalid, illegal or unenforceable provisions will be deemed amended to 
the minimum extent necessary to render any such provision or applicaon enforceable.

The  Policy  will  terminate  and  no  longer  be  enforceable  when  the  Company  ceases  to  be  listed  issuer  within  the  meaning  of 

Secon 10D of the Exchange Act.

-4-

 
ACKNOWLEDGEMENT

•

•

•

•

•

•

•

•

I acknowledge that I have received and read the Compensaon Recovery Policy (the “Policy”) of Allakos Inc. (the “Company”).

I  understand  and  acknowledge  that  the  Policy  applies  to  me,  and  all  of  my  beneficiaries,  heirs,  executors,  administrators  or 
other  legal  representaves  and  that  the  Company’s  right  to  recovery  in  order  to  comply  with  applicable  law  will  apply, 
regardless of the terms of any release of claims or separaon agreement I have signed or will sign in the future.

I agree to be bound by and to comply with the Policy and understand that determinaons of the Commiee (as such term is 
used in the Policy) will be final and binding and will be given the maximum deference permied by law.

I  understand  and  agree  that  my  current  indemnificaon  rights,  whether  in  an  individual  agreement  or  the  Company’s 
organizaonal documents, exclude the right to be indemnified for amounts required to be recovered under the Policy.

I  understand  that  my  failure  to  comply  in  all  respects  with  the  Policy  is  a  basis  for  terminaon  of  my  employment  with  the 
Company and any affiliate of the Company as well as any other appropriate discipline.

I  understand  that  neither  the  Policy,  nor  the  applicaon  of  the  Policy  to  me,  gives  rise  to  a  resignaon  for  good  reason  (or 
similar concept) by me under any applicable employment agreement or arrangement.

I  acknowledge  that  if  I  have  quesons  concerning  the  meaning  or  applicaon  of  the  Policy,  it  is  my  responsibility  to  seek 
guidance from the Compliance Officer or my own personal advisers.

I acknowledge that neither this Acknowledgement nor the Policy is meant to constute an employment contract.

Please review, sign and return this form to the Compliance Officer.

Execuve Officer

(print name)

(signature)

(date)