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CASI Pharmaceuticals Inc

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FY2021 Annual Report · CASI Pharmaceuticals Inc
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UNITED STATES 
SECURITIES AND EXCHANGE COMMISSION 
WASHINGTON, D. C. 20549 

FORM 10-K 

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

For the fiscal year ended December 31, 2021 

OR  

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

Commission file number 0-20713 

CASI PHARMACEUTICALS, INC. 
(Exact name of registrant as specified in its charter) 

Delaware 
(State of Incorporation) 

9620 Medical Center Drive, Suite 300, Rockville, MD
(Address of principal executive offices) 

58-1959440 
(I.R.S. Employer Identification No.)

20850 
(Zip Code) 

(240) 864-2600 

Registrant’s telephone number, including area code 

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

Common Stock, $0.01 par value 
(Title of each class) 

Trading Symbol
CASI

NASDAQ 
(Name of each exchange on which registered)

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,  or  a  smaller  reporting 
company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check 
one): 

Large accelerated filer  

Accelerated filer 

Non-accelerated filer ☒ 

Smaller reporting company ☒ 
Emerging growth company ☐ 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with 

any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its 
internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that 
prepared or issued its audit report. ☐ 

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

As of June 30, 2021, the aggregate market value of the shares of common stock held by non-affiliates was $179,150,437. 

As of March 18, 2022, 136,589,826 shares of the Company’s common stock were outstanding. 

Documents Incorporated By Reference 

The  registrant  intends  to  file  a  definitive  proxy  statement  pursuant  to  Regulation 14A  within  120 days  of  the  end  of  the  fiscal year  ended 

December 31, 2021. The proxy statement is incorporated herein by reference into the following parts of the Form 10-K: 

Part III, Item 10, Directors, Executive Officers and Corporate Governance; 
Part III, Item 11, Executive Compensation; 
Part III, Item 12, Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters; 
Part III, Item 13, Certain Relationships and Related Transactions, and Director Independence; and 
Part III, Item 14, Principal Accounting Fees and Services. 

 
 
 
 
 
 
 
  
  
 
 
  
 
 
 
Form 10-K 
Part No. 
I 

Form 10-K 
Item No. 
1 

1A 

1B 

2 

3 

4 

5 

6 

7 

7A 

8 

9 

9A 

9B 

10 

11 

12 

13 

14 

15 

II 

III 

IV 

CASI PHARMACEUTICALS, INC. 
FORM 10-K - FISCAL YEAR ENDED DECEMBER 31, 2021 

TABLE OF CONTENTS 

Description

  Business 

  Risk Factors 

  Unresolved Staff Comments 

  Properties 

  Legal Proceedings 

  Mine Safety Disclosure 

Market for Registrant’s Common Equity, Related Stockholder Matters And Issuer Purchases of 
Equity Securities 

  Selected Financial Data 

  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 

  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 and Financial Statement Schedules 

  Signatures 

  Audited Consolidated Financial Statements 

Page No.
4

20

43

43

44

44

45

45

45

52

52

53

53

53

54

54

54

54

54

55

59

F-1

2 

     
     
 
 
 
 
 
  
 
 
 
 
 
 
  
 
 
 
 
 
 
  
 
 
 
 
 
 
  
 
 
 
 
 
 
  
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
 
  
 
 
  
 
 
 
 
 
  
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
TRADEMARKS AND SERVICE MARKS 

We own or have rights to trademarks and trademark applications for use in connection with the operation of our business, 
including,  but  not  limited  to,  CASI  and  CASI  PHARMACEUTICALS.  All  other  trademarks  appearing  in  this  Annual  Report  on 
Form 10-K that are not identified as marks owned by CASI are the property of their respective owners. 

SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS 

This report contains certain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as 
amended and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements also may be included in 
other  statements  that  we  make.  All  statements  that  are  not  descriptions  of  historical  facts  are  forward-looking  statements.  These 
statements can generally be identified by the use of forward-looking terminology such as “believes,” “expects,” “intends,” “may,” “will,” 
“should,” or “anticipates” or similar terminology. These forward-looking statements include, among others, statements regarding the 
timing of our commercial launch of products, clinical trials, our cash position and future expenses, and our future revenues. 

Actual results could differ materially from those currently anticipated due to a number of factors, including: the risk that we 
may be unable to continue as a going concern as a result of our inability to raise sufficient capital for our operational needs; the possibility 
that we may be delisted from trading on The Nasdaq Capital Market if we fail to satisfy applicable continued listing standards, including 
compliance  with  the Nasdaq bid  price rule;  the  volatility in  the  market price  of our  common stock;  the  outbreak of  the  COVID-19 
pandemic and its effects on global markets and supply chains; the risk of substantial dilution of existing stockholders in future stock 
issuances;  the  difficulty  of  executing  our  business  strategy  on  a  global  basis  including  China;  our  inability  to  enter  into  strategic 
partnerships  for  the  development,  commercialization,  manufacturing  and  distribution  of  our  proposed  product  candidates  or  future 
candidates; legal or regulatory developments in China that adversely affect our ability to operate in China, our lack of experience in 
manufacturing products and uncertainty about our resources and capabilities to do so on a clinical or commercial scale; risks relating to 
the commercialization, if any, of our products and proposed products (such as marketing, safety, regulatory, patent, product liability, 
supply, competition and other risks); our inability to predict when or if our product candidates will be approved for marketing by the 
U.S. Food and Drug Administration (FDA), European Medicines Agency (EMA), National Medical Products Administration (NMPA), 
or other regulatory authorities; our inability to enter into strategic partnerships for the development, commercialization, manufacturing 
and distribution of our proposed product candidates or future candidates; the risks relating to the need for additional capital and the 
uncertainty of securing additional funding on favorable terms; the risks associated with our product candidates, and the risks associated 
with our other early-stage products under development; the risk that result in preclinical and clinical models are not necessarily indicative 
of clinical results; uncertainties relating to preclinical and clinical trials, including delays to the commencement of such trials; our ability 
to protect our intellectual property rights; our ability to design and implement a development plan for our ANDAs held by CASI Wuxi; 
the lack of success in the clinical development of any of our products; and our dependence on third parties; the risks related to our 
dependence on Juventas to conduct the clinical development of CNCT19 and to partner with us to co-market CNCT19; risks related to 
our dependence on Juventas to ensure the patent protection and prosecution for CNCT19; risks relating to the commercialization, if any, 
of our proposed products (such as marketing, safety, regulatory, patent, product liability, supply, competition and other risks); risks 
relating to interests of our largest stockholders and our Chairman and CEO that differ from our other stockholders; and risks related to 
the development of a new manufacturing facility by CASI Wuxi. Such factors, among others, could have a material adverse effect upon 
our business, results of operations and financial condition. 

We  caution  investors  that  actual  results  or  business  conditions  may  differ  materially  from  those  projected  or  suggested  in 
forward-looking statements as a result of various factors including, but not limited to, those described above and in Section IA, “Risk 
Factors” of this Annual Report on Form 10-K for the fiscal year ended December 31, 2021 (this “Annual Report”) and our other filings 
with  the  Securities  and  Exchange  Commission  (“SEC”).  We  cannot  assure  you  that  we  have  identified  all  the  factors  that  create 
uncertainties. Moreover, new risks emerge from time to time and it is not possible for our management to predict all risks, nor can we 
assess the impact of all risks on our business or the extent to which any risk, or combination of risks, may cause actual results to differ 
from those contained in any forward-looking statements. Readers should not place undue reliance on forward-looking statements, which 
only relate to events or information as of the date made. We undertake no obligation to publicly release the result of any revision of 
these  forward-looking  statements  to  reflect  events  or  circumstances  after  the  date  they  are  made  or  to  reflect  the  occurrence  of 
unanticipated events. Additional information about the factors and risks that could affect our business, financial condition and results of 
operations,  are  contained  in  our  filings  with  the  U.S.  Securities  and  Exchange  Commission  (“SEC”),  which  are  available  at 
www.sec.gov. 

3 

 
 
ITEM 1. BUSINESS. 

PART I 

CASI  Pharmaceuticals,  Inc.  (“CASI”  or  the  “Company”,  or  “we”  or  “our”)  (Nasdaq:  CASI)  is  a  U.S.  biopharmaceutical 
company focused on developing and commercializing innovative therapeutics and pharmaceutical products in China, the United States, 
and throughout the world. We were incorporated in 1991, and in 2012, with new leadership, we shifted our business strategy to China 
and has since built an infrastructure in China that includes sales and marketing, medical affairs, regulatory and clinical development and 
in  the  foreseeable  future,  manufacturing. We  are focused  on  acquiring,  developing  and  commercializing  products  that  augment  our 
hematology  oncology  therapeutic  focus  as  well  as  other  areas  of  unmet  medical  need.  We  are  executing  our  plan  to  become  a 
biopharmaceutical  leader  by  launching  medicines  in  the  greater  China  market,  leveraging  our  China-based  regulatory,  clinical  and 
commercial competencies and our global drug development expertise.  The majority of our operations are now located in China and are 
conducted primarily  through  two of  our  subsidiaries: (i) CASI Pharmaceuticals  (China)  Co.,  Ltd. (“CASI  China”),  which  is wholly 
owned and is located in Beijing, China, and (ii) CASI Pharmaceuticals (Wuxi) Co., Ltd. (“CASI Wuxi”), which is located in Wuxi, 
China.  Our  Beijing  office  is  primarily  responsible  for  our  day-to-day  operations,  and  our  commercial  team  of  over  100 
hematology/oncology sales and marketing specialists is based in China.  CASI Wuxi is part of the long-term strategy to support our 
future  clinical  and  commercial  manufacturing  needs,  to  manage  our  supply  chain  for  certain  products,  and  to  develop  a  GMP 
manufacturing facility in China. 

We  launched  our  first  commercial  product,  EVOMELA®  (Melphalan  for  Injection)  in  China  in  August 2019.  In  China, 
EVOMELA® is approved for use as a conditioning treatment prior to stem cell transplantation and as a palliative treatment for patients 
with multiple myeloma. The other core hematology/oncology assets in our pipeline include:  

•  CNCT19 is an autologous CD19 CAR-T investigative product (“CNCT19”) being developed by our partner Juventas Cell 
Therapy Ltd. (“Juventas”) for which we have exclusive World-Wide co-commercial and profit-sharing rights.   CNCT19 
is being developed as a potential treatment for patients with hematological malignancies which express CD19 including, 
B-cell acute lymphoblastic leukemia (“B-ALL”) and B-cell non-Hodgkin lymphoma (“B-NHL”).  The CNCT19 Phase 1 
studies in patients with  B-ALL and B-NHL in China have been completed by Juventas, the Phase 2 B-ALL and B-NHL 
registration studies are both currently enrolling in China since the fourth quarter of 2020. 

•  BI-1206 is an antibody which has a novel mode-of-action, blocking the inhibitory antibody checkpoint receptor FcγRIIB 
to  unlock  anti-cancer  immunity  and  enhance  the  efficacy  of  antibody-based  immunotherapy  in  both  hematological 
malignancies and solid tumors for which we have licensed exclusive greater China rights from BioInvent International AB 
(“BioInvent”).  BI-1206  is  being  investigated  by  BioInvent  in  a  Phase  1/2  trial,  in  combination  with  anti-PD1  therapy 
Keytruda®  (pembrolizumab),  in  patients  with  solid  tumors,  and  in  a  Phase  1/2a  trial  in  combination  with  MabThera® 
(rituximab) in patients with relapsed/refractory non-Hodgkin lymphoma (NHL). BI-1206 has the potential to restore the  
activity of rituximab in patients with relapsed/refractory non-Hodgkin lymphoma. Clinical Trial Application (CTA) was 
approved by China National Medical Products Administration (NMPA) in December 2021. We are planning Phase 1 trials 
of BI-1206 as a single agent to evaluate the PK/safety profile and in combination with rituximab in patients with NHL 
(mantle cell lymphoma, marginal zone lymphoma, and follicular lymphoma) to assess safety and tolerability, select the 
Recommended Phase 2 Dose and assess early signs of clinical efficacy as part of our development program for BI-1206 
in China. The studies are expected to start in the first half of 2022. 

•  CB-5339  is  a  novel  VCP/p97  inhibitor  focused  on  valosin-containing  protein  (VCP)/p97  as  a  novel  target  in  protein 
homeostasis, DNA damage response and other cellular stress pathways for therapeutic use in the treatment of patients with 
various malignancies.  We entered into an exclusive license on March 21, 2021 with Cleave Therapeutics, Inc. (“Cleave”) 
for the development and commercialization of CB-5339 in Mainland China, Hong Kong, Macau and Taiwan. CB-5339, 
an oral second-generation, small molecule VCP/p97 inhibitor, is being evaluated in a Phase 1 clinical trial in patients with 
acute  myeloid  leukemia  (AML)  and  myelodysplastic  syndrome  (MDS).    CB-5339  CTA  application  for  the  multiple 
myeloma indication is in preparation after receiving an acceptance letter for the CB-5339 IND package from the China 
Center of Drug Evaluation (“CDE”) 

•  CID-103  is  a  full  human  IgG1  anti-CD38  monoclonal  antibody  recognizing  a  unique  epitope  that  has  demonstrated 
encouraging preclinical efficacy and safety profile compared to other anti-CD38 monoclonal antibodies for which we have 
exclusive global rights.  CID-103 is being developed for the treatment of patients with multiple myeloma.  The Phase 1 

4 

 
 
 
dose  escalation  and  expansion  study  of  CID-103,  in  patients  with  previously  treated,  relapsed  or  refractory  multiple 
myeloma is ongoing in France and the UK. 

We also have greater China rights to Octreotide (Long Acting Injectable), a standard of care for the treatment of acromegaly 
and for the control of symptoms associated with certain neuroendocrine tumors; and Thiotepa, a cytotoxic agent which has a long history 
of established use in the hematology/oncology setting, we have an exclusive China license and distribution rights to a novel formulation 
of  thiotepa,  which  has  multiple  indications  including  use  as  a  conditioning  treatment  for  certain  allogeneic  haemopoietic  stem  cell 
transplants. However, due to the evolving standard of care environment, the rare and niche indication for these products, potential US 
regulatory action and our commitment to prioritize resources, we are currently evaluating our potential opportunities for these products.  
In addition, our assets include six FDA-approved ANDAs which we are evaluating due to generic drug pricing reforms by the Chinese 
government and its impact on the pricing and competitiveness of these products. 

CASI  has  built  a  fully  integrated,  world  class  biopharmaceutical  company  dedicated  to  the  successful  development  and 
commercialization of innovative and other therapeutic products. Our business development strategy is currently focused on acquiring 
additional targeted drugs and immuno-oncology therapeutics through licensing that will expand our hematology/oncology franchise. 
We use a market-oriented approach to identify pharmaceutical/biotechnology candidates that we believe to have the potential for gaining 
widespread  market  acceptance,  either  globally  or  in  China,  and  for  which  development  can  be  accelerated  under  our  global  drug 
development strategy. In many cases our business development strategy includes direct equity investments in the licensor company.  We 
intend  for  our  pipeline  to  reflect  a  diversified  and  risk-balanced  set  of  assets  that  include  (1) late-stage  clinical  drug  candidates  in-
licensed  for  China  or  global  regional  rights,  (2) proprietary  or  licensed  innovative  drug  candidates,  and  (3) select  high  quality 
pharmaceuticals that fit our therapeutic focus. We have focused on US/EU approved product candidates, and product candidates with 
proven  targets  or  product  candidates  that  have  reduced  clinical  risk  with  a  greater  emphasis  on  innovative  therapeutics.  Although 
oncology with a focus on hematological malignancies is our principal clinical and commercial target, we are opportunistic about other 
therapeutic areas that can address unmet medical needs. We will continue to pursue building a robust pipeline of drug candidates for 
development and commercialization in China as our primary market, and if rights are available for the rest of the world. 

We believe our China operations offer a significant market and growth potential due to the extraordinary increase in demand 
for high quality medicines coupled with regulatory reforms in China that facilitate the entry of new pharmaceutical products into the 
country.  We  will  continue  to  in-license  clinical-stage  and  late-stage  drug  candidates,  and  leverage  our  cross-border  operations  and 
expertise, and hope to be the partner of choice to provide access to the China market. We expect the implementation of our plans will 
include leveraging our resources and expertise in both the U.S. and China so that we can maximize regulatory, development and clinical 
strategies in both countries. 

Our commercial product, EVOMELA®, was originally licensed from Spectrum Pharmaceuticals, Inc. (“Spectrum”) and we had 
a supply agreement with Spectrum to support our application for import drug registration and for commercialization purposes. Spectrum 
completed the sale of its portfolio of FDA-approved hematology/oncology products including EVOMELA® to Acrotech Biopharma 
L.L.C. (“Acrotech”) on March 1, 2019. The original supply agreement with Spectrum was assumed by Acrotech; Spectrum agreed to 
continue with a short-term supply agreement for EVOMELA® for the initial commercial product supply in connection with the launch, 
with the long-term supply assumed by Acrotech. 

As part of the long-term strategy to support its future clinical and commercial manufacturing needs and to manage its supply 
chain for certain products, on December 26, 2018, the Company, together with Wuxi Jintou Huicun Investment Enterprise, a limited 
partnership organized under Chinese law (“Wuxi LP”) established CASI Pharmaceuticals (WUXI) Co., Ltd. (“CASI Wuxi”) to build 
and operate a GMP manufacturing facility in the Wuxi Huishan Economic Development Zone in Jiangsu Province, China.   

5 

 
CORE PRODUCT AND CANDIDATES IN HEMATOLOGY/ONCOLOGY 

EVOMELA® (Melphalan for Injection) - Launched In China 

EVOMELA®  (Melphalan  for  Injection)  is  an  intravenous  formulation  of  melphalan  commercialized  by  Acrotech
(formally by Spectrum) in the multiple myeloma treatment setting in the United States, of which we have exclusive
greater China rights. The EVOMELA® formulation avoids the use of propylene glycol, which is used as a co-solvent 
in  other  formulations  of  injectable  melphalan.    The  use  of  Captisol  in  the  EVOMELA®  formulation  improves  the 
melphalan  stability  when  reconstituted,  allowing  for  longer  preparation  and  infusion  times.  In  August 2019,  CASI 
launched  EVOMELA®  in  China  as  its  first  commercial  product.  The  NMPA  required  post-marketing  study  has 
completed and the clinical study report is being finalized for regulatory submission. 

CNCT19 (CD19 CAR-T).  

In June 2019, the Company acquired worldwide license and commercialization rights to CNCT19 from Juventas, a China-
based  domestic  company  engaged  in  cell  therapy.  Juventas  continues  to  be  responsible  for  the  clinical  development  and  regulatory 
submission and maintenance of CNCT19 regulatory applications and CASI is responsible for the launch and commercial activities of 
CNCT19  under  the  direction  of  a  joint  steering  committee.  Subsequently,  the  worldwide  license  and  commercialization  rights  to 
CNCT19 acquired in June 2019 were amended.  

CNCT19 is an autologous CD19 CAR-T investigative product (CNCT19) being developed by our partner Juventas for which 
we have co-commercial and profit-sharing rights.  CNCT19 targets CD19, a B-cell surface protein widely expressed during all phases 
of B-cell development and a validated target for B-cell driven hematological malignancies. CD19 targeted CAR constructs from several 
different  institutions  have  demonstrated  consistently  high  antitumor  efficacy  in  children  and  adults  with  relapsed  B-cell  acute 
lymphoblastic leukemia (B-ALL), chronic lymphocytic leukemia (CLL), and B-cell non-Hodgkin lymphoma (B-NHL).   

CNCT19  is  being  developed  as  a  potential  treatment  for  patients  with  hematological  malignancies  which  express  CD19 
including,  B-cell  acute  lymphoblastic  leukemia  (“B-ALL”)  and  B-cell  non-Hodgkin  lymphoma  (“B-NHL”).  The  CNCT19  Phase  1 
studies in patients with  B-ALL and B-NHL in China have been completed by Juventas, with the Phase 2 B-NHL and B-ALL registration 
studies both currently enrolling in China since the fourth quarter of 2020.    

BI-1206 (anti-FcyRIIB antibody) 

BI-1206 is an antibody which has a novel mode-of-action, blocking the inhibitory antibody checkpoint receptor FcγRIIB to 
unlock anti-cancer immunity and enhance the efficacy of antibody-based immunotherapy in both hematological malignancies and solid 
tumors for which we have licensed exclusive greater China rights.  BI-1206 was added to our portfolio in October 2020 pursuant to a 
license agreement with our partner, BioInvent International AB (“BioInvent”).  BI-1206 is being investigated by BioInvent in a Phase 
1/2 trial, in combination with anti-PD1 therapy Keytruda® (pembrolizumab), in patients with solid tumors, and in a Phase 1/2a trial in 
combination with MabThera® (rituximab) in patients with relapsed/refractory non-Hodgkin lymphoma (NHL). BI-1206 has the potential 
to restore the  activity of rituximab in patients with relapsed/refractory non-Hodgkin lymphoma. 

Clinical  Trial  Application  (CTA)  was  approved  by  China  National  Medical  Products  Administration  (NMPA)  in 
December 2021.  The  Company  is  planning  Phase  1  trials  of  BI-1206  as  a  single  agent  to  evaluate  the  PK/safety  profile  and  in 
combination with rituximab in patients with NHL (mantle cell lymphoma, marginal zone lymphoma, and follicular lymphoma) to assess 
safety and tolerability, select the Recommended Phase 2 Dose and assess early signs of clinical efficacy as part of its development 
program for BI-1206 in China. The studies are expected to start in the first half of 2022. 

CB-5339 (VCP/p97inhibitor) 

CB-5339  is  a  novel  VCP/p97  inhibitor  focused  on  valosin-containing  protein  (VCP)/p97  as  a  novel  target  in  protein 
homeostasis, DNA damage response and other cellular stress pathways for therapeutic use in the treatment of patients with cancer.  The 
Company  entered  into  an  exclusive  license  on  March 21,  2021  with  Cleave  Therapeutics,  Inc.  (Cleave”)  for  the  development  and 
commercialization  of  CB-5339  in  Mainland  China,  Hong  Kong,  Macau  and  Taiwan.  CB-5339,  an  oral  second-generation,  small 
molecule  VCP/p97  inhibitor,  is  being  evaluated  in  a  Phase  1  clinical  trial  in  patients  with  acute  myeloid  leukemia  (AML)  and 
myelodysplastic syndrome (MDS). CB-5339 CTA application for the multiple myeloma indication is in preparation after receiving an 
acceptance letter for the CB-5339 IND package from the China CDE. 

6 

 
 
 
 
CID 103 (anti-CD38 monoclonal antibody)  

CID-103 is a full human IgG1 anti-CD38 monoclonal antibody recognizing a unique epitope that has demonstrated encouraging 
preclinical efficacy and safety profile compared to other anti-CD38 monoclonal antibodies for which the Company has exclusive global 
rights.  CID-103 is being developed for the treatment of patients with multiple myeloma.  The Phase 1 dose escalation and expansion 
study of CID-103, in patients with previously treated, relapsed or refractory multiple myeloma is ongoing in the UK and France. 

OTHER MISCELLANEOUS ASSETS 

The Company also has greater China rights to Octreotide LAI, a standard of care for the treatment of acromegaly and for the 
control  of  symptoms  associated  with  certain  neuroendocrine  tumors,  and  Thiotepa,  a  cytotoxic  agent  which  has  a  long  history  of 
established  use  in  the  hematology/oncology  setting,  the  Company  has  an  exclusive  China  license  and  distribution  rights  to  a  novel 
formulation of thiotepa, which has multiple indications including use as a conditioning treatment for certain allogeneic haemopoietic 
stem  cell  transplants. However,  due  to  the evolving  standard of  care  environment,  the  rare  and niche  indication for  these  products, 
potential US regulatory action and the Company’s commitment to prioritize resources, the Company is currently evaluating its options 
for these products.  In addition, the Company’s assets include six FDA-approved ANDAs which the Company is evaluating due to 
generic drug pricing reforms by the Chinese government and its impact on the pricing and competitiveness of these products. 

BUSINESS DEVELOPMENT 

CASI  has  built  a  fully  integrated,  world  class  biopharmaceutical  company  dedicated  to  the  successful  development  and 

commercialization of innovative and other therapeutic products. 

Our  business  development  strategy  is  currently  focused  on  acquiring  additional  targeted  drugs  and  immuno-oncology 
therapeutics  through  licensing  that  will  expand  our  hematology/oncology  franchise.  We  use  a  market-oriented  approach  to  identify 
pharmaceutical/biotechnology candidates that we believe to have the potential for gaining widespread market acceptance, either globally 
or in China, and for which development can be accelerated under our global drug development strategy. In many cases our business 
development strategy includes direct equity investments in the licensor company.  We intend for our pipeline to reflect a diversified and 
risk-balanced  set  of  assets  that  include  (1) late-stage  clinical  drug  candidates  in-licensed  for  China  or  global  regional  rights, 
(2) proprietary or licensed innovative drug candidates, and (3) select high quality pharmaceuticals that fit our therapeutic focus. We 
have  focused  on  US/EU  approved  product  candidates,  and  product  candidates  with  proven  targets  or  product  candidates  that  have 
reduced clinical risk with a greater emphasis on innovative therapeutics. Although oncology with a focus on hematological malignancies 
is our principal clinical and commercial target, we are opportunistic about other therapeutic areas that can address unmet medical needs. 
We will continue to pursue building a robust pipeline of drug candidates for development and commercialization in China as our primary 
market, and, if rights are available, for the rest of the world. 

CASI PHARMACEUTICALS (CHINA) CO., LTD.  (“CASI China”) 

In  August 2012,  we  established  a  wholly-owned  China-based  subsidiary  CASI  Pharmaceuticals  (China)  Co.,  Ltd..  (“CASI 
China”).  CASI  China  is  headquartered  in  Beijing,  and  in 2020, we  established  an office  in  Shanghai.  CASI  China’s  staff  currently 
consists of 168 full-time employees which includes our commercial team of over 100 hematology and oncology sales and marketing 
specialists based in China.  Among its activities, our China operations oversee the Company’s sales and marketing of EVOMELA® and 
the anticipated commercial activities of our pipeline products, technology transfer, local preclinical and clinical operation activities, as 
well  as  its  NMPA  regulatory  activities.  In  addition,  our  Beijing  operations  include  business  development  activities  and  executive 
management activities. Global management decisions are primarily being made out of CASI China where our executive team spends a 
significant amount of time.  We expect our operations in China to continue to grow. 

CASI PHARMACEUTICALS (WUXI) CO., LTD.  (“CASI Wuxi”) 

On  December 26,  2018,  the  Company,  together  with  Wuxi  LP  established  CASI  Wuxi  to  build  and  operate  a  GMP 
manufacturing facility in the Wuxi Huishan Economic Development Zone in Jiangsu Province, China. The Company controls CASI 
Wuxi through 80% voting and ownership rights. Accordingly, the financial statements of CASI Wuxi have been consolidated in the 
Company’s consolidated financial statements since its inception. 

In November 2019, CASI Wuxi entered into a fifty-year lease agreement for the right to use state-owned land in China for the 
construction  of  a  GMP  manufacturing  facility.  Pursuant  to  the  agreement,  CASI  Wuxi  has  committed  to  invest  land  use  right  and 

7 

property, plant and equipment of RMB1 billion (equivalent to $143 million) by August 2022. In April 2020, CASI Wuxi received RMB 
15.9 million (equivalent to $2.2 million) from the Jiangsu Province Wuxi Huishan Economic Development Zone as government grant 
for  this  development  project  which  was  recorded  as  deferred  income  in  April 2020.  In  November 2021,  CASI  Wuxi  received  an 
additional RMB 3.0 million (equivalent to $0.5 million) from the Jiangsu Province Wuxi Huishan Economic Development Zone as a 
government grant for this development project which was recorded as deferred income in November 2021.  

In 2020, for the design and construction work of the land, CASI Wuxi entered into several contracts for RMB 76.1 million 
($12.0 million) to complete the phase 1 project of CASI Wuxi's research and development production base, the project was the estimated 
to be completed in October 2023. In February 2022, CASI Wuxi has reached an alignment with the Wuxi local government that it will 
collaborate with Wuxi LP to co-develop the land continuously in the future, and the development plan will be extended, details regarding 
the plan are under negotiation.  

Also in 2020, CASI Wuxi entered in to a lease agreement with local government for a manufactory building next to the leased 
land. Since then, the Company entered into a series of contracts for the remodeling and installation work of the building and warehouse, 
as well as purchase of equipments. The total contract amount entered into for this building is approximately RMB 92.9 million ($14.6 
million).     

RELATIONSHIPS RELATING TO PROGRAMS 

EVOMELA® (Melphalan Hydrochloride For Injection) 

The Company has product rights and perpetual exclusive licenses from Acrotech Biopharma L.L.C. (“Acrotech”) to develop 
and commercialize its commercial product EVOMELA® (Melphalan Hydrochloride For Injection) in the greater China region (which 
includes Mainland China, Taiwan, Hong Kong and Macau). The exclusive licenses held by the Company were originally licensed from 
Spectrum Pharmaceuticals, and Spectrum completed the sale of its portfolio of FDA-approved hematology/oncology products including 
EVOMELA®  to  Acrotech  on  March 1,  2019.  On  December 3,  2018,  the  Company  received  NMPA’s  approval  for  importation, 
marketing and sales in China and in August 2019 the Company launched EVOMELA® in China. The NMPA required post-marketing 
study has completed and the clinical study report is being finalized for regulatory submission. 

The Company has established relationships, coupled with supply agreements, to secure the necessary resources to supply   the 
EVOMELA®  commercial drug product   as well as any clinical trials materials required for our clinical development program. As an 
import drug product into China, we expect that the future supply of EVOMELA® will continue to be met by our partner Acrotech and 
its contract manufacturers. 

In March 2019, the Company entered into a three-year exclusive distribution agreement with China Resources Pharmaceutical 
Commercial  Group  International  Trading  Co.,  Ltd.  (“CRPCGIT”)  to  appoint  CRPCGIT  on  an  exclusive  basis  as  its  distributor  to 
distribute EVOMELA® in the territory of the People’s Republic of China (excluding Hong Kong, Taiwan and Macau), subject to certain 
terms  and  conditions.  The  Company’s  internal  marketing  and  sales  team  are  responsible  for  commercial  activities,  including,  for 
example, direct interaction with Key Opinion Leaders (KOL), physicians, hospital centers and the generation of sales. The agreement 
was renewed in March 2022 for another two years. 

CNCT19 (CAR-T CD19) 

In June 2019, the Company entered into a license agreement for exclusive worldwide license to commercialize an autologous 
anti-CD19 T-cell therapy product (CNCT19) from Juventas (the “Juventas license agreement”).  Juventas is a privated China-based 
company engaged in cell therapy. Upon completion of the financing, our investment in Juventas represented a 16.327% equity interest 
on a fully diluted basis. 

In  September 2020,  Juventas  and  its  shareholders  (including  CASI  Biopharmaceuticals  (WUXI)  Co.,  Ltd.  ("CASI 
Biopharmaceuticals”), a majority indirectly-owned subsidiary of us) agreed to certain terms and conditions required by a new third-
party investor to facilitate the Series B financing of Juventas, pursuant to which the Company agreed to amend and supplement the 
original licensing agreement (the "Supplementary Agreement") by agreeing to pay Juventas certain percentage of net profits generated 
from commercial sales of CNCT19 in addition to the royalty fee payment calculated as a percentage of net sales. The Supplementary 
Agreement also specifies a minimum annual target net profit to be distributed to Juventas and certain other terms and obligations. In 
return, the Company obtained additional equity interests in Juventas. 

8 

Under the Supplementary Agreement, Juventas and the Company will jointly market CNCT19, including, but not limited to, 
establishing medical teams, developing medical strategies, conducting post-marketing clinical studies, establishing Standardized Cell 
Therapy Centers, establishing and training providers with respect to cell therapy, testing for cell therapy, and monitoring quality controls 
(cell collection and transfusion, etc.), and patient management (adverse reactions treatment, patients’ follow-up visits, and establishment 
of a database). The Company also will reimburse Juventas for a portion of Juventas’ marketing expenses as reviewed and approved by 
a joint commercial committee to be constituted. The Company will continue to be responsible for recruiting and establishing a sales 
team to commercialize CNCT19. 

On October 26, 2021,  Juventas  completed  its  Series  C  financing. Upon  the completion  of  Juventas  Series  C  financing,  the 
Company’s equity ownership in Juventas decreased to 12.01% on a fully diluted basis, with the total fair value of the equity interest 
amounted to RMB 206 million ($32.3 million). 

BI-1206 (anti-FcyRIIB antibody) 

In October 2020, the Company entered into an exclusive licensing agreement with BioInvent International AB (“BioInvent”) 
for  the development  and  commercialization of  novel  anti-FcγRIIB  antibody,  BI-1206, in  mainland  China,  Taiwan, Hong Kong  and 
Macau.    BioInvent  is  a  biotechnology  company  focused  on  the  discovery  and  development  of  first-in-class  immune-modulatory 
antibodies  for  cancer  immunotherapy.    BI-1206  is  being  investigated  in  a  Phase  1/2  trial,  in  combination  with  anti-PD1  therapy 
Keytruda® (pembrolizumab), in patients with solid tumors, and in a Phase 1/2a trial in combination with MabThera® (rituximab) in 
patients  with  relapsed/refractory  non-Hodgkin  lymphoma  (NHL).  Clinical  Trial  Application  (CTA)  was  approved  by  NMPA  in 
December 2021.  The  Company  is  planning  Phase  1  trials  of  BI-1206  as  a  single  agent  to  evaluate  the  PK/safety  profile  and  in 
combination with rituximab in patients with NHL (mantle cell lymphoma, marginal zone lymphoma, and follicular lymphoma) to assess 
safety  and  tolerability,  select  the  Recommended  Phase  2  Dose  and  assess  potential  evidence  of    clinical  efficacy  as  part  of  its 
development program for BI-1206 in China. The studies are expected to start in the first half of 2022. 

Under the terms of the agreement, BioInvent and CASI will develop BI-1206 in both hematological malignancies and solid 
tumors, with CASI responsible for commercialization in China and associated markets. CASI made a $5.9 million upfront payment in 
November 2020 to BioInvent and will pay up to $83 million in development and commercial milestone payments plus tiered royalties 
in the high-single to mid-double-digit range on net sales of BI-1206.   

In conjunction with its license agreement entered into with BioInvent, CASI made a SEK 53.8 million investment (equivalent 
to $6.3 million) in 1.2 million new shares of BioInvent, and 14,700,000 new warrants, each warrant with a right to subscribe for 0.04 
new shares in BioInvent within a period of five years and at a subscription price of SEK 78.50 per share. 

As an import drug product into China, we expect that future supply of BI-1206 will be met by our partner BioInvent and its 
contract manufacturers.  For local development in China, we expect that our clinical materials and commercial inventory will be supplied 
by one or more contract manufacturers. 

CB-5339 (VCP/p97inhibitor)  

In March 2021, the Company entered into an exclusive license with Cleave Therapeutics, Inc. (“Cleave”) for the development 
and commercialization of CB-5339, an oral novel VCP/p97 inhibitor, in both hematological malignancies and solid tumors, in Mainland 
China, Hong Kong, Macau and Taiwan.  Cleave is a clinical-stage biopharmaceutical company focused on valosin-containing protein 
(VCP)/p97 as a novel target in protein homeostasis, DNA damage response and other cellular stress pathways for therapeutic use in the 
treatment of patients with cancer.   

CB-5339  is  being  evaluated  by  Cleave  in  a  Phase  1  clinical  trial  in  patients  with  acute  myeloid  leukemia  (AML)  and 
myelodysplastic syndrome (MDS). Under the terms of the agreement, CASI is responsible for development and commercialization in 
China and associated markets.  Cleave received a $5.5 million upfront payment and is eligible to receive up to $74 million in development 
and  commercial  milestone payments  plus  tiered royalties  in  the high-single  to  mid-double-digit  range  on  net  sales of  CB-5339.   In 
conjunction with the license agreement, CASI made a $5.5 million investment in Cleave through a convertible note. 

As an import drug product into China, we expect that future supply of CB-5339 will be met by our partner Cleave and its 
contract manufacturers.  For local development in China, we expect that our clinical materials and commercial inventory will be supplied 
by one or more contract manufacturers. 

9 

CID-103 (anti-CD38 Monoclonal Antibody) 

In April 2019, the Company entered into a license agreement with a newly established, privately held UK Company Black Belt 
Therapeutics Limited (“Black Belt”) for exclusive worldwide rights to CID-103, an investigational anti-CD38 monoclonal antibody 
(Mab) (formerly known as TSK011010). In conjunction with the license agreement, CASI invested 2 million euros in Black Belt. 

The  Company  expects  that  its  clinical  materials  and  commercial  inventory  will  be  supplied  by  one  or  more  contract 
manufacturers with whom the Company has contracted with.  Under the terms of the agreement, CASI obtained global rights to CID-103 
for an upfront payment of 5 million euros ($5.7 million) as well as certain milestone and royalty payments.  In June 2021, the Company 
achieved  the  First-Patient-In  (FPI)  in  the  Phase  1  dose  escalation  and  expansion  study  of  CID-103,  and  made  $750,000  milestone 
payment in June 2021 and €250,000 ($305,000) payment in August 2021 under the terms of the agreement. 

Thiotepa 

In August 2019, the Company entered into an Exclusive License and Distribution Agreement with Riemser Pharma GmbH 
(“Riemser”), pursuant to which we obtained exclusive distribution rights for Thiotepa in China. Under the agreement, Riemser will be 
responsible for manufacturing and supplying CASI with clinical trials materials and commercial drug product, and costs of clinical trials 
(if any) for the registration, product launch and commercialization of Thiotepa in China. In January 2020, Riemser was acquired by 
Esteve Healthcare, S.L. (“ESTEVE”), an international pharmaceutical company headquartered in Barcelona. 

Octreotide LAI 

In October 2019, the Company entered into an exclusive distribution agreement with Pharmathen Global BV ("Pharmathen") 
for the development and distribution of Octreotide LAI microsphere in China.  Octreotide LAI formulations, which are approved in 
various European countries, are considered a standard of care for the treatment of acromegaly and the control of symptoms associated 
with certain neuroendocrine tumors. Octreotide LAI’s ANDA review is pending due to CDE’s sterilization requirement is different from 
European standard. CASI is now working with licensor Pharmathen to improve the sterilization process in order to meeting CDE’s 
requirement.   

The terms of the agreement include an upfront payment of 1 million euros which was paid by the Company in 2019, and up to 
2 million euros of additional milestone payments, of which 1.5 million euros ($1.7 million) was expensed in the year ended December 31, 
2020 as acquired in-process research and development following Pharmathen’s achievement of certain milestones.  CASI is responsible 
for  the  development,  import  drug  registration,  product  approval  and  commercialization  in  China.  CASI  has  a  10-year  non-royalty 
exclusive distribution period after the product launch at agreed supply costs for the first three years. 

INTELLECTUAL PROPERTY 

We generally seek patent protection for our technology and product candidates in the United States, Canada, China and other 
key markets. The patent position of biopharmaceutical companies generally is highly uncertain and involves complex legal and factual 
questions. Our success will depend, in part, on whether we can: (i) obtain patents to protect our own products; (ii) obtain licenses to use 
the  technologies  of  third parties,  which may  be protected  by patents;  (iii)  protect  our  trade  secrets  and  know-how;  and (iv) operate 
without infringing the intellectual property and proprietary rights of others. 

With  regards  to  our  commercial  drug  EVOMELA®  licensed  for  greater  China  rights  from  our  partner,  we  have  acquired 

exclusive licenses to intellectual property to enable us to develop and continue to commercialize EVOMELA® in China. 

With regards to CNCT19, we have acquired an exclusive license to intellectual property from our partner Juventas to enable 
us to co-commercialize CNCT19 in China and well as the rest of the world. Juventas is responsible for prosecuting and maintaining the 
licensed intellectual property.  

With regards to BI-1206, we have acquired an exclusive license to intellectual property and the know-how from our partner 
BioInvent to enable us to develop and commercialize BI-1206 in our greater China commercial markets. BioInvent is responsible for 
prosecuting and maintaining the licensed BioInvent intellectual property.  

10 

With regards to CB-5339, we have acquired an exclusive license to intellectual property and the know-how from our partner 
Cleave  to  enable  us  to  develop  and  commercialize  CB-5339  in  our  greater  China  commercial  markets.  Cleave  is  responsible  for 
prosecuting and maintaining the licensed Cleave intellectual property.  

With regards to our in-licensed anti-CD38 antibody candidate CID-103, we have acquired an exclusive worldwide license to 
patents around CID-103 and other anti-CD38 antibodies, covering multiple pending applications worldwide, directed to the antibodies 
themselves and treatment methods using the antibodies. We have since filed additional applications, with current pending applications 
including U.S., Australia, Canada, China, Europe, India, Japan, Korea, New Zealand, Singapore and Hong Kong.  We intend to further 
expand our patent portfolio and in the submission stage of additional applications. The patent term for any patents granted from the 
earliest of these pending applications will expire in June 2038, assuming all annuities are paid and not considering any term extensions 
for regulatory approval that might be available. 

With regards to our drug candidates Thiotepa and Octreotide LAI, we have acquired exclusive licenses to intellectual property 

and/or the know-how to enable us to develop and commercialize the drug candidates in the China market. 

The Company holds certain intellectual property in connection with a proprietary aurora kinase inhibitor that we no longer 

devote resources to. Our intellectual property for this asset remains available for business development partnering. 

We currently own a number of registered trademarks and pending trademark applications for CASI, including our corporate 
logo and product name in the United States, China and other jurisdictions, and we are seeking further trademark protection for CASI, 
including our corporate logo, product name, and other marks in jurisdictions where available and appropriate. 

We review and assess our portfolio on a regular basis to secure protection and to align our intellectual property strategy with 

our overall business strategy.  

GOVERNMENT REGULATION 

U.S. Food and Drug Administration (FDA) 

Our research, development, testing, manufacture, labeling, sale, marketing, advertising, and distribution of therapeutics in the 
United States, China and other countries are subject to extensive regulations by federal, state, local and foreign governmental authorities. 

In the United States, the FDA regulates the development and commercialization of drugs and biologics. Drugs are subject to 
regulation under the Federal Food, Drug, and Cosmetic Act (FFDCA), and biological products, in addition to being subject to certain 
provisions of the FFDCA, are regulated under the Public Health Service Act (PHSA). We believe that the FDA will regulate the products 
currently being developed by us or our collaborators as drugs or biologics. Both the FFDCA and PHSA and corresponding regulations 
govern,  among  other  things,  the  testing,  manufacturing,  safety,  efficacy,  labeling,  storage,  recordkeeping,  advertising  and  other 
promotion of biologics and drugs, as the case may be. 

From  time  to  time,  legislation  is  drafted,  introduced  and  passed  in  Congress  that  could  significantly  change  the  statutory 
provisions governing the approval, manufacturing and marketing of products regulated by the FDA. In addition to new legislation, FDA 
regulations  and policies  are often revised or  reinterpreted by the  agency  in ways  that  may  significantly  affect  our  business  and our 
product candidates or any future product candidates we may develop. It is impossible to predict whether further legislative or FDA 
regulation or policy changes will be enacted or implemented and what the impact of such changes, if any, may be. 

Preparing drug and biologic candidates for regulatory approval is a costly and time-consuming process. Generally, a developer 
first must conduct preclinical studies in the laboratory and in animal model systems in accordance with applicable FDA requirements, 
including Good Laboratory Practice regulations, to gain preliminary information on an agent’s effectiveness and to identify any safety 
problems. The results of these studies, together with manufacturing information and analytical data as well as protocols and detailed 
descriptions for proposed clinical investigations, are submitted to FDA as a part of an Investigational New Drug Application (IND) for 
a drug or biologic, which must become effective before human clinical trials of an investigational drug can begin. An IND application 
will automatically become effective 30 days after receipt by the FDA, unless before that time the FDA raises concerns or questions 
about issues, such as the conduct of the clinical trials as outlined in the IND application, and places the clinical trial(s) on a clinical hold. 
In such a case, the IND application sponsor and the FDA must resolve any outstanding FDA concerns or questions before clinical trials 
can proceed. We cannot be certain that submission of an IND application will result in the FDA allowing clinical trials to begin. 

11 

We or our collaborators must then conduct adequate and well-controlled clinical trials, in accordance with applicable IND 
regulations, Good Clinical Practices (“GCPs”), and other clinical-trial related regulations, to establish the safety and efficacy of the 
candidate for each proposed indication We or our collaborators will be required to select qualified investigators (usually physicians 
within  medical  institutions)  to  supervise  the  administration  of  the  products,  test  or  otherwise  assess  patient  results,  and  collect  and 
maintain patient data; monitor the investigations to ensure that they are conducted in accordance with applicable requirements, including 
the requirements set forth in the general investigational plan and protocols contained in the IND; and comply with applicable reporting 
and recordkeeping requirements. The study protocol and informed consent information for study subjects in clinical trials must also be 
approved by an institutional review board (“IRB”) for each institution where the trials will be conducted before the trial can begin, and 
each IRB must monitor the study until completion. Study subjects must provide informed consent and sign an informed consent form 
before participating in a clinical trial. 

Clinical trials of drugs or biologics are normally done in three phases, although the phases may overlap or be combined. Phase 1 
trials  usually  involve  the  initial  introduction  of  the  investigational  candidate  into  humans  to  evaluate  its  short-term  safety,  dosage 
tolerance, metabolism, pharmacokinetics and pharmacologic actions, and, if possible, to gain an early indication of its effectiveness. 
Phase  2  trials  normally  involve  trials  in  a  limited  patient  population  to  evaluate  dosage  tolerance  and  appropriate  dosage,  identify 
possible adverse effects and safety risks, and evaluate preliminarily the efficacy of the candidate for specific target indications. Phase 3 
trials are expanded clinical trials with larger numbers of patients which are intended to evaluate the overall benefit-risk relationship of 
the drug and to gather additional information for proper dosage and labeling of the drug. Phase 3 clinical trials may take several years 
to complete. Annual progress reports detailing the results of the clinical studies must be submitted to the FDA and IND safety reports 
must be submitted to the FDA and investigators within 15 calendar days for serious and unexpected adverse events, any findings from 
other studies, tests in laboratory animals or in vitro testing that suggest a significant risk for human subjects, or any clinically important 
increase  in  the  rate  of  a  serious  suspected  adverse  reaction  over  that  listed  in  the  protocol  or  investigator  brochure.  We  or  our 
collaborators, the FDA, or an IRB (with respect to a particular study site) may suspend or terminate clinical trials at any time on various 
grounds, including a finding that the subjects or patients are being exposed to an unacceptable health risk. 

Post-approval  trials,  sometimes  referred  to  as  Phase  4  clinical  trials,  may  be  conducted  after  receiving  initial  marketing 
approval. These trials are used to gain additional experience from the treatment of patients in the intended therapeutic indication and are 
commonly intended to generate additional safety data regarding use of the product in a clinical setting. In certain instances, the FDA 
may mandate the performance of Phase 4 clinical trials as a condition of approval of the product or, in certain circumstances, post-
approval. 

The FDA has various programs, including fast track designation, breakthrough therapy designation, priority review, accelerated 
approval, and, for regenerative medicine therapies, regenerative medicine advanced therapy designation, which are intended to expedite 
or simplify the process for the development, and FDA’s review, of drugs and biologics (e.g., granting approval on the basis of surrogate 
endpoints subject to post-approval trials). Generally, drugs or biologics that may be eligible for one or more of these programs are those 
intended to treat serious or life-threatening diseases or conditions, those with the potential to address unmet medical needs for those 
disease  or  conditions,  and/or  those  that  provide  a  meaningful  benefit  over  existing  treatments.  Moreover,  if  a  sponsor  submits  a 
marketing application for a product intended to treat certain rare pediatric or tropical diseases or for use as a medical countermeasure 
for a material threat, and that meets other eligibility criteria, upon approval such sponsor may be granted a priority review voucher that 
can be used for a subsequent application. Even if a product qualifies for one or more of these programs, the FDA may later decide that 
the  product no  longer  meets the  conditions for qualification or  decide  that  the  time period for FDA review or  approval will  not be 
shortened. Furthermore, these programs do not change the standards for approval and may not ultimately expedite the development or 
approval process. 

If  clinical  trials  of  a  product  candidate  are  completed  successfully,  the  sponsor  of  the  product  may  seek  FDA  marketing 
approval. If the product is classified as a new drug, an applicant must file a New Drug Application (NDA). For biological products, an 
applicant must file a Biologics License Application (BLA). In each case, FDA must approve the application before the product can be 
marketed  commercially.  NDAs  and  BLAs  must  include,  among  other  things,  detailed  information  about  the  product’s  chemistry, 
manufacture, controls, and proposed labeling and the results of preclinical studies and clinical trials. To support marketing approval, the 
data submitted must be sufficient in quality and quantity to establish the safety and efficacy of a drug, and safety, purity, and potency 
of a biologic, to the satisfaction of the FDA. A user fee must be paid with the submission of an NDA or BLA (unless a fee waiver 
applies) in order to support the cost of agency review, which is currently almost $3 million. FDA usually will inspect the facility or the 
facilities  at  which  the  drug  is  manufactured  and  will  not  approve  the  product  unless  the  manufacturing  and  production  and  testing 
facilities are in compliance with current Good Manufacturing Practice (cGMP) regulations. In addition, FDA may also inspect clinical 
trial sites that generated data for the NDA or BLA as well as us or our collaborators as a clinical trial sponsor. 

12 

The testing and approval processes require substantial time and effort, and there can be no assurance that FDA will accept the 
application for filing or that any approval will be obtained on a timely basis, if at all. Under the goals and policies agreed to by the FDA 
under the Prescription Drug User Fee Act, the FDA has ten months from the 60 day filing date in which to complete its initial review of 
a standard application and respond to the applicant. However, the time required by the FDA to review and approve NDAs and BLAs is 
variable and, to a large extent, beyond our control. Notwithstanding the submission of relevant data, the FDA may ultimately decide 
that an NDA or BLA does not satisfy its regulatory criteria and deny the approval. In such instance, FDA will issue a Complete Response 
Letter, describing all the deficiencies that the FDA has identified in an application that must be satisfactorily addressed before it can be 
approved. A Complete Response Letter may require additional clinical data and/or an additional pivotal Phase 3 clinical trial(s), and/or 
other significant, expensive and time-consuming requirements related to clinical trials, preclinical studies or manufacturing. Further, 
even if such additional information is submitted, the FDA may ultimately decide that the application does not satisfy the criteria for 
approval. The FDA may also refer the application to an appropriate advisory committee, typically a panel of clinicians, for review, 
evaluation and a recommendation as to whether the application should be approved. The FDA is not bound by the recommendations of 
the advisory committee, but the Agency historically has tended to follow such recommendations. In addition, the FDA may condition 
marketing approval on the conduct of specific post-marketing studies to further evaluate safety and effectiveness or a Risk Evaluation 
and Mitigation Strategy (REMS) that may include both special labeling and controls, known as Elements to Assure Safe Use, on the 
distribution, prescribing, dispensing and use of a drug product. After approval is obtained, a marketed product is subject to continuing 
regulatory requirements and review relating to cGMP, adverse event reporting, promotion and advertising, and other matters. The FDA 
strictly regulates labeling, advertising, promotion and other types of information on products that are placed on the market. Products 
may be promoted only for the approved indications and consistent with the provisions of the approved label. Discovery of previously 
unknown problems or failure to comply with the applicable regulatory requirements may result in restrictions on the marketing of a 
product, mandated labeling changes, or withdrawal of the product from the market, as well as possible civil or criminal sanctions. 

Drugs and biological products may be eligible to receive certain regulatory exclusivities upon approval. For example, a drug 
that constitutes a new chemical entity (i.e., an active moiety that has not been previously approved in another NDA) is entitled to five 
years of exclusivity during which FDA may not accept an ANDA or 505(b)(2) NDA for filing referencing such chemical entity, unless 
a “Paragraph IV certification” is made in which case FDA may accept such applications four years after initial approval of the new 
chemical entity. In addition, three years of exclusivity can be awarded for applications (including supplements) containing the results of 
new clinical investigations (other than bioavailability studies) conducted by the applicant and essential to the FDA’s approval of new 
versions  or  conditions  of  use  of  previously  approved  drug  products,  such  as  new  indications,  delivery  mechanisms,  dosage  forms, 
strengths, or other conditions of use. 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. Moreover, a drug or biologic may receive 
orphan drug designation if 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 in the United States. If a product that has orphan designation subsequently receives the first FDA 
approval for the disease or condition for which it has such designation, the product is entitled to orphan drug exclusivity, which restricts 
FDA from approving 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, by providing a major contribution to patient care, or in instances of an inability to assure drug 
supply. 

FDA may approve generic drugs and biological products through abbreviated pathways. Generic drugs may be marketed upon 
approval of an ANDA, which contains information to show that the proposed product is identical in active ingredient, dosage form, 
strength, route of administration, labeling, quality, performance characteristics, and intended use, among other things, to a previously 
approved  drug.  Approval  is  generally  supported  by  data  from  bioequivalence  studies,  rather  than  complete  preclinical  and  clinical 
studies. Biological products that are biosimilar to or interchangeable with an FDA-licensed reference biological product are eligible for 
an abbreviated approval pathway. Although licensure of biosimilar or interchangeable products is generally expected to require less than 
the full complement of product-specific preclinical and clinical data required for reference products, the FDA has considerable discretion 
over the kind and amount of scientific evidence required to demonstrate biosimilarity and interchangeability. Under section 610 of the 
Further Consolidated Appropriations Act, 2020, entitled “Actions for Delays of Generic Drugs and Biological Products”, generic drug 
and  biosimilar  developers  may  sue  brand  manufacturers,  or  generic  or  biosimilar  manufacturers,  to  obtain  sufficient  quantities  of 
reference product necessary for approval of the developers’ generic or biosimilar product. If a generic drug or biosimilar developer is 
successful  in  its  suit,  the  defendant  manufacturer  would  be  required  to  provide  sufficient  quantities  of  product  on  commercially-
reasonable, market-based terms and may be required to pay the developer’s reasonable attorney’s fees and costs as well as financial 
compensation under certain circumstances. While intended to facilitate the timely entry of lower-cost generic and biosimilar products, 

13 

we  cannot  determine  what  effect  this  new  private  right  of  action  may  have  on  the  development  and  approval  of  generic  drug  and 
biosimilar products at this time. 

The  Generic  Drug  Enforcement  Act  of  1992  establishes  penalties  for  wrongdoing  in  connection  with  the  development  or 
submission of an application. In general, the FDA is authorized to temporarily or permanently bar companies and individuals, from 
submitting or assisting in the submission of applications to FDA, and to temporarily deny approval and suspend applications to market 
drugs under certain circumstances. FDA’s debarment authority has also been expanded to apply to certain import-related offenses. In 
addition to debarment, the FDA has numerous enforcement and disciplinary powers, including the authority to withdraw approval of an 
application or to approve an application under certain circumstances, to suspend the distribution of all drugs approved or developed in 
connection with certain wrongful conduct, and various civil and criminal penalties. The FDA may also withdraw product approval or 
take other corrective measures if, among other things, ongoing regulatory requirements are not met or if safety or efficacy questions are 
raised after the product reaches the market. 

Manufacturers and other entities involved in the manufacturing and distribution of approved products are required to register 
their establishments with the FDA and certain state agencies, and are subject to periodic unannounced inspections by the FDA and 
certain state agencies for compliance with cGMP and other laws. The cGMP requirements apply to all stages of the manufacturing 
process, including the production, processing, sterilization, packaging, labeling, storage and shipment of the product. Manufacturers 
must establish validated systems to ensure that products meet specifications and regulatory requirements, and test each product batch or 
lot prior to its release. We rely, and expect to continue to rely, on third parties for the production of clinical quantities of our product 
candidates and any future product candidates we may develop. Future FDA and state inspections may identify compliance issues at the 
facilities of our contract manufacturers that may disrupt production or distribution or may require substantial resources to correct. 

Healthcare Regulation 

Federal and state healthcare laws in the United States, including fraud and abuse and health information privacy and security 
laws, also apply to our business. If we fail to comply with those laws, we could face substantial penalties and our business, results of 
operations, financial condition and prospects could be adversely affected. The laws that may affect our ability to operate include, but 
are  not  limited  to:  the  federal  Anti-Kickback  Statute,  which  prohibits,  among  other  things,  soliciting,  receiving,  offering  or  paying 
remuneration, directly or indirectly, to induce, or in return for, the purchase or recommendation of an item or service reimbursable under 
a federal healthcare program, such as the Medicare and Medicaid programs; and federal civil and criminal false claims laws and civil 
monetary  penalty  laws,  which  prohibit,  among  other  things,  individuals  or  entities  from  knowingly  presenting,  or  causing  to  be 
presented, claims for payment from Medicare, Medicaid, or other third-party payers that are false or fraudulent. Additionally, we are 
subject to state law equivalents of each of the above federal laws, which may be broader in scope and apply regardless of whether the 
payer is a federal healthcare program, and many of which differ from each other in significant ways and may not have the same effect, 
further complicate compliance efforts. 

Numerous federal and state laws, including state security breach notification laws, state health information privacy laws and 
federal and state consumer protection laws, govern the collection, use and disclosure of personal information. Other countries also have, 
or are developing, laws governing the collection, use and transmission of personal information. In addition, most healthcare providers 
who are expected to prescribe our products and from whom we obtain patient health information, are subject to privacy and security 
requirements under the Health Insurance Portability and Accountability Act of 1996, as amended by the Health Information Technology 
and Clinical Health Act (HIPAA). Although we are not directly subject to HIPAA, we could be subject to criminal penalties if we obtain 
and/or disclose individually identifiable health information from a HIPAA-covered entity, including healthcare providers, in a manner 
that is not authorized or permitted by HIPAA. The legislative and regulatory landscape for privacy and data protection continues to 
evolve, and there has been an increasing amount of focus on privacy and data protection issues with the potential to affect our business, 
including recently enacted laws in a majority of states requiring security breach notification. These laws could create liability for us or 
increase our cost of doing business. 

In  addition,  the  Patient  Protection  and Affordable  Care Act,  as  amended  by  the Health  Care Education  Reconciliation Act 
(PPACA), created a federal requirement under the federal Open Payments program, that requires certain manufacturers to track and 
report to the Centers for Medicare and Medicaid Services, or CMS, annually certain payments and other transfers of value provided to 
physicians and teaching hospitals made in the previous calendar year. In addition, there are also an increasing number of state laws that 
require manufacturers to make reports to states on pricing and marketing information. These laws may affect our sales, marketing, and 
other promotional activities by imposing administrative and compliance burdens on us. In addition, given the lack of clarity with respect 
to these laws and their implementation, our reporting actions could be subject to the penalty provisions of the pertinent state and federal 
authorities. 

14 

For those marketed products which are covered in the United States by certain government healthcare programs (e.g., Medicare 
and Medicaid), we have various obligations, including government price reporting and rebate requirements, which generally require 
products be offered at substantial rebates/discounts to Medicaid and certain purchasers (including “covered entities” purchasing under 
the 340B Drug Discount Program). We are also required to discount such products to authorized users of the Federal Supply Schedule 
of the General Services Administration, under which additional laws and requirements apply. These programs require submission of 
pricing  data  and  calculation  of  discounts  and  rebates  pursuant  to  complex  statutory  formulas,  as  well  as  the  entry  into  government 
procurement contracts governed by the Federal Acquisition Regulations, and the guidance governing such calculations is not always 
clear. Compliance with such requirements can require significant investment in personnel, systems and resources, but failure to properly 
calculate prices, or offer required discounts or rebates could subject us to substantial penalties. 

National Medical Products Administration (NMPA, formerly the China Food and Drug Administration) 

In  the  PRC,  the  NMPA  is  the  authority  under  the  State  Administration  for  Market  Regulation  (SAMR)  that  monitors  and 
supervises the administration of pharmaceuticals products, medical appliances and equipment, and cosmetics. We are also subject to 
regulation and oversight by different levels of the Medical Products Administration and Administration of Market Regulation in China. 
For clinical-stage product candidates, our development activities in China can follow two purposes: (1) to obtain clinical data to support 
our global FDA-regulated trials as is the case for our proprietary ENMD 2076, and (2) to obtain clinical data to support local registration 
with the NMPA. For late-stage product candidates that we in-license for greater China rights, such as EVOMELA®, which has been 
launched, CID-103, BI-1206 and CB-5339, our development activities in China are to secure clinical trial notification, and marketing 
approval from the Center of Drug Evaluation (CDE) under the NMPA by conducting import drug registration. The “Law of the PRC on 
the Administration of Pharmaceuticals,” as last amended on August 26, 2019 and effective as of December 1, 2019, provides the basic 
legal framework for the administration of the production and sale of pharmaceuticals in China and covers the manufacturing, distributing, 
packaging, pricing and advertising of pharmaceutical products in China. 

We are also subject to other PRC laws and regulations that are applicable to pharmaceutical manufacturers and distributors in 
general such as “Drug Registration Regulation (DRR)”, which was updated on January 22, 2020 and became effective on July 1, 2020. 

The Marketing Authorization Holder System.  

Pursuant  to  the  amended  Law  of  the  PRC  on  the  Administration  of  Pharmaceuticals,  the  Marketing  Authorization  Holder 
System,  previously  implemented  in  a  few  pilot  regions  in  China,  is  now  implemented  nationwide.  Companies  and  research  and 
development  institutions  can  be  drug  marketing  authorization  holders  after  they  receive  drug  approvals.  The  drug  marketing 
authorization holder are responsible for their products throughout the life cycle, including nonclinical studies, clinical trials, production 
and  distribution,  post-market  studies,  and  the  monitoring,  reporting,  and  handling  of  adverse  reactions  in  connection  with 
pharmaceuticals in accordance with the amended law. 

The  marketing  authorization  holders  may  engage  contract  manufacturers  for  manufacturing,  provided  that  the  contract 
manufacturers are licensed pharmaceutical manufacturers, and may engage pharmaceutical distribution enterprises with a valid drug 
distribution license to sell their products. Upon receiving the marketing authorizations from the NMPA, a drug marketing authorization 
holder may transfer its drug marketing authorization and the transferee should have the capability of quality management, risk prevention 
and control, and liability compensation to ensure the safety, effectiveness and quality controllability of drugs, and fulfill the obligations 
of the drug marketing authorization holder. 

Product Manufacturing 

For the registration of locally manufactured drugs, the drug products need to be manufactured in China through either a self-
owned facility or a contract manufacturing organization. The study drug to be used for clinical trials must be manufactured in compliance 
with  NMPA  Good  Manufacturing  Practice  (GMP)  guidelines.  A  domestic  manufacturer  of  pharmaceutical  products  and  active 
pharmaceutical ingredient (API) must obtain the drug manufacturing license to produce pharmaceutical products and API for marketing 
in China. Pursuant to the newly amended Law of the PRC on the Administration of Pharmaceuticals, the GMP certification has been 
cancelled, but with its cancellation, drug manufacturing enterprises are still required to strictly comply with GMP requirements. GMP 
requirements  include  institution  and  staff  qualifications,  production  premises  and  facilities,  equipment,  raw  materials,  hygiene 
conditions, production management, quality controls, product distributions, maintenance of records and manner of handling customer 
complaints and adverse reaction reports. The drug manufacturing license is valid for five years, and must be renewed at least six months 
before its expiration date. 

15 

In  addition,  before  commencing  business,  a  pharmaceutical  manufacturer  must  also  obtain  a  business  license  from  the 

Administration of Market Regulation at the local level. 

Preclinical Research and Clinical Trials.  

For an investigational new drug application, a clinical trial approval issued from CDE was historically required to conduct 
clinical trials. However, since July 24, 2018, the NMPA announced to adopt a negative notification system for clinical trial approvals. 
In particular, if the applicant does not receive negative comments within 60 days after the CDE accepts the clinical trial application, the 
applicant can proceed with the clinical trial immediately based on the protocol submitted without waiting to receive an explicit clinical 
trial approval. Chemical generics, on the other hand, only need to undergo bioequivalent studies upon a filing for record with the NMPA. 
In order to apply for a clinical trial application approval to support local registration in China, a pharmaceutical company is required to 
conduct  a  series  of  preclinical  research  including  research  on  chemistry,  pharmacology,  toxicology  and  pharmacokinetics  of 
pharmaceuticals.  This preclinical  research  should be  conducted  in  compliance  with  the  relevant  regulatory  guidelines  issued  by  the 
NMPA. In particular, safety evaluation research must be conducted in compliance with China’s Good Laboratory Practice. 

After completion of preclinical studies and obtaining permission to conduct the clinical trial from the NMPA, clinical trials are 
generally conducted in three sequential phases that may overlap or be combined, known as Phase 1, Phase 2, and Phase 3 clinical trials, 
and Phase 4 clinical trials may be conducted at the post-marketing surveillance stage, in compliance with China’s Good Clinical Practice 
(GCP): 

Phase 1 – preliminary trial of clinical pharmacology and human safety evaluation studies. The primary objective is to 
observe the pharmacokinetics and the tolerance level of the human body to the new medicine as a basis for ascertaining the 
appropriate methods of dosage. 

Phase 2 – preliminary exploration on the therapeutic efficacy. The purpose is to assess preliminarily the efficacy and 
safety of pharmaceutical products on patients with the target indication of the pharmaceutical products and to provide the basis 
for the design and dosage tests for Phase 3. The dosing and methodology of research in this phase generally adopts double-
blind, random methods with limited sample sizes. 

Phase 3 – confirm the therapeutic efficacy. The objective is to further verify the efficacy and safety of pharmaceutical 
products  on  patients  within  the  target  indication,  to  evaluate  the  benefits  and  risks  and  finally  to  provide  sufficient 
experimentally  proven  evidence  to  support  the  registration  application  of  the  pharmaceutical  products.  In  general,  the  trial 
should adopt double-blind random methods with sufficient sample sizes. 

Phase 4 –assess therapeutic efficacy and adverse reactions post-approval. The purpose is, by conducting a new drug’s 
post-marketing study, to assess therapeutic efficacy and adverse reactions when the drug is widely used, to evaluate overall 
benefit-risk  relationships  of  the  drug  when  used  among  the  general  population  or  specific  groups  and  to  adjust  the 
administration dose, among others. 

In April 2020, the NMPA and the National Health Commission (NHC) released the amended GCP, which took effect on July 1, 
2020. The amended GCP is harmonized with the ICH-GCP.  Compared to the previous GCP, the amended GCP provides comprehensive 
and  substantive  requirements  on  the  design  and  conduct  of  clinical  trials  in  China.  In  particular,  the  amended  GCP  enhances  the 
protection for study subjects and tightens the control over bio-samples collected under clinical trials. 

Collecting and Using Patients’ Biospecimens and Derived Data.  

Foreign-invested sponsors that collect and use patients’ biospecimens in clinical trials are required to file with the China Human 
Genetic Resources Administrative Office, or the HGRAO, under the Ministry of Science and Technology, or the MOST. In 2017, the 
MOST issued the Circular on Optimizing the Administrative Examination and Approval of Human Genetic Resources, which simplified 
the approval for collecting and using human genetic resources for the purpose of commercializing a drug or medical device in the PRC. 
In June 2019, the State Council of the PRC issued the Regulation on the Administration of PRC Human Genetic Resources (effective 
as of July 1, 2019), which formalized the approval requirements pertinent to research collaborations between Chinese and foreign-owned 
entities. 

Pursuant to this new HGR Regulation, a new notification system (as opposed to the advance approval approach originally in 
place) was put in place for clinical trials using PRC patients’ biospecimens and data at clinical study sites without involving the export 

16 

of such specimens outside of China. The notification filing must specify the type, quantity, volume size and usage of the biospecimens, 
among others, with the HGRAO is required before conducting such clinical trials. The collection and use of PRC patients’ biospecimens 
and data in international basic research collaboration are still subject to the approval of the HGRAO. The notification filing with the 
HGRAO also applies to access to clinical study data by foreign entities.  

In October 2020, the Standing Committee of the NPC promulgated the PRC Biosecurity Law, which took effect on April 15, 
2021. The PRC Biosecurity Law, the higher law to the HGR Regulation, reaffirms the regulatory requirements stipulated by the HGR 
Regulation while potentially increasing the administrative fines significantly in cases where foreign entities are alleged to have collected, 
preserved or exported Chinese human genetic resources. 

Import Drug Registration or Multi Regional Clinical Trials.  

NMPA regulations allow foreign drug developers to conduct import drug registration or multi regional clinical trials in China 
for a new drug as part of a global drug development program. An International Multicenter Clinical Trial (IMCT) Application needs to 
be filed with the CDE for conducting the clinical trials. 

In  October,  2017,  the  NMPA  released  the  Decision  on  Adjusting  Items  concerning  the  Administration  of  Imported  Drug 

Registration, as well as current requirement in DRR, which includes the following key points: 

•  Phase 1 IMCT is allowed to be conducted in China. The IMCT drug does not need to gain prior approval or have entered into 
either a Phase 2 or 3 clinical trial in a foreign country before the IMCT could be conducted in China, except for preventive 
biological products.  

• 

If the IMCT is conducted in China and the local recruitment of patients number allied with CDE, the application for drug 
marketing authorization can be submitted directly after the completion of the IMCT. 

•  With respect to clinical trial and market authorization applications for imported innovative chemical drugs and therapeutic 
biological products, the marketing authorization in the country or region where the foreign drug manufacturer is located will 
not be required. 

•  With respect to drug applications that have been accepted before the release of this Decision, importation permission can be 
granted if such applications request exemption of clinical trials for the imported drugs based on the data generated from IMCT 
and if relevant requirements under the Administrative Measures of the Drug Registration are met. 

The NMPA Decision on IMCT and the application for imported new drugs has streamlined and accelerated the applications 

for imported new drugs. 

In order to apply for an IMCT Application in China, a biopharmaceutical company is required to submit a comprehensive 
investigation new drug application package filed with foreign regulatory agency, i.e. the FDA in our case, in a format compliant with 
NMPA guidance. 

After obtaining the IMCT permit from the CDE, clinical trials should be conducted in compliance with both the FDA/ICH and 

NMPA Good Clinical Practice guidelines. 

Data derived from IMCT can be used for the marketing authorization applications with the NMPA. When using IMCT data to 
support marketing authorization applications in China, applicants shall submit completed global clinical trial report, statistical analysis 
report and database, along with relevant supporting data in accordance with the ICH-CTD (International Conference on Harmonization-
Common Technical Document) content and format requirements; subgroup research results summary and comparative analysis shall 
also be conducted concurrently. 

Marketing Authorization Application 

After completion of the first 3 phases of clinical trials demonstrating the safety and effectiveness of a pharmaceutical in its 
targeted indication, a Marketing Authorization Application needs to be filled with the NMPA, which includes research data of chemistry, 
manufacturing and controls, pre-clinical studies and clinical trial report in order to register the new drug. For imported drugs, the New 
Drug Registration Application is also known as the Import Drug License Application. 

17 

Once a marketing authorization is received, the product can be sold nationwide in China. 

Pricing 

The  government  regulates  prices  for  pharmaceuticals  (except  for  narcotic  and  Type  1  psychotropic  drugs)  mainly  by 
establishing a price negotiation, consolidated procurement mechanism, and revising medical insurance reimbursement standards. The 
Chinese government has initiated several rounds of price negotiations with manufacturers of patented drugs, drugs with an exclusive 
source of supply, and oncology drugs since 2016. The average percentage of price reduction has been over 50%. Once the government 
agreed with the drug manufacturers on the supply prices, the drugs would be automatically listed in the National Reimbursement Drug 
List (NRDL) and qualified for public hospital purchase. 

Reimbursement 

China is a single-payor market with near universal healthcare provided by the government. Over 95% of the population receives 
healthcare coverage at various levels of reimbursement. Commercial insurance is available but is minimally adopted, and is seen as a 
supplement above and beyond government reimbursement. To obtain government reimbursement for a drug, the government must agree 
to add it to the NRDL or the provincial reimbursement drug lists at a negotiated price (at times at a significant discount to prevailing 
market price). Prior to this time, the market is self-pay, where patients will be responsible for 100% of the launch price determined by 
the  company.  We  believe  the  self-pay  market  in  China  is  expanding,  given  the  rise  in  personal  income  levels  in  the  country.  In 
December 2020,  the  National  Healthcare  Security  Administration  (NHSA)  and  the  PRC  Ministry  of  Human  Resources  and  Social 
Security released the National Drug Catalogue for Basic Medical Insurance, Work-Related Injury Insurance and Maternity Insurance, 
or the 2020 NRDL , and 119 new drugs were admitted to the 2020 NRDL. Previous updates to the NRDL occurred in 2019, 2017 and 
2009. In addition, there were also NRDL price negotiations in 2018, 2019, and 2020. In 2020, the average price reduction of the 119 
new  drugs  added  to  the  2020  NRDL  is  50.64%.  Admission  to  the  NRDL  depends  on  a  number  of  factors,  including  on-market 
experience, scale of patient adoption, physician endorsement, cost effectiveness and budget impact. Provincial governments have some 
discretion to add additional drugs not listed in the NRDL to provincial reimbursement drug lists. 

Medicines included in the NRDL are divided into two classes, Class A and Class B. Patients purchasing medicines included in 
the  NRDL  are  entitled  to  reimbursement  of  the  entire  amount  or  a  certain  percentage  of  the  purchase  price.  The  percentage  of 
reimbursement for Class B medicines differs from region to region in the PRC. 

Hospital Listing 

Government  hospitals  currently  represent  over  90%  of  the  pharmaceutical  market  in  China.  In  order  for  a  new  drug  to  be 
prescribed at a government hospital, it has to be listed in the hospital formulary. The process of entering into the formulary is commonly 
referred to as “hospital listing”, and typically requires a long lead time. These decisions are made on a hospital-by-hospital basis with 
timing  that  can  range  from  every  six months  to  every  five years.  Some  hospitals  also  have  temporary  listing  procedures  that  can 
accelerate timing. Private hospital and non-hospital pharmacies, which represent less than 10% of the drug market in China, do not 
require a formulary process to sell a drug. 

Centralized Procurement and Tenders 

Provincial and municipal government agencies will establish a provincial drug procurement agency to operate a mandatory 
collective tender process for purchases by government hospitals of a medicine included in provincial or local medicine procurement 
catalogs. The provincial or local medicine procurement catalogs are determined by the provincial drug procurement agency based on 
the National Essential Drugs List, the NRDL, local hospital formularies, etc. If a new drug has been included in a government hospital 
formulary, the NRDL or the provincial reimbursement drug list, the relevant hospitals must participate in collective tender processes for 
the purchase of such new drug. The centralized tender process is in principle conducted once every year in the relevant province or city 
in  China.  During  the  collective  tender  process,  the  provincial  drug  procurement  agency  will  establish  a  committee  consisting  of 
recognized  pharmaceutical  experts.  The  committee  will  assess  the  bids  submitted  by  the  various  participating  pharmaceutical 
manufacturers, taking into consideration, among other things, the quality and price of the drug product and the service and reputation of 
the  manufacturer.  Only  drug  products  that  have  been  selected  in  the  collective  tender  processes  may  be  purchased  by  participating 
hospitals. 

“4+7” Volume-based Drug Procurement and Tenders. In June 2018, the State Council decided to launch a new round of drug 
pricing and procurement reform. The reform policy aims to lower drug costs for patients, reduce transaction costs for enterprises, regulate 

18 

drug use of hospitals, and improve the centralized drug procurement and pricing system. This reform is implemented mainly by the 
NHSA. The NHC supports the reform by introducing policy that encourages purchasing and prescribing of the selected drug. The NMPA 
is responsible for the quality assurance of the drugs submitted for tenders. 

The  national  pilot  scheme  for  centralized  volume-based  drug  procurement  and  tenders  under  the  reform  was  launched  in 

November 2018. The selected drugs must pass the GQCE on quality and effectiveness. 

The centralized volume-based procurement is open to all approved enterprises that manufacture drugs on the government-set 
procurement list in China. The NHSA organized four rounds of volume-based procurement and tenders to this date. On February 3, 
2021, the results of the fourth round of the volume-based procurement and tender were announced. All of the 45 listed products were 
successfully qualified to enter into a supply agreement with the group procurement organization and the average price reduction was 
52%. 

COMPETITION 

Competition  in  the  pharmaceutical,  biotechnology  and  biopharmaceutical  industries  is  intense  and  based  significantly  on 
scientific and technological factors, the availability of patent and other protection for technology and products, the ability and length of 
time required to obtain governmental approval for testing, manufacturing and marketing and the ability to commercialize products in a 
timely  fashion.  Moreover,  the  biopharmaceutical  industry  is  characterized  by  rapidly  evolving  technology  that  could  result  in  the 
technological obsolescence of any products that we develop. 

We compete with many specialized biopharmaceutical firms, as well as a growing number of large pharmaceutical companies 
that are applying biotechnology to their operations. It is probable that the number of companies seeking to develop products and therapies 
for the treatment of unmet needs in oncology will increase. Many biopharmaceutical companies have focused their development efforts 
in the human therapeutics area, including oncology and inflammation, and many major pharmaceutical companies have developed or 
acquired  internal  biotechnology  capabilities  or  made  commercial  arrangements  with  other  biopharmaceutical  companies.  These 
companies,  as  well  as  academic  institutions,  governmental  agencies  and  private  research  organizations,  also  compete  with  us  in 
recruiting and retaining highly qualified scientific personnel and consultants. 

The biopharmaceutical industry has undergone, and is expected to continue to undergo, rapid and significant technological 
change. Consolidation and competition are expected to intensify as technical advances in each field are achieved and become more 
widely known. In order to compete effectively, we will be required to continually expand our scientific expertise and technology, identify 
and retain capable personnel and pursue scientifically feasible and commercially viable opportunities. 

Our competition will be determined in part by the potential indications for which our product candidates may be developed and 
ultimately approved by regulatory authorities. The relative speed with which we develop new products, complete clinical trials, obtain 
regulatory approvals, and complete the other requirements to get a pharmaceutical product on the market are critical factors in gaining 
a competitive advantage. We may rely on third parties to commercialize our products, and accordingly, the success of these products 
will depend in significant part on these third parties’ efforts and ability to compete in these markets. The success of any collaboration 
will depend in part upon our collaborative partners’ own competitive, marketing and strategic considerations, including the relative 
advantages of alternative products being developed and marketed by our collaborative partners and our competitors. 

Many of our existing or potential competitors have substantially greater financial, technical and human resources than we do 
and  may  be  better  equipped  to  develop,  manufacture  and  market  products.  In  addition,  many  of  these  competitors  have  extensive 
experience in preclinical testing and human clinical trials and in obtaining regulatory approvals. The existence of competitive products, 
including products or treatments of which we are not aware, or products or treatments that may be developed in the future, may adversely 
affect  the  marketability  of  products  that  we  may  develop.  Our  competitors’  drugs  may  be  more  effective  than  any  drug  we  may 
commercialize and may render our product candidates obsolete or non-competitive before we can recover the expenses of developing 
our product candidates. 

EMPLOYEES 

Our work force currently consists of 176 employees, all of which are full-time employees, the majority of whom are located in 
China. Certain of our activities, such as manufacturing and clinical trial operations, are outsourced at the present time. We may hire 
additional personnel,  in  addition  to utilizing  part-time or  temporary  consultants, on  an as-needed basis. None of our  employees  are 
represented by a labor union, and we believe our relations with our employees are satisfactory. 

19 

CORPORATE HEADQUARTERS 

We were incorporated under Delaware law in 1991. In 2012, with new leadership, the Company shifted its business strategy to 
China  and  has  since  built  an  infrastructure  in  China  that  includes  sales  and  marketing,  medical  affairs,  regulatory  and  clinical 
development and in the foreseeable future, distribution and manufacturing. The majority of the Company’s operations are now located 
in China. Our offices are located at 9620 Medical Center Drive, Suite 300, Rockville, Maryland 20850, and our telephone number is 
(240) 864-2600. Our wholly-owned subsidiary, CASI China, is headquartered in Beijing, China and CASI Wuxi is headquartered in 
Wuxi, China. We conduct substantially all of our China commercial, regulatory and related operations through CASI China and our 
operations in Wuxi through CASI Wuxi. CASI China’s headquarters are located at 1701-1702, China Central Office Tower 1, No.81 
Jianguo Road, Chaoyang District, Beijing, 100025 China.  

In 2020, we leased office space in Shanghai, China to accommodate our growing staff in that region.  Our address in Shanghai 

is No. 2904, Shengbang International, North Sichuan Road, Hongkou District, Shanghai, China. 

Management decisions are primarily being made out of CASI China where our executive team spends a substantial amount of 

time. 

CHINA OPERATIONS 

The majority of our operations are now located in China and are conducted primarily through two of our subsidiaries: (i) CASI 
Pharmaceuticals  (China)  Co.,  Ltd.  (“CASI  China”),  a  directly  wholly  owned  subsidiary  established  in  August 2012  and  located  in 
Beijing. CASI China is responsible for our day-to-day operations, development and commercialization of our product and (ii) CASI 
Pharmaceuticals (Wuxi) Co., Ltd. (“CASI Wuxi”), a directly wholly owned subsidiary established in November 2018 and located in 
Wuxi  Huishan  Economic  Development  Zone.  CASI  Wuxi  was  incorporated  as  the  holding  company  for  CASI’s  R&D  center, 
distribution center and manufacturing facilities. CASI Wuxi has a lease on industrial land, for 7.33 hectare. In December 2018, CASI 
Wuxi established a new subsidiary CASI Biopharmaceuticals as an investment platform for Chinese pharmaceutical asset acquisition or 
cooperation. 

We have about 168 FTEs in China. Over 100 employees are dedicated to commercial operations, which mainly account for 
EVOMELA’s sales and marketing activities. The clinical and regulatory team has 18 FTEs, who oversee local preclinical and clinical 
operations, and NMPA regulatory activities. The Wuxi R&D and manufacturing center has 24 employees at the current stage, and the 
team size will expand according to the progress of the facility’s construction. 

AVAILABLE INFORMATION 

Through our website at www.casipharmaceuticals.com, we make available, free of charge, our filings with the SEC, including 
our annual proxy statements, annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K, and all 
amendments thereto, as soon as reasonably practicable after such reports are filed with or furnished to the SEC. Additionally, our board 
committee charters and code of ethics are available on our website. We intend to post to this website all amendments to the charters and 
code of ethics. Our filings are also available through the SEC via their website, http://www.sec.gov. The information contained on our 
website is not incorporated by reference in this Annual Report on Form 10-K (this “Annual Report”) and should not be considered a 
part of this report. 

ITEM 1A.  RISK FACTORS. 

This section includes the most significant factors that we believe may adversely affect our business and operations. Before 
making  an  investment  decision,  you  should  carefully  consider  the  risks  described  below,  and  all  other  information  contained  or 
incorporated by reference in our filings with the SEC. We expect to update these Risk Factors from time to time in the periodic and 
current  reports  that  we  file  with  the  SEC.  Please  refer  to  these  subsequent  reports  for  additional  information  relating  to  the  risks 
associated with investing in our common stock. If any of such risks and uncertainties actually occurs, our business, financial condition, 
and results of operations could be severely harmed. This could cause the trading price of our common stock to decline, and you could 
lose all or part of your investment.   

20 

 
 
 
Risk Factors Summary 

Risks Relating to our Financial Position and Need for Additional Capital 

• 

If we do not regain compliance with the Nasdaq bid price rule, our common stock would be delisted from the Nasdaq Capital 
Market, which would impair our ability to raise capital and the liquidity of our common stock could be adversely affected. 
•  We have incurred significant operating losses since inception and anticipate that we will continue to incur operating losses for 

the foreseeable future and may never achieve or maintain profitability. 

•  The success of CASI Wuxi is subject to uncertainty and may increase our  losses, be difficult to accomplish, take longer than 

expected or require us to obtain additional financing. 

•  The current capital and credit market conditions may adversely affect our access to capital, cost of capital, and ability to execute 

our business plan as scheduled. 

•  We have limited revenue streams and we are uncertain whether additional funding will be available for our future capital needs 
and  commitments. If we  cannot  raise additional funding, or  access  the  capital  markets,  we  may be  unable  to  complete  the 
development and commercialization of our products and product candidates.  

Risks Relating to Our Business 

• 
If we are ultimately unable to obtain regulatory approval for our drug candidates, our business will be substantially harmed. 
•  We are substantially dependent on the commercial success of EVOMELA™. Our medicine may fail to achieve and maintain 
the degree of market acceptance by physicians, patients, third-party payors, and others in the medical community necessary for 
commercial success.  

•  We currently rely on a single source for our supply of EVOMELA which has high risk of supply chain disruption. 
•  Our business has been and may continue to be adversely affected by the current COVID-19 pandemic and could be impacted 

by future COVID-19 variants and other outbreaks of contagious diseases. 

•  The existence of counterfeit pharmaceutical products in pharmaceutical markets may compromise our brand and reputation 

and have a material adverse effect on our business, operations and prospects. 

•  We face significant competition from other biotechnology and pharmaceutical companies and our business will suffer if we 

fail to compete effectively. 

•  We  may  need  new  collaborative  partners  to  further  develop  and  commercialize  products,  and  if  we  enter  into  such 

arrangements, we may lose control over the development and approval process. 

•  We may not have sufficient funds to acquire new product candidates or pay milestone payments. 
•  We must show the safety and efficacy of our product candidates through clinical trials, the results of which are uncertain. 
•  Compliance with ongoing post-marketing obligations for our approved products may uncover new safety information that could 
give rise to a product recall, updated warnings, or other regulatory actions that could have an adverse impact on our business. 
•  Undesirable adverse events caused by our medicines and drug candidates could interrupt, delay or halt clinical trials, delay or 
prevent regulatory approval, limit the commercial profile of an approved label, or result in significant negative consequences 
following any regulatory approval. 

•  Potential products may subject us to product liability for which insurance may not be available. 
• 

If we are unable to obtain both adequate coverage and adequate reimbursement from third-party payers for our products before 
the competitor’s product launch our revenues and prospects for profitability will suffer. 

•  Cybersecurity incidents could impair our ability to conduct business effectively. 
•  Our business depends substantially on the continuing efforts of our senior management, key employees and qualified personnel, 

and our business operations may be adversely and negatively impacted if we lose their services. 

•  Certain  of  our  directors  and  officers  may  have  business  interests  that  may  conflict  with  our  interests  and  those  of  our 

stockholders.  

21 

•  We  or  the  third  parties  upon  whom  we  rely  on  may  be  adversely  affected  by  epidemic  outbreaks,  earthquakes,  tornadoes, 
hurricanes or other natural disasters, and our business continuity and disaster recovery plans may not adequately protect us 
from a serious disaster. 

Risks Relating to Our Reliance on Third Parties  

• 

Independent clinical investigators and contract research organizations that we engage to conduct our clinical trials may not 
devote sufficient time or attention to our clinical trials or be able to repeat their past success. 

•  We have no current manufacturing capacity and rely on limited suppliers for some of our products.   
•  The design and manufacture of a manufacturing facility by CASI Wuxi may be delayed. 
• 

If we fail to maintain an effective distribution channel for our medicines, our business and sales could be adversely affected. 

 Risks Related to Extensive Government Regulation 

•  All material aspects of the research, development, manufacturing and commercialization of pharmaceutical products are heavily 
regulated, and we may face difficulties in complying with or be unable to comply with such regulations, which could have a 
material adverse effect on our business.  

•  We are subject to certain U.S. healthcare laws, regulation and enforcement; our failure to comply with those laws could have 

a material adverse effect on our results of operations and financial condition.  

•  Current healthcare laws and regulations and future legislative or regulatory reforms to the healthcare system may affect our 

ability to sell our products profitably. 

•  Our  medicines  and  any  future  approved  drug  candidates  will  be  subject  to  ongoing  regulatory  obligations  and  continued 
regulatory review, which may result in significant additional expense and we may be subject to penalties if we fail to comply 
with regulatory requirements or experience unanticipated problems with our medicines and drug candidates. 

Risks Relating to Our Intellectual Property 

•  We depend on patents and other proprietary rights, some of which are uncertain.  If we are unable to protect our intellectual 

property rights our business and competitive position would be harmed. 

•  Third parties may initiate legal proceedings alleging infringement of intellectual property rights, the outcome of which would 

be uncertain and could harm our business. 

•  Although China recently adopted changes to its patent law to include patent term extension and an early resolution mechanism 
for  pharmaceutical  patent  disputes  starting  in  June 2021,  key  provisions  of  the  law  remain  unclear  and/or  subject  to 
implementing regulations. The absence of effective regulatory exclusivity for pharmaceutical products in China could further 
increase the risk of early generic or biosimilar competition with our medicines in China. 

Risks Relating to Our Common Stock 

•  The market price of our common stock may be highly volatile or may decline regardless of our operating performance. 
•  Our largest stockholders, including our directors and executive officers and investment funds with which they are associated, 
hold a significant amount of our outstanding common stock and, if they acted together, could influence our management and 
affairs. 

•  Our amended and restated bylaws provide that the Court of Chancery of the State of Delaware will be the exclusive forum for 
certain legal actions between us and our stockholders, which could increase costs to bring a claim, discourage claims or limit 
the ability of our stockholders to bring a claim in a judicial forum viewed by the stockholders as more favorable for disputes 
with us or our directors, officers or other employees. 

Risks Relating to Our Auditor 

•  The audit report included in this Annual Report on Form 10-K  is prepared by auditors who are not currently inspected by the 
PCAOB and, as such, our stockholders are deprived of the benefits of such inspection.  In addition, various legislative and 
regulatory  developments  related  to  U.S.-listed  China  based  companies  due  to  lack  of  PCAOB  inspection  and  other 
developments due to political tensions between the United States and China may have a material adverse impact on our listing 
and trading in the United States and the trading prices of our shares of common stock.  

22 

•  We could be delisted if our auditors are unable to meet the PCAOB inspection requirements in time. 

Risks Relating to Our Business Operations in China 

•  We conduct a majority of our operations in China, which exposes us to risks associated with operating outside of the U.S. 
Changes in international trade and economic policy by the U.S. and Chinese governments could have a material adverse effect 
on our business and operations. 

•  Governmental control of currency conversion and payments of RMB out of mainland China may limit our ability to utilize our 

cash balances effectively and affect the value of your investment. 

•  Changes in China’s economic, political or social conditions or government policies could have a material adverse effect on our 

business and operations. 

•  The Chinese government exerts substantial influence over the manner in which we must conduct our business activities. 
•  We are subject to the Enterprise Income Tax Law, and we may therefore be subject to PRC income tax on our global income. 
•  China  regulations  relating  to  investments  in  offshore  companies  by  China  residents  may  subject  our  China-resident 
stockholders, beneficial owners or our China subsidiaries to liability or penalties, limit our ability to inject capital into our 
China subsidiaries or limit our China subsidiaries’ ability to increase their registered capital or distribute profits to us. 

•  We may be subject to fines and legal sanctions by SAFE or other China government authorities if we or our employees who 
are China citizens fail to comply with regulations relating to employee stock options granted by companies listed on exchanges 
outside of China to China citizens. 

General Risk Factors  

•  We may engage in strategic, commercial and other corporate transactions that could negatively affect our financial condition 

and prospects. 

If securities or industry analysts publish inaccurate or unfavorable research about our business, our stock price could decline. 

• 
•  Subsequent resales of shares of our common stock in the public market may cause the price of our common stock to fall. 
• 

Issuances of additional shares of our common stock may cause substantial dilution of existing stockholders. 

Risks Relating to our Financial Position and Need for Additional Capital 

If we do not regain compliance with the Nasdaq bid price rule, our common stock would be delisted from the Nasdaq Capital Market, 
which would impair our ability to raise capital and the liquidity of our common stock could be adversely affected. 

Our  listing on the Nasdaq  Capital  Market  is  contingent upon  meeting  all  the  continued  listing  requirements  of  the Nasdaq 

Capital Market.  

On  December 30,  2021,  CASI  received  a  deficiency  letter  from  the  Listing  Qualifications  Department  (the  “Staff”)  of  the 
Nasdaq Stock Market (“Nasdaq”) notifying CASI that, for the previous 30 consecutive business days, the bid price of CASI’s common 
stock had closed below the minimum $1.00 per share requirement for continued inclusion on the Nasdaq Capital Market pursuant to 
Nasdaq Listing Rule 5550(a)(2) (the “Bid Price Rule”). 

The Nasdaq deficiency letter has no immediate effect on the listing of CASI’s common stock on the Nasdaq Capital Market. 

In accordance with Nasdaq Listing Rule 5810(c)(3)(A) (the “Compliance Period Rule”), CASI has been provided an initial 
period of 180 calendar days, or until June 28, 2022 (the “Compliance Date”), to regain compliance with the Bid Price Rule. If, at any 
time  before  the  Compliance  Date,  the  bid  price  for  CASI’s  common  stock  closes  at  $1.00  or  more  per  share  for  a  minimum  of  10 
consecutive business days, as required under the Compliance Period Rule, the Staff will provide written notification to CASI that it 
complies with the Bid Price Rule, unless the Staff exercises its discretion to extend this 10-day period pursuant to Nasdaq Listing Rule 
5810(c)(3)(H). 

If CASI does not regain compliance with the Bid Price Rule by the Compliance Date, CASI may be eligible for an additional 
180 calendar day compliance period (the “Second Compliance Period”). To qualify, CASI would need to meet the continued listing 
requirement for the market value of publicly held shares and all other initial listing standards of the Nasdaq Capital Market, with the 
exception  of  the  Bid  Price  Rule,  and  provide  written  notice  to  the  Staff  of  its  intention  to  cure  the  deficiency  during  the  Second 
Compliance Period by effecting a reverse stock split, if necessary. 

23 

However, if CASI does not regain compliance with the Bid Price Rule by the Compliance Date and it appears to the Staff that 
CASI will not be able to regain compliance with the Bid Price Rule during the Second Compliance Period, or CASI is otherwise not 
eligible for the Second Compliance Period, then Nasdaq will provide notice to CASI that CASI’s common stock will be subject to 
delisting. At that time, CASI may appeal the Staff’s delisting determination to a Nasdaq Listing Qualifications Panel (the “Panel”). 
CASI expects that its common stock would remain listed pending the Panel’s decision. There can be no assurance that, if CASI does 
appeal the Staff’s delisting determination to the Panel, such appeal would be successful. 

CASI intends to actively monitor the closing bid price of its common stock between now and the Compliance Date and will 
consider available options, including a reverse stock split. In order to make available the option of a reverse stock split, CASI may 
submit a reverse stock split proposal to its stockholders at a special meeting of stockholders or its next annual meeting of stockholders. 
However, there can be no assurance that the reverse stock split will be approved or that CASI will be able to regain compliance with the 
Bid Price Rule. If our common stock is delisted from the Nasdaq Capital Market, our ability to raise capital in the future may be limited. 
Delisting could also result in less liquidity for our stockholders and a lower stock price. 

If our common stock is delisted by Nasdaq, our common stock may be eligible to trade on the OTC Bulletin Board or another 
over-the-counter market. Any such alternative would likely result in it being more difficult for us to raise additional capital through the 
public or private sale of equity securities and for investors to dispose of, or obtain accurate quotations as to the market value of, our 
common stock. In addition, there can be no assurance that our common stock would be eligible for trading on any such alternative 
exchange or markets. 

We have incurred significant operating losses since inception and anticipate that we will continue to incur operating losses for the 
foreseeable future and may never achieve or maintain profitability. 

To date, we have been engaged primarily in research and development activities. Previously, we have not derived significant 
revenues from operations; however, in the years ended December 31, 2021 and 2020, we had EVOMELA® sales totaling $30.0 million 
and $15.0 million, respectively. 

We have experienced losses in each year since inception. Through December 31, 2021, we had an accumulated deficit of $605.6 
million. We expect that we will seek to raise capital to continue our operations and, although we have been successfully funded to date 
through the sales of our equity securities, our capital-raising efforts may not produce the funding needed to sustain our operations. If we 
are unable to obtain additional funding for operations, we may not be able to continue operations as proposed, requiring us to modify 
our business plan, curtail various aspects of our operations or cease operations. In any such event, investors may lose a portion or all of 
their investment. 

We  expect  that  our  ongoing  preclinical,  clinical,  marketing  and  corporate  activities  will  result  in  operating  losses  for  the 
foreseeable  future.  In  addition,  to  the  extent  we  rely  on  others  to  develop  and  commercialize  our  products,  our  ability  to  achieve 
profitability will depend upon the success of these other parties. To support our research and development of certain product candidates, 
we may seek and rely on cooperative agreements from governmental and other organizations as a source of support. If a cooperative 
agreement were to be reduced to any substantial extent, it may impair our ability to continue our research and development efforts. To 
become and remain profitable, we must successfully commercialize one or more product candidates with significant market potential. 
This will require us to be successful in a range of challenging activities, including completing clinical trials of our product candidates, 
developing commercial scale manufacturing processes, obtaining marketing approval, manufacturing, marketing and selling any current 
and future product candidates for which we may obtain marketing approval, and satisfying any post-marketing requirements. We may 
never succeed in any or all of these activities and, even if we do, we may never generate sufficient revenue to achieve profitability. 

The success of CASI Wuxi is subject to uncertainty and may increase our losses, be difficult to accomplish, take longer than expected 
or require us to obtain additional financing. 

We intend to invest $80 million in CASI Pharmaceuticals (Wuxi) Co., Ltd., that is building a manufacturing facility in the 
Wuxi  Huishan  Economic  Development  Zone  in  Jiangsu  Province,  China.  Since  the  construction  began,  we  have  incurred  capital 
expenditures of $12.1 million. CASI Wuxi will also operate the facility upon completion. As of December 31, 2021, we have invested 
$31 million in cash, transferred selected ANDAs valued at $30 million and will invest an additional $19 million in cash in the future. 
The Company’s total investment is intended to account for 80% of the equity of the CASI Wuxi. CASI Wuxi may not achieve the 
expected goal as the planned manufacturing facility will not be entirely within our control. It can take years to build and establish a new 
manufacturing facility.  

24 

 
 
 
Once built, the new facility might fail validation or not meet regulatory standards for a commercial manufacturing facility. In 
addition, we may not obtain or retain the requisite legal permits to manufacture in China, and costs or operational limitations may be 
imposed in connection with obtaining and complying with such permits. Our ability to establish and operate a manufacturing facility in 
China may be adversely affected by changes in Chinese laws and regulations such as those related to, among other things, taxation, 
import and export tariffs, environmental regulations, land use rights, intellectual property, employee benefits and other matters. The 
success of CASI Wuxi also relies on our ability to make additional payments in the future, which is uncertain. Our plan may require us 
to obtain additional debt or equity financing, resulting in additional debt obligations, increased interest expense or dilution of equity 
ownership.  If  we  are  unable  to  establish  a  new  manufacturing  facility,  purchase  equipment,  hire  adequate  personnel  to  support  our 
manufacturing  efforts  or  implement  necessary  process  improvements,  we  may  be  unable  to  produce  commercial  materials  or  meet 
demand, if any should develop, for our product candidates. Any one of the factors cited above, or a combination of them, could result 
in unanticipated costs, which could materially and adversely affect our business and planned operations and earnings in China. 

The current capital and credit market conditions may adversely affect our access to capital, cost of capital, and ability to execute our 
business plan as scheduled. 

Access to capital markets is critical to our ability to operate. Traditionally, we have funded our operations by raising capital in 
the equity markets. Declines and uncertainties in these markets over the past few years have restricted raising new capital in amounts 
sufficient to conduct our current operations and have affected our ability to continue to expand or fund additional development efforts. 
We require significant capital for research and development for our product candidates, clinical trials, and marketing activities. Our 
inability to access the capital markets on favorable terms because of our low stock price, or upon our delisting from the Nasdaq Capital 
Market if we fail to satisfy a listing requirement, could affect our ability to execute our business plan as scheduled. Moreover, we rely 
and intend to rely on third parties, including our clinical research organizations, third party manufacturers, and certain other important 
vendors and consultants. As a result of the current volatile and unpredictable global economic situation, there may be a disruption or 
delay  in  the  performance  of  our  third-party  contractors  and  suppliers.  If  such  third  parties  are  unable  to  adequately  satisfy  their 
contractual commitments to us in a timely manner, our business could be adversely affected. 

We have limited revenue streams and we are uncertain whether additional funding will be available for our future capital needs and 
commitments. If we cannot raise additional funding, or access the capital markets, we may be unable to complete the development 
and commercialization of our products and product candidates. 

We will require substantial funds in addition to our existing working capital to develop and commercialize our products and 
product candidates and to otherwise meet our business objectives. We have never generated sufficient revenue during any period since 
our  inception  to  cover  our  expenses  and  have  spent,  and  expect  to  continue  to  spend,  substantial  funds  to  continue  our  clinical 
development programs and commercialization of our products and product candidates. Any one of the following factors, among others, 
could cause us to require additional funds or otherwise cause our cash requirements in the future to increase materially: 

• 

• 

• 

• 

• 

• 

progress of our clinical trials or correlative studies; 

results of clinical trials; 

changes in or terminations of our relationships with strategic partners; 

changes in the focus, direction, or costs of our research and development programs; 

competitive and technological advances; 

establishment and expansion of marketing and sales capabilities; 

•  manufacturing; 

• 

• 

the regulatory approval process; or 

product launch and distribution. 

At December 31, 2021, we had cash and cash equivalents of $38.7 million. We may continue to seek additional capital through 
public or private financing or collaborative agreements in 2021 and beyond. Our operations require significant amounts of cash. We 
may be required to seek additional capital for the future growth and development of our business. We can give no assurance as to the 
availability of such additional capital or, if available, whether it would be on terms acceptable to us. If we are not successful in obtaining 
sufficient capital because we are unable to access the capital markets on favorable terms, it could reduce our research and development 
efforts and materially adversely affect our future growth, results of operations and financial results. There can be no assurance that we 
would be able to obtain any required financing on a timely basis or at all. 

25 

Risks Relating to Our Business 

If we are ultimately unable to obtain regulatory approval for our drug candidates, our business will be substantially harmed 

The  time  required  to  obtain  approval  by  FDA  and  NMPA  is  unpredictable  and  typically  takes  many years  following  the 
commencement of preclinical studies and clinical trials and depends on numerous factors, including the substantial discretion of the 
regulatory authorities. 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

Our drug candidates could be delayed or fail to receive regulatory approval for many reasons, including: 

failure to begin or complete clinical trials due to disagreements with regulatory authorities; 

delays in subject enrollment or interruptions in clinical trial supplies or investigational product; 

failure to demonstrate that a drug candidate is safe and effective or that a biologic candidate is safe, pure, and potent for its 
proposed indication; 

failure of clinical trial results to meet the level of statistical significance required for approval; 

reporting or data integrity issues related to our clinical trials; 

disagreement with our interpretation of data from preclinical studies or clinical trials; 

changes in approval policies or regulations that render our preclinical and clinical data insufficient for approval or require us 
to amend our clinical trial protocols; 

regulatory  requests  for  additional  analyses,  reports,  data,  nonclinical  studies  and  clinical  trials,  or  questions  regarding 
interpretations of data and results and the emergence of new information regarding our drug or biologic candidates or other 
products; 

failure to satisfy regulatory conditions regarding endpoints, patient population, available therapies and other requirements for 
our clinical trials in order to support marketing approval on an accelerated basis or at all; 

our failure to conduct a clinical trial in accordance with regulatory requirements or our clinical trial protocols; and 

clinical sites, investigators or other participants in our clinical trials deviating from a trial protocol, failing to conduct the trial 
in accordance with regulatory requirements, or dropping out of a trial. 

The  FDA,  NMPA  or  a  comparable  regulatory  authority  may  require  more  information,  including  additional  preclinical, 
chemistry,  manufacturing  and  controls,  and/or  clinical  data,  to  support  approval,  which  may  delay  or  prevent  approval  and  our 
commercialization plans, or we may decide to abandon the development program. 

Changes in regulatory requirements and guidance may also occur, and we may need to amend clinical trial protocols submitted 
to applicable regulatory authorities to reflect these changes. Amendments may require us to resubmit clinical trial protocols to IRBs or 
ethics committees for re-examination, which may impact the costs, timing or successful completion of a clinical trial. 

If  we  experience  delays  in  the  completion  of,  or  the  termination  of,  a  clinical  trial  of  any  of  our  product  candidates,  the 
commercial prospects of that candidate may be harmed, and our ability to generate product sales revenues from any of those candidates 
may be delayed. In addition, any delays in completing our clinical trials will increase our costs, slow down our candidate development 
and approval process, and jeopardize our ability to commence product sales and generate related revenues for that candidate. Any of 
these occurrences may harm our business, financial condition and prospects significantly. In addition, many of the factors that cause, or 
lead to, a delay in the commencement or completion of clinical trials may also ultimately lead to the denial of regulatory approval of 
our product candidates. 

Our success in commercializing these drugs and biologics may be inhibited by a number of factors, including: 

• 

• 

• 

• 

our inability to obtain/maintain regulatory approvals; 

our inability to recruit, train and retain adequate numbers of effective sales and marketing personnel; 

the inability of sales personnel to obtain access to or educate physicians on the benefits of our products; 

our lack of experience in manufacturing drugs for commercial sales; 

26 

• 

• 

• 

• 

• 

• 

our or our partners’ inability to secure widespread acceptance of our products from physicians, healthcare payors, patients and 
the medical community; 

our ability to win tenders through the collective tender processes in which we decide to participate; 

the lack of complementary products to be offered by sales personnel, which may put us at a competitive disadvantage relative 
to companies with more extensive product lines; 

unforeseen costs and expenses associated with creating an independent sales and marketing organization; 

generic and biosimilar competition; and 

regulatory exclusivities or patents held by competitors that may inhibit our products’ entry to the market. 

If we decide to rely on third parties to manufacture, sell, market and distribute our products and product candidates, we may 
not be successful in entering into arrangements with such third parties or may be unable to do so on terms that are favorable to us. In 
addition, our product revenues and our profitability, if any, may be lower if we rely on third parties for these functions than if we were 
to market, sell and distribute any products that we develop ourselves. We likely will have little control over such third parties, and any 
of them may fail to devote the necessary resources and attention to sell and market our products effectively. If we do not establish sales, 
marketing and distribution capabilities successfully, either on our own or in collaboration with third parties, we will not be successful 
in commercializing our product candidates, which would adversely affect our business and financial condition. 

We are substantially dependent on the commercial success of EVOMELA™. Our medicine may fail to achieve and maintain the 
degree  of  market  acceptance  by  physicians,  patients,  third-party  payors,  and  others  in  the  medical  community  necessary  for 
commercial success. 

The  success  of  our  business  is  substantially  dependent  on  our  ability  to  successfully  commercialize  EVOMELA.  On 
December 3, 2018, we received the NMPA approval for importation, marketing and sales in China for EVOMELA®, and on August 12, 
2019, we announced the commercial launch of EVOMELA® in China. We will continue to spend our time, resources and efforts on the 
commercialization of EVOMELA® in China. 

Reimbursement and hospital listing may be the most critical market access factors for our commercialization success in China. 
The NRDL is updating on annual basis via a negotiation mechanism. Although participating the NRDL pricing negotiation is voluntarily, 
it usually results significant price discount. The Company has no intention to list EVOMELA® in the NRDL any time before a direct 
competitor’s compound commercially launch, therefore, our market will be limited given only a small portion of the Chinese population 
would be able to afford EVOMELA® through self-pay. 

The government owned hospitals in China usually restrict the drug use outside the hospital formulary. Therefore, been listed 
in hospital formulary is critical. In order to list in the hospital formulary, the Company must participate the provincial level tendering 
process.  Wining  the  tendering  does  not  guarantee  the  hospital  listing.  If  we  were  unable  to  quickly  add  EVOMELA®  to  hospitals’ 
formulary, doctors and patients will have limited access to EVOMELA® through hospital pharmacies, the demand for EVOMELA®, 
and  the  revenues  from  EVOMELA®  will  be  materially  and  adversely  affected.  On  the  other  hand,  patients  are  able  to  purchase 
EVOMELA with the prescription from the physician from pharmacies the product is not available in the hospital, however, the hospitals 
do not encourage such activities. 

We currently rely on a single source for our supply of EVOMELA which has high risk of supply chain disruption 

We  currently  rely  on  a  single  source  for  our  supply  of  EVOMELA®.  Early  in  the  COVID-19  pandemic  we  experienced  a 
disruption to our supply chain for EVOMELA®, we have experienced minimal supply disruptions in 2021.  However, if suppliers refuse 
or are unable to provide products for any reason (including the occurrence of an event like the COVID-19 pandemic that makes delivery 
impractical), we would have to work with Acrotech to negotiate an agreement with a substitute supplier, which would likely interrupt 
further manufacturing of EVOMELA®, cause delays or increase our costs. 

Our business has been and may continue to be adversely affected by the current COVID-19 pandemic and could be impacted by 
future COVID-19 variants and other outbreaks of contagious diseases 

The COVID-19 pandemic has adversely affected, and may continue to adversely affect, the economies and financial markets 
of many countries, which may result in a period of regional, national, and global economic slowdown or regional, national, or global 
recessions that could affect our ability to continue to commercialize and expand distribution of EVOMELA® (Melphalan For Injection) 
or other drugs in our existing product pipeline. Early in the COVID-19 pandemic we experienced a disruption to our supply chain for 
EVOMELA®,  we  have  experienced  no  supply  disruption  in  2021;  however,  there  can  be  no  assurance  that  restrictions  will  not  be 

27 

 
 
imposed again. In addition, economic and other uncertainties may adversely affect other parties’ willingness to negotiate and execute 
product licenses and thus hamper our ability to in-license clinical-stage and late-stage drug candidates in China or elsewhere. 

Clinical trials, whether planned or ongoing, may be affected by the COVID-19 pandemic. Our partner, Juventas, experienced 
some delay in the start of the CNCT19 clinical trials due to the COVID-19 pandemic. The COVID-19 pandemic has also impacted our 
targeted start time of our CID-103 trial due to the lock-down of many medical facilities in Europe. Study procedures (particularly any 
procedures that may be deemed non-essential), site initiation, participant recruitment and enrollment, participant dosing, shipment of 
our product candidates, distribution of clinical trial materials, study monitoring, site inspections and data analysis may be paused or 
delayed due to changes in hospital or research institution policies, federal, state or local regulations, prioritization of hospital and other 
medical resources toward COVID-19 efforts, or other reasons related to the pandemic. In addition, there could be a potential effect of 
COVID-19 on the operations of the health regulatory authorities, which could result in delays of reviews and approvals, including with 
respect to our product candidates. Any prolongation or de-prioritization of our clinical trials or delay in regulatory review resulting from 
such disruptions could materially affect the development and study of our product candidates. 

The existence of counterfeit pharmaceutical products in pharmaceutical markets may compromise our brand and reputation and 
have a material adverse effect on our business, operations and prospects. 

Counterfeit  products,  including  counterfeit  pharmaceutical  products,  are  a  significant  problem,  particularly  in  China. 
Counterfeit pharmaceuticals are products sold or used for research under the same or similar names, or similar mechanism of action or 
product class, but which are sold without proper licenses or approvals. Such products may be used for indications or purposes that are 
not recommended or approved or for which there is no data or inadequate data with regard to safety or efficacy. Such products divert 
sales  from  genuine  products,  often  are  of  lower  cost,  often  are  of  lower  quality  (having  different  ingredients  or  formulations,  for 
example),  and  have  the  potential  to  damage  the  reputation  for  quality  and  effectiveness  of  the  genuine  product.  If  counterfeit 
pharmaceuticals illegally sold or used for research result in adverse events or side effects to consumers, we may be associated with any 
negative publicity resulting from such incidents. Consumers may buy counterfeit pharmaceuticals that are in direct competition with our 
pharmaceuticals,  which  could  have  an  adverse  impact  on  our  revenues,  business  and  results  of  operations.  In  addition,  the  use  of 
counterfeit products could be used in non-clinical or clinical studies, or could otherwise produce undesirable side effects or adverse 
events that may be attributed to our products as well, which could cause us or regulatory authorities to interrupt, delay or halt clinical 
trials and could result in the delay or denial of regulatory approval by the FDA or other regulatory authorities and potential product 
liability  claims.  With  respect  to  China,  although  the  government  has  recently  been  increasingly  active  in  policing  counterfeit 
pharmaceuticals, there is not yet an effective counterfeit pharmaceutical regulation control and enforcement system in China. As a result, 
we may not be able to prevent third parties from selling or purporting to sell our products in China. The proliferation of counterfeit 
pharmaceuticals has grown in recent years and may continue to grow in the future. The existence of and any increase in the sales and 
production of counterfeit  pharmaceuticals,  or  the  technological  capabilities  of  counterfeiters,  could negatively  impact  our revenues, 
brand reputation, business and results of operations. 

We face significant competition from other biotechnology and pharmaceutical companies and our business will suffer if we fail to 
compete effectively. 

If competitors were to develop superior drug candidates, our products could be rendered noncompetitive or obsolete, resulting 
in a material adverse effect to our business. Developments in the biotechnology and pharmaceutical industries are expected to continue 
at a rapid pace. Success depends upon achieving and maintaining a competitive position in the development of products and technologies. 
Competition  from  other  biotechnology  and  pharmaceutical  companies  can  be  intense.  Many  competitors  have  substantially  greater 
research and development capabilities, marketing, financial and managerial resources and experience in the industry. 

In the generic products market, we face competition from other generic pharmaceutical companies, which may impact our 
selling price and revenues from such products. The FDA approval process often results in the FDA granting final approval to a number 
of ANDAs for a given product at the time a patent for a corresponding brand product or other market exclusivity expires. This may force 
us  to  face  immediate  competition  when  we  seek  to  introduce  a  generic  product  into  the  market.  If  competition  from  other  generic 
pharmaceutical companies intensifies, revenues may decline. 

The availability of our competitors’ products could limit the demand, and the price we are able to charge, for product candidates 
we develop. We will not achieve our business plan if the acceptance of our products is inhibited by price competition or reimbursement 
issues or if physicians switch to other new drug products or choose to reserve our product candidates for use in limited circumstances. 
The inability to compete with existing or subsequently introduced drug products would have a material adverse impact on our business, 
financial condition and prospects. 

28 

 
 
We may need new collaborative partners to further develop and commercialize products, and if we enter into such arrangements, we 
may lose control over the development and approval process. 

We  may  develop  and  commercialize  our  product  candidates  both  with  and  without  corporate  alliances  and  partners. 
Nonetheless, we intend to explore opportunities for new corporate alliances and partners to help us develop, commercialize and market 
our product candidates. We may grant to our partners certain rights to commercialize any products developed under these agreements, 
and we may rely on our partners to conduct research and development efforts and clinical trials on, obtain regulatory approvals for, and 
manufacture and market any products licensed to them. Each individual partner will seek to control the amount and timing of resources 
devoted to these activities generally. We anticipate obtaining revenues from our strategic partners under such relationships in the form 
of research and development payments and payments upon achievement of certain milestones. Since we generally expect to obtain a 
royalty  for  sales  or  a percentage  of  profits  of  products  licensed  to  third  parties,  our  revenues  may  be  less  than  if  we  retained  all 
commercialization rights and marketed products directly. In addition, there is a risk that our corporate partners will pursue alternative 
technologies or develop competitive products as a means for developing treatments for the diseases targeted by our product candidates. 

We may not be successful in establishing any collaborative arrangements. Even if we do establish such collaborations, we may 
not successfully commercialize any products under or derive any revenues from these arrangements. There is a risk that we will be 
unable to manage simultaneous collaborations, if any, successfully. With respect to existing and potential future strategic alliances and 
collaborative arrangements, we will depend on the expertise and dedication of sufficient resources by these outside parties to develop, 
manufacture, or market products. If a strategic alliance or collaborative partner fails to develop or commercialize a product to which it 
has rights, we may not recognize any revenues on that particular product. 

We may not have sufficient funds to acquire new product candidates or pay milestone payments. 

Our growth strategy relies on our in-license of new product candidates from third parties. Our pipeline will be dependent upon 
the  availability  of  suitable  acquisition  candidates  at  favorable  prices  and  upon  advantageous  terms  and  conditions.  Even  if  such 
opportunities are present, we may not be able to successfully identify appropriate acquisition candidates. Moreover, other companies, 
many of which may have substantially greater financial resources are competing with us for the right to acquire such product candidates. 

If a product candidate is identified, the third parties with whom we seek to cooperate may not select us as a potential partner or 
we may not be able to enter into arrangements on commercially reasonable terms or at all. Furthermore, the negotiation and completion 
of collaborative and license arrangements could cause significant diversion of management’s time and resources and potential disruption 
of our ongoing business. 

We must show the safety and efficacy of our product candidates through clinical trials, the results of which are uncertain. 

Before obtaining regulatory approvals for the commercial sale of our products, we must demonstrate, through preclinical studies 
(animal testing) and clinical trials (human testing), that our proposed products are safe and effective for use in each target indication. 
Testing of our product candidates will be required, and failure can occur at any stage of testing. Clinical trials may not demonstrate 
sufficient safety and efficacy to obtain the required regulatory approvals or result in marketable products. The failure to adequately 
demonstrate the safety and efficacy of a product under development could delay or prevent regulatory approval of the potential product. 

Clinical trials for the product candidates we are developing may be delayed by many factors, including that potential patients 
for testing are limited in number. The failure of any clinical trials to meet applicable regulatory standards could cause such trials to be 
delayed or terminated, which could further delay the commercialization of any of our product candidates. Newly emerging safety risks 
observed in animal or human studies also can result in delays of ongoing or proposed clinical trials. Any such delays will increase our 
product development costs. If such delays are significant, they could negatively affect our financial results and the commercial prospects 
for our products. 

Compliance with ongoing post-marketing obligations for our approved products may uncover new safety information that could give 
rise to a product recall, updated warnings, or other regulatory actions that could have an adverse impact on our business. 

After the FDA approves a drug or biologic for marketing, the product’s sponsor must comply with several post-marketing 
obligations that continue until the product is discontinued. These post-marketing obligations include the reporting of adverse events to 
the  agency  within  specified  timeframes,  the  submission  of  product-specific  annual  reports  that  include  changes  in  the  distribution, 
manufacturing, and labeling information, and notification when a drug product is found to have significant deviations from its approved 
manufacturing  specifications  (among  others).  Our  ongoing  compliance  with  these  types  of  mandatory  reporting  requirements  could 
result in additional requests for information from the FDA and, depending on the scope of a potential product issue that the FDA may 
decide to pursue, potentially also result in a request from the agency to conduct a product recall or to strengthen warnings and/or revise 

29 

other label information about the product. FDA may also require or request the withdrawal of the product from the market. Any of these 
post-marketing regulatory actions could materially affect our sales and, therefore, have the potential to adversely affect our business, 
financial condition, results of operations and cash flows. 

Undesirable adverse events caused by our medicines and drug candidates could interrupt, delay or halt clinical trials, delay or prevent 
regulatory approval, limit the commercial profile of an approved label, or result in significant negative consequences following any 
regulatory approval 

Undesirable adverse events ("AEs") caused by our medicines and drug candidates could cause us or regulatory authorities to 
interrupt, delay or halt clinical trials and could result in a more restrictive label or the delay or denial of regulatory approval, or could 
result in limitations or withdrawal following approvals. If the conduct or results of our trials or patient experience following approval 
reveal a high and unacceptable severity or prevalence of AEs, our trials could be suspended or terminated and regulatory authorities 
could  order  us  to  cease  further  development  of,  or  deny  approval  of,  our  drug  candidates  or  require  us  to  cease  commercialization 
following approval. 

As is typical in the development of pharmaceutical products, drug-related AEs and serious AEs ("SAEs") have been reported 
in our clinical trials. Some of these events have led to patient deaths. Drug-related AEs or SAEs could affect patient recruitment or the 
ability of enrolled subjects to complete the trial and could result in product liability claims. Any of these occurrences may harm our 
reputation, business, financial condition and prospects significantly. In our periodic and current reports filed with the SEC and our press 
releases and scientific and medical presentations released from time to time we disclose clinical results for our drug candidates, including 
the occurrence of AEs and SAEs. 

Potential products may subject us to product liability for which insurance may not be available. 

The use of our potential products in clinical trials and the marketing of any pharmaceutical products may expose us to product 
liability claims. We have obtained a level of liability insurance coverage that we believe is adequate in scope and coverage for our 
current stage of development. However, our present insurance coverage may not be adequate to protect us from liabilities we might 
incur. In addition, our existing coverage will not be adequate as we further develop products and, in the future, adequate insurance 
coverage and indemnification by collaborative partners may not be available in sufficient amounts or at a reasonable cost. If a product 
liability claim or series of claims are brought against us for uninsured liabilities, or in excess of our insurance coverage, the payment of 
such liabilities could have a negative effect on our business and financial condition. 

If we are unable to obtain both adequate coverage and adequate reimbursement from third-party payers for our products before the 
competitor’s product launch our revenues and prospects for profitability will suffer. 

Successful commercialization of our products is highly dependent on the extent to which coverage and reimbursement is, and 
will be, available from third-party payers, including governmental payers and private health insurers. Patients may not be capable of 
paying for our products themselves and may rely on third-party payers to pay for, or subsidize, the costs of their medications, among 
other medical costs. If third-party payers do not provide coverage or reimbursement for our products, our revenues and prospects for 
profitability will suffer. In addition, even if third-party payers provide some coverage or reimbursement for our products, the availability 
of such coverage or reimbursement for prescription drugs under private health insurance and managed care plans often varies based on 
the type of contract or plan purchased. 

Cybersecurity incidents could impair our ability to conduct business effectively. 

Cybersecurity incidents against us or against a third party that has authorized access to our data or networks, failure of our 
disaster recovery systems, or consequential employee error, could have an adverse effect on our ability to communicate or conduct 
business, negatively impacting our operations and financial condition. This adverse effect can become particularly acute if those events 
affect our electronic data processing, transmission, storage, and retrieval systems, or impact the availability, integrity, or confidentiality 
of our data.  

We depend heavily upon computer systems to perform necessary business functions. Our computer systems, networks, and 
data, like those of other companies, could be subject to cyberattacks and unauthorized access, use, alteration, or destruction. If one or 
more of these events occurs, it could potentially jeopardize the confidential, proprietary, and other information processed, stored in, and 
transmitted through our computer systems and networks. Such an attack could cause interruptions or malfunctions in our operations, 
which could result in financial losses, litigation, regulatory penalties, reputational damage, and increased costs associated with mitigation 
of damages and remediation. Third parties with which we do business may also be sources of cybersecurity or other technological risk. 

30 

The use of quarantines and social distancing restrictions to reduce the spread of COVID-19, including employees who have 
transitioned to working remotely, may present additional cybersecurity risks to us. Policies of extended periods of remote working, 
whether  by  us  or  third  parties  with  which  we  do  business  with,  could  strain  technology  resources,  introduce  operational  risks  and 
otherwise heighten the risks described above. 

Our business depends substantially on the continuing efforts of our senior management, key employees and qualified personnel, and 
our business operations may be adversely and negatively impacted if we lose their services. 

Our future success depends substantially on the continued efforts of our senior management team and key employees. Our 
employees play key roles in the areas of product development, marketing, sales, and general and administrative functions. Competition 
for  qualified  staff  or  other  key  employees  in  the  biopharmaceutical  industry  in  China  is  intense,  particularly  for  individuals  with 
multinational experience. If one or more of our members of senior management or key employees are unable or unwilling to continue 
their services with us, we might not be able to replace them easily, at an acceptable cost or in a timely manner, if at all.  

Many of the companies with which we compete for experienced personnel have greater resources than we have and some of 
these companies may offer more lucrative compensation packages. If any of our key personnel joins a competitor or forms a competing 
company, we may lose customers, know-how and key professionals and staff members. Even if we enter into employment agreements 
and non-compete agreements with our employees, certain provisions under these agreements may be deemed invalid or unenforceable 
under PRC laws. Our continued ability to compete effectively depends on our ability to attract new employees and to retain and motivate 
our existing employees. Since the demand and competition for talent is intense in our industry, we may need to offer higher compensation 
and other benefits in order to attract and retain key personnel in the future, which could increase our compensation expenses. If we do 
not succeed in attracting additional highly skilled personnel or retaining or motivating our existing personnel, we may be unable to grow 
effectively. 

Certain of our directors and officers may have business interests that may conflict with our interests and those of our stockholders. 

Certain  of  our  directors  and  officers  have  relationships  with  venture  capital  or  similar  funds  that  invest  in  life  sciences 
companies  that  may  compete  with  us.  James  Huang,  a  director,  is  the  founding  partner  of  Panacea  Venture,  a  global  venture  fund 
focusing on investments in innovative and transformative early and growth stage healthcare and life science companies. Dr. Quan Zhou, 
another director, previously served as the president of IDG Technology Venture Investment Inc. and has been the managing member of 
IDG Technology Venture Investments, LP and its successor fund since 2000 and the director of various IDG-Accel China funds since 
2005. 

Our  Chairman  and  CEO,  Dr. Wei-Wu  He,  is  the  founder  and  managing  partner  of  Emerging  Technology  Partners,  LLC 
(“ETP”), a life science focused venture fund, and its related investing entities. Through funds affiliated with ETP, Dr. He is a founder 
and significant shareholder of Juventas and currently serves as chairman of Juventas’ board of directors. Mr. Huang, through Panacea 
Venture, also is an investor in Juventas. In addition, we have an equity investment in Juventas. 

Although  we  require  that  all  transactions  with  Juventas  must  be  approved  by  a  committee  of  independent  directors,  our 
commercial  license,  loan  to, and other  transactions with  Juventas  could create  conflicts  of  interests  for Dr. He  or Mr. Huang.  Even 
though  we  are  an  investor  in  Juventas,  Dr. He  and  Mr. Huang  may  have  different  business  and  personal  interests  than  our  other 
stockholders. In particular, Dr. He, as a founder of Juventas, has a direct interest in the financial success of Juventas that may encourage 
him to support strategies to further the financial success of Juventas that could potentially adversely impact us. To the extent we fail to 
appropriately deal with any such conflicts of interests, it could negatively impact our reputation and ability to raise additional funds and 
the willingness of counterparties to do business with us, all of which could have an adverse effect on our business, financial condition, 
results of operations, and cash flows. 

We or the third parties upon whom we rely on may be adversely affected by epidemic outbreaks, earthquakes, tornadoes, hurricanes 
or other natural disasters, and our business continuity and disaster recovery plans may not adequately protect us from a serious 
disaster. 

We have offices in Rockville, Maryland, and a wholly owned subsidiary in Beijing, China through which substantially all of 
our operations are conducted. We also rely and intend to rely on third parties, including our clinical research organizations, third party 
manufacturers,  and  certain  other  important  vendors  and  consultants  in  China  and  in  United  States.  The  occurrence  of  one  or  more 
epidemic outbreaks  such  as  Ebola,  Zika,  SARS-CoV,  COVID-19  or  measles,  natural  disasters,  such  as  tornadoes, hurricanes, fires, 
floods, hail  storms  and  earthquakes, unusual  weather  conditions,  terrorist  attacks  or disruptive political  events  in regions where we 
operate our business could adversely affect the operations of the third parties we rely on and our business, results of operations, financial 
condition and our prospects. 

31 

If an epidemic outbreak, natural disaster, power outage or other event occurred that prevented us or the third parties we rely on 
from using all or a significant portion of our or their offices, damaged critical infrastructure or disrupted operations, it may be difficult, 
or  in  certain  cases,  impossible  for  us  to  continue  our  business  for  a  substantial  period  of  time.  The  disaster  recovery  and  business 
continuity plan we have in place currently are limited and are unlikely to prove adequate in the event of a serious disaster or similar 
event. We may incur substantial expenses as a result of the limited nature of our disaster recovery and business continuity plans, which 
could have a material adverse effect on our business. 

Risks Relating to Our Reliance on Third Parties  

Independent clinical investigators and contract research organizations that we engage to conduct our clinical trials may not devote 
sufficient time or attention to our clinical trials or be able to repeat their past success. 

We depend on independent clinical investigators and contract research organizations (“CROs”) to assist in the conduct of our 
clinical trials under their agreements with us. The investigators are not our employees, and we cannot control the amount or timing of 
resources  that  they  devote  to  our  programs.  If  independent  investigators  fail  to  devote  sufficient  time  and  resources  to  our  drug 
development programs, or if their performance is substandard or deviates from regulatory requirements, GCPs, or the protocol, it could 
delay the approval of our FDA applications and our introduction of new products. The CROs we contract with to assist with the execution 
of our clinical trials play a significant role in the conduct of the trials and the subsequent collection and analysis of data. Failure of the 
CROs to meet their obligations, as well as any failure of us or our collaborators to effectively monitor and audit our CROs and clinical 
trials, could adversely affect clinical development of our products. 

We have no current manufacturing capacity and rely on limited suppliers for some of our products. 

We plan to operate a manufacturing facility in the Wuxi Huishan Economic Development Zone in Jiangsu Province, China. 
We do not currently have the capacity to manufacture products and we have limited experience in these activities. The manufacturing 
processes for the pipeline we are developing have not yet been tested at commercial levels, and it may not be possible to manufacture 
these materials in a cost-effective manner. If we elect to perform these functions, we will be required to either develop these capacities, 
or contract with others to perform some or all of these tasks. We may be dependent to a significant extent on corporate partners, licensees, 
or other entities for manufacturing of our products. If we engage directly in manufacturing, we will require substantial additional funds 
and personnel and will be required to comply with extensive regulations. We may be unable to develop or contract for these capacities 
when required to do so in connection with our business. 

We depend on our third-party manufacturers to perform their obligations effectively and on a timely basis. These third parties 
may not meet their obligations and any such non-performance may delay clinical development or submission of products for regulatory 
approval, or otherwise impair our competitive position. Any significant problem experienced by one of our suppliers could result in a 
delay or interruption in the supply of materials to us until such supplier resolves the problem or an alternative source of supply is located. 
Any delay or interruption would likely lead to a delay or interruption of manufacturing operations, which could negatively affect our 
operations. Although we have identified alternative suppliers for our product candidates, we have not entered into contractual or other 
arrangements with them. If we needed to use an alternate supplier for any product, we would experience delays while we negotiated an 
agreement with them for the manufacture of such product. In addition, we may be unable to negotiate manufacturing terms with a new 
supplier as favorable as the terms we have with our current suppliers. 

Problems with any manufacturing processes, including deviations from cGMP, could result in product defects, which could 
require us to delay shipment of products or recall products previously shipped, as well as regulatory action. In addition, any prolonged 
interruption  in  the  operations  of  the  manufacturing  facilities  of  one  of  our  sole-source  suppliers  could  result  in  the  cancellation  of 
shipments. A number of factors could cause interruptions, including equipment malfunctions or failures, or damage to a facility due to 
natural disasters or otherwise. We expect our future manufacturing processes to be, highly complex and subject to a lengthy regulatory 
approval process. Alternative qualified production capacity may not be available on a timely basis or at all. Difficulties or delays in our 
manufacturing could increase our costs and damage our reputation. 

The manufacture of pharmaceutical products can be an expensive, time consuming, and complex process. Manufacturers often 
encounter difficulties in scaling-up production of new products, including quality control and assurance and shortages of personnel. 
Delays in formulation and scale-up to commercial quantities could result in additional expense and delays in our clinical trials, regulatory 
submissions, and commercialization. 

Failure of manufacturing facilities producing our product candidates to maintain regulatory approval could delay or otherwise 
hinder our ability to market our product candidates. Any manufacturer of our product candidates will be subject to applicable cGMP 
prescribed by the FDA or other rules and regulations prescribed by the NMPA and other foreign regulatory authorities. We and any of 

32 

 
our collaborators may be unable to enter into or maintain relationships either domestically or abroad with manufacturers whose facilities 
and procedures comply or will continue to comply with cGMP and who are able to produce our products in accordance with applicable 
regulatory standards. Failure by a manufacturer of our products to comply with cGMP could result in significant time delays or our 
inability to obtain marketing approval or, should we have market approval, for such approval to continue. Changes in our manufacturers 
could require new product testing and facility compliance inspections. In the U.S., failure to comply with cGMP or other applicable 
legal requirements can lead to federal seizure of violated products, injunctive actions brought by the federal government, inability to 
export product, and potential criminal and civil liability on the part of a company and its officers and employees. 

The design and manufacture of a manufacturing facility by CASI Wuxi may be delayed.  

Together with our partner, Wuxi Jintou Huicun Investment Enterprise, a limited partnership organized under Chinese law, we 
established  CASI  Wuxi,  to  build  and  operate  a  GMP  manufacturing  facility  in  the  Wuxi  Huishan  Economic  Development  Zone  in 
Jiangsu Province, China. Under the terms of our agreement, we have agreed to invest $80 million in CASI Wuxi. As of December 31, 
2021, we have invested $31 million in cash and transferred selected ANDAs valued at $30 million to CASI Wuxi . We are required to 
invest an additional $19 million in cash for the following two years. We have an 80% interest in CASI Wuxi and our partner has a 20% 
interest. 

In November 2019, CASI Wuxi entered into a lease agreement for the right to use state-owned land in China for the construction 
of a manufacturing facility. Pursuant to this agreement, CASI Wuxi has committed to invest in land use rights and property, plant and 
equipment of RMB1 billion (equivalent to US $143 million) by August 2022. The lease agreement also specifies dates by which certain 
milestones must be met, including a construction start date in August 2020.  Construction of the manufacturing facility began in the 
fourth quarter of 2020. In February 2022, we have reached an alignment with the Wuxi local government that we will collaborate with 
Wuxi LP to co-develop the land continuously in the future, and the development plan will be extended, details regarding the plan are 
under negotiation. 

The undertaking of building and establishing a new manufacturing facility can take years. Once completed, the new facility 
might fail validation or not meet regulatory standards for a commercial manufacturing facility. In addition, the facility may not obtain 
or retain the requisite legal permits to manufacture in China, and costs or operational limitations may be imposed in connection with 
obtaining  and  complying  with  such  permits.  Accordingly,  there  can  be  no  assurance  that  CASI  Wuxi  will  meet  the  expenditure 
requirements and other deadlines set forth in the lease agreement. 

The success of CASI Wuxi also relies on our ability to make additional payments in the future, which is uncertain. Our plan 
may require us to obtain additional debt or equity financing, resulting in additional debt obligations, increased interest expense or dilution 
of equity ownership. 

The timing of the development and investment plans for a manufacturing facility are subject to further discussions with the 
government. We may seek to renegotiate the terms of our investment in CASI Wuxi, as well as the terms of the various agreements to 
which CASI Wuxi is a party. There can be no assurance that we will be able to obtain more favorable terms.  

If we fail to maintain an effective distribution channel for our medicines, our business and sales could be adversely affected 

We rely on third-party distributors to distribute our approved medicines. Our ability to maintain and grow our business will 
depend on our ability to maintain an effective distribution channel that ensures the timely delivery of our medicines. However, we have 
relatively limited control over our distributors, who may fail to distribute our drugs in the manner we contemplate. If price controls or 
other  factors  substantially  reduce  the  margins  our  distributors  can  obtain  through  the  resale  of  our  medicines  to  hospitals,  medical 
institutions  and  sub-distributors,  they  may terminate  their  relationship with us.  While  we  believe  alternative  distributors  are readily 
available,  there  is  a risk  that,  if  the distribution of  our  medicines  is  interrupted,  our  sales  volumes  and  business prospects  could be 
adversely affected. 

Risks Related to Extensive Government Regulation 

All material aspects of the research, development, manufacturing and commercialization of pharmaceutical products are heavily 
regulated, and we may face difficulties in complying with or be unable to comply with such regulations, which could have a material 
adverse effect on our business 

All jurisdictions in which we conduct or intend to conduct our pharmaceutical-industry activities regulate these activities in 
great depth and detail. We are currently focusing our activities in the major markets of the United States, China and Europe. These 
geopolitical areas all strictly regulate the pharmaceutical industry, and in doing so they employ broadly similar regulatory strategies, 

33 

 
including regulation of product development and approval, manufacturing, and marketing, sales and distribution of products. However, 
there  are  differences  in  the  regulatory  regimes-some  minor,  some  significant-that  make  for  a  more  complex  and  costly  regulatory 
compliance burden for a company like ours that plans to operate in each of these regions. 

The process of obtaining regulatory approvals and compliance with appropriate laws and regulations require the expenditure 
of  substantial  time  and  financial  resources.  Failure  to  comply  with  the  applicable  requirements  at  any  time  during  the  product 
development process, approval process, or after approval, may subject us to administrative or judicial sanctions. These sanctions could 
include a regulator’s refusal to approve pending applications, withdrawal of an approval, license revocation, a clinical hold, voluntary 
or mandatory product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, refusals of 
government contracts, restitution, disgorgement, or civil or criminal penalties. The failure to comply with these regulations could have 
a material adverse effect on our business. 

We are subject to certain U.S. healthcare laws, regulation and enforcement; our failure to comply with those laws could have a 
material adverse effect on our results of operations and financial condition. 

We are subject to certain U.S. healthcare laws and regulations and enforcement by the federal government and the states in 

which we conduct our business. The laws that may affect our ability to operate include, without limitation: 

• 

• 

• 

• 

• 

the  federal  Anti-Kickback  Statute  (“AKS”),  which  governs  our  business  activities,  including  our  marketing  practices, 
educational programs, pricing policies, and relationships with healthcare providers or other entities. The AKS prohibits, among 
other things, persons and entities from knowingly and willfully soliciting, receiving, offering or paying remuneration, directly 
or indirectly, in exchange for or to induce either the referral of an individual for, or the purchase, order or recommendation of, 
any good or service for which payment may be made under federal healthcare programs such as the Medicare and Medicaid 
programs. Remuneration has been broadly interpreted to include anything of value, including for example, gifts, discounts, 
coupons,  the furnishing  of supplies or  equipment,  credit arrangements, payments  of  cash,  waivers  of payments, ownership 
interests  and  providing  anything  at  less  than  its  fair  market  value.  This  statute  has  been  broadly  interpreted  to  apply  to 
manufacturer arrangements with prescribers, purchasers and formulary managers, among others; 

the FFDCA, and its regulations which prohibit, among other things, the introduction or delivery for introduction into interstate 
commerce of any food, drug, device, biologic, or cosmetic that is adulterated or misbranded; 

the  PHSA,  which  prohibits,  among  other  things,  the  introduction  into  interstate  commerce  of  biological  product  unless  a 
biologics license is in effect for that product; 

federal civil and criminal false claims laws and civil monetary penalty laws, which prohibit, among other things, individuals 
or entities from knowingly presenting, or causing to be presented, claims for payment from Medicare, Medicaid, or other third-
party payers that are false or fraudulent, or making a false statement to avoid, decrease or conceal an obligation to pay money 
to the federal government; 

federal criminal laws that prohibit executing a scheme to defraud any healthcare benefit program or making false statements 
relating to healthcare matters; 

•  HIPAA and its implementing regulations, which impose certain requirements relating to the privacy, security and transmission 

of individually identifiable health information; 

• 

• 

• 

state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws, which may apply to items 
or  services  reimbursed  by  any  third-party  payer,  including  commercial  insurers,  and  state  laws  governing  the  privacy  and 
security of health information in certain circumstances, many of which differ from each other in significant ways and may not 
have the same effect, thus complicating compliance efforts; 

federal and state consumer protection and unfair competition laws, which broadly regulate marketplace activities and activities 
that potentially harm consumers; 

federal and state government price reporting laws that require us to calculate and report complex pricing metrics to government 
programs, where such reported prices may be used in the calculation of reimbursement and/or discounts on our marketed drugs 
(participation  in  these programs  and  compliance  with  the applicable requirements  may  subject  us  to potentially  significant 
discounts on our products, increased infrastructure costs, and could potentially affect our ability to offer certain marketplace 
discounts); and 

34 

• 

federal and state financial transparency laws, which generally require certain types of expenditures in the U.S. to be tracked 
and reported (compliance with such requirements may require investment in infrastructure to ensure that tracking is performed 
properly, and some of these laws result in the public disclosure of various types of payments and relationships with healthcare 
providers and healthcare entities, which could potentially have a negative effect on our business and/or increase enforcement 
scrutiny of our activities). 

In addition, certain marketing practices, including off-label promotion, may also violate certain federal and state healthcare 
fraud and abuse laws, FDA rules and regulations, as well as false claims laws. If our operations are found to be in violation of any of 
the laws described above or any other governmental regulations that apply to us, we, or our officers or employees, may be subject to 
penalties, including administrative civil and criminal penalties, damages, fines, withdrawal of regulatory approval, the curtailment or 
restructuring of our operations, the exclusion from participation in federal and state healthcare programs and imprisonment, any of which 
could adversely affect our ability to sell our products or operate our business and also adversely affect our financial results. 

Current healthcare laws and regulations and future legislative or regulatory reforms to the healthcare system may affect our ability 
to sell our products profitably. 

The U.S. and some foreign jurisdictions are considering or have enacted a number of legislative and regulatory proposals to 
change the healthcare system in ways that could affect our ability to sell our products profitably. Among policy makers and payers in 
the  U.S.  and  elsewhere,  there  is  significant  interest  in  promoting  changes  in  healthcare  systems  with  the  stated  goals  of  containing 
healthcare costs, improving quality and/or expanding access. In the U.S., the pharmaceutical industry has been a particular focus of 
these efforts and has been significantly affected by major legislative initiatives. 

We  expect  that  healthcare  reform  measures,  including  the  potential  repeal  and  replacement  of  the  Patient  Protection  and 
Affordable Care Act (“PPACA”), that may be adopted in the future, may have a significant impact on our business. Most recently, the 
Tax Cuts and Jobs Acts was enacted, which, among other things, removed penalties for not complying with the individual mandate to 
carry  health  insurance.  Additionally,  all  or  a  portion  of  PPACA  and  related  subsequent  legislation  may  be  modified,  repealed  or 
otherwise  invalidated  through  judicial  challenge,  which  could  result  in  lower  numbers  of  insured  individuals,  reduced  coverage  for 
insured individuals and adversely affect our business. If PPACA is repealed or replaced, it is unclear how the replacement statute may 
impact our business. If PPACA is not repealed or replaced, it will continue to impose requirements on our business. 

Moreover, certain politicians have announced intentions to propose initiatives to regulate the prices of pharmaceutical products. 
We cannot know what form any such legislation may take or the market’s perception of how such legislation would affect us. Any 
reduction  in  reimbursement  from  government  programs  may  result  in  a  similar  reduction  in  payments  from  private  payors.  The 
implementation of cost containment measures or other healthcare reforms may prevent us from being able to generate revenue, attain 
profitability, or commercialize our current products and/or those for which we may receive regulatory approval in the future. 

Our medicines and any future approved drug candidates will be subject to ongoing regulatory obligations and continued regulatory 
review, which may result in significant additional expense and we may be subject to penalties if we fail to comply with regulatory 
requirements or experience unanticipated problems with our medicines and drug candidates. 

Our medicines and any additional drug candidates that are approved will be subject to ongoing regulatory requirements for 
manufacturing, labeling, packaging, storage, advertising, promotion, sampling, record-keeping, conduct of post-marketing studies, and 
submission of safety, efficacy, and other post-marketing information, including both federal and state requirements in China, the US 
and other regions. As such, we and our collaborators will be subject to ongoing review and periodic inspections to assess compliance 
with  applicable  post-approval  regulations.  Additionally,  to  the  extent  we  want  to  make  certain  changes  to  the  approved  medicines, 
product  labeling, or manufacturing processes,  we will  need  to  submit  new  applications  or  supplements  to  regulatory  authorities  for 
approval. 

Manufacturers and manufacturers’ facilities are required to comply with extensive FDA, NMPA and comparable regulatory 
authority requirements, ensuring that quality control and manufacturing procedures conform to GMP regulations. As such, we and our 
contract manufacturers are and will be subject to continual review and inspections to assess compliance with GMP and adherence to 
commitments  made  in  any  NDA  or  BLA,  other  marketing  application,  and  previous  responses  to  any  inspection  observations. 
Accordingly, we and others with whom we work must continue to expend time, money and effort in all areas of regulatory compliance, 
including manufacturing, production and quality control. The failure to comply with these requirements could have a material adverse 
effect on our business. 

The regulatory approvals for our medicine and any approvals that we receive for our drug candidates are and may be subject 
to limitations on the approved indicated uses for which the medicine may be marketed or to the conditions of approval, which could 
adversely affect the drug’s commercial potential or contain requirements for potentially costly post-marketing testing and surveillance 

35 

to monitor the safety and efficacy of the drug or drug candidate. The FDA, NMPA, EMA or comparable regulatory authorities may also 
require a REMS program or comparable program as a condition of approval of our drug candidates or following approval. In addition, 
if the FDA, NMPA, EMA or a comparable regulatory authority approves our drug candidates, we will have to comply with requirements 
including, for example, submissions of safety and other post-marketing information and reports, establishment registration, as well as 
continued compliance with GMP and good clinical practice (“GCP”) for any clinical trials that we conduct post-approval. 

The FDA, NMPA, EMA or comparable regulatory authorities may seek to impose a consent decree or withdraw marketing 
approval if compliance with regulatory requirements is not maintained or if problems occur after the drug reaches the market. Later 
discovery of previously unknown problems with our medicines or drug candidates or with our drug’s 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 our medicines, withdrawal of the product from the market, or voluntary or 
mandatory product recalls; 

fines, untitled or warning letters, or holds on clinical trials; 

refusal by the FDA, NMPA, EMA or comparable regulatory authorities to approve pending applications or supplements to 
approved applications filed by us or suspension or revocation of license approvals or withdrawal of approvals; 

product seizure or detention, or refusal to permit the import or export of our medicines and drug candidates; and 

injunctions or the imposition of civil or criminal penalties. 

The FDA, NMPA, EMA and other regulatory authorities strictly regulate the marketing, labeling, advertising and promotion 
of products that are placed on the market. Drugs may be promoted only for their approved indications and for use in accordance with 
the provisions of the approved label. The FDA, NMPA, EMA and other regulatory authorities 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. The policies of the FDA, NMPA, EMA and of other regulatory authorities may change and additional government 
regulations  may  be  enacted  that  could  prevent,  limit  or  delay  regulatory  approval  of  our  drug  candidates.  We  cannot  predict  the 
likelihood, nature or extent of government regulation that may arise from future legislation or administrative action, either in the United 
States or abroad, particularly in China, where the regulatory environment is constantly evolving. 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 regulatory approval that we may have obtained and we may not achieve or sustain profitability. 

In addition, if we obtain accelerated approval or conditional approval of any of our drug candidates, as we have done with the 
initial approval of EVOMELA® in China we will be required to conduct a confirmatory study (also called Post Marketing Study “PMS”) 
to verify the predicted clinical benefit and may also be required to conduct post-marketing safety studies. Other comparable regulatory 
authorities may have similar requirements. The results from the confirmatory study may not support the clinical benefit, which could 
result in the approval being withdrawn. While operating under accelerated approval, we will be subject to certain restrictions that we 
would not be subject to upon receiving regular approval. 

Risks Relating to Our Intellectual Property 

We depend on patents and other proprietary rights, some of which are uncertain.  If we are unable to protect our intellectual property 
rights our business and competitive position would be harmed. 

We  have  in-licensed  rights  to  a  variety  of  product  candidates.  Our  success,  competitive  position  and  future  revenues  with 
respect to these product candidates will depend, in part, on our ability to protect our intellectual property. We will be able to protect our 
proprietary rights from unauthorized use by third parties only to the extent that our proprietary rights are covered by valid and enforceable 
patents or are effectively maintained as trade secrets. We attempt to protect our proprietary position by maintaining trade secrets and by 
filing U.S. and foreign patent applications related to our in-licensed technology, inventions and improvements that are important to the 
development of our business. Our failure to do so may adversely affect our business and competitive position. 

The patent positions of biotechnology and pharmaceutical companies can be highly uncertain and involve complex legal and 
factual questions for which important legal principles remain unresolved. We may not be able to protect our intellectual property rights 
throughout the world. No consistent policy regarding the breadth of claims allowed in pharmaceutical patents has emerged to date in 
the U.S. or in many jurisdictions outside of the U.S. Changes in either the patent laws or interpretations of patent laws in the U.S. and 
other countries may diminish the value of our intellectual property and therefore we cannot predict with certainty whether any patent 

36 

applications that we have filed or that we may file in the future will be approved, will cover our products or product candidates or that 
any resulting patents will be enforced. In addition, third parties may challenge, seek to invalidate, limit the scope of or circumvent any 
of our patents, once they are issued. Thus, any patents that we own or license from third parties or CASI Wuxi or development partners 
may not provide any protection against competitors. Any patent applications that we have filed or that we may file in the future, or those 
we may license from third parties or CASI Wuxi or development partners, may not result in patents being issued. Moreover, disputes 
between our licensing or joint development partners and us may arise over license scope, or ownership, assignment, inventorship and/or 
rights  to  use  or  commercialize  patent  or  other  proprietary  rights,  which  may  adversely  impact  our  ability  to  obtain  and  protect  our 
proprietary  technology  and  products.  Also,  patent  rights  may  not  provide  us  with  adequate  proprietary  protection  or  competitive 
advantages against competitors with similar technologies or products. 

Third parties may initiate legal proceedings alleging infringement of intellectual property rights, the outcome of which would be 
uncertain and could harm our business 

Third parties may assert patent or other intellectual property infringement claims against us or our licensors arising from the 
manufacture, use and sale of our current or future product candidates in China or in any other jurisdictions we ultimately commercialize 
in. The validity of our current or future patents or patent applications or those of our licensors may be challenged in litigation, interference 
or derivation proceedings, opposition, post grant review, inter parts review, or other similar enforcement and revocation proceedings, 
provoked by third parties or brought by us, may be necessary to determine the validity of our patents or patent applications or those of 
our licensors. Our patents could be found invalid, unenforceable, or their scope significantly reduced. 

An unfavorable outcome could require us to cease using the related technology 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 a license on commercially reasonable terms. Our 
defense  of  litigation  or  interference  proceedings  may  fail  and,  even  if  successful,  may  result  in  substantial  costs  and  distract  our 
management and other employees. In the event of a successful claim of infringement against us, we may have to pay substantial damages, 
including treble damages and attorneys’ fees for willful infringement, pay royalties, redesign our infringing products or obtain one or 
more licenses from third parties, which may be impossible or require substantial time and monetary expenditure. 

Although China recently adopted changes to its patent law to include patent term extension and an early resolution mechanism for 
pharmaceutical  patent  disputes  starting  in  June 2021,  key  provisions  of  the  law  remain  unclear  and/or  subject  to  implementing 
regulations. The absence of effective regulatory exclusivity for pharmaceutical products in China could further increase the risk of 
early generic or biosimilar competition with our medicines in China. 

In China, laws on patent term extension, patent linkage, and data exclusivity (referred to as regulatory data protection) are still 
developing. Therefore, a lower-cost generic drug can emerge onto the market much more quickly. Chinese regulators have set forth a 
framework for integrating patent linkage and data exclusivity into the Chinese regulatory regime, as well as for establishing a pilot 
program for patent term extension. The Economic and Trade Agreement Between the United States of America and the People's Republic 
of China announced in January 2020 (the "Trade Agreement") also provides for a mechanism for early resolution of patent disputes and 
patent term extension systems. To be implemented, this framework will require adoption of legislation and regulations. In October 2020, 
China adopted amendments to its Patent Law (the “Amended PRC Patent Law”), which will become effective on June 1, 2021. The 
Amended PRC Patent Law contains both patent term extension and a mechanism for early resolution of patent disputes, which may be 
comparable to patent linkage in the United States. However, the provisions for patent term extension and an early resolution mechanism 
are unclear and/or remain subject to the approval of implementing regulations that are still in draft form or have not yet been proposed, 
leading to uncertainty about their scope and implementation. 

Until the relevant implementing regulations for patent term extension and an early resolution mechanism in the Amended PRC 
Patent Law are implemented, and until data exclusivity is adopted and implemented, we may be subject to earlier generic competition. 

Risks Relating to Our Common Stock 

The market price of our common stock may be highly volatile or may decline regardless of our operating performance. 

The volatile price of our stock makes it difficult for investors to predict the value of their investments, to sell shares at a profit 
at any given time, or to plan purchases and sales in advance. Our common stock price has fluctuated from year-to-year and quarter-to-
quarter and will likely continue to be volatile. During 2021, our stock price ranged from $0.77 to $3.63. We expect that the trading price 
of our common stock is likely to be highly volatile in response to a variety of factors that are beyond our control, such as: 

• 

our ability to maintain regulatory approval for EVOMELA® and obtain regulatory approval for our other product candidates; 

37 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

• 

issues in importation, marketing and sales of EVOMELA®; 

the success of CASI Wuxi to build and operate a manufacturing facility in China; 

the clinical development of CNCT19, BI-1206 and CID-103; 

publicity regarding actual or potential clinical test results relating to products under development by our competitors or us; 

initiating, completing or analyzing, or a delay or failure in initiating, completing or analyzing, preclinical or clinical trials or 
animal trials or the design or results of these trials for products in development; 

the entry into, or termination of, key agreements, including key commercial partner agreements; 

the initiation of, material developments in, or conclusion of litigation to enforce or defend any of our intellectual property rights 
or defend against the intellectual property rights of others; 

achievement or rejection of regulatory approvals for products in development by our competitors or us; 

announcements of technological innovations or new commercial products by our competitors or us; 

developments concerning our collaborations and supply chain; 

regulatory developments in the United States and foreign countries; 

economic or other crises and other external factors; 

•  COVID-19 pandemic, especially as a result of investor concerns and uncertainty related to the impact of the outbreak on the 

economics of countries worldwide; 

the loss of key employees; 

period-to-period fluctuations in our revenues and other results of operations; 

changes in financial estimates by securities analysts; or 

publicity or activity involving possible future acquisitions, strategic investments, partnerships or alliances.  

• 

• 

• 

• 

We will not be able to control many of these factors, and we believe that period-to-period comparisons of our financial results 
will  not  necessarily  be  indicative  of  our  future  performance.  The  valuations  of  many  biotechnology  companies  without  consistent 
product revenues and earnings are extraordinarily high based on conventional valuation standards, such as price to earnings and price 
to sales ratios. These trading prices and valuations may not be sustained. In the future, our operating results in a particular period may 
not meet the expectations of any securities analysts whose attention we may attract, or those of our investors, which may result in a 
decline in the market price of our common stock. Any negative change in the public’s perception of the prospects of biotechnology 
companies could depress our stock price regardless of our results of operations. These factors may materially and adversely affect the 
market price of our common stock. 

Our largest stockholders, including our directors and executive officers and investment funds with which they are associated, hold 
a significant amount of our outstanding common stock and, if they acted together, could influence our management and affairs. 

A small number of our stockholders, including our directors and executive officers and investment funds with which they are 
associated, hold a significant amount of our outstanding common stock. In addition, our executive officers and directors and investment 
funds with which they are associated could determine to make additional purchases of common stock, to the extent permitted by law. In 
the  future,  our  executive  officers  and  directors  also  could  be  issued  shares  of  common  stock  as  determined  by  the  Compensation 
Committee and the Board in connection with current or future equity incentive plans. 

These  stockholders,  if  they  acted  together,  could  significantly  influence  the  vote  on  all  matters  requiring  approval  by  our 
stockholders, including the election of directors and the approval of mergers or other business combination transactions. We cannot 
assure you that our largest stockholders will not seek to influence our business and affairs in a manner that is contrary to the interests of 
our other stockholders. In addition, the significant concentration of ownership in our common stock may adversely affect the trading 
price for our common stock because investors often perceive disadvantages in owning stock in companies with significant stockholders.   

38 

Our amended and restated bylaws provide that the Court of Chancery of the State of Delaware will be the exclusive forum for certain 
legal actions between us and our stockholders, which could increase costs to bring a claim, discourage claims or limit the ability of 
our  stockholders  to  bring  a  claim  in  a  judicial  forum  viewed  by  the  stockholders  as  more  favorable  for  disputes  with  us  or  our 
directors, officers or other employees. 

Our amended and restated bylaws, effective September 10, 2020, provide that unless CASI consents in writing to the selection 
of an alternative forum, the Court of Chancery of the State of Delaware will be the sole and exclusive forum for any (i) any derivative 
action or proceeding brought on behalf of CASI, (ii) any action asserting a claim of breach of a fiduciary duty owed by any director, 
officer or other employee of CASI to CASI or CASI’s stockholders, (iii) any action asserting a claim arising under any provision of the 
General Corporation Law of the State of Delaware, CASI’s certificate of incorporation or CASI’s Amended and Restated By-Laws or 
(iv) any action asserting a claim governed by the internal affairs doctrine. The choice of forum provision may increase costs to bring a 
claim, discourage claims or 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  such  lawsuits  against  us  or  our  directors,  officers  and  other 
employees. Alternatively, if a court were to find the choice of forum provision contained in our amended and restated bylaws to be 
inapplicable or unenforceable in an action, CASI may incur additional costs associated with resolving such action in other jurisdictions. 
In addition, unless CASI consents in writing to the selection of an alternative forum, the federal district courts of the United States of 
America will be the exclusive forum for the resolution of any complaint asserting a cause of action arising under the Securities Act of 
1933. 

Risks Relating to Our Auditor 

The audit report included in this Annual Report on Form 10-K are prepared by auditors who are not currently inspected by the 
PCAOB and, as such, our stockholders are deprived of the benefits of such inspection.  In addition, various legislative and regulatory 
developments related to U.S.-listed China based companies due to lack of PCAOB inspection and other developments due to political 
tensions between the United States and China may have a material adverse impact on our listing and trading in the United States 
and the trading prices of our shares of common stock. 

Our auditor, the independent registered public accounting firm that issued the audit report included in this Annual Report on 
Form 10-K, as an auditor of companies that are traded publicly in the United States and a firm registered with the Public Company 
Accounting  Oversight  Board  (“PCAOB”),  is  subject  to  laws  in  the  United  States  pursuant  to  which  the  PCAOB  conducts  regular 
inspections to assess its compliance with applicable professional standards. Our auditor is located in, and organized under the laws of, 
the  PRC,  which  is  a  jurisdiction  where  the  PCAOB  has  been  unable  to  conduct  inspections  without  the  approval  of  the  Chinese 
authorities. 

On  April 21,  2020,  the  SEC  and  the  PCAOB  released  a  joint  statement  highlighting  the  risks  associated  with  investing  in 
companies based in or having substantial operations in emerging markets including China. The joint statement emphasized the risks 
associated with lack of access for the PCAOB to inspect auditors and audit work papers in China and higher risks of fraud in emerging 
markets. 

On May 18, 2020, Nasdaq filed three proposals with the SEC to (i) apply a minimum offering size requirement for companies 
primarily operating in a “Restrictive Market,” (ii) adopt a new requirement relating to the qualification of management or the board of 
directors for Restrictive Market companies, and (iii) apply additional and more stringent criteria to an applicant or listed company based 
on the qualifications of the company’s auditor. 

On December 18, 2020, the President signed the “Holding Foreign Companies Accountable Act” (the “HFCAA”) into law. 
This  legislation  requires  certain  issuers  of  securities  to  establish  that  they  are  not  owned  or  controlled  by  a  foreign  government. 
Specifically, an issuer must make this certification if the PCAOB is unable to audit specified reports because the issuer has retained a 
foreign public accounting firm not subject to inspection by the PCAOB. Furthermore, if the PCAOB is unable to inspect the issuer's 
public accounting firm for three consecutive years, the issuer's securities are banned from trading on a national exchange or through 
other methods.  

On March 24, 2021, the SEC adopted interim final rules relating to the implementation of certain disclosure and documentation 
requirements of the HFCA Act. We will be required to comply with these rules if the SEC identifies us as having a “non-inspection” 
year under a process to be subsequently established by the SEC. On December 2, 2021, the SEC adopted final amendments to its rules 
implementing the HFCA Act (the “Final Amendments”). The Final Amendments finalize the interim final rules adopted in March with 
two major modifications. First, the Final Amendments clarify how the requirements apply to variable interest entities. Second, the Final 
Amendments include requirements to disclose information, including the auditor name and location, the percentage of shares of the 
issuer owned by governmental entities, whether governmental entities in the applicable foreign jurisdiction with respect to the auditor 
has a controlling financial interest with respect to the issuer, the name of each official of the Chinese Communist Party who is a member 

39 

of the board of the issuer, and whether the articles of incorporation of the issuer contains any charter of the Chinese Communist Party. 
The Final Amendments also establish procedures the SEC will follow in identifying issuers and prohibiting trading by certain issuers 
under the HFCA Act. 

On June 22, 2021, the U.S. Senate passed the Accelerating Holding Foreign Companies Accountable Act (the “AHFCA Act”), 
which if enacted into law would amend the HFCA Act and require the SEC to prohibit an issuer’s securities from trading on any U.S. 
stock exchanges if its auditor is not subject to PCAOB inspections for two consecutive years instead of three. 

On  November 5,  2021,  the  SEC  approved  the  PCAOB’s  Rule  6100,  Board  Determinations  Under  the  Holding  Foreign 
Companies Accountable Act. Rule 6100 will establish a framework for the PCAOB’s determinations under the HFCA Act that the 
PCAOB is unable to inspect or investigate completely registered public accounting firms located in a foreign jurisdiction because of a 
position  taken  by  an  authority  in  that  jurisdiction.  On  December 16,  2021,  the  PCAOB  issued  a  report  to  notify  the  SEC  its 
determinations that it is unable to inspect or investigate completely registered public accounting firms headquartered in Mainland China 
and identifies the registered public accounting firms in Mainland China that are subject to such determinations. Our auditor is identified 
by the PCAOB and is subject to the determination. 

The lack of access to the PCAOB inspection in China prevents the PCAOB from fully evaluating audits and quality control 
procedures of the auditors based in China. As a result, investors may be deprived of the benefits of such PCAOB inspections. The 
inability  of  the  PCAOB  to  conduct  inspections  of  auditors  in  China  makes  it  more  difficult  to  evaluate  the  effectiveness  of  these 
accounting firm’s audit procedures or quality control procedures as compared to auditors outside of China that are subject to the PCAOB 
inspections, which could cause investors and potential investors in our common stock to lose confidence in our audit procedures and 
reported financial information and the quality of our financial statements. 

We could be delisted if our auditors are unable to meet the PCAOB inspection requirements in time.  

The HFCAA requires the SEC to prohibit securities of any foreign companies from being listed on U.S. securities exchanges 
or traded “over-the-counter” if a company retains a foreign accounting firm that cannot be inspected by the PCAOB for three consecutive 
years, beginning in 2021. The AHFCAA would shorten this period to two consecutive years, also beginning in 2021. Our independent 
registered public accounting firm is located in and organized under the laws of the PRC, a jurisdiction where the PCAOB is currently 
unable to conduct inspections without the approval of the Chinese authorities, and therefore our auditors are not currently inspected by 
the PCAOB. As such, the requirements under the HFCAA will apply to us beginning in 2022, and we will be subject to the related 
reporting requirements in 2023 and (as discussed below) the trading restrictions would apply to us in 2024. 

The enactment of the HFCAA, the AHFCAA and any additional rulemaking efforts to increase U.S. regulatory access to audit 
information in China could cause investor uncertainty for affected SEC registrants, including us, and the market price of our shares of 
common stock could be materially adversely affected. Additionally, whether the PCAOB will be able to conduct inspections of our 
auditors in the next three years, or at all, is subject to substantial uncertainty and depends on a number of factors out of our control. If 
we are unable to meet the PCAOB inspection requirement in time, we could be delisted from the Nasdaq Capital Market and our shares 
of common stock will not be permitted for trading "over-the-counter" market. Such a delisting would substantially impair your ability 
to sell or purchase our shares of common stock when you wish to do so, and the risk and uncertainty associated with delisting would 
have a negative impact on the price of our shares. Also, such a delisting would significantly affect our ability to raise capital on terms 
acceptable to us, or at all, which would have a material adverse impact on our business, financial condition and prospects. 

Risks Relating to Our Business Operations in China  

We conduct a majority of our operations in China, which exposes us to risks associated with operating outside of the U.S. Changes 
in international trade and economic policy by the U.S. and Chinese governments could have a material adverse effect on our business 
and operations. 

We have operations and conduct business in China, and we plan to continue to expand these operations. Therefore, we are 
subject to risks related to operating in foreign countries, which include complex foreign laws or regulatory requirements or unexpected 
changes to those laws or requirements; other laws and regulatory requirements to which our business activities abroad are subject, such 
as the Foreign Corrupt Practices Act; changes in the political or economic condition of a specific country or region; fluctuations in the 
value of foreign currency versus the U.S. dollar; our ability to deploy overseas funds in an efficient manner; tariffs, trade protection 
measures,  import  or  export  licensing  requirements,  trade  embargoes,  and  sanctions  (including  those  administered  by  the  Office  of 
Foreign Assets Control of the U.S. Department of the Treasury), and other trade barriers; difficulties in attracting and retaining qualified 
personnel; and cultural differences in the conduct of business. There is currently significant uncertainty about the future relationship 
between the U.S. and various other countries, including China, with respect to trade policies, treaties, government regulations and tariffs. 

40 

Any of the foregoing could harm our business and we cannot anticipate all of the ways in which the current political climate could 
adversely impact our business. 

Governmental control of currency conversion and payments of RMB out of mainland China may limit our ability to utilize our cash 
balances effectively and affect the value of your investment. 

Our China subsidiaries have cash and cash equivalents of 122.9 million China Renminbi (“RMB”), valued at $19.3 million in 
U.S. dollars as of December 31, 2021. On a consolidated basis this balance accounts for 50% of our total cash and cash equivalents. The 
Chinese government imposes controls on the convertibility of RMB into foreign currencies and, in certain cases, the remittance of RMB 
out of mainland China. Control on payments out of mainland China may restrict the ability of our China subsidiaries to remit RMB to 
us. Approval from China’s State Administration of Foreign Exchange (“SAFE”) and the People’s Bank of China (“PBOC”) may be 
required where RMB are to be converted into foreign currencies, including U.S. dollars, and approval from SAFE and the PBOC or 
their  branches  may  be  required  where  RMB  are  to  be  remitted  out  of  mainland  China.  Specifically,  under  the  existing  restrictions, 
without prior approval from SAFE and the PBOC, the cash balance of our China subsidiaries is not available to us for activities outside 
of China, including the support of our in-licensing efforts. Furthermore, because repatriation of funds requires the prior approval of 
SAFE and the PBOC, such repatriation could be delayed, restricted or limited. 

Changes in China’s economic, political or social conditions or government policies could have a material adverse effect on our 
business and operations. 

Chinese  society  and  the  Chinese  economy  continue  to  undergo  significant  change.  Adverse  changes  in  the  political  and 
economic policies of the Chinese government could have a material adverse effect on the overall economic growth of China, which 
could  adversely  affect  our  ability  to  conduct  business  in  China.  The  Chinese  government  continues  to  adjust  economic  policies  to 
promote economic growth. Some of these measures benefit the overall Chinese economy but may also have a negative effect on us. For 
example,  our  financial  condition  and  results  of  operations  in  China  may  be  adversely  affected  by  government  control  over  capital 
investments or changes in tax regulations. As the Chinese pharmaceutical industry grows and evolves, the Chinese government may 
also implement measures to change the structure of foreign investment in this industry. We are unable to predict the frequency and scope 
of such policy changes, any of which could materially and adversely affect our liquidity, access to capital and its ability to conduct 
business in China. Any failure on our part to comply with changing government regulations and policies could result in the loss of our 
ability to develop and commercialize our product candidates in China. 

The Chinese government exerts substantial influence over the manner in which we must conduct our business activities. 

The China government has exercised and continues to exercise substantial control over virtually every sector of the Chinese 
economy through regulation and state ownership. Our ability to operate in China may be harmed by changes in its laws and regulations, 
including those relating to taxation, import and export tariffs, environmental regulations, land use rights, property, healthcare regulations, 
and  other  matters.  We  believe  that  our  operations  in  China  are  in  material  compliance  with  all  applicable  legal  and  regulatory 
requirements. However, the central or local governments of the jurisdictions in which we operate may impose new, stricter regulations 
or interpretations of existing regulations that would require additional expenditures and efforts on our part to ensure our compliance 
with such regulations or interpretations. 

Accordingly, government actions in the future, including any decision not to continue to support recent economic reforms and 
to return to a more centrally planned economy or regional or local variations in the implementation of economic policies, could have a 
significant effect on economic conditions in China or particular regions thereof and could require us to divest ourselves of any interest 
we then hold in Chinese properties, subsidiaries, or joint ventures. 

We are subject to the Enterprise Income Tax Law, and we may therefore be subject to PRC income tax on our global income. 

Under the PRC Enterprise Income Tax Law and its implementing rules, both of which came into effect on January 1, 2008, 
enterprises established under the laws of jurisdictions outside of China with “de facto management bodies” located in China may be 
considered PRC tax resident enterprises for tax purposes and may be subject to the PRC enterprise income tax at the rate of 25% on 
their global income. “De facto management body” refers to a managing body that exercises substantive and overall management and 
control over the production and business, personnel, accounting books and assets of an enterprise. The State Administration of Taxation 
issued  the  Notice  Regarding  the  Determination  of  Chinese-Controlled  Offshore-Incorporated  Enterprises  as  PRC  Tax  Resident 
Enterprises on the basis of de facto management bodies, or Circular 82, on April 22, 2009. Circular 82 provides certain specific criteria 
for determining whether the “de facto management body” of a Chinese-controlled offshore-incorporated enterprise is located in China. 

41 

  
Although Circular 82 only applies to offshore enterprises controlled by PRC enterprises, not those controlled by foreign enterprises or 
individuals, the determining criteria set forth in Circular 82 may reflect the State Administration of Taxation’s general position on how 
the  “de  facto  management  body”  test  should  be  applied  in  determining  the  tax  resident  status  of  offshore  enterprises,  regardless  of 
whether they are controlled by PRC enterprises. If we were to be considered a PRC resident enterprise, we would be subject to PRC 
enterprise income tax at the rate of 25% on our global income. In such case, our profitability and cash flow may be materially reduced 
as a result of our global income being taxed under the Enterprise Income Tax Law. Although we believe that none of our entities outside 
of China should be considered a PRC resident enterprise for PRC tax purposes. the tax resident status of an enterprise is subject to 
determination by the PRC tax authorities and uncertainties remain with respect to the interpretation of the term “de facto management 
body.” 

China regulations relating to investments in offshore companies by China residents may subject our China-resident stockholders, 
beneficial owners or our China subsidiaries to liability or penalties, limit our ability to inject capital into our China subsidiaries or 
limit our China subsidiaries’ ability to increase their registered capital or distribute profits to us. 

The State Administration of Foreign Exchange, or SAFE, promulgated the Circular on Relevant Issues Concerning Foreign 
Exchange  Control  on  Domestic  Residents’  Offshore  Investment  and  Financing  and  Roundtrip  Investment  through  Special  Purpose 
Vehicles,  or  SAFE  Circular  37,  on  July 4,  2014,  which  replaced  the  former  circular  commonly  known  as  “SAFE  Circular  75” 
promulgated by SAFE on October 21, 2005. SAFE Circular 37 requires China residents to register with local branches of SAFE in 
connection with their direct establishment or indirect control of an offshore entity, for the purpose of overseas investment and financing, 
with such China residents’ legally owned assets or equity interests in domestic enterprises or offshore assets or interests, referred to in 
SAFE Circular 37 as a “special purpose vehicle.” SAFE Circular 37 further requires amendment to the registration in the event of any 
significant changes with respect to the special purpose vehicle, such as increase or decrease of capital contributed by China individuals, 
share transfer or exchange, merger, division or other material event. In the event that a China shareholder holding interests in a special 
purpose vehicle fails to fulfill the required SAFE registration, the China subsidiaries of that special purpose vehicle may be prohibited 
from making profit distributions to the offshore parent and from carrying out subsequent cross-border foreign exchange activities, and 
the special purpose vehicle may be restricted in its ability to contribute additional capital into its China subsidiary. Moreover, failure to 
comply with the various SAFE registration requirements described above could result in liability under China law for evasion of foreign 
exchange controls. According to the Notice on Further Simplifying and Improving Policies for the Foreign Exchange Administration of 
Direct  Investment  released  on  February 13,  2015  by  SAFE,  local  banks  will  examine  and  handle  foreign  exchange  registration  for 
overseas direct investment, including the initial foreign exchange registration and amendment registration, under SAFE Circular 37 from 
June 1, 2015. 

According to SAFE Circular 37, our stockholders or beneficial owners, who are China residents, are subject to SAFE Circular 
37 or other foreign exchange administrative regulations in respect of their investment in our company. We may not be aware of the 
identities of all of our stockholders or beneficial owners who are China residents, and we do not know whether they are aware of SAFE 
Circular 37. We do not have control over our stockholders or beneficial owners and there can be no assurance that all of our China-
resident stockholders or beneficial owners will comply with SAFE Circular 37 and subsequent implementation rules, and there is no 
assurance that the registration under SAFE Circular 37 and any amendment will be completed in a timely manner, or will be completed 
at  all.  The  failure  of  our  stockholders  or  beneficial  owners  who  are  China  residents  to  register  or  amend  their  foreign  exchange 
registrations in a timely manner pursuant to SAFE Circular 37 and subsequent implementation rules, or the failure of future stockholders 
or beneficial owners who are China residents to comply with the registration procedures set forth in SAFE Circular 37 and subsequent 
implementation rules, may subject such stockholders or beneficial owners or our China subsidiaries to fines and legal sanctions. Failure 
to register or comply with relevant requirements may also limit our ability to contribute additional capital to our China subsidiaries and 
limit our China subsidiaries’ ability to distribute dividends to us. Because a majority of our operating activities take place in and our 
strategic focus is on China, any such limitations would have a material adverse effect on our business, financial condition and results of 
operations. 

We may be subject to fines and legal sanctions by SAFE or other China government authorities if we or our employees who are 
China citizens fail to comply with regulations relating to employee stock options granted by companies listed on exchanges outside 
of China to China citizens. 

On February 15, 2012, SAFE promulgated the Circular on Relevant Issues Concerning the Foreign Exchange Administration 
for  Domestic  Individuals’  Participating  in  the  Share  Incentive  Plans  of  Overseas-Listed  Companies,  or  SAFE  Circular  7,  replacing 
earlier rules promulgated in 2007. Under SAFE Circular 7, China resident individuals who participate in a share incentive plan of a 
company that is listed on an overseas exchange are required to register with SAFE and complete certain other procedures. All participants 
to  a  plan  need  to  retain  a  China  agent  through  Chinese  subsidiaries  of  the  overseas  listed  company  to  handle  foreign  exchange 

42 

registration, account opening, funds transfer and remittance and other related matters. An overseas agent should also be designated to 
handle matters in connection with the exercise or sale of share awards and proceeds transferring for the share incentive plan participants. 
We believe that our share incentive plans for our China resident employees are in compliance with SAFE Circular 7; however, any 
failure to comply with these or similar regulations in the future may subject us or our Chinese employees to fines and legal sanctions 
imposed by SAFE or other government authorities and may prevent us from further granting options under our share incentive plans to 
our employees. Such events could adversely affect our business operations. 

General Risk Factors 

We may engage in strategic, commercial and other corporate transactions that could negatively affect our financial condition and 
prospects. 

We may consider strategic, commercial, and other corporate transactions as opportunities present themselves. There are risks 
associated with such activities. These risks include, among others, incorrectly assessing the quality of a prospective strategic partner, 
encountering greater than anticipated costs in integration, being unable to profitably deploy assets acquired in the transaction, such as 
drug candidates, possible dilution to our stockholders, and the loss of key employees due to changes in management. Further, strategic 
transactions  may  place  additional  constraints  on  our  resources  by  diverting  the  attention  of  our  management  from  our  business 
operations. To the extent we issue securities in connection with additional transactions, these transactions and related issuances may 
have a dilutive effect on existing shareholders. Our financial condition and prospects after an acquisition depend in part on our ability 
to successfully integrate the operations of the acquired business or technologies. We may be unable to integrate operations successfully 
or to achieve expected cost savings. Any cost savings which are realized may be offset by losses in revenues or other charges to earnings. 

If securities or industry analysts publish inaccurate or unfavorable research about our business, our stock price could decline. 

The trading market for our common stock will depend in part on the research and reports that securities or industry analysts 
publish about us or our business. If one or more of the analysts who may cover us downgrade our common stock or publish inaccurate 
or unfavorable research about our business, our common stock price would likely decline. 

Subsequent resales of shares of our common stock in the public market may cause the market price of our common stock to fall. 

The market value of our common stock could decline as a result of sales by investors from time to time, or perceptions that 

such sales may occur, of a substantial amount of the shares of common stock held by them. 

Issuances of additional shares of our common stock may cause substantial dilution of existing stockholders. 

We may issue additional shares of common stock or other securities that are convertible into or exercisable for common stock 
in connection with future acquisitions, future sales of our securities for capital raising purposes, future strategic relationships, or for 
other business purposes. The future issuance of any additional shares of our common stock may create downward pressure on the trading 
price  of  our  common  stock.  There  can  be  no  assurance  that  we  will  not  be  required  to  issue  additional  shares,  warrants  or  other 
convertible securities in the future in conjunction with any capital raising efforts, including at a price (or exercise prices) below the price 
at which shares of our common stock are then traded. 

ITEM 1B.  UNRESOLVED STAFF COMMENTS. 

We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and are not required to 

provide the information under this item. 

ITEM 2. 

PROPERTIES. 

As of December 31, 2021, we hold leases for land, office and laboratory space, as follows: 

China: 

•  The primary office of CASI China is located in Beijing, China with approximately 14,000 square feet of office space.  
• 

In November 2019, CASI Wuxi entered into a fifty-year lease agreement for the right to use state-owned land in Wuxi 
China.  The  land  parcel  is  approximately  666,000  square  feet,  and  the  GMP  manufacturing  facility  is  now  under 
construction.   

•  CASI Wuxi has workshop space of approximately 90,000 square feet.   
•  CASI China has office space in Shanghai of approximately 1,600 square feet. 

43 

 
 
 
 
 
United States: 

•  We have office space in Rockville, Maryland of approximately 6,100 square feet. 

We believe that our facilities are adequate for current needs; however, the Company is in the process of expanding operations 
in China and, accordingly, intends to increase facilities to meet our foreseeable and long-term needs. We do not own any real property. 

ITEM 3. 

LEGAL PROCEEDINGS. 

CASI is subject in the normal course of business to various legal proceedings in which claims for monetary or other damages 

may be asserted. Management does not believe such legal proceedings, unless otherwise disclosed herein, are material. 

ITEM 4.  MINE SAFETY DISCLOSURES. 

Not applicable. 

44 

 
 
 
 
 
 
 
PART II 

ITEM 5.  MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER 
PURCHASES OF EQUITY SECURITIES. 

Market for Common Equity 

Our common stock trades on The Nasdaq Capital Market under the symbol “CASI.” As of March 18, 2022, there were 254 

holders of record of our common stock. 

Dividend Policy 

The Company has never declared or paid dividends on its common stock or any other securities and does not anticipate paying 

any dividends in the foreseeable future. 

ITEM 6. 

SELECTED FINANCIAL DATA. 

We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and are not required to 

provide the information under this item. 

ITEM 7.  MANAGEMENT’S  DISCUSSION  AND  ANALYSIS  OF  FINANCIAL  CONDITION  AND  RESULTS  OF 
OPERATIONS. 

The following discussion should be read in conjunction with the Consolidated Financial Statements and Notes thereto appearing 

elsewhere in this report. See also “Risk Factors” in Item 1A of this Annual Report. 

OVERVIEW 

We  are  a  U.S.  biopharmaceutical  company  focused  on  developing  and  commercializing  innovative  therapeutics  and 
pharmaceutical products in China, the United States, and throughout the world. We were incorporated in 1991, and in 2012, with new 
leadership, the Company shifted its business strategy to China and has since built an infrastructure in China that includes sales and 
marketing, medical affairs, regulatory and clinical development and in the foreseeable future, manufacturing. In 2014, the Company 
changed its name to “CASI Pharmaceuticals, Inc.” We are focused on acquiring, developing and commercializing products that augment 
our hematology oncology therapeutic focus as well as other areas of unmet medical need. The Company is executing our plan to become 
a biopharmaceutical leader by launching medicines in the greater China market, leveraging our China-based regulatory, clinical and 
commercial competencies and our global drug development expertise.  The majority of the Company’s operations are now located in 
China and are conducted primarily through two of our subsidiaries: (i) CASI Pharmaceuticals (China) Co., Ltd.. (“CASI China”), which 
is wholly owned and is located in Beijing, China, and (ii) CASI Pharmaceuticals (Wuxi) Co., Ltd.. (“CASI Wuxi”), which is located in 
Wuxi,  China.  Our  Beijing  office  is  primarily  responsible  for  our  day-to-day  operations  and  our  commercial  team  of  over  100 
hematology/oncology sales and marketing specialists based in China.  CASI Wuxi is part of the long-term strategy to support our future 
clinical and commercial manufacturing needs, to manage our supply chain for certain products, and to develop a GMP manufacturing 
facility in China. 

We  launched  our  first  commercial  product,  EVOMELA®  (Melphalan  for  Injection)  in  China  in  August 2019.  In  China, 
EVOMELA® is approved for use as a conditioning treatment prior to stem cell transplantation and as a palliative treatment for patients 
with multiple myeloma. The other core hematology/oncology assets in the Company’s pipeline include:  

•  CNCT19  is  an  autologous  CD19  CAR-T  investigative  product  (CNCT19)  being  developed  by  the  Company’s  partner 
Juventas for which the Company has exclusive World-Wide co-commercial and profit-sharing rights.   CNCT19 is being 
developed as a potential treatment for patients with hematological malignancies which express CD19 including, B-cell 
acute lymphoblastic leukemia (“B-ALL”) and B-cell non-Hodgkin lymphoma (“B-NHL”).  The CNCT19 Phase 1 studies 
in  patients  with    B-ALL  and  B-NHL  in  China  have  been  completed  by  Juventas,  the  Phase  2  B-ALL  and  B-NHL 
registration studies are both currently enrolling in China the fourth quarter of 2020. 

45 

 
 
 
 
 
 
 
•  BI-1206 is an antibody which has a novel mode-of-action, blocking the inhibitory antibody checkpoint receptor FcγRIIB 
to  unlock  anti-cancer  immunity  and  enhance  the  efficacy  of  antibody-based  immunotherapy  in  both  hematological 
malignancies  and  solid  tumors  for  which  the  Company  has  licensed  exclusive  greater  China  rights  from  BioInvent 
International AB (“BioInvent”). BI-1206 is being investigated by BioInvent in a Phase 1/2 trial, in combination with anti-
PD1 therapy Keytruda® (pembrolizumab), in patients with solid tumors, and in a Phase 1/2a trial in combination with 
MabThera® (rituximab) in patients with relapsed/refractory non-Hodgkin lymphoma (NHL). BI-1206 has the potential to 
restore the activity of rituximab in patients with relapsed/refractory non-Hodgkin lymphoma. Clinical Trial Application 
(CTA) was approved by China National Medical Products Administration (NMPA) in December 2021. The Company is 
planning Phase 1 trials of BI-1206 as a single agent to evaluate the PK/safety profile and in combination with rituximab in 
patients  with  NHL  (mantle  cell  lymphoma,  marginal  zone  lymphoma,  and  follicular  lymphoma)  to  assess  safety  and 
tolerability, select the Recommended Phase 2 Dose and assess early signs of clinical efficacy as part of its development 
program for BI-1206 in China. The studies are expected to start in the first half of 2022. 

•  CB-5339  is  a  novel  VCP/p97  inhibitor  focused  on  valosin-containing  protein  (VCP)/p97  as  a  novel  target  in  protein 
homeostasis, DNA damage response and other cellular stress pathways for therapeutic use in the treatment of patients with 
various malignancies.  The Company entered into an exclusive license on March 21, 2021 with Cleave Therapeutics, Inc. 
(Cleave”) for the development and commercialization of CB-5339 in Mainland China, Hong Kong, Macau and Taiwan. 
CB-5339, an oral second-generation, small molecule VCP/p97 inhibitor, is being evaluated in a Phase 1 clinical trial in 
patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).  CB-5339 CTA application for the 
multiple myeloma indication is in preparation after receiving an acceptance letter for the CB-5339 IND package from the 
China CDE. 

•  CID-103  is  a  full  human  IgG1  anti-CD38  monoclonal  antibody  recognizing  a  unique  epitope  that  has  demonstrated 
encouraging  preclinical  efficacy  and  safety  profile  compared  to  other  anti-CD38  monoclonal  antibodies  for  which  the 
Company has exclusive global rights.  CID-103 is being developed for the treatment of patients with multiple myeloma.  
The Phase 1 dose escalation and expansion study of CID-103, in patients with previously treated, relapsed or refractory 
multiple myeloma is ongoing in the UK and France. 

The Company also has greater China rights to Octreotide (Long Acting Injectable), a standard of care for the treatment of 
acromegaly and for the control of symptoms associated with certain neuroendocrine tumors; and Thiotepa, a cytotoxic agent which has 
a long history of established use in the hematology/oncology setting, the Company has an exclusive China license and distribution rights 
to  a  novel  formulation  of  thiotepa,  which  has  multiple  indications  including  use  as  a  conditioning  treatment  for  certain  allogeneic 
haemopoietic stem cell transplants.  However, due to the evolving standard of care environment, the rare and niche indication for these 
products, potential US regulatory action and the Company’s commitment to prioritize resources, the Company is currently evaluating 
its options for these products.  In addition, the Company’s assets include six FDA-approved ANDAs which the Company is evaluating 
due to generic drug pricing reforms by the Chinese government and its impact on the pricing and competitiveness of these products. 

CASI  has  built  a  fully  integrated,  world  class  biopharmaceutical  company  dedicated  to  the  successful  development  and 
commercialization of innovative and other therapeutic products. Our business development strategy is currently focused on acquiring 
additional targeted drugs and immuno-oncology therapeutics through licensing that will expand our hematology/oncology franchise. 
We use a market-oriented approach to identify pharmaceutical/biotechnology candidates that we believe to have the potential for gaining 
widespread  market  acceptance,  either  globally  or  in  China,  and  for  which  development  can  be  accelerated  under  our  global  drug 
development strategy. In many cases our business development strategy includes direct equity investments in the licensor company.  We 
intend  for  our  pipeline  to  reflect  a  diversified  and  risk-balanced  set  of  assets  that  include  (1) late-stage  clinical  drug  candidates  in-
licensed  for  China  or  global  regional  rights,  (2) proprietary  or  licensed  innovative  drug  candidates,  and  (3) select  high  quality 
pharmaceuticals that fit our therapeutic focus. We have focused on US/EU approved product candidates, and product candidates with 
proven  targets  or  product  candidates  that  have  reduced  clinical  risk  with  a  greater  emphasis  on  innovative  therapeutics.  Although 
oncology with a focus on hematological malignancies is our principal clinical and commercial target, we are opportunistic about other 
therapeutic areas that can address unmet medical needs. We will continue to pursue building a robust pipeline of drug candidates for 
development and commercialization in China as our primary market, and if rights are available for the rest of the world.  

We believe our China operations offer a significant market and growth potential due to the extraordinary increase in demand 
for high quality medicines coupled with regulatory reforms in China that facilitate the entry of new pharmaceutical products into the 
country.  We  will  continue  to  in-license  clinical-stage  and  late-stage  drug  candidates,  and  leverage  our  cross-border  operations  and 
expertise, and hope to be the partner of choice to provide access to the China market. We expect the implementation of our plans will 

46 

 
 
 
include leveraging our resources and expertise in both the U.S. and China so that we can maximize regulatory, development and clinical 
strategies in both countries. 

The Company’s commercial product, EVOMELA®, was originally licensed from Spectrum Pharmaceuticals, Inc. (“Spectrum”) 
and the Company had a supply agreement with Spectrum to support the Company’s application for import drug registration and for 
commercialization purposes. Spectrum completed the sale of its portfolio of FDA-approved hematology/oncology products including 
EVOMELA®  to  Acrotech  Biopharma  L.L.C.  (“Acrotech”)  on  March 1,  2019.  The  original  supply  agreement  with  Spectrum  was 
assumed by Acrotech; Spectrum agreed to continue with a short-term supply agreement for EVOMELA® for the initial commercial 
product supply in connection with the Company’s launch, with the long-term supply assumed by Acrotech.  

As part of the long-term strategy to support our future clinical and commercial manufacturing needs and to manage our supply 
chain for certain products, on December 26, 2018, we established CASI Wuxi, between the Company and Wuxi LP, to develop a future 
GMP manufacturing facility that will be located in the Wuxi Huishan Economic Development Zone in Jiangsu Province, China. In 
November 2019, CASI Wuxi entered into a fifty-year lease agreement for the right to use state-owned land in China for the construction 
of a GMP manufacturing facility. Pursuant to the agreement, CASI Wuxi has committed to invest land use right and property, plant and 
equipment  of  RMB1  billion  (equivalent  to  $143  million)  by  August 2022.  In  April 2020,  CASI  Wuxi  received  RMB  15.9  million 
(equivalent  to  $2.2  million)  from  the  Jiangsu  Province  Wuxi  Huishan  Economic  Development  Zone  as  government  grant  for  this 
development project which was recorded as deferred income in April 2020. In November 2021, CASI Wuxi received an additional RMB 
3.0 million (equivalent to $0.5 million) from the Jiangsu Province Wuxi Huishan Economic Development Zone as a government grant 
for this development project which was recorded as deferred income in November 2021. In 2020, for the design and construction work 
of the land, CASI Wuxi entered into several contracts for RMB 76.1 million ($12.0 million) to complete the phase 1 project of CASI 
Wuxi's research and development production base, the project was the estimated to be completed in October 2023. In February 2022, 
CASI Wuxi has reached an alignment with the Wuxi local government that it will collaborate with Wuxi LP to co-develop the land 
continuously in the future, and the development plan will be extended, details regarding the plan are under negotiation. Also in 2020, 
CASI Wuxi entered in to a lease agreement with local government for a manufactory building next to the leased land. Since then, the 
Company entered into a series of contracts for the remodeling and installation work of the building and warehouse, as well as purchase 
of equipments. The total contract amount entered into for this building is approximately RMB 92.9 million ($14.6 million). 

During the peak of the COVID-19 pandemic in 2020, we experienced disruptions to the EVOMELA® marketing and sales 
activities as well as to the supply chain for EVOMELA®. The COVID-19 pandemic also impacted our targeted start time of our CID-103 
trial due to the lock down of many medical facilities in Europe. During 2021, we have experienced minimal disruption to our business 
activities or supply chain as a result of the COVID-19 pandemic. Furthermore, in June 2021 we achieved the First-Patient-In (FPI) in 
the Phase 1 dose escalation and expansion study of CID-103 in patients with previously treated, relapsed or refractory multiple myeloma. 
The study is designed to assess the safety, tolerability, pharmacology and clinical activity of CID-103. 

We  currently  rely  on  a  single  source  for  the  supply  of  EVOMELA®.  The  continuation  of  the  COVID-19  pandemic  or  the 
emergence of new COVID-19 variants or new pandemics may affect the economies and financial markets of many countries, which 
may result in a period of economic slowdown or recessions. In such an event, our ability to continue to commercialize and expand 
distribution of EVOMELA® could be adversely affected if the supplier refuses or is unable to provide products for any reason (including 
the occurrence of an event like the COVID-19 pandemic that makes delivery impractical). We would have to work with Acrotech to 
negotiate  an  agreement  with  a  substitute  supplier,  which,  assuming  a  substitute  supplier  was  available,  would  likely  interrupt  the 
manufacturing of EVOMELA®, cause supply chain delays and increase costs. 

The COVID-19 pandemic has adversely affected, and may continue to adversely affect, the economies and financial markets 
of many countries, which may result in a period of regional, national, and global economic slowdown or regional, national, or global 
recessions that could affect our ability to continue to commercialize and expand distribution of EVOMELA® (Melphalan For Injection) 
or other drugs in our existing product pipeline. Early in the COVID-19 pandemic, we experienced a disruption to our supply chain for 
EVOMELA®,  we  have  experienced  no  supply  disruption  in  2021;  however,  there  can  be  no  assurance  that  restrictions  will  not  be 
imposed again. In addition, economic and other uncertainties may adversely affect other parties’ willingness to negotiate and execute 
product licenses and thus hamper our ability to in-license clinical-stage and late-stage drug candidates in China or elsewhere. 

47 

CRITICAL ACCOUNTING POLICIES AND THE USE OF ESTIMATES 

The preparation of our financial statements in conformity with accounting principles generally accepted in the United States 
requires management to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and 
accompanying notes. Actual results could differ materially from those estimates. Our critical accounting policies, including the items in 
our financial statements requiring significant estimates and judgments, are as follows: 

Stock-Based Compensation 

We record compensation expense associated with service and performance-based stock options in accordance with provisions 
of authoritative guidance. The estimated fair value of service-based awards is measured on the grant date and is generally amortized on 
a straight-line basis over the requisite service period and based on the proportionate amount of the requisite service period that has been 
rendered  during  each  reporting  period.  The  estimated  fair  value  of  performance-based  awards  is  measured  on  the  grant  date  and  is 
recognized when it is determined that it is probable that the performance condition will be achieved. If the required vesting conditions 
are not met resulting in the forfeiture of the share-based awards, previously recognized compensation expense relating to those awards 
are reversed as occurred. 

Grant date fair value was determined using an option pricing model which is affected by the fair value of underlying ordinary 
shares as well as assumptions regarding a number of complex and subjective variables, such as expected volitality, expected term of 
options, risk-free rate, and expected dividend yield. 

Fair value measurement of investment in equity interests of Juventas Cell Therapy Ltd. using the measurement alternative 

The investment in the equity interests of Juventas was accounted for as an investment in equity securities using the measurement 
alternative at its cost, minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions 
for the identical or a similar investment of the same issuer, as the fair value of the equity securities of Juventas is not readily determinable. 
The fair value of such investment was determined based on the price in the orderly transaction for newly issued equity interests of 
Juventas, which is further adjusted to reflect the differences between the newly issued equity interests of Juventas and the Company’s 
investment.  

RESULTS OF OPERATIONS 

Years Ended December 31, 2021 and 2020. 

Operating Items 

Revenues 

Product Sales 

Revenues consist of product sales of EVOMELA® that launched during August 2019. Revenue was $30.0 million for the year 
ended December 31, 2021, compared to $15.0 million for the year ended December 31, 2020. Revenues increased by 100% in the year 
ended December 31, 2021, as compared to same period in 2020 due to the continued growth in EVOMELA® sales.   

Lease Income 

Lease income consists primarily of an equipment lease with Juventas (a related party). Lease income was $148,000 for the year 

ended December 31, 2021 compared to $140,000 for the year ended December 31, 2020. 

Operating Expenses 

Costs of Revenues 

Costs of revenues consists primarily of the cost of inventories of EVOMELA® and sales-based royalties related to the sale of 

EVOMELA®. 

48 

Costs of revenues were $12.6 million for the year ended December 31, 2021, as compared to $9.5 million for the year ended 
December 31, 2020. The increase of costs of revenues primarily resulted from the increase of EVOMELA sales during the same period. 
Included in our costs of revenues are royalty amounts of $5.9 million for the year ended December 31, 2021 and $3.0 million for the 
year  ended  December 31,  2020.  The  other  primary  components  of  our  costs  of  revenues  are  cost  of  goods  sold,  which  were 
approximately  $6.6 million and $6.6 million for the years ended December 31, 2021 and 2020, and as a percentage of revenues were 
22% in the year ended December 31, 2021, compared to 44% in the year ended December 31, 2020, with such decrease as a percentage 
of  revenue  mainly due  to  the  alternate manufacturer  in place,  resulting  in  a  considerable  decrease  in the  unit  cost of  inventories  of 
EVOMELA.  

Research and Development Expenses 

Research  and  development  (R&D)  expenses  consist  primarily  of  compensation  and  other  expenses  related  to  research  and 
development personnel, research collaborations, costs associated with internal and contract preclinical testing and clinical trials of our 
product candidates, including the costs of drug substance and drug product, regulatory maintenance costs of ANDAs, facilities expenses, 
and amortization expense of acquired ANDAs. 

Research and development expenses for the year ended December 31, 2021 were $14.4 million, compared with $11.5 million 
for the year ended December 31, 2020. The increase in R&D expenses primarily due to an increase in R&D expenses incurred related 
to the development of CID-103, BI-1206 and CB-5339. 

General and Administrative Expenses 

General  and  administrative  expenses  include  compensation  and  other  expenses  related  to  executive,  finance,  business 

development and administrative personnel, professional services, investor relations and facilities. 

General and administrative expenses for the year ended December 31, 2021 were $23.8 million, compared with $19.7 million 
for  the year  ended  December 31,  2020.  The  increase  in  general  and  administrative  expenses  was  primarily  due  to  an  increase  in 
headcount and payroll expenses amounted to $2.7 million and an increase in professional fees amounted to $1.9 million. 

Selling and Marketing Expenses 

Selling  and  marketing  expenses  are  the  direct  costs  related  to  the  sales  of  EVOMELA®  that  was  launched  in  China  in 

August 2019, such as sales force salaries, bonuses, advertising, and other marketing efforts. 

Selling and marketing expenses for the year ended December 31, 2021, were $14.7 million, compared with $7.8 million for 
the year ended December 31, 2020.  The increase is primarily due to the increase of sales commission in accordance with the  increase 
sales of EVOMELA. 

Gain on disposal of intangible assets 

There was no gain on disposal of intangible assets for the year ended December 31, 2021. 

Gain on disposal of intangible assets for the year ended December 31, 2020 was $1.2 million. The gain on disposal during 2020 

was primarily due to the $1.2 million gain on the sale of twenty-one ANDAs during the year. 

Impairment of intangible assets 

There was no impairment of intangible assets for the year ended December 31, 2021. 

Impairment of intangible assets for the year ended December 31, 2020 was $1.5 million. The impairment of intangible assets 

was primarily due to the reduction of the carrying value of intangible assets to their fair value. 

Acquired in-process Research and Development Expenses 

Acquired in-process R&D expenses for the year ended December 31, 2021 were $6.6 million, compared with $17.8 million for 
the year ended December 31, 2020. The amount reported for the year ended December 31, 2021 consisted of the upfront payment of 
$5.5 million to Cleave for the development of CB-5339 and milestone payments to Alesta of $1.06 million for the development of 

49 

CID-103. The amount reported for the year ended December 31, 2020 comprised of milestone fees paid to Pharmathen of $1.7 million, 
to Juventas of $10.3 million and to BioInvent of $5.9 million, respectively.  

Non-Operating Items 

Interest income, net 

Interest income, net for the year ended December 31, 2021 was $0.3 million compared with $0.9 million for the year ended 
December 31, 2020. The decrease in interest income, net, is mainly due to that the amount reported for the year ended December 31, 
2020 included interest income from loans made to Juventas (a related party) which was repaid in September 2020. 

Other income  

Other income for the year ended December 31, 2021 was $558,000, compared with $82,000 for the year ended December 31, 
2020.  Other income of $51,000 and $35,000 recorded in the years ended December 31, 2021 and 2020, relate to CASI Wuxi’s receipt 
of RMB 15.9 million (equivalent to $2.2 million) in April 2020, and RMB 3.0 million (equivalent to $0.5 million) in November 2021 
from the Jiangsu Province Wuxi Huishan Economic Development Zone as government grant for the development of leased state-owned 
land in China for the construction of a manufacturing facility. The grants were recorded as deferred income and amortized over the term 
of the lease of the land. Other income of $471,807 recorded in the year ended December 31, 2021 relates to the loan to the Company 
under the Paycheck Protection Program (PPP) that was forgiven in September 2021. 

Foreign exchange gains and losses 

Foreign exchange gains (losses) for the year ended December 31, 2021 was gain of $0.3 million compared with losses of $1.3 
million  for  the  year  ended  December 31,  2020.  The  foreign  exchange  gains  (losses)  are  primarily  due  to  accounts  receivable  with 
CRPCGIT and USD denominated cash accounts that are held by our Chinese subsidiaries. 

Change in fair value of investments 

The change in fair value of investments for the years ended December 31, 2021 and 2020 was $5.7 million and $4.3 million 
respectively.  The  changes  represent  unrealized  gains  or  losses  on  the  Company’s  investments  in  equity  securities  and  long-term 
investment. 

Impairment loss of long-term investments 

Impairment loss of long-term investments for the year ended December 31, 2021 was $865,000 relating to the investment in a 
privately held UK Company, Black Belt Tx”. The Company did not record any impairment loss of long-term investments during the 
year ended December 31, 2020. 

LIQUIDITY AND CAPITAL RESOURCES 

To date, the Company has been engaged primarily in research and development activities. As a result, the Company has incurred 

and expect to continue to incur operating losses in 2022 and the foreseeable future.  

The Company will require significant additional funding to fund operations beyond the first quarter of 2023 until such time, if 
ever, it becomes profitable. The Company intends to augment its cash balances by pursuing other forms of capital infusion, including 
strategic  alliances  or  collaborative  development  opportunities  with  organizations  that  have  capabilities  and/or  products  that  are 
complementary to its capabilities and products in order to continue the development of its potential product candidates that they intend 
to  pursue  to  commercialization.  If  the  Company  seeks  strategic  alliances,  licenses,  or  other  alternative  arrangements,  such  as 
arrangements with collaborative partners or others, to raise further financing, it may need to relinquish rights to certain of its existing 
product candidates, or products they would otherwise seek to develop or commercialize on its own, or to license the rights to its product 
candidates on terms that are not favorable to it. 

The Company will also continuously invest in its development of the Wuxi land and construction of the manufacturing building. 
Commencing from the fourth quarter of 2020, in relation to the development of the Wuxi land and construction of the manufacturing 

50 

building, the Company entered into a series of contracts for the development and construction work. Total commitment under these 
contracts was RMB 69.1 million ($10.8 million) as of December 31, 2021.  

The Company will continue to seek to raise additional capital to fund its commercialization efforts, expansion of its operations, 
capital expenditure, research and development, and for the acquisition of new product candidates, if any. The Company intends to and 
is currently actively communicating to explore one or more of the following alternatives to raise additional capital: 

• 

• 
• 

• 

• 

raising bank loans; 

selling additional equity securities; 

out-licensing product candidates to one or more corporate partners; 

completing an outright sale of non-priority assets; and/or 

engaging in one or more strategic transactions. 

The Company also will continue to manage its cash resources prudently and cost-effectively. 

There can be no assurance that adequate additional financing under such arrangements will be available to the Company on 
terms that they deem acceptable, if at all. If additional funds are raised by issuing equity securities, dilution to existing stockholders may 
result, or the equity securities may have rights, preferences, or privileges senior to those of the holders of its common stock. If they fail 
to obtain additional capital when needed, they may be required to delay or scale back their commercialization efforts, advancement of 
the Spectrum products, and the ANDA products, or plans for other product candidates, if any. 

Since its inception in 1991, the Company has incurred significant losses from operations and, as of December 31, 2021, has 
incurred an accumulated deficit of $605.6 million. As of December 31, 2021, the Company had a consolidated balance of cash and cash 
equivalents of $38.7 million. The Company believes that it has sufficient resources to fund its operations at least one year beyond the 
date that the audited consolidated financial statements are issued. 

FINANCING ACTIVITIES 

Stock repurchase program 

On December 15, 2021, our board of directors approved a stock repurchase program for the repurchase of up to USD 10 million 
of our common stock (and no more than 12,500,000 shares of our common stock) through open market purchases in compliance with 
Rule 10b-18 under the Securities Exchange Act of 1934 and through trading plans established pursuant to Rule 10b5-1 of the Securities 
Exchange  Act.  Under  any  Rule  10b5-1  trading  plan  we  might  adopt,  our  third-party  broker,  subject  to  Securities  and  Exchange 
Commission regulations regarding certain price, market, volume and timing constraints, would have authority to purchase our common 
stock in accordance with the terms of the plan. The actual timing, number and value of shares repurchased under the stock repurchase 
program will depend on a number of factors, including constraints specified in any Rule 10b5-1 trading plans, price, general business 
and market conditions, and alternative investment opportunities. Subject to the purchase terms under our existing and future Rule 10b5-1 
trading plans, the stock repurchase program does not obligate the Company to acquire any specific number of shares in any period, and 
may be expanded, extended, modified or discontinued at any time. The Company has funded and anticipates funding for stock repurchase 
program to come from available corporate funds, including cash on hand and future cash flow. As of March 18, 2022, the Company has 
repurchased 3,207,661 shares of common stock for an aggregate of $2.5 million under a Rule 10b5-1 trading plan that will terminate on 
March 31, 2022. 

March 2021 Underwritten Public Offering  

On March 24, 2021, the Company closed an underwritten public offering of 15,853,658 shares of the Company’s common 
stock (the “Offering”) at a price to the public of $2.05 per share. The gross proceeds to CASI from the Offering were $32.5 million 
before deducting the underwriting discounts and commissions and offering expenses payable by CASI. 

The Offering was made by means of a written prospectus supplement and accompanying prospectus forming part of a shelf 
registration statement on Form S-3, previously filed with the SEC on November 20, 2020, which was declared effective on December 2, 
2020. We have filed a final prospectus supplement, dated March 24, 2021, with the SEC relating to the Offering. 

51 

 
 
 
  
 
The Company is using the net proceeds of this offering for working capital and general corporate purposes, which include, but 
are  not  limited  to  advancing  the  Company’s  product  portfolio,  acquiring  the  rights  to  new  product  candidates  and  general  and 
administrative expenses. 

July 2020 Underwritten Public Offering 

On July 24, 2020, the Company closed an underwritten public offering of 23 million shares of common stock (the "Offering") 
and  received  gross  proceeds  of  $43.7  million  before  deducting  the  underwriting  discounts  and  commissions  and  offering  expenses 
payable by CASI. Certain insiders, including CASI's Chairman and CEO, and CASI's President, purchased shares of common stock in 
the Offering at the public offering price and on the same terms as the other purchasers in this Offering. CASI's Chairman and CEO 
purchased 2,952,426 shares directly and ETP Global Fund LP purchased 1,200,000 shares. CASI's President purchased 20,152 shares. 

Sales Agreements 

On February 23, 2018, the Company entered into a Common Stock Sales Agreement (the “Sales Agreement”), as amended,  

with H.C. Wainwright & Co., LLC (“HCW”) that would allow the Company to sell up to $20 million of shares of common stock in “at-
the-market”  transactions,  subject  to  compliance  with  the  terms  and  conditions  of  the  Sales  Agreement.  During  the  year  ended 
December 31, 2021, the Company has not offered and sold any shares of common stock under the Sales Agreement, and a total of 
143,248  shares,  resulting  in  net  proceeds  to  the  Company  of  $475,000  have  been  issued  since  inception.  During  the  year  ended 
December 31, 2021, the Company has not offered and sold any shares of common stock under the Sales Agreement. Concurrently with 
and  upon  the  execution  of  the  new  Stock  Sales  Agreement  mentioned  below,  the  Sales  Agreement  dated  as  of  February 23,  2018, 
between CASI and HCW, was terminated by mutual agreement of the parties.   

On July 19, 2019, the Company entered into an Open Market Sale AgreementSM with Jefferies LLC, as sales agent (the “Open 
Market Agreement”) pursuant to which the Company may elect to sell from time to time, at its option, up to $30 million in shares of the 
Company’s common stock, subject to the terms and conditions of the Open Market Agreement.  In 2019, the Company issued 59,000 
shares under the Open Market Agreement resulting in net proceeds to the Company of $182,000. In 2020, there were 434,000 shares 
issued under the Open Market Agreement with net proceeds of $1,357,000. During the year ended December 31, 2021, the Company 
has not offered and sold any shares of common stock under the Open Market Agreement. As of March 25, 2022, the Company has 
issued 493,000 shares with net proceeds of $1,539,000. As of March 25, 2022, $28.5 million remained available under the Open Market 
Agreement. 

On October 29, 2021, the Company has entered into a common stock sales agreement (“Stock Sales Agreement”), with H.C. 
Wainwright & Co., LLC, relating to shares of common stock of the Company. In accordance with the terms of the sales agreement, the 
Company  may  offer  and  sell  shares  of  common  stock  in  “at-the-market”  transactions,  subject  to  compliance  with  the  terms  and 
conditions  of  the  Stock  Sales  Agreement,  with  an  aggregate  offering  price  of  no  more  than  $20,000,000.  During  the  year  ended 
December 31, 2021, the Company has not offered or sold any shares of common stock under the sales agreement. As of March 25, 2022, 
the Company has not offered or sold any shares of common stock under the sales agreement. 

INTEREST RATE CHANGES 

Management does not believe that our working capital needs are sensitive to changes in interest rates. 

OFF-BALANCE-SHEET ARRANGEMENTS 

We had no off-balance sheet arrangements. 

ITEM 7A.  QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK. 

We are a smaller reporting company as defined by Rule 12b-2 of the Securities Exchange Act of 1934 and are not required to 

provide the information under this item. 

ITEM 8. 

FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA. 

The response to this item is submitted in a separate section of this report. See Index to Consolidated Financial Statements on 

page F-1. 

52 

 
 
 
 
ITEM 9. 
DISCLOSURE. 

CHANGES  IN  AND  DISAGREEMENTS  WITH  ACCOUNTANTS  ON  ACCOUNTING  AND  FINANCIAL 

None. 

ITEM 9A. CONTROLS AND PROCEDURES. 

Disclosure Controls and Procedures 

As of December 31, 2021, we carried out an evaluation, under the supervision and with the participation of our management, 
including our Chief Executive Officer and Principal Financial Officer of the effectiveness of the design and operation of our disclosure 
controls  and  procedures  (as  defined  in  the  Securities  Exchange  Act  of  1934  Rules 13a-15(e) and  15d-15(e)).  Our  Chief  Executive 
Officer,  and  Principal  Financial  Officer    have  concluded  that  our  disclosure  controls  and  procedures  are  effective  to  ensure  that 
information  required  to  be  disclosed  by  us  in  the  reports  that  we  file  or  submit  under  the  Exchange  Act  is  recorded,  processed, 
summarized and reported within the time periods specified in the rules and forms of the Securities and Exchange Commission and that 
such information is accumulated and communicated to our management (including our Chief Executive Officer, and Principal Financial 
Officer ) to allow timely decisions regarding required disclosures. Based on such evaluation, our Chief Executive Officer, and Principal 
Financial Officer  have concluded these disclosure controls and procedures are effective as of December 31, 2021. 

Changes in Internal Control Over Financial Reporting 

There have not been any changes in our internal control over financial reporting during the fourth quarter ended December 31, 

2021 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting. 

Management’s 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 Securities Exchange Act Rules 13a-15(f) and 15d-15(f). Our internal control over financial reporting is designed to 
provide  reasonable  assurance  to  our  management  and  board  of  directors  regarding  the  reliability  of  financial  reporting  and  the 
preparation  and  fair  presentation  of  financial  statements  for  external  purposes  in  accordance  with  generally  accepted  accounting 
principles. Any internal control over financial reporting, no matter how well designed, has inherent limitations. As a result of these 
inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Therefore, even those internal 
controls  determined  to  be  effective  can  provide  only  reasonable  assurance  with  respect  to  reliability  of  financial  reporting  and  the 
preparation of financial statements for external purposes in accordance with generally accepted accounting principles. 

Under the supervision and with the participation of our management, including our Chief Executive Officer, and Principal 
Financial Officer, we conducted an assessment of the effectiveness of our internal control over financial reporting using the criteria set 
forth  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission  (COSO)  in  Internal  Control —  Integrated 
Framework  2013.  Based  on  our  assessment,  we  concluded  that  our  internal  control  over  financial  reporting  was  effective  as  of 
December 31, 2021.  

ITEM 9B. OTHER INFORMATION. 

Annual Meeting of Stockholders 

Our 2022 Annual Meeting of Stockholders will be held on May 25, 2022. Further information will be provided in our proxy 

statement that will be filed with the SEC and mailed to stockholders of record as soon as practicable. 

53 

 
 
 
 
 
 
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE. 

PART III 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  the  Company’s  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of the Company’s 
fiscal year ended December 31, 2021. 

We  have  adopted  a  Code  of  Ethics,  as  defined  in  applicable  SEC  rules,  that  applies  to  directors,  officers  and  employees, 
including  our  chief  executive  officer  and  principal  financial  officer.  The  Code  of  Ethics  is  available  on  the  Company’s  website  at 
www.casipharmaceuticals.com. 

ITEM 11. EXECUTIVE COMPENSATION. 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  the  Company’s  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of the Company’s 
fiscal year ended December 31, 2021. 

ITEM 12.  SECURITY  OWNERSHIP  OF  CERTAIN  BENEFICIAL  OWNERS  AND  MANAGEMENT  AND  RELATED 
STOCKHOLDER MATTERS. 

The information required under this item, with the exception of information relating to compensation plans under which equity 
securities of the Company are authorized for issue, which appears below, is incorporated herein by reference to the Company’s definitive 
proxy statement pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of 
the Company’s fiscal year ended December 31, 2021. 

Options under Employee Benefit Plans.    The following table discloses certain information about the options issued and 

available for issuance under all outstanding Company option plans, as of December 31, 2021. 

Plan category 
Equity compensation plans approved by security holders

(a)

(b) 

  Weighted-average 
exercise price of 

  Number of securities to 
  be issued upon exercise  
  of outstanding options,   outstanding options,   
  warrants and rights   
 2.04  

warrants and rights 
33,243,790

$

(c)
  Number of securities 
  remaining available for
  future issuance under 
  equity compensation 

plans [excluding 
securities reflected in
column (a)] 

10,515,448

Warrants issued under the unauthorized plans represent compensation for consulting services rendered by the holders. 

ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE. 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  the  Company’s  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of the Company’s 
fiscal year ended December 31, 2021. 

ITEM 14. PRINCIPAL ACCOUNTING FEES AND SERVICES. 

The  information  required  under  this  item  is  incorporated  herein  by  reference  to  the  Company’s  definitive  proxy  statement 
pursuant to Regulation 14A, which proxy statement will be filed with the SEC not later than 120 days after the close of the Company’s 
fiscal year ended December 31, 2021. 

54 

 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PART IV 

ITEM 15. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES. 

(a)  1. FINANCIAL STATEMENTS - See index to Consolidated Financial Statements. 

2. Schedules 

All financial statement schedules are omitted because they are not applicable, not required under the instructions or all the 

information required is set forth in the financial statements or notes thereto. 

3. Exhibits 

1.1  Open  Market  Sale  Agreement  SM  by  and  between  CASI  Pharmaceuticals, Inc.  and  Jefferies  LLC  dated  July 19,  2019 

(incorporated by reference from Exhibit 1.1 to our Current Report on Form 8-K filed on July 19, 2019) 

1.2  Common Stock Sales Agreement, dated October 29, 2021, by and between CASI Pharmaceuticals, Inc. and H.C. Wainwright &
Co., LLC (incorporated by reference to Exhibit 1.1 on our Form 8-K filed with the Securities and Exchange Commission on 
October 29, 2021) 

3.1  Restated Certificate of Incorporation of CASI Pharmaceuticals, Inc. (incorporated by reference to exhibit 3.1 on our Form 10-Q 

for the quarter ended June 30, 2019 filed with the Securities and Exchange Commission on August 9, 2019)

3.2  Amended and Restated Bylaws dated September 10, 2020 (incorporated by reference to Exhibit 3.2 of our 10-Q/A filed with the 

Securities and Exchange Commission on February 10, 2021)

4.1  Description of Common Stock (incorporated by reference to Exhibit 4.1 of our Form 10-K filed with the Securities and Exchange 

Commission on March 30, 2021) 

4.2 

4.3 

4.4 

Form of Common Stock Purchase Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K filed with the Securities 
and Exchange Commission on October 19, 2017)

Form of Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K filed with the Securities and Exchange Commission 
on March 23, 2018) 

Form of Warrant (incorporated by reference to Exhibit 4.1 of our Form 8-K filed with the Securities and Exchange Commission 
on September 14, 2018) 

10.1  Form of Change in Control Agreement* (incorporated by reference to Exhibit 10.1 of our Form 8-K filed with the Securities and 

Exchange Commission on April 17, 2007) 

10.2  First Amendment to Change in Control Agreement by and between the Company and Alexander Zukiwski* (incorporated by

reference to Exhibit 10.3 of our Form 8-K filed with the Securities and Exchange Commission on December 10, 2021)

10.3  License  Agreement,  dated  as  of  September 17,  2014,  by  and  between  CASI  Pharmaceuticals, Inc.  and  Spectrum 
Pharmaceuticals, Inc. ++ (incorporated by reference to Exhibit 10.4 of our Form 10-K filed with the Securities and Exchange 
Commission on March 30, 2021) 

10.4  License Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. and Spectrum Pharmaceuticals
Cayman, L.P. ++ (incorporated by reference to Exhibit 10.5 of our Form 10-K filed with the Securities and Exchange Commission 
on March 30, 2021) 

10.5  License Agreement, dated as of September 17, 2014, by and between CASI Pharmaceuticals, Inc. and Talon Therapeutics, Inc. 
++ (incorporated by reference to Exhibit 10.6 on our Form 10-K filed with the Securities and Exchange Commission on March 30, 
2021) 

55 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.6  Employment Agreement by and between CASI Pharmaceuticals, Inc. and Alex Zukiwski, dated as of April 3, 2017* (incorporated 
by reference to Exhibit 10.1 of our Form 10-Q filed with the Securities and Exchange Commission on August 14, 2017)

10.7  First Amendment to the Employment Agreement by and between CASI Pharmaceuticals, Inc. and Alexander Zukiwski, dated as
of  December 9,  2021*  (incorporated  by  reference  to  Exhibit  10.1  on  our  Form 8-K  filed  with  the  Securities  and  Exchange 
Commission on December 10, 2021) 

10.8  Asset  Purchase  Agreement  dated  as  of  January 26,  2018  by  and  between  CASI  Pharmaceuticals,  Inc.  and  Sandoz  Inc.  ++
(incorporated by reference to Exhibit 10.8 of our Form 10-K filed with the Securities and Exchange Commission on March 30, 
2021)  

10.9  Memorandum of Understanding, dated November 16, 2018, by and between Management Committee of Wuxi Huishan Economic
Development Zone and CASI Pharmaceuticals, Inc. (incorporated by reference to Exhibit 10.20 of our Form 10-K filed with the 
Securities and Exchange Commission on March 29, 2019)

10.10  Investment  Agreement,  dated  November 16,  2018,  by  and  between  Administrative  Committee  of  Wuxi  Huishan  Economic 
Development  Zone,  Jiangsu  Province  and  CASI  Pharmaceuticals,  Inc.  (incorporated  by  reference  to  Exhibit  10.21  on  our
Form 10-K filed with the Securities and Exchange Commission on March 29, 2019)

10.11  Supplementary Agreement, dated November 16, 2018, by and between Administrative Committee of Wuxi Huishan Economic
Development  Zone,  Jiangsu  Province  and  CASI  Pharmaceuticals, Inc.  (incorporated  by  reference  to  Exhibit 10.22  on  our 
Form 10-K filed with the Securities and Exchange Commission on March 29, 2019)

10.12  Shareholders’ Agreement, dated November 16, 2018, between CASI Pharmaceuticals, Inc. and Wuxi Jintou Huicun Investment 
Enterprise  (Limited  Partnership)  (incorporated  by  reference  to  Exhibit 10.23  on  our  Form 10-K  filed  with  the  Securities  and
Exchange Commission on March 29, 2019) 

10.13  Lease Contract, by and between Wuxi Huishan New City Life Science & Technology Industry Development Co., Ltd. and CASI 
Pharmaceuticals, Inc.  (incorporated  by  reference  to  Exhibit 10.24  on  our  Form 10-K  filed  with  the  Securities  and  Exchange 
Commission on March 29, 2019) 

10.14  Joint Venture Contract on Establishment of CASI (Wuxi) Pharmaceuticals Co. Ltd. by and between CASI Pharmaceuticals, Inc. 
and Wuxi Jintou Huicun Investment Enterprise Limited Partnership, dated as of November 16, 2018 (incorporated by reference
to Exhibit 10.25 on our Form 10-K filed with the SEC on March 29, 2019)

10.15  Labor  Contract,  effective  as  of  September 1,  2018,  between  CASI  (Beijing)  Pharmaceuticals, Inc.  and  Wei  (Larry)  Zhang* 

(incorporated by reference to Exhibit 10.26 to the Company’s Form 10-K filed with the SEC on March 29, 2019)

10.16  CASI Pharmaceuticals, Inc. 2011 Long Term Incentive Plan, as amended* (previously filed with, and incorporated herein by

reference to the Company’s Definitive Proxy Statement filed on April 30, 2019)

10.17  CASI Pharmaceuticals, Inc. 2021 Long Term Incentive Plan, as amended* (previously filed with, and incorporated herein by

reference to the Company’s Definitive Proxy Statement filed on May 10, 2021)

10.18  Exclusive Distribution Agreement, effective as of March 5, 2019, by and among CASI Pharmaceuticals, Inc, China Resources
Guokang Pharmaceuticals Co., Ltd. and CASI (Beijing) Biopharmaceuticals Technology Co., Ltd. (incorporated by reference to
Exhibit 10.1 to the Quarterly Report filed May 15, 2019)

10.19  Offer  Letter  from  CASI  Pharmaceuticals, Inc.  to  Dr. He  dated  March 22,  2019,  effective  April 2,  2019*  (incorporated  by 

reference to Exhibit 10.2 to the Quarterly Report filed May 15, 2019)

10.20  License Agreement by and between CASI Pharmaceuticals, Inc. and Black Belt Therapeutics Limited entered into as of April 16, 

2019 (incorporated by reference to Exhibit 10.3 to the Quarterly Report filed May 15, 2019)+ 

10.21  Exclusive License Agreement by and between CASI Pharmaceuticals, Inc. and Juventas Cell Therapy Ltd effective June 15, 2019 

(incorporated by reference to Exhibit 10.1 to the Company’s Form 10-Q filed on August 9, 2019)+ 

56 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.22  Investment Agreement in respect of Juventas Cell Therapy Ltd effective June 15, 2019 (incorporated by reference to Exhibit 10.2 

to the Company’s Form 10-Q filed on August 9, 2019)+

10.23  Contract  for  Assignment  of  the  Right  to  the  Use  of  the  State-owned  Construction  Land  (no.  3202842019CR0019)  dated
November 15, 2019 (incorporated by reference to Exhibit 10.22 on our Annual Report on Form 10-K filed on March 16, 2020).

10.24  Form of  CASI  Pharmaceuticals, Inc.  Performance-Contingent  2011  Long-Term  Incentive  Plan  Non-Qualified  Stock  Option 
Grant Agreement (for Optionees in China)* (incorporated by reference to Exhibit 4.1 on our Quarterly Report on Form 10-Q 
filed May 15, 2019) 

10.25  Form of CASI Pharmaceuticals, Inc. Performance-Contingent 2021 Long-Term Incentive Plan Non-Qualified Stock Option Grant
Agreement (for Optionees in China)* (incorporated by reference to Exhibit 10.1 on our Quarterly Report on Form 10-Q filed 
August 12, 2021) 

10.26  Form of  CASI  Pharmaceuticals, Inc.  2011  Long-Term  Incentive  Plan  Non-Qualified  Stock  Option  Grant  Agreement  (for 
Optionees in China)* (incorporated by reference to Exhibit 4.2 on our Quarterly Report on Form 10-Q filed May 15, 2019)

10.27  Form of  CASI  Pharmaceuticals,  Inc.  2021  Long-Term  Incentive  Plan  Non-Qualified  Stock  Option  Grant  Agreement  (for 

Optionees in China) (incorporated by reference to Exhibit 10.2 on our Quarterly Report on Form 10-Q filed August 12, 2021)

10.28  Form of CASI Pharmaceuticals, Inc. Performance-Contingent 2011 Long-Term Incentive Plan Non-Qualified Stock Option Grant 
Agreement (for Optionees in the US)* (incorporated by reference to Exhibit 4.3 on our Quarterly Report on Form 10-Q filed 
May 15, 2019) 

10.29  Form of  CASI  Pharmaceuticals, Inc.  Performance-Contingent  2021  Long-Term  Incentive  Plan  Non-Qualified  Stock  Option 
Grant Agreement (for Optionees in the US)* (incorporated by reference to Exhibit 10.3 on our Quarterly Report on Form 10-Q 
filed August 12, 2021) 

10.30  Form of  CASI  Pharmaceuticals, Inc.  2011  Long-Term  Incentive  Plan  Non-Qualified  Stock  Option  Grant  Agreement  (for 
Optionees in the US)* (incorporated by reference to Exhibit 4.4 on our Quarterly Report on Form 10-Q filed May 15, 2019)

10.31  Form of  CASI  Pharmaceuticals,  Inc.  2021  Long-Term  Incentive  Plan  Non-Qualified  Stock  Option  Grant  Agreement  (for 
Optionees in the US)* (incorporated by reference to Exhibit 10.4 on our Quarterly Report on Form 10-Q filed August 12, 2021)

10.32  Supplementary Agreement to the Exclusive License Agreement effective as of September 29, 2020++ (incorporated by reference 

to Exhibit 10.1 on our Quarterly Report on Form 10-Q filed on November 9, 2020)

10.33  Investment Agreement by and between Juventas Cell Therapy Ltd and CASI Biopharmaceuticals (WUXI) Co., Ltd. effective as
of September 22, 2020++ (incorporated by reference to Exhibit 10.2 on our Quarterly Report on Form 10-Q filed on November 9, 
2020) 

10.34  License and Development Agreement, dated March 5, 2021, between the Company and Cleave Therapeutics Inc., (incorporated 

by reference to Exhibit 10.1 on our Quarterly Report on Form 10-Q filed on May 13, 2021)++ 

10.35  License  and  Development  Agreement  for  BI-1206  dated  October 26,  2020  by  and  between  the  Company  and  BioInvent, 

International AB ++ (incorporated by reference to Exhibit 10.30 to the Annual Report on Form 10-K filed on March 30, 2021)

21 

Subsidiaries of the Registrant ** 

23.1  Consent of Independent Registered Public Accounting Firm **

31.1  Rule 13a-14(a) Certification of Chief Executive Officer **

31.2  Rule 13a-14(a) Certification of Principal Financial Officer **

32.1  Rule 13a-14(b) Certification by Chief Executive Officer **

57 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
32.2  Rule 13a-14(b) Certification by Principal Financial Officer **

101** Interactive Data Files The following financial information from the Registrant’s Annual Report on Form 10-K for the year ended 
December 31, 2021, formatted in Inline eXtensible Business Reporting Language (XBRL): (i) Consolidated Balance Sheets as
of  December 31,  2021  and  2020,  (ii) Consolidated  Statements  of  Operations  and  Comprehensive  Loss  for  the years  ended 
December 31, 2010 and 2020, (iii) Consolidated Statements of Stockholders’ Equity for the years ended December 31, 2020 and 
2019 (iv) Consolidated Statements of Cash Flows for the years ended December 31, 2021 and 2020 and (v) Notes to Consolidated 
Financial Statements. 

104  Cover Page Interactive Data File (formatted in Inline XBRL and Contained in Exhibit 101)

*     Management Contract or any compensatory plan, contract or arrangement. 

+    Certain  portions  of  this  exhibit  have  been  omitted  based  upon  a  request  for  confidential  treatment  under  17  C.F.R.  section 
200.80(b)(4) and 240.24b-2.  The confidential portions of this exhibit have been omitted and are marked accordingly.  The confidential 
portions have been filed separately with the Commission pursuant to our confidential treatment request. 

++   Information  in  this  exhibit  identified  by  brackets  is  confidential  and  has  been  excluded  pursuant  to  Item  601(B)(10)(IV) of 
Regulation S-K because it (i) is not material and (ii) would likely cause competitive harm to CASI Pharmaceuticals, Inc. if publicly 
disclosed. 

**    Filed herewith 

58 

 
 
 
 
 
 
 
SIGNATURES 

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this 

report to be signed on its behalf by the undersigned, thereunto duly authorized. 

Date: March 28, 2022 

CASI Pharmaceuticals, Inc.

By:/s/Wei-Wu He
Wei-Wu He
Chief Executive Officer

Pursuant to the requirements of the Securities Act of 1934, this report has been signed below by the following persons in the 

capacities and on the dates indicated. 

SIGNATURE 

/s/ Wei-Wu He 
Wei-Wu He 

/s/ Larry (Wei) Zhang 
Larry (Wei) Zhang 

/s/ James Z. Huang 
James Z. Huang 

/s/ Franklin C. Salisbury 
Franklin C. Salisbury 

/s/ Rajesh C. Shrotriya 
Rajesh C. Shrotriya 

/s/ Y. Alexander Wu 
Y. Alexander Wu  

/s/ Quan Zhou 
Quan Zhou 

      TITLE 

Chief Executive Officer and Chairman
(Principal Executive Officer)

DATE 

March 28, 2022 

President (Principal Financial Officer)

March 28, 2022 

Director

Director

Director

Director

Director

March 28, 2022 

March 28, 2022 

March 28, 2022 

March 28, 2022 

March 28, 2022 

59 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(This page has been left blank intentionally.)

The following consolidated financial statements of CASI Pharmaceuticals, Inc. are included in Item 8: 

Report of Independent Registered Public Accounting Firm (PCAOB ID 1186)
Consolidated Balance Sheets as of December 31, 2021 and 2020 
Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 2021 and 2020 
Consolidated Statements of Stockholders’ Equity for the years ended December 31, 2021 and 2020 
Consolidated Statements of Cash Flows for the years ended December 31, 2021 and 2020 
Notes to Consolidated Financial Statements 

F-2
F-4
F-5
F-6
F-7
F-8

F-1 

 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

To the Stockholders and Board of Directors 
CASI Pharmaceuticals, Inc.: 

Opinion on the Consolidated Financial Statements 

We have audited the accompanying consolidated balance sheets of CASI Pharmaceuticals, Inc. and subsidiaries (the Company) as of 
December 31, 2021 and 2020, the related consolidated statements of operations and comprehensive loss, stockholders’ equity, and cash 
flows for the years then ended, and the related notes (collectively, the consolidated financial statements). In our opinion, the consolidated 
financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2021 and 2020, 
and the results of its operations and its cash flows for the years then ended, in conformity with U.S. generally accepted accounting 
principles. 

Basis for Opinion 

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion 
on these consolidated 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 consolidated 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 consolidated 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  consolidated  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 
consolidated 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 consolidated 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 consolidated financial statements and (2) involved our especially challenging, subjective, or complex judgments. The 
communication of a critical audit matter does not alter in any way our opinion on the consolidated financial statements, taken as a whole, 
and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the 
accounts or disclosures to which it relates. 

Fair Value Measurement of Investment in Equity Interests of Juventas Cell Therapy Ltd. Using the Measurement Alternative 

As discussed in Note 3 to the consolidated financial statements, as of December 31, 2021, the Company’s investment in Juventas Cell 
Therapy Ltd. (“Juventas”)’s equity interests was US$32,308. The investment is measured using the measurement alternative at its cost, 
minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a 
similar investment of the same issuer. The Company recognized gain of fair value change for equity interests of US$ 5.5 million for the 
year ended December 31, 2021, based on the price in an orderly transaction for newly issued equity interests of Juventas, which is further 
adjusted to reflect the differences between the newly issued equity interests of Juventas and the Company’s investment. 

We identified the fair value measurement of the investment in equity interests of Juventas as a critical audit matter. Specialized skill and 
knowledge and subjective auditor judgment were needed to evaluate the expected volatility used to determine the fair value. 

F-2 

The following are the primary procedures we performed to address this critical audit matter. We evaluated the design of certain internal 
controls related to the Company’s process to estimate the fair value of the investment in equity interests of Juventas, including controls 
over  the  Company’s    evaluation  of  expected  volatility  applied  to  the  valuation  model  .  We  involved  valuation  professionals  with 
specialized skills and knowledge who assisted in: 

evaluating  the  expected  volatility  determined  by  the  Company  by  comparing  such  volatility  to  an  expected  volatility  that  was 

• 
independently developed using publicly available market data for comparable entities 

developing an estimate of the fair value of the investment in equity interests of Juventas using the independently developed expected 

• 
volatility and comparing it to the value determined by the Company. 

/s/ KPMG Huazhen LLP 

We have served as the Company’s auditor since 2019.

Beijing, China  
March 28, 2022 

F-3 

 
 
  
  
 
 
 
CASI Pharmaceuticals, Inc. 
Consolidated Balance Sheets 
(In thousands, except share and per share data) 

December 31, 2021 

December 31, 2020 

ASSETS 
Current assets: 

Cash and cash equivalents 
Investment in equity securities, at fair value 
Accounts receivable, net of $0 allowance for doubtful accounts
Inventories 
Prepaid expenses and other 

Total current assets 

Property, plant and equipment, net 
Intangible assets, net 
Long-term investments 
Right of use assets 
Other assets 
Total assets 

LIABILITIES, REDEEMABLE NONCONTROLLING INTEREST AND 
STOCKHOLDERS’ EQUITY 
Current liabilities: 

Accounts payable 
Accrued and other current liabilities 
Bank borrowings 
Notes payable 

Total current liabilities 

Deferred income 
Other liabilities 
Total liabilities 

$

$

$

Commitments and contingencies (Note 21) 

Redeemable noncontrolling interest, at redemption value (Note 12)

Stockholders’ equity: 
Preferred stock, $1.00 par value: 5,000,000 shares authorized and 0 shares issued and
   outstanding 
Common stock, $0.01 par value: 
 250,000,000 shares authorized at December 31, 2021 and December 31, 2020
 139,877,032 shares and 124,023,374 shares issued at December 31, 2021  and 
December 31, 2020, respectively; 
 139,797,487 shares and 123,943,829 shares outstanding at December 31, 2021 and 
December 31, 2020, respectively 

Additional paid-in capital 
Treasury stock, at cost: 79,545 shares held at December 31, 2021 and 
December 31, 2020 
Accumulated other comprehensive income  
Accumulated deficit 

Total stockholders’ equity 
Total liabilities, redeemable noncontrolling interest and stockholders' equity

$

$ 

$ 

$ 

38,704  
 9,868  
 9,803  
 1,907  
 1,688  
61,970  

12,712  
12,203  
40,128  
 9,107  
 2,178  
138,298  

 4,789  
 8,397  
 —  
 —  
13,186  

 2,828  
14,325  
30,339  

23,457  

 —  

 1,399  
694,826  

(8,034)  
 1,954  
(605,643)  
84,502  
138,298  

$ 

57,064
9,309
4,645
1,356
1,651
74,025

2,062
13,210
29,442
8,696
299
127,734

3,260
3,424
826
466
7,976

2,351
13,834
24,161

22,033

—

1,240
658,246

(8,034)
589
(570,501)
81,540
127,734

The accompanying notes are an integral part of these consolidated financial statements. 

F-4 

 
 
 
 
 
 
     
     
 
     
 
     
 
  
 
 
  
  
 
 
 
 
  
  
 
 
  
 
  
 
    
  
    
  
  
 
 
  
 
  
 
  
  
  
 
  
 
    
  
 
  
 
 
 
  
 
    
  
  
  
 
  
 
  
  
  
 
 
  
  
  
  
  
 
CASI Pharmaceuticals, Inc. 
Consolidated Statements of Operations and Comprehensive Loss 
(In thousands, except share and per share data) 

Year Ended December 31 

2021 

2020 

$ 

30,020  
148  
30,168  

Revenues: 

Product sales 
Lease income from a related party 

Total revenues 

Costs of revenues: 

Cost of goods sold 
Royalty fee 

Total costs of revenues 

Gross Profit 

Operating expenses: 

Research and development 
General and administrative 
Selling and marketing 
Acquired in-process research and development 
Gain on disposal of intangible assets 
Impairment of intangible assets 

Total operating expenses 

Loss from operations 

Non-operating income (expense): 

Interest income, net 
Other income 
Foreign exchange gain (losses)  
Change in fair value of investments 
Impairment loss of long-term investments 

Loss before income tax expense 

Income tax expense 

Net loss 
Less: loss attributable to redeemable noncontrolling interest
Accretion to redeemable noncontrolling interest redemption value
Net loss attributable to CASI Pharmaceuticals, Inc. 

Net loss per share (basic and diluted)
Weighted average number of common stock outstanding (basic and 
diluted) 

Comprehensive loss: 
Net loss 
Foreign currency translation adjustment 
Total comprehensive loss 
Less: Comprehensive loss attributable to redeemable 
noncontrolling interest 
Comprehensive loss attributable to common stockholders

$

$

$

$

$

6,616  
5,941  
12,557  

17,611  

14,422  
23,766  
14,705  
6,555  
—  
—  
59,448  

(41,837) 

321  
558  
321  
5,660  
(865) 
(35,842) 
—  
(35,842) 
(700) 
1,512  
(36,654) 

(0.27) 

136,105,539  

(35,842) 
1,977  
(33,865) 

$ 

$ 

$ 

$ 

(88) 
(33,777) 

15,001
140
15,141

6,553
2,955
9,508

5,633

11,470
19,661
7,815
17,828
(1,152)
1,537
57,159

(51,526)

866
82
(1,255)
4,322
—
(47,511)
—
(47,511)
(918)
1,694
(48,287)

(0.44)

110,452,288

(47,511)
3,904
(43,607)

(331) 
(43,276) 

$
The accompanying notes are an integral part of these consolidated financial statements. 

$ 

F-5 

 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
CASI Pharmaceuticals, Inc. 
Consolidated Statements of Stockholders’ Equity 
Years Ended December 31, 2021 and 2020 
(In thousands, except share data) 

  Preferred Stock 
    Shares     Amount       Shares

Common Stock

Additional
Paid-in
    Amount      Capital

Accumulated 
Other 

Treasury Comprehensive   Accumulated

     Stock      Income/(Loss)      Deficit

     Total

Balance at December 31, 2019 

Issuance of common stock for options 

and warrants exercised 

Repurchase of stock options to satisfy 

tax withholding obligations 

Issuance of common stock pursuant to 

financing agreements  

Stock issuance costs 
Stock-based compensation expense, net 

of forfeitures 

Foreign currency translation adjustment   
Net loss attributable to CASI 

Pharmaceuticals, Inc. 
Balance at December 31, 2020 

Issuance of common stock pursuant to 

financing agreements  

Stock issuance costs 
Stock-based compensation expense, net 

of forfeitures 

Foreign currency translation adjustment   
Net loss attributable to CASI 

Pharmaceuticals, Inc. 
Balance at December 31, 2021 

 —   $ 

 —  

97,771,698

979

$ 606,686

$ (8,034)

$ 

 (2,728)  $

(523,908) $ 72,995

 —  

 —  

 —  
 —  

 —  
 —  

 —  

2,737,795

 —  

 —  
 —  

 —  
 —  

—

23,434,336
—

—
—

27

—

234
—

—
—

3,847

—   

(251)

—   

44,865
(3,028)

7,821
—

—   
—   

—   
—   

 —  

 —  

 —  
 —  

 —  
 3,317  

—

—

—
—

—
—

3,874

(251)

45,099
(3,028)

7,821
3,317

 —  
 —   $ 

 —  
—
 —   123,943,829

—
$ 1,240

(1,694)
$ 658,246

—   
$ 

$ (8,034)

 —  
 589   $

(48,287)
(46,593)
(570,501) $ 81,540

 —  
 —  

 —  
 —  

 —  
 —  

 —  
 —  

15,853,658
—

—
—

159
—

—
—

32,341
(2,019)

7,770
—

—   
—   

—   
—   

 —  
 —  

 —  
 1,365  

—
—

—
—

32,500
(2,019)

7,770
1,365

 —  
 —   $ 

 —  
—
 —   139,797,487

—
$ 1,399

(1,512)
$ 694,826

—   
$ 

$ (8,034)

 —  
 1,954   $

(36,654)
(35,142)
(605,643) $ 84,502

The accompanying notes are an integral part of these consolidated financial statements. 

F-6 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
  
 
  
  
 
  
  
 
  
  
 
  
  
 
  
 
  
  
 
  
  
  
 
  
  
 
  
  
 
  
 
  
  
 
  
 
 
CASI Pharmaceuticals, Inc. 
Consolidated Statements of Cash Flows 
(In thousands) 

Year Ended  

December 31, 2021 

December 31, 2020 

CASH FLOWS FROM OPERATING ACTIVITIES 
Net loss 
Adjustments to reconcile net loss to net cash used in operating activities: 

$

(35,842) 

Depreciation for property, plant and equipment 
Loss on disposal of property, plant and equipment 
Amortization of intangible assets and held-for-sale assets 
Reduction in the carrying amount of the right-of-use assets 
Gain on disposal of intangible assets 
Impairment of intangible assets 
Stock-based compensation expense 
Acquired in-process research and development 
Government grant as a result of loan forgiveness 
Change in fair value of investments 
Impairment loss of long-term investments 
Changes in operating assets and liabilities: 

Accounts receivable 
Inventories 
Prepaid expenses and other assets 
Accounts payable 
Accrued liabilities and other liabilities 
Deferred income 

Net cash used in operating activities 

CASH FLOWS FROM INVESTING ACTIVITIES 
Proceeds from disposal of intangible assets 
Proceeds from disposal of property and equipment 
Purchases of property, plant and equipment 
Loan to a related party 
Receipt of repayment of loan from a related party 
Cash paid to acquire in-process research and development 
Cash paid to acquire convertible loan in Black Belt Tx Limited 
Receipt of repayment of Black Belt convertible note 
Cash paid to acquire convertible loan in Alesta Tx 
Cash paid to acquire convertible loan in Cleave 
Cash paid to acquire equity securities in BioInvent International AB 
Receipt of government grants related to land use right 
Net cash used in investing activities 

CASH FLOWS FROM FINANCING ACTIVITIES 
Proceeds from  notes payable 
Proceeds from bank borrowings 
Repayment of bank borrowings 
Stock issuance costs 
Proceeds from sale of common stock 
Proceeds from exercise of stock options 
Repurchase of stock options to satisfy tax withholding obligations 
Net cash provided by financing activities 

Effect of exchange rate change on cash and cash equivalents 
Net  (decrease)/ increase in cash and cash equivalents 

Cash and cash equivalents at beginning of year 
Cash and cash equivalents at end of year 

Supplemental disclosure of cash flow information: 

Interest paid 
Income taxes paid 

Non-cash investing and financing activities: 

Purchases of property, plant and equipment in accrued and other current liabilities
Government grant as a result of loan forgiveness (Note 10) 

$

$
$

$
$

468  
65  
1,347  
1,280  
—  
—  
7,770  
6,555  
(472) 
(5,660) 
865  

(5,158) 
(551) 
(1,303) 
1,491  
2,354  
(51) 
(26,842) 

—  
10  
(8,945) 
—  
—  
(6,555) 
(86) 
172  
(261) 
(5,500) 
—  
474  
(20,691) 

—  
709  
(1,548) 
(2,019) 
32,500  
—  
—  
29,642  

(469) 
(18,360) 

57,064  
38,704  

42  
—  

3,288  
472  

$ 

$ 
$ 

$ 
$ 

The accompanying notes are an integral part of these consolidated financial statements. 

F-7 

(47,511)

562
—
1,397
1,272
(1,152)
1,537
7,821
17,828
—
(4,322)
—

(3,352)
3,186
(184)
(1,540)
(1,393)
(35)
(25,886)

2,700
—
(1,499)
(10,033)
10,033
(17,828)
(83)
—
—
—
(6,318)
2,309
(20,719)

466
783
—
(2,818)
45,099
3,874
(251)
47,153

2,895
3,443

53,621
57,064

—
—

467
—

 
 
 
 
 
 
 
 
 
 
 
 
     
     
  
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
   
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
   
  
 
 
 
 
   
  
 
 
 
 
CASI Pharmaceuticals, Inc. 

Notes to Consolidated Financial Statements 
December 31, 2021 and 2020 

1.      DESCRIPTION OF BUSINESS 

CASI Pharmaceuticals, Inc. (“CASI” or the “Company”) (Nasdaq: CASI) is a U.S. biopharmaceutical company focused on 
developing and commercializing innovative therapeutics and pharmaceutical products in China, the United States, and throughout the 
world. The Company was incorporated in 1991, and in 2012, with new leadership, the Company shifted its business strategy to China 
and has since built an infrastructure in China that includes sales and marketing, medical affairs, regulatory and clinical development and 
in the foreseeable future, manufacturing. In 2014, the Company changed its name to “CASI Pharmaceuticals, Inc.” The majority of the 
Company’s operations are now located in China. The Company is focused on acquiring, developing and commercializing products that 
augment its hematology/oncology therapeutic focus as well as other areas of unmet medical need. The Company is executing its plan to 
become a biopharmaceutical leader by launching medicines in the greater China market leveraging its China-based regulatory, clinical 
and commercial competencies and its global drug development expertise.   

The  Company  launched  its  first  commercial  product,  EVOMELA®  (Melphalan  for  Injection)  in  China  in  August 2019.  In 
China, EVOMELA® is approved for use as a conditioning treatment prior to stem cell transplantation and as a palliative treatment for 
patients with multiple myeloma. The other core hematology/oncology assets in the Company’s pipeline include:  

•  CNCT19 is an autologous CD19 CAR-T investigative product (“CNCT19”) being developed by our partner Juventas Cell 
Therapy Ltd. (“Juventas”) for which the Company has exclusive World-Wide co-commercial and profit-sharing rights.   
CNCT19 is being developed as a potential treatment for patients with hematological malignancies which express CD19 
including, B-cell acute lymphoblastic leukemia (“B-ALL”) and B-cell non-Hodgkin lymphoma (“B-NHL”).  The CNCT19 
Phase 1 studies in patients with  B-ALL and B-NHL in China have been completed by Juventas, the Phase 2 B-ALL and 
B-NHL registration studies are both currently enrolling in China since the fourth quarter of 2020. 

•  BI-1206 is an antibody which has a novel mode-of-action, blocking the inhibitory antibody checkpoint receptor FcγRIIB 
to  unlock  anti-cancer  immunity  and  enhance  the  efficacy  of  antibody-based  immunotherapy  in  both  hematological 
malignancies  and  solid  tumors  for  which  the  Company  has  licensed  exclusive  greater  China  rights  from  BioInvent 
International AB (“BioInvent”). BI-1206 is being investigated by BioInvent in a Phase 1/2 trial, in combination with anti-
PD1 therapy Keytruda® (pembrolizumab), in patients with solid tumors, and in a Phase 1/2a trial in combination with 
MabThera® (rituximab) in patients with relapsed/refractory non-Hodgkin lymphoma (NHL). BI-1206 has the potential to 
restore the  activity of rituximab in patients with relapsed/refractory non-Hodgkin lymphoma. Clinical Trial Application 
(CTA) was approved by China National Medical Products Administration (NMPA) in December 2021. The Company is 
planning Phase 1 trials of BI-1206 as a single agent to evaluate the PK/safety profile and in combination with rituximab in 
patients  with  NHL  (mantle  cell  lymphoma,  marginal  zone  lymphoma,  and  follicular  lymphoma)  to  assess  safety  and 
tolerability, select the Recommended Phase 2 Dose and assess early signs of clinical efficacy as part of its development 
program for BI-1206 in China. The studies are expected to start in the first half of 2022. 

•  CB-5339  is  a  novel  VCP/p97  inhibitor  focused  on  valosin-containing  protein  (VCP)/p97  as  a  novel  target  in  protein 
homeostasis, DNA damage response and other cellular stress pathways for therapeutic use in the treatment of patients with 
various malignancies.  The Company entered into an exclusive license on March 21, 2021 with Cleave Therapeutics, Inc. 
(“Cleave”) for the development and commercialization of CB-5339 in Mainland China, Hong Kong, Macau and Taiwan. 
CB-5339, an oral second-generation, small molecule VCP/p97 inhibitor, is being evaluated in a Phase 1 clinical trial in 
patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).  CB-5339 CTA application for the 
multiple myeloma indication is in preparation after receiving an acceptance letter for the CB-5339 IND package from the 
China Center of Drug Evaluation (“CDE”). 

•  CID-103  is  a  full  human  IgG1  anti-CD38  monoclonal  antibody  recognizing  a  unique  epitope  that  has  demonstrated 
encouraging  preclinical  efficacy  and  safety  profile  compared  to  other  anti-CD38  monoclonal  antibodies  for  which  the 
Company has exclusive global rights.  CID-103 is being developed for the treatment of patients with multiple myeloma.  
The Phase 1 dose escalation and expansion study of CID-103, in patients with previously treated, relapsed or refractory 
multiple myeloma is ongoing in France and the UK. 

F-8 

 
 
 
 
The Company also has greater China rights to Octreotide (Long Acting Injectable), a standard of care for the treatment of 
acromegaly and for the control of symptoms associated with certain neuroendocrine tumors; and Thiotepa, a cytotoxic agent which has 
a long history of established use in the hematology/oncology setting, the Company has an exclusive China license and distribution rights 
to  a  novel  formulation  of  thiotepa,  which  has  multiple  indications  including  use  as  a  conditioning  treatment  for  certain  allogeneic 
haemopoietic stem cell transplants. However, due to the evolving standard of care environment, the rare and niche indication for these 
products, potential US regulatory action and its commitment to prioritize resources, the Company is currently evaluating its potential 
opportunities for these products.  In addition, the Company’s assets include six FDA-approved ANDAs which it is evaluating due to 
generic drug pricing reforms by the Chinese government and its impact on the pricing and competitiveness of these products. 

CASI  has  built  a  fully  integrated,  world  class  biopharmaceutical  company  dedicated  to  the  successful  development  and 
commercialization of innovative and other therapeutic products. Its business development strategy is currently focused on acquiring 
additional targeted drugs and immuno-oncology therapeutics through licensing that will expand its hematology/oncology franchise. The 
Company uses a market-oriented approach to identify pharmaceutical/biotechnology candidates that it believes to have the potential for 
gaining widespread market acceptance, either globally or in China, and for which development can be accelerated under its global drug 
development strategy. In many cases its business development strategy includes direct equity investments in the licensor company.  The 
Company intends for its pipeline to reflect a diversified and risk-balanced set of assets that include (1) late-stage clinical drug candidates 
in-licensed  for  China  or  global  regional  rights,  (2) proprietary  or  licensed  innovative  drug  candidates,  and  (3) select  high  quality 
pharmaceuticals that fit its therapeutic focus. The Company has focused on US/EU approved product candidates, and product candidates 
with proven targets or product candidates that have reduced clinical risk with a greater emphasis on innovative therapeutics. Although 
oncology with a focus on hematological malignancies is its principal clinical and commercial target, the Company is opportunistic about 
other therapeutic areas that can address unmet medical needs. The Company will continue to pursue building a robust pipeline of drug 
candidates for development and commercialization in China as its primary market, and if rights are available for the rest of the world. 

The Company believes its China operations offer a significant market and growth potential due to the extraordinary increase 
in demand for high quality medicines coupled with regulatory reforms in China that facilitate the entry of new pharmaceutical products 
into the country. The Company will continue to in-license clinical-stage and late-stage drug candidates, and leverage its cross-border 
operations  and  expertise,  and  hope  to  be  the  partner  of  choice  to  provide  access  to  the  China  market.  The  Company  expects  the 
implementation of its plans will include leveraging its resources and expertise in both the U.S. and China so that the Company can 
maximize regulatory, development and clinical strategies in both countries. 

The Company’s commercial product, EVOMELA®, was originally licensed from Spectrum Pharmaceuticals, Inc. (“Spectrum”) 
and it had a supply agreement with Spectrum to support its application for import drug registration and for commercialization purposes. 
Spectrum  completed  the  sale  of  its  portfolio  of  FDA-approved  hematology/oncology  products  including  EVOMELA®  to  Acrotech 
Biopharma L.L.C. (“Acrotech”) on March 1, 2019. The original supply agreement with Spectrum was assumed by Acrotech; Spectrum 
agreed to continue with a short-term supply agreement for EVOMELA® for the initial commercial product supply in connection with 
the launch, with the long-term supply assumed by Acrotech. 

F-9 

As part of the long-term strategy to support its future clinical and commercial manufacturing needs and to manage its supply 
chain for certain products, on December 26, 2018, the Company established CASI Pharmaceuticals (Wuxi) Co., Ltd.. (“CASI Wuxi”) 
to develop a future GMP manufacturing facility that will be in the Wuxi Huishan Economic Development Zone in Jiangsu Province, 
China.  In November 2019, CASI Wuxi entered into a fifty-year lease agreement for the right to use state-owned land in China for the 
construction of a manufacturing facility. Pursuant to the agreement, CASI Wuxi has committed to invest land use right and property, 
plant and equipment of RMB 1 billion (equivalent to $143 million) by August 2022. In April 2020, CASI Wuxi received RMB 15.9 
million (equivalent to $2.2 million) from the Jiangsu Province Wuxi Huishan Economic Development Zone as government grant for 
this development project which was recorded as deferred income in April 2020. In November 2021, CASI Wuxi received additional 
RMB 3.0 million (equivalent to $0.5 million) from the Jiangsu Province Wuxi Huishan Economic Development Zone as a government 
grant for this development project which was recorded as deferred income in November 2021. In 2020, for the design and construction 
work of the land, CASI Wuxi entered into several contracts for RMB 76.1 million ($12.0 million) to complete the phase 1 project of 
CASI  Wuxi's  research  and  development  production  base,  the  project  was  the  estimated  to  be  completed  in  October 2023.  In 
February 2022, CASI Wuxi has reached an alignment with the Wuxi local government that it will collaborate with Wuxi LP to co-
develop the land continuously in the future, and the development plan will be extended, details regarding the plan are under negotiation. 
Also in 2020, CASI Wuxi entered in to a lease agreement with local government for a manufactory building next to the leased land. 
Since then, the Company entered into a series of contracts for the remodeling and installation work of the building and warehouse, as 
well as purchase of equipments. The total contract amount entered into for this building is approximately RMB 92.9 million ($14.6 
million).   

Certain  line  item,  as  disclosed  below,  in  the  December 31,  2020  consolidated  financial  statements  has  been  reclassified  to 
conform  to  the  December 31,  2021  presentation.  Payables  related  to  property  and  equipment  in  the  amount  of  $0.5  million  as  of 
December 31, 2020, which was previously included in accounts payable, and has been reclassified as accrued and other current liabilities 
on the consolidated balance sheet as of December 31, 2020 (see Note 8). 

Liquidity and Capital Resources 

Since its inception in 1991, the Company has incurred significant losses from operations and, as of December 31, 2021, has 

incurred an accumulated deficit of $605.6 million.  

Taking into consideration the cash and cash equivalents as of December 31, 2021, the Company believes that it has sufficient 
resources  to  fund  its  operations  at  least  one  year  beyond  the  date  that  the  consolidated  financial  statements  are  issued.  As  of 
December 31, 2021, the Company had a balance of cash and cash equivalents of $38.7 million, of which $19.3 million was held in the 
financial  institutions  in  the  PRC.  The  Company  intends  to  continue  to  exercise  tight  controls  over  operating  expenditures  and  will 
continue to pursue opportunities, as required, to raise additional capital and will also actively pursue non- or less-dilutive capital raising 
arrangements or opportunities.  

Risks and Uncertainties 

During the peak of the COVID-19 pandemic in 2020, the Company experienced disruptions to the EVOMELA® marketing 
and sales activities as well as to the supply chain for EVOMELA®. The COVID-19 pandemic also impacted the targeted start time of 
its  CID-103  trial  due  to  the  lock  down  of  many  medical  facilities  in  Europe.  During  2021,  the  Company  has  experienced  minimal 
disruption to its business activities or supply chain as a result of the COVID-19 pandemic. Furthermore, in June 2021, the Company 
achieved the First-Patient-In (FPI) in the Phase 1 dose escalation and expansion study of CID-103 in patients with previously treated, 
relapsed or refractory multiple myeloma. The study is designed to assess the safety, tolerability, pharmacology and clinical activity of 
CID-103. 

The Company currently relies on a single source for the supply of EVOMELA®. The continuation of the COVID-19 pandemic 
or the emergence of new COVID-19 variants or new pandemics may affect the economies and financial markets of many countries, 
which may result in a period of economic slowdown or recessions. In such an event, its ability to continue to commercialize and expand 
distribution of EVOMELA® could be adversely affected if the supplier refuses or is unable to provide products for any reason (including 
the  occurrence  of  an  event  like  the  COVID-19  pandemic  that  makes  delivery  impractical.  The  Company  would  have  to  work  with 
Acrotech to negotiate an agreement with a substitute supplier, which, assuming a substitute supplier was available, would likely interrupt 
the manufacturing of EVOMELA®, cause supply chain delays and increase costs. 

The COVID-19 pandemic has adversely affected, and may continue to adversely affect, the economies and financial markets 
of many countries, which may result in a period of regional, national, and global economic slowdown or regional, national, or global 
recessions that could affect the Company’s ability to continue to commercialize and expand distribution of EVOMELA® (Melphalan 

F-10 

For Injection) or other drugs in its existing product pipeline. Early in the COVID-19 pandemic, the Company experienced a disruption 
to its supply chain for EVOMELA®, it has experienced no supply disruption in 2021; however, there can be no assurance that restrictions 
will not be imposed again. In addition, economic and other uncertainties may adversely affect other parties’ willingness to negotiate and 
execute product licenses and thus hamper our ability to in-license clinical-stage and late-stage drug candidates in China or elsewhere. 

License and Distribution Agreements 

Acrotech License Arrangements 

The Company has product rights and perpetual exclusive licenses from Acrotech Biopharma L.L.C. (“Acrotech”) to develop 
and commercialize its commercial product EVOMELA® (Melphalan Hydrochloride For Injection) in the greater China region (which 
includes Mainland China, Taiwan, Hong Kong and Macau), as well as similar rights to assets ZEVALIN® (Ibritumomab Tiuxetan) and 
MARQIBO®  (Vincristine  Sulfate  Liposome  Injection).  The  exclusive  licenses  held  by  the  Company  were  originally  licensed  from 
Spectrum Pharmaceuticals, and Spectrum completed the sale of its portfolio of FDA-approved hematology/oncology products including 
EVOMELA®  to  Acrotech  on  March 1,  2019.  On  December 3,  2018,  the  Company  received  NMPA’s  approval  for  importation, 
marketing and sales in China and in August 2019 the Company launched EVOMELA® in China. The NMPA required post-marketing 
study has completed and the clinical study report is being finalized for regulatory submission. 

China Resources Pharmaceutical Commercial Group International Trading Co., Ltd. 

In March 2019, the Company entered into a three-year exclusive distribution agreement with China Resources Pharmaceutical 
Commercial  Group  International  Trading  Co.,  Ltd.  (“CRPCGIT”)  to  appoint  CRPCGIT  on  an  exclusive  basis  as  its  distributor  to 
distribute EVOMELA® in the territory of the People’s Republic of China (excluding Hong Kong, Taiwan and Macau), subject to certain 
terms  and  conditions.  The  Company’s  internal  marketing  and  sales  team  are  responsible  for  commercial  activities,  including,  for 
example, direct interaction with Key Opinion Leaders (KOL), physicians, hospital centers and the generating of sales. The agreement 
was renewed in March 2022 for another two years. Commercial sales of EVOMELA®  were launched in August 2019. For the years 
ended December 31, 2021 and 2020, the Company recognized $30.0 million and $15.0 million, respectively, of revenues from sales of 
EVOMELA® under this arrangement. 

Juventas Cell Therapy Ltd. 

In June 2019, the Company entered into a license agreement for exclusive worldwide license to commercialize an autologous 
anti-CD19 T-cell therapy product (CNCT19) from Juventas (the “Juventas license agreement”).  Juventas is a China-based company 
engaged in cell therapy. The terms of the agreement include RMB 70 million ($10 million) of milestone payments upon the registration 
of Phase II clinical trial of CNCT19 and sales royalty payments.  The milestone was met during the quarter ended September 30, 2020.  
As  a  result,  the  Company  paid  the  milestone  payment  of  RMB  70  million  to  Juventas  in  September 2020  (see  Note  3),  which  was 
expensed as acquired in-process research and development in the consolidated statement of operations and comprehensive loss for the 
year ended December 31, 2020. 

In September 2020, Juventas and its shareholders (including CASI Biopharmaceuticals) agreed to certain terms and conditions 
required by a new third-party investor to facilitate the Series B financing of Juventas, pursuant to which the Company agreed to amend 
and supplement the original licensing agreement (the "Supplementary Agreement") by agreeing to pay Juventas certain percentage of 
net profits generated from commercial sales of CNCT19 in addition to the royalty fee payment calculated as a percentage of net sales. 
The Supplementary Agreement also specifies a minimum annual target net profit to be distributed to Juventas and certain other terms 
and obligations. In return, the Company obtained additional equity interests in Juventas (see Note 3). 

Under the Supplementary Agreement, Juventas and the Company will jointly market CNCT19, including, but not limited to, 
establishing medical teams, developing medical strategies, conducting post-marketing clinical studies, establishing Standardized Cell 
Therapy Centers, establishing and training providers with respect to cell therapy, testing for cell therapy, and monitoring quality controls 
(cell collection and transfusion, etc.), and patient management (adverse reactions treatment, patients’ follow-up visits, and establishment 
of a database). The Company also will reimburse Juventas for a portion of Juventas’ marketing expenses as reviewed and approved by 
a joint commercial committee to be constituted. The Company will continue to be responsible for recruiting and establishing a sales 
team to commercialize CNCT19.  

BioInvent International AB  

In October 2020, the Company entered into an exclusive licensing agreement with BioInvent International AB (“BioInvent”) 
for  the development  and  commercialization of  novel  anti-FcγRIIB  antibody,  BI-1206, in  mainland  China,  Taiwan, Hong Kong  and 

F-11 

Macau.    BioInvent  is  a  biotechnology  company  focused  on  the  discovery  and  development  of  first-in-class  immune-modulatory 
antibodies  for  cancer  immunotherapy.    BI-1206  is  being  investigated  in  a  Phase  1/2  trial,  in  combination  with  anti-PD1  therapy 
Keytruda® (pembrolizumab), in patients with solid tumors, and in a Phase  1/2a trial in combination with MabThera® (rituximab) in 
patients with relapsed/refractory non-Hodgkin lymphoma (NHL). Clinical Trial Application (CTA) was approved by China National 
Medical Products Administration (NMPA) in December 2021. The Company is planning Phase 1 trials of BI-1206 as a single agent to 
evaluate  the  PK/safety  profile  and  in  combination  with  rituximab  in  NHL  (mantle  cell  lymphoma,  marginal  zone  lymphoma,  and 
follicular lymphoma) to assess safety and tolerability, select the Recommended Phase 2 Dose and assess early signs of clinical efficacy 
as part of its development program for BI-1206 in China. The studies are expected to start in the first half of 2022. 

Under the terms of the agreement, BioInvent and CASI will develop BI-1206 in both hematological malignancies and solid 
tumors, with CASI responsible for commercialization in China and associated markets. CASI made a $5.9 million upfront payment in 
November 2020 to BioInvent and will pay up to $83 million in development and commercial milestone payments plus tiered royalties 
in the high-single to mid-double-digit range on net sales of BI-1206.  Because BI-1206 underlying the acquired rights has not reached 
technological feasibility and has no alternative future uses, the Company expensed $5.9 million as acquired in-process research and 
development in the accompanying consolidated statement of operations and comprehensive loss for the year ended December 31, 2020.  

Black Belt Therapeutics Limited 

In April 2019, the Company entered into a license agreement with Black Belt Therapeutics Limited (“Black Belt”) for exclusive 
worldwide  rights  to  CID-103,  an  investigational  anti-CD38  monoclonal  antibody  (Mab)  (formerly  known  as  TSK011010).  The 
Company expects that its clinical materials and commercial inventory will be supplied by one or more contract manufacturers with 
whom the Company has contracted with. Under the terms of the agreement, CASI obtained global rights to CID-103 for an upfront 
payment of 5 million euros ($5.7 million) and would pay up to $46.3 million in development milestone payments and certain royalties 
based on sales milestones. In June 2021, the Company achieved the First-Patient-In (FPI) in the Phase 1 dose escalation and expansion 
study of CID-103, and made $750,000 milestone payment in June 2021 and €250,000 ($305,000) payment in August 2021 under the 
terms  of  the  agreement.  Because  CID-103  underlying  the  acquired  rights  has  not  yet  reached  technological  feasibility  and  has  no 
alternative uses, the Company expensed 5 million euros as acquired in-process research and development in the consolidated statement 
of operations and  comprehensive  loss for the  year  ended  December 31,  2019,  and $1.1  million  as  acquired  in-process  research and 
development in the consolidated statements of operations and comprehensive loss for the year ended December 31, 2021.  

Cleave Therapeutics, Inc.  

In March 2021, the Company entered into an exclusive license with Cleave Therapeutics, Inc. (“Cleave”) for the development 
and commercialization of CB-5339, an oral novel VCP/p97 inhibitor, in both hematological malignancies and solid tumors, in Mainland 
China, Hong Kong, Macau and Taiwan.  Cleave is a clinical-stage biopharmaceutical company focused on valosin-containing protein 
(VCP)/p97 as a novel target in protein homeostasis, DNA damage response and other cellular stress pathways for therapeutic use in the 
treatment of patients with cancer.  Cleave and the Company will develop CB-5339 in both hematological malignancies and solid tumors, 
with CASI responsible for development and commercialization in China and associated markets. The Company paid a $5.5 million 
upfront payment to Cleave and will pay up to $74 million in development and commercial milestone payments plus tiered royalties in 
the high-single to mid-double-digit range on net sales of CB-5339. 

CB-5339  is  being  evaluated  by  Cleave  in  a  Phase  1  clinical  trial  in  patients  with  acute  myeloid  leukemia  (AML)  and 
myelodysplastic syndrome (MDS). Because CB-5339 has not yet reached technological feasibility and has no alternative future uses, 
the Company expensed the $5.5 million upfront payment as acquired in-process research and development in the consolidated statements 
of operations and comprehensive loss for the year ended December 31, 2021.  

Pharmathen Global BV 

On  October 29,  2019,  the  Company  entered  into  an  exclusive  distribution  agreement  with  Pharmathen  Global  BV 
("Pharmathen")  for  the  development  and  distribution  of  octreotide  long  acting  injectable  (Octreotide  LAI)  microsphere  in  China.  
Octreotide LAI formulations, which are approved in various European countries, are considered a standard of care for the treatment of 
acromegaly and the control of symptoms associated with certain neuroendocrine tumors. CASI intends to advance the development, 
import drug registration, and market approval of this product in China. 

The terms of the agreement include an upfront payment of 1 million euros which was paid by the Company in 2019, and up to 
2 million euros of additional milestone payments, of which 1.5 million euros ($1.7 million) was paid by the Company with achievements 
of certain milestones and was expensed as acquired in-process research and development in the accompanying consolidated statement 

F-12 

of operations and comprehensive loss for the year ended December 31, 2020. CASI is responsible for the development, import drug 
registration, product approval and commercialization in China. CASI has a 10-year non-royalty exclusive distribution period after the 
product launch at an agreed supply costs for the first three years. 

Riemser Pharma GmbH 

In August 2019, the Company entered into a distribution agreement in China with Riemser Pharma GmbH (“Riemser”) to a 
novel  formulation  of  thiotepa,  a  chemotherapeutic  agent,  which  has  multiple  potential  indications  including  use  as  a  conditioning 
treatment  for  use  prior  to  allogenic  hematopoietic  stem  cell  transplantation.  Thiotepa  has  a  long  history  of  established  use  in  the 
hematology/oncology setting. Pursuant to the distribution agreement, CASI obtained the exclusive distribution right of the products in 
China, and Riemser will be responsible for manufacturing and supplying CASI with clinical materials and commercial inventory. The 
Company  is  applying NADA registration and,  subject  to  regulatory  and marketing  approvals,  the Company  intends  to  advance  and 
commercialize this product in China. In January 2020, Riemser was acquired by Esteve Healthcare, S.L. (“ESTEVE”), an international 
pharmaceutical company headquartered in Barcelona. There is no contingent milestone payment due to Riemser under the agreement. 

2.      SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES 

Basis of Presentation 

The accompanying consolidated financial statements have been prepared in accordance with accounting principles generally 

accepted in the United States of America (“U.S. GAAP”). 

Use of Estimates 

The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates 
and  assumptions  that  affect  the  amounts  reported  in  the  financial  statements  and  accompanying  notes.  The  Company's  significant 
accounting  estimates  relate  to  recoverability  of  operating  lease  right-of-use  assets,  intangible  assets  and  long-term  investments,  net 
realizable  value  and  obsolescence  allowance  for  inventories,  deferred  tax  assets  and  valuation  allowance,  allowance  for  doubtful 
accounts,  stock-based  arrangements  and  fair  value  of  investments.  Management  bases  its  estimates  on  historical  experience  and  on 
various other assumptions that it believes are reasonable under the circumstances. Actual results may differ from those estimates, and 
such differences may be material to the consolidated financial statements. 

Consolidation 

The accompanying consolidated financial statements include the accounts of the Company and its subsidiaries, in which CASI, 

directly or indirectly, has a controlling financial interest.  

These  subsidiaries  include  Miikana  Therapeutics,  Inc.  (“Miikana”),  CASI  China,  CASI  Wuxi,  CASI  Biopharmaceuticals 
(WUXI) Co., Ltd. (“CASI Biopharmaceuticals”), CASI Pharmaceuticals (Hainan) Co., Ltd. (“CASI Hainan”) and ZhongBio (Beijing) 
Tech Co. Ltd. ("ZhongBio”). 

CASI China is a Chinese entity with 100% of its interest owned by CASI. CASI China received approval for a business license 
from  the  Beijing  Industry  and  Commercial  Administration  in  August 2012  and  has  operating  facilities  in  Beijing.  CASI  Wuxi  was 
established on December 26, 2018 in China to develop a manufacturing facility in China. CASI Biopharmaceuticals is a wholly owned 
subsidiary  of  CASI  Wuxi  and  was  established  in  April 2019.  The  Company  controls  CASI  Wuxi  through  80%  voting  rights. 
Accordingly, the financial statements of CASI Wuxi have been consolidated in the Company's consolidated financial statements since 
its  inception.  CASI  Hainan  and  ZhongBio  are  wholly  owned  subsidiaries  of  CASI  China  and  was  established  in  June 2021  and 
September 2016, respectively. 

All inter-company balances and transactions have been eliminated in consolidation. The Company currently operates in one 
operating segment, which is the development of innovative therapeutics addressing cancer and other unmet medical needs for the global 
market. 

Foreign Currency Translation and Transactions 

The accompanying consolidated financial statements of the Company are reported in US dollars. The financial position and 
results  of  operations  of  the  Company’s  subsidiaries  in  the  PRC  are  measured  using  the  Renminbi  (RMB),  which  is  the  local  and 
functional currency of these entities. Assets and liabilities of the Company’s PRC subsidiaries are translated into US$ using the exchange 

F-13 

 
rates in effect at the consolidated balance sheet date. The revenues and expenses of these entities are translated into US$ at the weighted 
average exchange rates for the period. The resulting translation gains (losses) are recorded in accumulated other comprehensive loss as 
a component of shareholders’ equity. 

Transactions denominated in foreign currencies are remeasured into the functional currency at the exchange rates prevailing 
on the transaction dates. Foreign currency denominated financial assets and liabilities are remeasured at the exchange rates prevailing 
at the balance sheet date. Net gains or losses resulting from foreign currency denominated transactions are recorded in foreign exchange 
gain (losses) in the consolidated statements of operations and comprehensive loss. 

Revenue Recognition 

Product sales recognized in the consolidated statements of operations and comprehensive loss are considered revenue from 

contracts with customers and, accordingly, the Company recognizes revenue using the following steps: 

• 

• 

Identification of the contract, or contracts, with a customer; 

Identification of the performance obligations in the contract; 

•  Determination of the transaction price, including the identification and estimation of variable consideration; 

•  Allocation of the transaction price to the performance obligations in the contract; and 

•  Recognition of revenue when the Company satisfies a performance obligation. 

The Company recognizes revenue on sales of EVOMELA®  when the control of the product is transferred to the distributor, 
which occurs upon delivery of the product to the carrier appointed by the distributor, in an amount that reflects the consideration to 
which the Company expects to be entitled to in exchange for the product, excluding amounts collected on behalf of third parties (e.g. 
value-added taxes). Payment terms for these sales are due within 90 days. The arrangement does not include any variable consideration. 
The Company recognizes accounts receivable when it recognizes revenues as its right to consideration is unconditional and only the 
passage of time is required before payment of that consideration is due. 

The costs of assurance type warranties that provide the customer the right to exchange purchased product that does not meet 
appropriate quality standards are recognized when they are probable and are reasonably estimable. There was no product exchange 
during the years ended December 31, 2021 and 2020. As of December 31, 2021 and 2020, the Company did not incur, and therefore did 
not defer, any material costs to obtain or fulfill contracts. The Company did not have any contract assets or contract liabilities as of 
December 31, 2021 and 2020. 

Concentrations Risks 

Cash Concentration Risk 

The Company maintains its U.S. and RMB cash in bank deposit accounts, which, at times, may exceed regulated insured limits. 

The Company believes it is not exposed to significant credit risk on cash and cash equivalents. 

Vendor Concentration Risk 

The Company has a sole supplier for its EVOMELA®  product. Through the second quarter of 2020, it was sourced solely from 
Spectrum Pharmaceuticals, Inc. (“Spectrum”) and its suppliers.  Starting with the third quarter of 2020, and all future needs will be 
sourced from Acrotech and its suppliers. The Company’s ability to select other providers of EVOMELA®  is limited by FDA regulations. 

Accounts Receivable and Credit Concentration 

CRPCGIT is the sole customer of the Company's EVOMELA®  product sales in China. All consolidated revenues for the years 
ended December 31, 2021 and 2020 were generated from sales to CRPCGIT in China, and all the Company's accounts receivable balance 
as of December 31, 2021 and 2020 were due from CRPCGIT. 

The  Company  extends  credit  to  CRPCGIT  on  an  unsecured  basis  and  maintains  an  allowance  for  doubtful  accounts  for 
estimated losses inherent in its accounts receivable. In establishing the required allowance, management considers the historical losses, 

F-14 

customer’s  financial  condition,  the  amount  of  accounts  receivables  in  dispute,  the  accounts  receivables  aging  and  the  customer’s 
payment pattern. The Company determined that no allowance for doubtful accounts were necessary as of December 31, 2021 and 2020. 
The balance of accounts receivable as of December 31, 2021 has been subsequently collected. 

Fair Value of Financial Instruments 

Fair  value  is  the  price  that  would  be  received  from  the  sale  of  an  asset  or  paid  to  transfer  a  liability  assuming  an  orderly 
transaction in the most advantageous market at the measurement date. U.S. GAAP establishes a hierarchical disclosure framework which 
prioritizes and ranks the level of observability of inputs used in measuring fair value. These tiers include: 

•  Level 1—Quoted prices (unadjusted) in active markets that are accessible at the measurement date for identical assets or 

liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs. 

•  Level 2—Observable market-based inputs other than quoted prices in active markets for identical assets or liabilities. 

Level 3—Unobservable inputs are used when little or no market data is available. The fair value hierarchy gives the lowest 

priority to Level 3 inputs.  

See Note 3 and Note 19 for additional fair value disclosures. 

Cash and Cash Equivalents 

Cash and cash equivalents include cash and highly liquid investments with original maturities of less than 90 days that are 

readily convertible to known amounts of cash. 

Inventories 

Inventories consist of EVOMELA®  finished goods and raw materials to be used in production of ANDAs and are stated at the 
lower of cost or net realizable value. Cost is determined using a first-in, first-out method. Net realizable value is the estimated selling 
prices in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. Adjustments are 
recorded to write down the carrying amount of any obsolete and excess inventory to its estimated net realizable value based on historical 
and forecasted demand. 

Property, Plant and Equipment 

Property, plant and equipment are stated at cost, less accumulated depreciation and impairment, if any. 

Costs incurred in the construction of property, plant and equipment, including down payments and progress payments, are 
initially capitalized as construction-in-progress and transferred into their respective asset categories when the assets are ready for their 
intended use, at which time depreciation commences. Furniture and equipment are depreciated over their estimated useful lives of 3 to 
5 years. Leasehold improvements are amortized over the shorter of their useful lives or the lease term. Depreciation and amortization 
expense are determined on a straight-line basis. 

Costs of Revenues 

Costs of revenues consist primarily of the cost of inventories of EVOMELA®  and sales-based royalties related to the sale of 

EVOMELA®. 

Investments 

The Company’s investments consist of investments in equity securities with readily determinable fair value, equity securities 

without readily determinable fair value, and investments measured using fair value option. 

Investment in equity securities with readily determinable fair value are measured at fair values, and any changes in fair value 
are  recognized  in  earnings.  Where  the  fair  value  of  an  investment  in  equity  securities  is  not  readily  determinable,  the  Company 
recognizes such investment in long-term investments, and uses the measurement alternative of cost minus impairment, if any, plus or 
minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same 
issuer.  

F-15 

For equity investments measured at fair value with changes in fair value recorded in earnings, the Company does not assess 
whether  those  securities  are  impaired.  For  equity  investments  without  readily  determinable  fair  value,  at  each  reporting  period,  the 
Company makes a qualitative assessment considering impairment indicators to evaluate whether the investment is impaired. Impairment 
indicators that the Company considers include, but are not limited to, (i) the deterioration of earnings performance, credit rating, asset 
quality, or business prospects of the investee, (ii) a significant adverse change in the regulatory, economic, or technological environment 
of the investee, (iii) a significant adverse change in the general market condition of either the geographic area or the industry in which 
the investee operates. If a qualitative assessment indicates that the investment is impaired, the Company has to estimate the investment’s 
fair value and if the fair value is less than the investment’s carrying value, the Company recognizes an impairment loss in non-operating 
expenses equal to the difference between the carrying value and fair value.  

Dividend income is recognized in other income when earned. 

The  Company  elected  to  use  fair  value  option  to  account  for  its  investment  in  Cleave  (see  Note  3) as  permitted  under 
Accounting  Standards  Codification  (“ASC”)  825,  Financial  Instruments  (“ASC  825”),  which  then  refers  to  ASC  820,  Fair  Value 
Measurement (“ASC 820”) to provide the fair value framework for valuing such investments. In accordance with ASC 820, the Company 
records such investment at fair value, with changes in fair value recorded in change in fair value of investments in the consolidated 
statements of operations and comprehensive loss. 

Leases 

At contract inception, the Company determines whether an arrangement is or contains a lease and whether the lease should be 
classified as an operating or a financing lease. A contract is or contains a lease if the contract conveys the right to control the use of the 
identified asset for a period of time in exchange for consideration. Control is determined based on the right to obtain all of the economic 
benefits from use of the identified asset and the right to direct the use of the identified asset. Right of use (“ROU”) assets for operating 
leases represent the right to use an underlying asset for the lease term, and operating lease liabilities represent the obligation to make 
lease payments. 

ROU assets and lease liabilities are recognized upon lease commencement for operating leases based on the present value of 
lease  payments  over  the  lease  term.  As  the  rate  implicit  in  the  lease  cannot  be  readily  determined,  the  Company  uses  incremental 
borrowing rate at the lease commencement date in determining the imputed interest and present value of lease payments. The incremental 
borrowing rate  was  determined based on  the  rate of  interest  that  the  Company  would have  to  borrow  an  amount equal  to  the  lease 
payments on a collateralized basis over a similar term. The incremental borrowing rate is primarily influenced by the risk-free interest 
rate of China and the US, the Company’s credit rating and lease term, and is updated for measurement of new lease liabilities. 

For operating leases, the Company recognizes a single lease cost on a straight-line basis over the remaining lease term.  

The Company has elected not to recognize ROU assets or lease liabilities for leases with an initial term of 12 months or less; 
the Company recognizes lease expense for these leases on a straight-line basis over the lease term. In addition, the Company has elected 
not to separate non-lease components (e.g., common area maintenance fees) from the lease components. 

Land use rights acquired are recognized in right-of-use assets if they meet the definition of lease. 

Impairment of Long-Lived Assets 

Long-lived assets, including property, plant and equipment, operating lease right-of-use (“ROU”) assets and intangible assets 
subject to amortization, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of 
an asset may not be recoverable. Such events and circumstances include the use of the asset or asset group in current research and 
development projects and any potential alternative future uses of the asset or asset group. If circumstances require a long-lived asset or 
asset group be tested for possible impairment, the Company first compares undiscounted cash flows expected to be generated by that 
asset or asset group to its carrying value. If the carrying value of the long-lived asset or asset group is not recoverable on an undiscounted 
cash flow basis, an impairment is recognized to the extent that the carrying value exceeds its fair value. Fair value is determined through 
various valuation techniques including discounted cash flow models, quoted market values and third-party independent appraisals, as 
considered necessary.  Impairment charges related to intangible assets were $0 and $1.5 million for the years ended December 31, 2021 
and 2020, respectively.   

F-16 

Research and Development Expenses 

Research and development expenses consist primarily of compensation and other expenses related to research and development 
personnel, research collaborations, costs associated with pre-clinical testing and clinical trials of the Company’s product candidates, 
including the costs of manufacturing drug substance and drug product, regulatory maintenance costs, and facilities expenses, along with 
the amortization of acquired ANDAs. Research and development costs are expensed as incurred. 

Acquired In-Process Research and Development Expense 

The  Company  has  acquired  rights  to  develop  and  commercialize  product  candidates.  Upfront  payments  that  relate  to  the 
acquisition of a new drug compound, as well as pre-commercial milestone payments, are immediately expensed as acquired in-process 
research and development in the period in which they are incurred, provided that the new drug compound did not also include processes 
or activities that would constitute a “business” as defined under U.S. GAAP, the drug has not achieved regulatory approval for marketing 
and, absent obtaining such approval, has no established alternative future use. 

The  Company  also  pays  contingent  development  milestone  payments  in  accordance  with  agreements  (see  Note  1).  The 
Company recognizes development milestone payments as acquired in-process research and development expenses when the milestones 
are reached. 

Stock-Based Compensation 

The Company records compensation expense associated with service and performance-based stock options in accordance with 
provisions of authoritative guidance. The estimated fair value of service-based awards is measured on the grant date and is generally 
recognized on a straight-line basis over the requisite service period and based on the proportionate amount of the requisite service period 
that has been rendered during each reporting period. The estimated fair value of performance-based awards is measured on the grant 
date and is recognized when it is determined that it is probable that the performance condition will be achieved. If the required vesting 
conditions are not met resulting in the forfeiture of the share-based awards, previously recognized compensation expense relating to 
those awards are reversed as occurred. 

Grant date fair value was determined using an option pricing model which is affected by the fair value of underlying ordinary 
shares as well as assumptions regarding a number of complex and subjective variables, such as expected volitality, expected term of 
options, risk-free rate, and expected dividend yield. 

Government Grants 

Government grants are recognized when there is reasonable assurance that the Company will comply with required conditions 
and the grants will be received. Government grants related to assets are presented as deferred income that is recognized on a systematic 
basis over the useful life of the asset. 

Income Taxes 

Income tax expense is recognized using the asset and liability method.  Deferred tax assets and liabilities are determined based 
on the difference between the financial statement and tax bases of assets and liabilities and operating loss and tax credit carryforwards 
as measured by the enacted tax rates that will be in effect when these differences reverse. A valuation allowance is provided to reduce 
the amount of deferred income tax assets if it is considered more likely than not that some portion or all of the deferred income tax assets 
will not be realized. 

The Company recognizes in its consolidated financial statements the impact of a tax position if a tax return position or future 
tax position is “more likely-than-not” to be sustained upon examination, based on the technical merits of the position. Tax positions that 
meet the “more-likely-than-not” recognition threshold are measured at the largest amount of tax benefit that has a greater than fifty 
percent likelihood of being realized upon settlement.  The Company recognizes interest and penalties related to uncertain tax positions, 
if any, in income tax expense. 

Net Loss Per Share 

Net loss per share (basic and diluted) was computed by dividing net loss attributable to common stockholders by the weighted 

average number of shares of common stock outstanding.  

F-17 

New Accounting Pronouncements 

Recently Adopted Pronouncements 

In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the 
Disclosure Requirements for Fair Value Measurement. ASU 2018-13 eliminates, adds and modifies certain disclosure requirements for 
fair value measurements. The amendments applicable to the disclosures of changes in unrealized gains and losses, the range and weighted 
average  of  significant  unobservable  inputs  used  to  develop  Level  3  fair  value  measurements,  and  the  narrative  description  of 
measurement uncertainty should be applied prospectively for only the most recent interim or annual period presented in the initial year 
of adoption. This ASU is effective for all entities for fiscal years beginning after December 15, 2019, including interim periods therein. 
All other amendments should be applied retrospectively to all periods presented upon their effective date. Early adoption is permitted, 
and an entity is also permitted to early adopt any removed or modified disclosures and delay adoption of the additional disclosures until 
their effective date. The Company adopted this guidance effective January 1, 2020. The adoption of this new accounting standard did 
not have a significant impact on the Company's consolidated financial statements. 

Accounting Pronouncements Not Yet Adopted 

In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments — Credit Losses (Topic 326) (“ASU 2016-13”) and 
subsequent amendments to the initial guidance including ASU No. 2018-19, ASU No. 2019-04, and ASU No. 2019-05 (collectively, 
“Topic 326”). Topic 326 requires entities to measure all expected credit losses for financial assets held at the reporting date based on 
historical experience, current conditions, and reasonable and supportable forecasts. This replaces the existing incurred loss model and 
is applicable to the measurement of credit losses on financial assets measured at amortized cost. This standard is effective for public 
business  entities,  excluding  entities  eligible  to  be  smaller  reporting  companies  for  fiscal  years  beginning  after  December 15,  2019, 
including  interim  periods  within  those  fiscal  years.  For  all  other  entities,  this  standard  is  effective  for  annual  and  interim  periods 
beginning after December 15, 2022 and early adoption is permitted for annual and interim periods beginning after December 15, 2018. 
As a smaller reporting company, the Company expects to adopt this standard in fiscal year 2023. The Company is currently assessing 
the impact that the adoption of this ASU will have on the consolidated financial statements. 

There are no other recently issued accounting pronouncements that are expected to have a material effect on the Company’s 

financial position, results of operations or cash flows. 

3.      INVESTMENT IN EQUITY SECURITIES, AT FAIR VALUE AND LONG-TERM INVESTMENTS 

Investment in equity securities, at fair value 

MaxCyte Inc. 

The  Company  has  an  equity  investment  in  the  common  stock  of  MaxCyte,  a  publicly  traded  company.  The  Company’s 
investment  in  this  equity  security  is  carried  at  its  fair  value,  with  changes  in  fair  value  reported  in  the  consolidated  statements  of 
operations and comprehensive loss in each reporting period. The fair value of this security was measured using its quoted market price, 
a Level 1 input, and was $3.9 million as of December 31, 2021 and $2.7 million on December 31, 2020 (see Note 19). 

BioInvent International AB 

In October 2020, in conjunction with its license agreement entered into with BioInvent (see Note 1), a publicly traded company, 
CASI made a $6.3 million investment (equivalent to SEK 53.8 million) to acquire 1.2 million new shares (after 25:1 reverse stock split) 
of BioInvent, and 14,700,000 warrants, each warrant with a right to subscribe for 0.04 shares (after 25:1 reverse stock split)  in BioInvent 
within a period of five years. 

The investments in the ordinary shares and warrants of BioInvent are carried at fair value, with changes in fair value reported 
in the statement of operations each reporting period. The fair value of the ordinary shares was measured using its quoted market price, 
a Level 1 input, and was $6.0 million and $6.6 million as of December 31, 2021 and 2020 (see Note 19). 

The fair value of the warrants was measured using observable market-based inputs other than quoted prices in active markets 
for identical assets, level 2 inputs.  The Company uses the Black-Scholes-Merton valuation model to estimate the fair value of warrants. 
The fair value of the warrants was $591,000 as of December 31, 2021 (see Note 19), with assumptions including an expected life of 
3.91 years, an assumed volatility of 46.32%, and a risk-free interest rate of 0.07%. The fair value of the warrants was $840,000 as of 

F-18 

 
December 31, 2020, with assumptions including an expected life of 4.91 years, an assumed volatility of 47.63%, and a risk-free interest 
rate of 0.36%. The Company recognized for such warrants unrealized loss of $0.25 million for the year ended December 31, 2021 and 
unrealized gain of $0.18 million for the year ended December 31, 2020, respectively. 

The following table summarizes the Company’s investments in equity securities at fair value as of December 31, 2021 and 

2020, respectively: 

(In thousands) 
As of December 31, 2021 

MaxCyte - equity interest 
BioInvent - equity interest 

Total 

(In thousands) 
As of December 31, 2020 

MaxCyte - equity interest 
BioInvent - equity interest 

Total 

Classification 
Investment
Investment

Classification 
Investment
Investment

Cost 

— $
$

5,661

Cost 

— $
$

5,661

$
$

$
$

Gross 

unrealized    Aggregate fair

gains  
 3,866   $ 
 341   $ 
   $ 

value 

3,866
6,002
9,868

Gross 

unrealized    Aggregate fair

gains  
 2,729   $ 
 919   $ 
   $ 

value 

2,729
6,580
9,309

Unrealized gains on the Company’s equity investments for the years ended December 31, 2021 and 2020 were $1.1 million 
and $3.0 million, respectively. Unrealized lossess on the Company’s equity investments for the years ended December 31, 2021 and 
2020 were $0.6 million and nil, respectively.Unrealized gains (losses) on the Company’s equity investments are recognized as change 
in fair value of investment in the consolidated statements of operations and comprehensive loss. 

F-19 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
    
    
     
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
    
    
     
 
 
591
5,576

1,385
32,308
—
40,128

Aggregate 
fair value 

83

840

Long-term investments 

Long-term investments as of December 31, 2021 and 2020 consisted of the following: 

As of December 31, 2021 
(In thousands) 
Available-for-sale debt securities: 

Gross 
unrealized 
gains 

Gross 
unrealized 
  losses (including 
 impairment) 

Foreign 
currency 
translation 
adjustment 

Aggregate 
fair value 

Cost 

Alesta Therapeutics B.V. - convertible loan 

  $

261

$

7

$

—   $ 

— $

268

Securities measured at fair value: 

BioInvent International AB - warrants 
Cleave Therapeutics, Inc. - convertible loan 

Equity securities without readily determinable fair 
value: 

Alesta Therapeutics B.V. - equity interests 
Juventas Cell Therapy Ltd - equity interests 
Juventas Cell Therapy Ltd - put option 

Total 

  $

656
5,500

2,250
23,500
491
32,658

$

—
76

—
6,958
—
7,041

(65) 
—  

—
—

(865) 
—  
(521) 
(1,451)  $ 

—
 1,850
30
 1,880

$

$

As of December 31, 2020 
(In thousands) 
Available-for-sale debt securities: 

Gross 
unrealized 
gains 

Gross 
unrealized 
  losses (including 
 impairment) 

Foreign 
currency 
translation 
adjustment 

Cost 

Black Belt Tx Limited - convertible loan 

  $

83

$

— $

—   $ 

— $

Securities measured at fair value: 

BioInvent International AB - warrants 

Equity securities without readily determinable fair 
value: 

Alesta Therapeutics B.V. - equity interests 
Juventas Cell Therapy Ltd - equity interests 
Juventas Cell Therapy Ltd - put option 

Total 

  $

656

184

—  

—

2,250
23,500
491
26,980

$

—
1,469
—
1,653

$

—  
—  
(306) 
(306)  $ 

—
 1,090
25
 1,115

$

2,250
26,059
210
29,442

Alesta Therapeutics B.V. (previously Black Belt Tx Limited) 

In April 2019, in conjunction with its license agreement the Company entered into with Black Belt (see Note 1), the Company 
made a 2 million euros ($2,249,600) equity investment in the ordinary shares of a newly established, privately held UK Company, Black 
Belt Tx Limited (“Black Belt Tx”), representing a 14.1% equity interest with the right to appoint a non-voting board observer.  

Because the Company does not have significant influence over operating and financial policies of Black Belt Tx, and the equity 
interests do not yet have readily determinable fair value, the investment in Black Belt Tx is stated at cost minus impairment, if any, plus 
or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment. 

In July 2021, Alesta Therapeutics B.V. (“Alesta Tx”) was incorporated as the parent company holding all shares of Black Belt 
Tx with same ownership structure as Black Belt Tx. CASI obtained 14.1% equity interest in Alesta Tx in exchange for its 14.1% equity 
interest in Black Belt Tx. In July 2021, a new investor contributed 750,000 euros to Alesta Tx in exchange for 770,270 newly issued 
common stocks, representing 8.3% of the fully diluted capital. Upon the completion of the capital contribution, the Company’s equity 
ownership in Alesta Tx was diluted from 14.1% to 12.9% with a fair value of $1,385,000, indicating an impairment of equity investment 
in Black Belt Tx. The Company recorded impairment of $865,000 representing the difference between the fair value of the investment 
and its carrying amount during the year ended December 31, 2021. 

In July 2020, the Company entered into a three-year convertible loan agreement with Black Belt Tx (the “Black Belt Tx Loan”) 
in the amount of 211,800 euros ($250,000) with a non-compounding annual interest rate of 6% payable, together with the principal 
balance at maturity.  

F-20 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
    
    
     
    
  
 
    
 
    
 
    
 
   
 
 
 
 
 
 
 
 
 
   
  
 
  
 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
    
    
     
    
  
 
    
 
    
 
    
 
   
 
 
 
 
 
 
 
 
  
 
  
 
  
 
  
 
The loan principal will be disbursed in three equal installments of 70,600 euros. The first tranche of 70,600 euros ($83,000) 
was disbursed upon execution of the loan agreement in August 2020. The second tranche of 70,600 euros ($86,000) was disbursed in 
February 2021, upon Black Belt Tx’s achievement of certain operational targets as stipulated in the loan agreement and approved by the 
Black Belt Tx’s Board of Directors. The third tranche would have been disbursed if Black Belt Tx reaches certain additional operational 
targets as stipulated in the loan agreement and approved by Black Belt Tx's Board of Directors. 

In the event that Black Belt Tx, on or prior to the maturity date, completes an equity financing round of at least 5,000,000 euros 
($5.9 million), then the outstanding principal amount shall be automatically converted into such shares at 80% of the price per share 
issued divided by a compensating factor based on the number of years that the Black Belt Tx Loan has been outstanding. The investment 
in convertible loan is accounted for as investment in debt securities as available-for-sale instrument. 

In July 2021, Black Belt Tx repaid the convertible loan of 146,566 ($172,000) euros to the Company, including 1st tranche of 
70,600 euros ($83,000), 2nd tranche of 70,600 euros ($83,000)and interest of 5,366 euros ($6,000). Concurrently, the Company entered 
into a three-year convertible loan agreement with Alesta Tx (the “Alesta Tx Loan”) in the amount of 217,166 euros ($261,000) with a 
non-compounding annual interest rate of 6% payable, together with the principal balance, at maturity. 

Juventas Cell Therapy Ltd. 

In June 2019, in conjunction with its license agreement entered into with Juventas (see Note 1), the Company, through CASI 
Biopharmaceuticals,  made  an  RMB  80  million  ($11,788,000)  investment  in  Juventas,  a  privately  held,  China-based  company,  in 
Juventas’ Series A plus equity, which represented a 16.327% equity interests on a fully diluted basis, and the right to appoint a non-
voting board observer. The Company is entitled to substantive liquidation preference over the founding shareholders of Juventas. In 
addition, the Juventas’ founding shareholders provided a put option to the Company pursuant to which the Company can put the equity 
investment to the founding shareholders at a fixed return of 8% per annum upon occurrence of certain events. The investment in the 
equity interests of the Juventas and the investment in put option to the founding shareholders were accounted for as investments in 
equity securities using the measurement alternative at its cost, minus impairment, if any, plus or minus changes resulting from observable 
price changes in orderly transactions for the identical or a similar investment of the same issuer, as the fair value of the equity securities 
of Juventas is not readily determinable. The consideration of RMB 80 million ($11,788,000) was allocated into investment in equity 
interests and investment in put option based on their relative fair value on the transaction date. 

In September 2020, in conjunction with the Supplementary Agreement entered into with Juventas (see Note 1), the Company 
obtained  additional  Series  A  plus  equity  interests  in  Juventas  with  substantive  liquidation  preference  over  Juventas’  founding 
shareholders, resulting in the Company's equity ownership increasing to 16.45% (post-Juventas Series B financing) on a fully diluted 
basis. CASI Biopharmaceuticals is also entitled to appoint a director to Juventas’ board of directors. Juventas' founding shareholders 
also provided a put option to the Company pursuant to which the Company can put the additional equity investment to the founding 
shareholders at RMB 70 million plus a fixed return of 8% per annum upon occurrence of certain events. The transaction closed on 
September 29, 2020. The fair value of the Company’s additional equity interests in Juventas and the new put option was RMB 83.7 
million ($12.3 million) and RMB 0.4 million ($64,000) on September 29, 2020, respectively. 

Since  the  equity  interests  with  substantive  liquidation  preference  is  not  in-substance  common  stock,  the  investment  in  the 
additional  equity  interests  of  Juventas  was  accounted  for  as  an  investment  in  equity  securities  at  transaction  date  fair  value  with  a 
corresponding credit to Other Liabilities. The profit-sharing liability represents the Company’s obligation to pay an increased share of 
future  profits  pursuant  to  the  Supplementary  Agreement  (see  Note  1) which  was  conveyed  by  the  Company  in  exchange  for  the 
additional equity interests in Juventas. The Company views this as a payment from a vendor that should reduce cost of revenues over 
the period of royalty payments. The long-term liability will be derecognized as payments are made on a systematic and rational basis 
representing  the  pattern  in  which  the  Company  expects  to  settle  the  profit-sharing payment  during  the  commercialization  period of 
CNCT19. 

The investments are measured using the measurement alternative at its cost, minus impairment, if any, plus or minus changes 
resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer, as the fair 
value of the equity securities of Juventas is not readily determinable. In addition, the changes in the fair value of the original investment 
in equity interests and put option in the amount of $1,116,000 resulting from the observable price in this transaction was recognized 
during the year ended December 31, 2020.  

On  October 26,  2021,  Juventas  completed  its  Series  C  financing  through  which  it  raised  capital  of  RMB 410  million  ($63 
million).  Upon the completion of Juventas Series C financing, the Company’s equity ownership in Juventas decreased to 12.01% on a 
fully diluted basis. The Company determined the Series C financing represented an orderly transaction for a similar investment of the 
same issuer. The fair value of the Company’s equity interests in Juventas and the put option was RMB 205.6 million ($32.3 million) 

F-21 

and nil on October 26, 2021, respectively. The Company recognized gain of fair value change for equity interests of RMB 35.2 million 
($5.5 million) and loss of fair value change for put option of RMB1.4 million ($0.2 million), respectively, in its consolidated statements 
of operations and comprehensive loss for the year ended December 31, 2021, based on the price in the orderly transaction for newly 
issued  equity  interests  of  Juventas,  which  is  further  adjusted  to  reflect  the  differences  between  the  newly  issued  equity  interests  of 
Juventas and the Company’s investment. 

In  June 2020,  the  Company  entered  into  a  one-year  loan  agreement  with  Juventas  in  the  amount  of  RMB  30,000,000 
($4,243,000) with an annual interest rate of 20%. In August 2020, the Company entered into another one-year loan with Juventas in the 
amount of RMB 40 million ($5,790,000) for one year with an annual interest rate of 20%. In September 2020, the Company received 
early  repayments  for  both  principals  and  accrued  interest  from  Juventas.  For  the  year  ended  December 31,  2020,  the  Company 
recognized interest income of $351,000 and $375,000, respectively, for these two loans. 

Cleave Therapeutics, Inc. 

In March 2021, in conjunction with its license agreement entered into with Cleave (see Note 1), CASI made a $5.5 million 
investment in Cleave through a three-year convertible note with an annual interest rate of 3% payable at maturity. The principal balance 
is also due at maturity.  The proceeds will support and advance Cleave’s programs and general operations. 

In the event that Cleave, on or prior to the maturity date, completes an equity financing round of preferred stock of at least 
$10.0 million, then the outstanding principal amount and accrued interest shall be automatically converted into such shares at 80% of 
the price per share issued.  The investment in the convertible loan is designated an investment measured at fair value through profit or 
loss. The Company recognized fair value change of $76,000 for the year ended December 31, 2021. 

4.      INVENTORIES 

The Company’s inventories consist of finished goods amounted to $1.9 million and $1.4 million, as of December 31, 2021 and 
2020, respectively. No provisions to write down the carrying amount of inventory have been recorded in the year ended December 31, 
2021 and December 31, 2020.  

5.      LEASES 

Operating lease ROU assets and liabilities are recognized at commencement date based on the present value of lease payments 

over the lease term. Rent expense is recognized on a straight-line basis over the lease term. 

Operating  lease  liabilities  are  included  in  accrued  and  other  current  liabilities  and  other  liabilities  (noncurrent)  in  the 
consolidated balance sheets as of December 31, 2021 and 2020. As of December 31, 2021  and 2020, the Company did not have any 
finance leases. 

In November 2019, CASI Wuxi entered into a fifty-year lease agreement for the right to use state-owned land in China for the 
construction of a manufacturing facility. The land parcel is 74,028.40 square meters.  The Company classifies this lease as an operating 
lease. The Company prepaid all of the lease payments for the land use right in 2019 in the amount of RMB45 million (equivalent to $6.5 
million).  

Rent expense for the years ended December 31, 2021 and 2020 was $1,452,000 and $1,600,000, respectively. There were no 

variable lease costs or sublease income for leased assets for the years ended December 31, 2021 and 2020. 

F-22 

 
 
 
 
 
Right of use assets and liabilities as of December 31, 2021 and 2020 were classified on the consolidated balance sheets as 

follows: 

(In thousands) 
Right of use assets 

Accrued and other current liabilities 
Other liabilities 
Total lease liabilities 

Supplemental cash flow information related to leases was as follows: 

(In thousands) 
Cash paid for amounts included in the measurement of lease liabilities:

Operating cash flows 

Right of use assets obtained in exchange for lease obligations:

December 31,  
2021 

December 31,  
2020 

$

$

$

 9,107  

 1,061  
 1,105  
 2,166  

$

$

$

8,696

939
965
1,904

Year Ended December 31,  
2021 

2020 

$

$

 1,354

 1,525

$

$

1,375

1,196

All of the Company’s existing leases as of December 31, 2021 and 2020 are classified as operating leases. As of December 31, 
2021 and 2020, the Company had eight and seven, respectively, material operating leases for land and facilities with remaining terms 
expiring  from  2022  through  2069  and  a  weighted  average  remaining  lease  term  of  36.47  years  and  38.37  years,  respectively.  The 
Company has fair value renewal options for many of the Company’s existing leases, none of which are considered reasonably certain 
of being exercised or included in the minimum lease term. Weighted average discount rates used in the calculation of the lease liability 
for 2021 and 2020 is 3.56% and 3.72%, respectively. The discount rates reflect the estimated incremental borrowing rate, which includes 
an assessment of the credit rating to determine the rate that the Company would have to pay to borrow, on a collateralized basis for a 
similar term, an amount equal to the lease payments in a similar economic environment. 

A  maturity  analysis  representing  the  future  undiscounted  cash  flow  of  the  Company’s  operating  leases  liabilitiesas  of 

December 31, 2021 is as follows: 

(In thousands) 
2022 
2023 
2024 
Total 
Discount factor 
Lease liability 
Amounts due within 12 months 
Non-current lease liability 

$ 

$ 

1,122
774
359
2,255
(89)
2,166
1,061
1,105

6.      PROPERTY, PLANT AND EQUIPMENT 

The Company’s property, plant and equipment (“PP&E”) mainly includes construction in progress (“CIP”), furniture and 

equipment, and  leasehold improvements. 

Construction  in  progress  (“CIP”)  is  stated  at  cost  and  includes  costs  incurred  to  acquire,  construct,  or  install  PP&E.  CIP 
overhead is expensed as incurred. Construction in progress is not depreciated until such time when the asset is substantially completed 
and ready for its intended use.  Furniture and equipment are stated at cost and are depreciated over their estimated useful lives of 3 to 5 
years. Leasehold improvements are stated at cost and are amortized over the shorter of their useful lives or the lease term. Depreciation 
and amortization expense are determined on a straight-line basis.  

In November 2019, CASI Wuxi entered into a lease agreement for the right to use state-owned land in China for the construction 
of a manufacturing facility. In 2020 and 2021, CASI Wuxi entered into a series of construction contracts for the building, remodeling 
and installation of Wuxi Project. As of December 31, 2021, the project was still under construction and the ending balance of CIP is 
$12.1 million. 

F-23 

 
 
 
 
     
 
 
     
     
 
 
 
 
  
 
 
 
     
 
 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
Property, plant and equipment consist of the following: 

(In thousands) 

Furniture and equipment 
Leasehold improvements 
Construction in progress 
Total property, plant and equipment, gross
Accumulated depreciation and amortization
Impairment of property, plant and equipment

December 31,  

2021 

2020 

1,728  
1,133  
12,095  
14,956  
(1,817) 
(427) 
12,712  

$ 

$ 

1,622
985
1,193
3,800
 (1,322)
(416)
2,062

$

$

Depreciation expense were $468,000 and $562,000 in 2021 and 2020, respectively. The Company recognized no impairment 

during the years ended December 31, 2021 and 2020. 

7.      INTANGIBLE ASSETS 

Intangible assets include ANDAs that were acquired as part of 2018 asset acquisitions of U.S. marketed generic products, as 
well as capitalized costs related to a cloud computing arrangement (“CCA”). These intangible assets were originally recorded at relative 
estimated  fair  values  based  on  the  purchase  price  for  the  asset  acquisitions  and  are  stated  net  of  accumulated  amortization  and 
impairment, if any. 

The ANDAs are amortized over their estimated useful lives of 13 years, using the straight-line method. The CCA is being 

amortized over its useful life of 5 years. 

In  February 2020,  the  Company  entered  into  an  agreement  with  Chartwell  Rx  Sciences,  LLC  (“Chartwell”)  in  which  the 
Company sold and transferred the control of seven U.S. FDA-approved ANDAs to Chartwell in exchange for $450,000 in cash, which 
the Company received in March 2020. These ANDAs had a net book value of $0 at the time of sale. The Company is entitled to an 
additional $1 million, contingent upon Chartwell receiving certain FDA approvals relating to certain of these ANDAs. The Company 
recognized a gain on disposal of intangible assets in the amount of $450,000 in the accompanying consolidated statement of operations 
and comprehensive loss for the year ended December 31, 2020. The additional $1 million is treated as variable consideration. Because 
the amount of variable consideration is highly susceptible to factors outside the Company's influence and the Company’s experience 
with similar types of contracts is limited, the Company did not include the amount of variable consideration in recognition of gain on 
disposal  of  intangible  assets  for  the  year  ended  December 31,  2021.  The  Company  will  recognize  the  variable  consideration  and 
additional gain on disposal of intangible assets when the constraint on variable consideration is resolved, i.e., Chartwell receives relevant 
FDA approvals. As of December 31, 2021, no FDA approvals have been obtained by Chartwell on those products. 

Intangible assets at December 31, 2021 and 2020 consists of the following: 

(In thousands) 
Asset as of December 31, 2021 
ANDAs 
Others 
Total 

(In thousands) 
Asset as of December 31, 2020 
ANDAs 
Others 
Total 

  $

  $

  $

  $

Purchase Price 

     Accumulated Amortization 

Purchase Price 

     Accumulated Amortization 

      Estimated useful lives 
13 years
5 years

      Estimated useful lives 
13 years
5 years

 (3,688)  
 (138) 
 (3,826) 

 (2,721)  
 (98) 
 (2,819)  

15,832
197
16,029

$

$

15,832
197
16,029

$

$

F-24 

 
 
 
 
 
 
 
     
     
  
 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
    
 
The changes in intangible assets for the years ended December 31, 2021 and 2020 are as follows: 

(In thousands) 
Balance at the beginning of the year 
Amortization expense 
Foreign currency translation adjustment 
Balance at the ending of the year 

2021 

2020 

$

$

 13,210   $
 (1,347) 
 340  
 12,203   $

13,674
(1,289)
825
13,210

Expected future amortization expense is as follows as of December 31, 2021: 

(In thousands) 
2022 
2023 
2024 
2025 
2026 
2027 and thereafter 

$ 

 1,351
 1,351
 1,323
 1,323
 1,323
 5,532

8.       ACCRUED AND OTHER CURRENT LIABILITIES, AND OTHER LIABILITIES 

(In thousands) 
Accrued and other current liabilities: 

Payroll and welfare payable 
Payables related to property and equipment
Lease liabilities-current (Note 5) 
Value-added tax and other tax payable
Other 

Other Liabilites 

Profit-sharing liability to Juventas (Note 3)
Lease liabilities-noncurrent (Note 5) 

Year Ended December 31,  

2021 

2020 

3,336   
3,288  
1,061  
652  
60   
8,397  

13,220  
1,105  
14,325  

$ 

$ 

$ 

$ 

1,535
467
939
434
49
3,424

 12,869
965
 13,834

$

$

$

$

9.       BANK BORROWINGS 

On November 3, 2020, Beijing Branch of China CITIC Bank Corporation Limited approved a guaranteed line of credit (“Bank 
Borrowings”) to the Company with maximum borrowings of RMB 10.0 million ($1.5 million).  The joint and several liability guarantee 
was provided by Beijing Capital Financing Guarantee Co, Ltd.. At December 31, 2020, the Company had outstanding borrowings under 
the Bank Borrowings of RMB 5.4 million ($0.8 million), which matured and was repaid in on November 7, 2021, and beared interest at 
a fixed rate of 3.35% per annum.    

On  February 3,  2021,  the  Company  obtained  an  additional  borrowings  of  RMB  4.6  million  ($0.7  million)  under  the  Bank 

Borrowing which also matured and was repaid in 2021, and beared a fixed interest rate of 3.72% per annum. 

Interest expense of $41,000 and $1,000 was recorded for the years ended December 31, 2021 and 2020, respectively. 

10.      NOTES PAYABLE 

On  April 27,  2020,  M&T  Bank  approved  a  $465,595  loan  to  the  Company  under  the  Paycheck  Protection  Program  (PPP) 
pursuant to the Coronavirus Aid, Relief and Economic Security (CARES) Act that was signed into law on March 27, 2020.   The loan, 
evidenced by a promissory note to M&T Bank as lender and dated April 29, 2020, has a term of two years, is unsecured, and is guaranteed 

F-25 

 
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
by the Small Business Administration (SBA). The loan bears interest at a fixed rate of one percent per annum.  Some or all of the loan 
may be forgiven if the Company complies with certain relevant conditions.  In June 2020, the PPP was amended through enactment of 
the Paycheck Protection Program Flexibility Act of 2020 (PPPFA).  Under the PPPFA, the Company’s payments of principal and interest 
were deferred until October 2021.  In September 2021, the loan principal of $465,595 and outstanding interest of $6,212 were forgiven 
and recorded in other income in the Company’s consolidated statements of operations and comprehensive loss. 

Interest expense of $2,900 and $3,100 was recorded for the years ended December 31, 2021 and 2020, respectively. 

11.      GRANTS 

In November 2019, CASI Wuxi entered into a fifty-year lease agreement for the right to use state-owned land in China for the 
construction  of  a  manufacturing  facility  (see  Note  5).  In  November 2019,  the  Company  entered  into  a  grant  agreement  with  the 
Administrative Committee of Wuxi Huishan Economic Development Zone, under which, the Company is eligible for grants up to RMB 
25 million (equivalent to $3.6 million) to support the development of CASI Wuxi’s manufacturing site. 

In April 2020, CASI Wuxi received RMB 15.9 million (equivalent to $2.2 million) from the Jiangsu Province Wuxi Huishan 
Economic Development Zone as a government grant for this development project which was recorded as deferred income in April 2020. 
In November 2021,  CASI Wuxi  received  additional  RMB  3.0  million  (equivalent  to  $0.5 million)  from  the  Jiangsu Province  Wuxi 
Huishan Economic Development Zone as a government grant for this development project which was recorded as deferred income in 
November 2021.   

As of December 31, 2021 and 2020, deferred income balance represents the grants related to the lease of the land and will be 
amortized over the remaining term of the lease of the land. The Company recognized $51,000 and $35,000 of other income during the 
years ended December 31, 2021 and 2020, respectively. 

12.      REDEEMABLE NONCONTROLLING INTEREST 

On  December 26,  2018,  the  Company,  together  with  Wuxi  Jintou  Huicun  Investment  Enterprise,  a  limited  partnership 
organized under Chinese law (“Wuxi LP”) established CASI Wuxi to build and operate a manufacturing facility in the Wuxi Huishan 
Economic Development Zone in Jiangsu Province, China. The Company holds 80% of the equity interests in CASI Wuxi and will invest, 
over time, $80 million in CASI Wuxi. The Company’s investment will consist of (i) $21 million in cash (paid in February 2019), (ii) a 
transfer of selected ANDAs valued at $30 million (transferred in May 2019), and (iii) an additional $29 million cash payment within 
three years from the date of establishment of CASI Wuxi. The payment schedule has been changed into three installments of $10 million 
paid in July 2021, $10 million and $9 million to be paid in 2022 and 2023, respectively. Wuxi LP holds 20% of the equity interest in 
CASI Wuxi through its investment in RMB of $20 million in cash (paid in March 2019). As the transfer of ANDAs, valued at $30 
million,  was  to  the  Company’s  consolidated  subsidiary  (CASI  Wuxi),  the  Company  recognized  the  transfer  of  the  ANDAs  at  their 
carrying value and did not recognize a gain on the transfer. 

Pursuant  to  the  investment  contract  between  the  Company  and  Wuxi  LP  and  Articles  of  Association  of  CASI  Wuxi,  the 
Company has the call option to purchase the 20% equity interest in CASI Wuxi held by Wuxi LP at any time within 5 years from the 
date of establishment of CASI Wuxi (i.e. up to December 26, 2023). Wuxi LP has the put option to require the Company to redeem the 
20% equity interest in CASI Wuxi at any time after December 26, 2023. The redemption value under both the Company’s embedded 
put option and Wuxi LP’s embedded call option is equal to $20 million plus interest at the bank loan interest rate issued by the People's 
Bank of China for the period beginning with the initial capital contribution by Wuxi LP to the date of redemption. In addition, Wuxi LP 
has the put option to require the Company to redeem the 20% equity interest in CASI Wuxi at $20 million upon the occurrence of any 
of the following conditions: (i) the Company fails to fulfill its investment obligation to CASI Wuxi; (ii) CASI Wuxi suffers serious 
losses, discontinued operation, dissolution, goes into process of bankruptcy liquidation; or (iii) the Company substantially violates the 
investment contract and Articles of Association of CASI Wuxi. 

The  investment  of  Wuxi  LP  in  CASI  Wuxi  is  treated  as  redeemable  noncontrolling  interest  and  is  classified  outside  of 
permanent equity on the consolidated balance sheets because (1) the noncontrolling interest is not mandatorily redeemable financial 
instruments, and (2) it is redeemable at the option of the holder, or upon the occurrence of an event that is not solely within the control 
of the Company. The Company initially recorded the redeemable noncontrolling interest at its fair value of $20 million. The carrying 
amount of the redeemable noncontrolling interest is subsequently recorded at the greater of the amount of (1) the initial carrying amount, 
increased or decreased for the redeemable noncontrolling interest’s share of net income or loss in CASI Wuxi or (2) the redemption 

F-26 

 
   
 
value, assuming the noncontrolling interest is redeemable at the balance sheet date. Accretion of the carrying amount of redeemable 
noncontrolling interest to the redemption value is recorded in additional paid-in capital. 

Changes in redeemable noncontrolling interest during the years ended December 31, 2021 and 2020 are as follows: 

(In thousands) 
Balance at beginning of period 
Share of CASI Wuxi net loss 
Accretion of redeemable noncontrolling interest 
Foreign currency translation adjustment 
Balance at end of period 

13.      STOCKHOLDERS’ EQUITY 

Year Ended December 31,  

2021 

2020 

$

$

22,033    $ 
(700)
1,512
612
23,457

$ 

20,670
(918)
1,694
587
22,033

The Company had 250 million of authorized common stock at December 31, 2021 and 2020, respectively. The Company had 
5 million of authorized preferred stock as of December 31, 2021 and 2020. The Company held 79,545 of shares of common stock in 
treasury at its acquisition cost at December 31, 2021 and 2020. 

Stock Repurchase Program 

On December 15, 2021, the board of directors of CASI Pharmaceuticals, Inc. (the “Company”) approved a stock repurchase 
program for the repurchase of up to USD 10 million of the Company’s common stock (and no more than 12,500,000 shares of the 
Company’s common stock) through open market purchases in compliance with Rule 10b-18 under the Securities Exchange Act of 1934 
and through trading plans established pursuant to Rule 10b5-1 of the Securities Exchange Act. Under any Rule 10b5-1 trading plan the 
Company might adopt, the Company’s third-party broker, subject to Securities and Exchange Commission regulations regarding certain 
price, market, volume and timing constraints, would have authority to purchase the Company’s common stock in accordance with the 
terms of the plan. The actual timing, number and value of shares repurchased under the stock repurchase program will depend on a 
number of factors, including constraints specified in any Rule 10b5-1 trading plans, price, general business and market conditions, and 
alternative investment opportunities. The stock repurchase program does not obligate the Company to acquire any specific number of 
shares in any period, and may be expanded, extended, modified or discontinued at any time. The Company anticipates funding for stock 
repurchase program to come from available corporate funds, including cash on hand and future cash flow. As of March 18, 2022, the 
Company has repurchased 3,207,661 shares of common stock amounted to $2.5 million under a Rule 10b5-1 trading plan that will 
terminate on March 31, 2022. 

March 2021 Underwritten Public Offering  

On March 24, 2021, the Company closed an underwritten public offering of 15,853,658 shares of the Company’s common 
stock (the “Offering”) at a price to the public of $2.05 per share. The gross proceeds to CASI from the Offering were $32.5 million 
before deducting the underwriting discounts and commissions and offering expenses payable by CASI. 

The Company is using the net proceeds of this offering for working capital and general corporate purposes, which include, but 
are  not  limited  to  advancing  the  Company’s  product  portfolio,  acquiring  the  rights  to  new  product  candidates  and  general  and 
administrative expenses. 

July 2020 Underwritten Public Offering 

On July 24, 2020, the Company closed an underwritten public offering of 23 million shares of common stock (the "Offering") 
and  received  gross  proceeds  of  $43.7  million  before  deducting  the  underwriting  discounts  and  commissions  and  offering  expenses 
payable by CASI. Certain insiders, including CASI's Chairman and CEO, and CASI's President, purchased shares of common stock in 
the Offering at the public offering price and on the same terms as the other purchasers in this Offering. CASI's Chairman and CEO 
purchased 2,952,426 shares directly and ETP Global Fund LP purchased 1,200,000 shares. CASI's President purchased 20,152 shares. 

Common Stock Sales Agreements 

On February 23, 2018, the Company entered a Common Stock Sales Agreement (the “Sales Agreement”), as amended, with 
H.C. Wainwright & Co., LLC (“HCW”) that would allow the Company to sell up to $20 million of shares of common stock in “at-the-

F-27 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
market” transactions, subject to compliance with the terms and conditions of the Sales Agreement. In 2018, the Company issued 143,248 
shares under the Sales Agreement resulting in net proceeds to the Company of $475,000. During the year ended December 31, 2021, 
the Company has not offered and sold any shares of common stock under the Sales Agreement. Concurrently with and upon the execution 
of the new Stock Sales Agreement mentioned below, the Sales Agreement dated as of February 23, 2018, between CASI and HCW, 
was terminated by mutual agreement of the parties. 

On July 19, 2019, the Company entered into an Open Market Sale AgreementSM with Jefferies LLC , as sales agent (the “Open 
Market Agreement”) pursuant to which the Company may elect to sell from time to time, at its option, up to $30 million in shares of the 
Company’s common stock, subject to the terms and conditions of the Open Market Agreement. In 2019, the Company issued 59,000 
shares under the Open Market Agreement resulting in net proceeds to the Company of $182,000. In 2020, the Company issued 434,000 
shares under the Open Market Agreement with net proceeds of $1,357,000. During the year ended December 31, 2021, the Company 
has not offered and sold any shares of common stock under the Open Market Agreement. As of December 31, 2021, the Company issued 
493,000 shares with net proceeds of $1,539,000. As of December 31, 2021, $28.5 million remained available under the Open Market 
Agreement.  

On October 29, 2021, the Company has entered into a common stock sales agreement (“Stock Sales Agreement”), with H.C. 
Wainwright & Co., LLC, relating to shares of common stock of the Company. In accordance with the terms of the sales agreement, the 
Company  may  offer  and  sell  shares  of  common  stock  in  “at-the-market”  transactions,  subject  to  compliance  with  the  terms  and 
conditions of the Stock Sales Agreement, with an aggregate offering price of not more than $20,000,000. As of December 31, 2021, the 
Company has not offered or sold any shares of common stock under the sales agreement. 

Stock Purchase Warrants 

In  history,  the  Company  issued  shares  of  its  common  stock  with  accompanying  warrants  to  certain  institutional  investors, 

accredited investors and existing stockholders. 

Stock purchase warrants activity for the years ended December 31, 2021 and 2020 is as follows: 

Outstanding at December 31, 2019 

Exercised 
Expired 

Outstanding at December 31, 2020 

Expired 

Outstanding at December 31, 2021 
Exercisable at December 31, 2021 

Number of 
 Warrants 
9,843,720    $ 
(82,304)   $ 
(1,489,707)   $ 
8,271,709    $ 
(2,098,877)   $ 
6,172,832    $ 
6,172,832    $ 

  Weighted Average
      Exercise Price 
4.43
1.69
3.75
4.58
7.19
3.69
3.69

All outstanding warrants are equity classified and will expire by March 2023. 

14.      COSTS OF REVENUES 

Costs of revenues consists primarily of the cost of inventories of EVOMELA®  and sales-based royalties related to the sale of 
EVOMELA®. The Company is obligated to pay 20% of the Company’s revenue from EVOMELA®  sales as royalties for a period of 10 
years after the commercial launch of the products in 2019. 

15.      NET LOSS PER SHARE 

Net loss per share (basic and diluted) was computed by dividing net loss attributable to common stockholders, considering the 
accretions to redemption value of the redeemable noncontrolling interest, by the weighted average number of shares of common stock 
outstanding.  As  of  December 31,  2021,  and  2020,  outstanding  stock  options  totaling  33,243,790  and  16,746,238,  respectively,  and 
outstanding  warrants  totaling  6,172,832  and  8,271,709,  respectively,  were  anti-dilutive,  and  therefore,  were  not  included  in  the 
computation of weighted average shares used in computing diluted loss per share. 

F-28 

 
 
 
 
 
 
 
 
 
    
 
 
The following table sets forth the basic and diluted net loss per share computation and provides a reconciliation of the numerator 

and denominator for the periods presented: 

(In thousands, except share and per share data) 
Numerator: 
Net loss attributable to CASI Pharmaceuticals, Inc. 
Denominator: 
Weighted average number of common stock 
Denominator for basic and diluted net loss per share calculation
Net loss per share 
— Basic and diluted 

16.      EMPLOYEE BENEFIT PLAN 

Year Ended December 31,  

2021 

2020 

$

$

(36,654) 

$ 

(48,287)

136,105,539  
136,105,539  

110,452,288
110,452,288

(0.27) 

$ 

(0.44)

The Company sponsors the CASI Pharmaceuticals, Inc. 401(k) Plan and Trust. The plan covers substantially all U.S. employees 
and enables participants to contribute a portion of salary and wages on a tax-deferred basis. Contributions to the plan by the Company 
are discretionary. Contributions by the Company totaled $187,000 and $250,000 for the years ended December 31, 2021 and 2020, 
respectively. 

Full time employees of the Company in the PRC participate in a government mandated defined contribution plan, pursuant to 
which certain pension benefits, medical care, employee housing fund and other welfare benefits are provided to employees. Chinese 
labor regulations require that the PRC subsidiaries of the Company make contributions to the government for these benefits based on 
certain percentages of the employees’ salaries. The Company has no legal obligation for the benefits beyond the contributions made. 
The total amounts for such employee benefits, which were expensed as incurred, were $3,137,000 and $1,542,000 for the years ended 
December 31, 2021 and 2020, respectively. 

17.      STOCK-BASED COMPENSATION 

The  Company  has  adopted  various  stock  compensation  plans  for  executive,  scientific  and  administrative  personnel  of  the 

Company, as well as outside directors and consultants.  

In June 2019, the Company’s stockholders approved an amendment to the 2011 Long-Term Incentive Plan (the “2011 Plan” ), 
increasing the number of shares of common stock reserved for issuance from 20,230,000 to 25,230,000 to be available for grants and 
awards.  

On June 15, 2021, the 2021 Long-Term Incentive Plan (the “2021 Plan”) was approved by the Company's stockholders. The 
maximum number of shares of common stock that are available for grants and awards equals to 20,000,000 shares of stock, which 
includes  10,726,673  shares  of  common  stock  remaining  under  the  2011  Plan  as  of  April 12,  2021.  Currently,  the  2021  Plan  is 
administered by the Company’s compensation committee. 

As of December 31, 2021, a total of 10,515,448 shares remained available for grant under the Company’s 2021 Long-Term 

Incentive Plan. 

In addition to the 2011 Plan and the 2021 Plan, the Company also granted stock options to Dr. He, the Company’s Chairman 
and CEO. On June 20, 2019, the Company’s stockholders approved a grant of stock options to Dr. He at the 2019 Annual Meeting. 
Under the terms of the grant, Dr. He received a stock option covering 4 million shares of common stock, at an exercise price of $2.85, 
vesting upon the earlier of (i) the completion of a transformative event by the Company as determined at the discretion of the Company’s 
compensation committee and (ii) April 2, 2021, the second anniversary of the date of his appointment as CEO. On June 15, 2021, the 
Board approved a grant of stock options to Dr. He which consists of 4 million shares time-based and 4 million shares performance-
based stock options. 

F-29 

 
 
 
 
 
 
         
 
 
 
 
  
  
   
 
 
 
 
 
The  share-based  compensation  expenses  are  recorded  as  components  of  general  and  administrative  expense,  selling  and 

marketing expense, and research and development expense, as follows: 

(In thousands) 
Research and development 
Sales and Marketing 
General and administrative 
Share-based compensation expense 

Year Ended December 31,  

2021 

2020 

$

$

361
449
6,960
7,770

$

$

 245
 39
 7,537
 7,821

Compensation expense related to stock options with service conditions is recognized over the requisite service period, which 
is generally the option vesting term of up to five years. Compensation expense related to stock options with performance conditions are 
recognized when it is probable that the performance condition will be achieved. For the years ended December 31, 2021 and 2020, 
$2,319,000  and  $49,000  was  expensed  for  stock  option  awards  with  performance  conditions  that  were  probable  during  the  year, 
respectively. 

The Company uses the Black-Scholes-Merton valuation model to estimate the fair value of service based and performance-
based  stock  options  granted  to  employees.  Option  valuation  models,  including  Black-Scholes-Merton,  require  the  input  of  highly 
subjective assumptions, and changes in the assumptions used can materially affect the grant date fair value of an award.  

Expected Volatility—Volatility is a measure of the amount by which a financial variable such as a share price has fluctuated 
(historical volatility) or is expected to fluctuate (expected volatility) during a period. The Company uses the historical volatility based 
on the daily price observations of its common stock during the period immediately preceding the share-based award grant that is equal 
in length to the award’s expected term. The Company believes that historical volatility represents the best estimate of future long term 
volatility. 

Risk-Free Interest Rate—This is the average interest rate consistent with the yield available on a U.S. Treasury note (with a 

term equal to the expected term of the underlying grants) at the date the option was granted. 

Expected  Term  of  Options—This  is  the  period  of  time  that  the  options  granted  are  expected  to  remain  outstanding.  The 
Company uses a simplified method for estimating the expected term of service based awards granted. For performance based awards, 
the expected term of service is based on the derived service period. 

Expected Dividend Yield—The Company has never declared or paid dividends on its common stock and does not anticipate 

paying any dividends in the foreseeable future. As such, the dividend yield percentage is assumed to be zero. 

Following are the weighted-average assumptions used in valuing the stock options granted to employees during the years ended 

December 31, 2021 and 2020: 

Expected volatility 
Range of expected volatility 
Range of risk free interest rate 
Expected term of option 
Expected dividend yield 

Year Ended December 31,  

2021 

79.68 %
75.69%-81.50 %
0.72%-1.38 %

2020 

 78.70  %
75.84% to 81.63  %
0.31% to 1.77  %

6.17 years
0.00 %

 6.10  years
 0.00  %

The weighted average fair value of stock options granted during the years ended December 31, 2021 and 2020 were $1.0 and 

$1.85, respectively. 

F-30 

 
 
 
 
 
    
    
  
 
 
 
 
 
 
 
 
 
 
 
 
    
     
     
 
A summary of the Company’s stock option plans and changes in options outstanding under the plans during the years ended 

December 31, 2021 and 2020 is as follows: 

  Weighted Average Weighted Average Remaining  

Outstanding at December 31, 2019 

Exercised 
Granted 
Expired 
Forfeited 
Cancelled 

Outstanding at December 31, 2020 

Exercised 
Granted 
Expired 
Forfeited 
Cancelled 

Outstanding at December 31, 2021 
Vested and expected to vest at 
December 31, 2021 
Exercisable at December 31, 2021 

 18,268,372
 (2,789,473)
2,380,686
(117,722)
(995,625)

     Number of Options     Exercise Price 
2.58
1.39
2.71
5.06
3.78
—
2.71
—
1.49
4.56
2.64
—
2.04

$
$
$
$
$
— $
$
— $
$
$
$
— $
$

 17,939,552
(387,000)
 (1,055,000)

 16,746,238

 33,243,790

 33,243,790
 15,294,016

$
$

2.04
2.44

     Contractual Term In Years       Aggregate Intrinsic Value

   $

1,856,978

   $

7.71   $

7.71   $
5.81   $

—

—

—
—

The aggregate intrinsic value is calculated as the difference between (i) the closing price of the common stock at December 31, 
2021 and (ii) the exercise price of the underlying awards, multiplied by the number of options that had an exercise price less than the 
closing price on the last trading day of the year. Cash received from option exercises under all share-based payment arrangements for 
the twelve months ended December 31, 2021 and 2020 was $0 and $3.9 million, respectively. 

The following summarizes information about stock options that are outstanding at December 31, 2021: 

Options Outstanding 

Options Exercisable 

Range of 
Exercise Prices 
$0.00 - $1.00 
$1.01 - $2.00 
$2.01 - $4.00 
$4.01 - $7.00 
$7.01 - $9.00 

Weighted 
Average 
   Remaining    
   Contractual   

Number 

   Outstanding at 
    December 31, 2021     Life in Years      
$
$
$
$
$
$

3,223,853
20,495,481
8,209,456
1,110,000
205,000
33,243,790

        7.66
        7.98
        7.25
        6.65
        6.50
7.71

  Weighted 
Average 
Exercise 
Price 

Number 

  Exercisable at 

      December 31, 2021     
$
$
$
$
$
$

 1,373,853
 6,158,707
 6,746,456
 810,000
 205,000
 15,294,016

0.87   
1.52   
2.99   
6.82   
8.23   
2.04   

  Weighted 
Average 
Exercise 
Price 

0.87
1.47
2.94
6.89
8.23
2.44

As of December 31, 2021, there was $16,148,000 of total unrecognized compensation cost related to non-vested stock options, 
excluding not-probable performance condition options. That cost is expected to be recognized over a weighted-average period of 2.7 
years. 

18.      INCOME TAXES 

For financial reporting purposes, loss before income taxes includes the following components: 

(In thousands) 
United States 
PRC 
Total 

2021 

(32,169) 
(3,673) 
(35,842) 

$ 

$ 

2020 

 (40,626)
 (6,885)
 (47,511)

$

$

F-31 

 
 
 
 
 
 
 
 
 
 
 
  
      
  
  
      
  
      
  
 
 
  
      
  
 
 
  
  
      
  
      
  
      
 
 
 
  
 
  
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 
 
  
  
 
 
 
 
  
 
  
 
  
 
 
  
  
 
  
  
  
  
  
 
  
 
 
 
 
 
 
 
     
     
  
 
Significant components of the Company’s deferred income tax assets and liabilities as of December 31, 2021 and 2020 are as 

follows: 

(In thousands) 
Deferred income tax assets: 
   Net operating loss carryforwards 

Research and development credit carryforwards
Intangible assets 
Stock-based compensation 
Impairment loss of long-term investments
Others 
Valuation allowance for deferred income tax assets

Deferred income tax liabilities: 

Deferred Royalty Income 
Change in fair value of investments 
Others 

December 31,  

2021 

2020 

69,684  
4,259  
8,051  
5,336  
182  
540  
(83,651) 
4,401  

(2,342) 
(1,865) 
(194) 
(4,401) 

$ 

$ 

$ 

 78,790
6,244
8,049
5,126
—
394
 (94,986)
3,617

 (2,823)
(690)
(104)
 (3,617)

$

$

$

The Company has U.S. federal and state net operating loss (NOL) carryforwards of $302.1 million at December 31, 2021. 
Federal and certain state NOLs generated after 2017, have indefinite lives. Certain NOLs generated prior to 2018 begin to expire in 
years  2022  through  2037.  The  Company  also  has  People’s  Republic  of  China  (“PRC”)  NOLs  carryforward  of  $24.2  million  at 
December 31, 2021 that begin to expire in years 2022 through 2026. The Company also has research and experimentation (“R&E”) tax 
credit carryforwards of $4.3 million as of December 31, 2021 that begin to expire in years 2022 through 2038. Unused R&E tax credit 
carryforwards expire after a period of 20 years. 

Under the provisions of the Internal Revenue Code, the NOL and tax credit carryforwards are subject to review and possible 
adjustment by the Internal Revenue Service and state tax authorities. NOL and tax credit carryforwards may become subject to an annual 
limitation in the event of certain cumulative changes in the ownership interest of significant shareholders over a three-year period in 
excess of 50%, as defined under Sections 382 and 383 of the Internal Revenue Code of 1986, respectively, as well as similar state tax 
provisions. This could limit the amount of tax attributes that the Company can utilize annually to offset future taxable income or tax 
liabilities. The amount of the annual limitation, if any, will be determined based on the value of the Company immediately prior to the 
ownership change. Subsequent ownership changes may further affect the limitation in future years. For financial reporting purposes, a 
100% valuation allowance has been recognized to reduce the net deferred tax assets to zero because it is more likely than not that the 
Company could not generate sufficient taxable income in the future to realize the benefit of deferred income tax assets. 

A reconciliation of the provision for income taxes to the federal statutory rate is as follows: 

(In thousands) 
Tax benefit at statutory rate of 21% 
State taxes 
Attribute expiration 
Change in applicable tax rates 
Nondeductible expenses 
Deemed royalty 
Others 
Change in valuation allowance 

2021 

2020 

(7,526) 
—  
10,676  
7,117  
1,059  
—  
9  
(11,335) 
 —  

$ 

$ 

 (9,977)
(732)
 13,707
 11,612
358
4,220
(54)
 (19,134)
 —

$

$

Note (1) Change in applicable tax rates represents the difference between the US federal statutory tax rate and the PRC statutory 
tax rate applied to the entities that operate in PRC. Additionally, change in applicable tax rates reflects the reduction of the Company’s 
deferred tax assets related to the change in the Company’s activities in and the tax laws of certain states. 

F-32 

 
 
 
 
 
 
 
     
     
    
 
  
  
  
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
  
  
  
 
 
  
  
 
 
A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows: 

(In thousands) 
Unrecognized tax benefits balance at January 1
Reductions for tax positions of prior periods
Additions for tax positions of current period
Unrecognized tax benefits balance at December 31

2021 

2020 

2,082   $ 
(642) 
 —  
1,440   $ 

2,581
(499)
—
2,082

$

$

The Company had $1.4 million of unrecognized tax benefits as of December 31, 2021 related to net R&E tax credit. For the year 
ended  December 31,  2021,  there  was  a  net  reduction  of  unrecognized  tax  benefits  of  $0.6  million  related  to  R&E  tax  credits.  The 
Company has a  full  valuation  allowance  at  December 31,  2021  and 2020  against  the full  amount of its  net deferred  tax  assets  and, 
therefore,  there  was  no  impact  on  the  Company’s  financial  position.  The  Company  does  not  expect  significant  changes  to  the 
unrecognized benefit during 2020. As of December 31, 2021 and 2020, the Company did not accrue any interest related to uncertain tax 
positions. To date, there have been no interest or penalties charged to the Company related to income taxes. 

The Company and each of its PRC subsidiaries file income tax returns in the United States and the PRC, respectively. Due to 
the existence of tax attribute carryforwards (which are currently offset by a full valuation allowance), all of the Company’s tax returns 
since 1999 are open to examination by the taxing authorities. According to the PRC Tax Administration and Collection Law, the statute 
of limitations is three years if the underpayment of taxes is due to computational errors made by the taxpayer or the withholding agent. 
The  statute  of  limitations  is  extended  to  five  years  under  special  circumstances  where  the  underpayment  of  taxes  is  more  than 
RMB100,000 ($14,334). In the case of transfer pricing issues, the statute of limitations is ten years. There is no statute of limitations in 
the case of tax evasion. In the US, the Company is no longer subject ot income tax examinations by authorities for years ended on or 
before December 31, 2017 except for certain states where the open periods are one year longer.  

19.      FAIR VALUE MEASUREMENTS 

Financial instruments of the Company primarily consist of cash and cash equivalents, investment in equity securities, accounts 
receivable, long-term investments, accounts payable, accrued liabilities, notes payable and bank borrowings. As of December 31, 2021 
and 2020, the carrying amount of cash and cash equivalents, accounts receivable, accounts payable, accrued liabilities, notes payable 
and bank borrowings are carried at cost which approximates their fair values due to the short-term nature of the instruments. 

Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis 

The Company evaluates financial assets and liabilities subject to fair value measurements on a recurring basis to determine the 
appropriate level at which to classify them each reporting period. This determination requires the Company to make subjective judgments 
as to the significance of inputs used in determining fair value and where such inputs lie within the hierarchy. 

The Company has equity investments in the common stock of two publicly traded companies. The Company’s investments in 
these  equity  securities  are  carried  at  their  estimated  fair  value,  with  changes  in  fair  value  reported  in  the  consolidated  statement  of 
operations and comprehensive loss each reporting period (see Note 3). The fair value of the common stock is based on quoted market 
price for the investees’ common stock, a Level 1 input. 

The Company has an equity investment in the warrants of a publicly traded company. The Company’s investment is carried at 
its estimated fair value, with changes in fair value reported in the consolidated statement of operations and comprehensive loss each 
reporting period (see Note 3). The fair value of the warrants was measured using observable market-based inputs other than quoted 
prices in active markets for identical assets, level 2 inputs.  The Company uses the Black-Scholes-Merton valuation model to estimate 
the fair value of warrants. Option valuation models, including Black-Scholes-Merton, require the input of highly subjective assumptions, 
and changes in the assumptions used can materially affect the fair value determination of a warrant. 

The Company has an investment in the convertible debt of Black Belt Tx. The Company’s investment is carried at its estimated 
fair value, with changes in fair value reported in the consolidated statement of operations and comprehensive loss each reporting period 
(see Note 3) using Level 3 input. 

The Company has an investment in the convertible debt of Cleave. The Company’s investment is carried at its estimated fair 
value, with changes in fair value reported in the consolidated statement of operations and comprehensive loss each reporting period (see 
Note 3) using Level 3 input. 

F-33 

 
 
 
 
 
     
     
  
  
 
 
 
The following tables present the Company’s financial assets accounted for at fair value on a recurring basis as of December 31, 

2021 and December 31, 2020, by level within the fair value hierarchy: 

(In thousands) 

Description 

Fair Value at   
     December 31, 2021     

Level 1 

Level 2 

Level 3 

Investments classified as Current and non-Current Assets 
Investments in common stock 
Investment in warrants - Designated as investment measured at 
FVTPL  
Investment in convertible loan - AFS 
Investment in convertible loan - Designated as investment 
measured at FVTPL 

$

  $

$

$

9,868

591
268

5,576

$

$

$

$

9,868   $ 

— $

—   $ 
—   $ 

$

 591

— $

—

—
268

—   $ 

— $

5,576

Investment in convertible loan - Designated as investment 
measured at FVTPL 

Description 

Quantitative Information about Level 3 Fair Value Measurements 

Fair Value at 
December 31, 2021

  $

5,576

Valuation  
Techniques 
Discounted 
cash flow 

Unobservable
 Input 
Discount 
rate

Average/Median

20%/20%

(In thousands) 

Description 

Fair Value at 
     December 31, 2020     

Level 1 

Level 2 

Level 3 

Investments classified as Current and non-Current Assets 
Investments in common stock 
Investment in warrants - Designated as investment measured at 
FVTPL  
Investment in convertible loan - AFS 

$

$
$

9,309

840
83

$

$
$

9,309   $ 

— $

—   $ 
 —   $ 

 840

$
— $

—

—
83

Financial Assets and Liabilities Measured at Fair Value on a Non-Recurring Basis 

The Company measures equity investments without readily determinable fair values at its cost, minus impairment, if any, plus 

or minus changes resulting from observable transactions of identical or similar securities of the same issuer.  

On September 29, 2020 and October 23, 2021, respectively, the Company remeasured the investments in equity securities in 
Juventas  to the fair value (see Note 3). The Company estimated the fair value of these securities based on the transaction price of similar 
securities issued by the investee. 

Description 

Investment in equity securities using 
measurement alternative 

Fair Value at 
 September 29, 2020 
    (remeasurement date)

Valuation Techniques

  $ 

 26,059    Market approach   

Unobservable Input 
Multiples of selected 
comparable 
companies 

Average/Median

5.3/1.1

Quantitative Information about Level 3 Fair Value Measurements 

Description 
Investment in equity securities using 
measurement alternative 

       (remeasurement date)

Valuation Techniques

Unobservable Input 

Average/Median

  $ 

 32,308    Market approach   

Expected volatility    

59%/58%

Quantitative Information about Level 3 Fair Value Measurements 

Fair Value at 
 October 23, 2021 

On June 30, 2021, the Company remeasured the investment in equity securities in Alesta to the fair value of $1,385,000 (see 
Note 3). The Company estimated the fair value of the securities using Level 2 inputs based on the transaction price of identical securities 
issued by the investee. 

Non-Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis 

The Company has no non-financial assets and liabilities that are measured at fair value on a recurring basis. 

F-34 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
     
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
 
 
 
  
 
 
 
 
 
 
 
 
  
 
 
Non-Financial Assets and Liabilities Measured at Fair Value on a Non-Recurring Basis 

As of June 30, 2020, the intangible assets and assets held for sale with a total carrying amount of $3,087,000 were written down 
to their fair value of $1,550,000, resulting in an impairment charge of $1,537,000, which represents the difference between the carrying 
value of the intangible asset and assets held for sale and its fair value. The Company estimated the fair value using Level 2 inputs based 
on quoted price. Assets held for sale were subsequently sold in July 2020 and October 2020, respectively. 

No impairment was recorded for the year ended December 31, 2021. The Company has no non-financial assets and liabilities 

that are measured at fair value on a non- recurring basis as of December 31, 2021. 

20.      RELATED PARTY TRANSACTIONS 

Juventas. On July 1, 2019, the Company entered into a one-year equipment lease with Juventas in the amount of RMB 80,000 
($15,000) a month, which is classified as an operating lease. Transactions with Juventas are considered to be related party transactions 
as the Company’s CEO and Chairman is the chairman and one of the founding shareholders of Juventas. The lease was renewed for 
another year in July 2020 and in June 2021 with the same monthly lease income. During the years ended December 31, 2021 and 2020, 
the Company recognized lease income of $148,000 and $140,000, respectively.  

BioCheck.  In June 2019, the Company entered into a one-year agreement primarily for the sublease of certain office and lab 
space  with  BioCheck  Inc.  (“BioCheck”)  in  the  amount  of  $60,000  ($5,000  a  month),  which  is  classified  as  an  operating  lease. 
Transactions with BioCheck are considered to be related party transactions because Dr. Wei-Wu He, the Company’s Chairman  and 
CEO is also the Chairman of BioCheck. Transactions with ETP, parent of BioCheck, and a more than 5% shareholder of the Company, 
are  also  considered  to be  related  party  transactions  as  Dr. Wei-Wu He,  the  Company’s  CEO  and  Chairman  is  also  the  founder  and 
managing partner of ETP. 

Because the Company required additional office space, in January 2020, the agreement was amended for annualized rents in 
the amount of $144,000 ($12,000 a month) with a stipulation that the new rent was retroactive to October 1, 2019. The lease expired on 
June 9, 2021 and was not renewed. During the years ended December 31, 2021 and 2020, the Company recognized rent expense of 
$60,000 and $144,000, respectively.  

March 2021 Underwritten Public Offering Transactions.  On March 24, 2021, the Company closed an underwritten public 
offering of 15,853,658 shares of the Company’s common stock (the “Offering”) at a price to the public of $2.05 per share. The gross 
proceeds to CASI from the Offering were $32.5 million before deducting the underwriting discounts and commissions and offering 
expenses payable by CASI. 

ETP BioHealth III Fund LP (“ETP BioHealth”), in which CASI's Chairman and CEO is the founder and managing partner of 
ETP BioHealth’s general partner (Emerging Technology Partners, LLC (“ETP”)), purchased shares of common stock in the Offering at 
the public offering price and on the same terms as the other purchasers in the Offering. ETP BioHealth purchased 3,000,000 shares at 
the public offering price of $2.05 per share for a total of $6.15 million. 

21.      COMMITMENTS AND CONTINGENCIES 

In  conjunction  with  the  Cleave  agreement  entered  into  during  2021  (see  Note  1),  the  Company  is  responsible  for  certain 

milestone and royalty payments. As of December 31, 2021, no milestones have been achieved. 

In conjunction with the BioInvent agreement entered into during 2020 (see Note 1), the Company is responsible for certain 

milestone and royalty payments. As of December 31, 2021, no milestones have been achieved. 

In conjunction with the Black Belt agreement entered into during 2019 (see Note 1), the Company is responsible for certain 
milestone  and royalty payments.  In  June 2021,  the  Company  achieved  the  First-Patient-In (FPI)  in  the  Phase 1 dose escalation  and 
expansion study of CID-103, and made $750,000 milestone payment in June 2021 and 250,000 euros ($305,000) in August 2021. As of 
December 31, 2021, no other milestones have been achieved. 

In conjunction with the Pharmathen agreement entered into during 2019 (see Note 1), the Company is responsible for one 

remaining milestone payment. As of December 31, 2021, the remaining milestone has not been achieved. 

In November 2019, CASI Wuxi entered into a lease agreement for the right to use state-owned land in China for the construction 
of  a  manufacturing  facility.  Pursuant  to  the  agreement,  CASI  Wuxi  has  committed  to  invest  land  use  right  and  property,  plant  and 

F-35 

 
 
 
equipment of RMB1 billion (equivalent to $143 million) by August 2022. In 2020, for the design and construction work of the land, 
CASI Wuxi entered into several contracts for RMB 76.1 million ($12.0 million) to complete the phase 1 project of CASI Wuxi's research 
and development production base, the project was the estimated to be completed in October 2023. In February 2022, the Company has 
reached an alignment with the Wuxi local government that it will collaborate with Wuxi LP to co-develop the land continuously in the 
future, and the original three-year investment plan will be extended, details regarding the plan are under negotiation. The commitment 
under these contracts was RMB 54.5 million ($8.5 million). 

Also in 2020, CASI Wuxi entered in to a lease agreement with local government for a manufactory building next to the leased 
land. Since then, the Company entered into a series of contracts for the remodeling and installation work of the building and warehouse, 
as well as purchase of equipments. The total contract amount entered into for this building is approximately RMB 92.9 million ($14.6 
million), and the commitment under these contracts was RMB 14.6 million ($2.3 million). 

The Company is subject in the normal course of business to various legal proceedings in which claims for monetary or other 

damages may be asserted.  Management does not believe such legal proceedings, unless otherwise disclosed herein, are material. 

22.      SUBSEQUENT EVENTS 

Renewal of Agreement with CRPCGIT 

In March 2019, the Company entered into a three-year exclusive distribution agreement with CRPCGIT to appoint CRPCGIT 
on an exclusive basis as its distributor to distribute EVOMELA® in the territory of the People’s Republic of China (excluding Hong 
Kong, Taiwan and Macau), subject to certain terms and conditions. The Company’s internal marketing and sales team are responsible 
for commercial activities, including, for example, direct interaction with Key Opinion Leaders (KOL), physicians, hospital centers and 
the generating of sales. The agreement was renewed in March 2022 for another two years. 

F-36 

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