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Galmed Pharmaceuticals Ltd.UNITED STATES SECURITIES AND EXCHANGE COMMISSIONWASHINGTON, D.C. 20549 FORM 10K(Mark One)☒ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended December 31, 2020 or ☐TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from _______________________ to ___________________ Commission File Number: 00138207 Celcuity Inc.(Exact name of registrant as specified in its charter) Delaware 822863566(State or Other Jurisdiction ofIncorporation or Organization) (I.R.S. EmployerIdentification No.) 16305 36th Avenue North, Suite 100Minneapolis, MN 55446(Address of principal executive offices) (Zip Code) Registrant’s telephone number, including area code: (763) 3920767 Securities registered pursuant to Section 12(b) of the Act: Title of each classTrading Symbol(s)Name of each exchange on which registeredCommon Stock, $0.001 par value per shareCELCThe Nasdaq Stock Market LLC Securities registered pursuant to Section 12(g) of the Act: None Indicate by check mark if the registrant is a wellknown 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 Section 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 (orfor 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 ST (§232.405 of thischapter) 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 nonaccelerated filer, a smaller reporting company, or an emerging growth company. Seethe definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b2 of the Exchange Act.: Large accelerated filer☐Accelerated filer☐Nonaccelerated 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 accountingstandards 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 reportingunder Section 404(b) of the SarbanesOxley Act (15 U.S.C. 262(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 12b2 of the Act). ☐ Yes ☒ No The aggregate market value of the voting and nonvoting common equity held by nonaffiliates of the registrant, based on $6.93, the closing price of the shares of common stock on June30, 2020 (the last business day of the registrant’s most recently completed second fiscal quarter) as reported by The Nasdaq Capital Market on such date, was approximately $40,900,174. As of February 5, 2021, there were 10,304,089 shares of the registrant’s common stock outstanding. DOCUMENTS INCORPORATED IN PART BY REFERENCE Portions of the registrant’s definitive proxy statement relating to its 2021 Annual Meeting of Stockholders are incorporated by reference into Part III of this Annual Report on Form 10K. 2020 Annual Report on Form 10K Table of Contents Page PART I Item 1.Business 4 Item 1A.Risk Factors 22 Item 1B.Unresolved Staff Comments 35 Item 2.Properties 35 Item 3.Legal Proceedings 35 Item 4.Mine Safety Disclosures 35 PART II Item 5.Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 36 Item 6.Selected Financial Data 37 Item 7.Management’s Discussion and Analysis of Financial Condition and Results of Operations 38 Item 7A.Quantitative and Qualitative Disclosures About Market Risk 44 Item 8.Financial Statements and Supplementary Data 45 Item 9.Changes in and Disagreements with Accountants on Accounting and Financial Disclosures 60 Item 9A.Controls and Procedures 60 Item 9B.Other Information 60 PART III Item 10.Directors, Executive Officers and Corporate Governance 61 Item 11.Executive Compensation 62 Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters 63 Item 13.Certain Relationships and Related Transactions, and Director Independence 63 Item 14.Principal Accounting Fees and Services 63 PART IV Item 15.Exhibits, Financial Statement Schedules 64 Item 16.Form 10K Summary 64 Signatures 65 2 Special Note Regarding ForwardLooking Statements The Private Securities Litigation Reform Act of 1995 provides a “safe harbor” for forwardlooking statements. This Annual Report on Form 10K (this “Annual Report”) containsforwardlooking statements regarding us, our business prospects and our results of operations that are subject to certain risks and uncertainties that could cause our actual business,prospects and results of operations to differ materially from those that may be anticipated by such forwardlooking statements. Factors that could cause or contribute to such differencesinclude, but are not limited to, those described in Part I, Item 1A, “Risk Factors” and elsewhere in this Annual Report. Readers are cautioned not to place undue reliance on theseforwardlooking statements, which speak only as of the date of this Annual Report. We expressly disclaim any intent or obligation to update or revise any forwardlooking statements,whether as a result of new information, future events or otherwise. Readers are urged to carefully review and consider the various disclosures made by us in this Annual Report and inour other reports filed with the Securities and Exchange Commission (the “SEC”) that advise interested parties of the risks and uncertainties that may affect our business. All statements, other than statements of historical facts, contained in this Annual Report, including statements regarding our plans, objectives and expectations for ourbusiness, operations and financial performance and condition, are forwardlooking statements. In some cases, you can identify forwardlooking statements by the following words:"anticipate," "believe," "continue," "could," "estimate," "expect," "intend," "may," "might," "target," "ongoing," "plan," "potential," "predict," "project," "should," "will," "would," orthe negative of these terms or other comparable terminology, although not all forwardlooking statements contain these words. Forwardlooking statements involve known and unknownrisks, uncertainties and other factors that may cause our results, performance or achievements to be materially different from the information expressed or implied by the forwardlookingstatements in this Annual Report. Additionally, our forwardlooking statements do not reflect the potential impact of any future acquisitions, mergers, dispositions, joint ventures orinvestments that we may make. Forwardlooking statements may include, among other things, statements relating to: ·our plans to develop and commercialize our CELsignia platform and CELsignia tests for patients with cancer and our expectations regarding the various cancer subtypesour CELsignia tests will identify; ·any perceived advantage of our CELsignia platform and CELsignia tests as compared to traditional molecular or other diagnostic tests, including, without limitation, theability of our platform and tests to help physicians treat their patients’ cancers or to identify new patient populations not diagnosable with currently available diagnostictests; ·our expected firstmover advantage in providing products to culture living tumor cells on a commercial scale, or the sustainability of our competitive advantages; ·the size and growth potential of the markets for our CELsignia platform, and our ability to serve those markets; ·the rate and degree of market acceptance, both in the United States and internationally, and clinical utility of our diagnostic platform and tests; ·our ability to partner with and generate revenue from pharmaceutical partners and physicians, and the market opportunity for HER2 and cMet therapies and otherCELsignia programs for our pharmaceutical partners as a result of our CELsignia platform; ·the success of competing tests that are or may become available; ·expectations with respect to our CELsignia MultiPathway Test, which combines our CELsignia HER2 Pathway Activity Test with additional tests to analyze cMet andPI3K signaling function and the expected capabilities of such test; ·the ability of our CELsignia platform and tests to impact clinical trials by our pharmaceutical partners, such as streamlining approval from the U.S. Food and DrugAdministration (the “FDA”) of targeted therapeutics; ·the success, cost and timing of our CELsignia platform development activities and planned clinical trials, as well as our reliance on collaboration with third parties toconduct our clinical trials; ·expectations with respect to clinical trials and collaborations with third parties, including anticipated outcomes and timing of interim and final results; ·our commercialization, marketing and manufacturing capabilities and strategy; ·expectations regarding federal, state, and foreign regulatory requirements and developments, such as potential FDA regulation of our CELsignia platform and CELsigniatests, our operations and our laboratory; ·our plans with respect to pricing in the United States and internationally, and our ability to obtain reimbursement for CELsignia tests, including expectations as to ourability or the amount of time it will take to achieve successful reimbursement from thirdparty payors, such as commercial insurance companies and health maintenanceorganizations, and from government insurance programs, such as Medicare and Medicaid; ·our ability to obtain funding for our operations, including funding necessary to complete further development and commercialization of our CELsignia platform andCELsignia tests; ·our expectations with respect to our facility needs; ·our estimates regarding expenses, future revenue, capital requirements and needs for additional financing; ·future agreements with third parties about the commercialization of our CELsignia diagnostic platform and tests; ·our expectations regarding our ability to obtain and maintain intellectual property protection for our CELsignia platform and approach; ·our ability to attract and retain key scientific or management personnel; ·our expectations regarding the period during which we qualify as an emerging growth company defined under the Jumpstart Our Business Startups Act of 2012 (the“JOBS Act”); ·the impact on our business of the requirements of being a public company; ·our anticipated use of the net proceeds from our initial public offering (“IPO”); and ·our expectations regarding the impact that the COVID19 pandemic and related economic effects will have on our business and results of operations. 3Table of Contents PART I ITEM 1. Business Overview Unless otherwise provided in this Annual Report, references to the “Company,” “we,” “us,” and “our” and similar references refer to Celcuity Inc., a Delaware corporation.We own various unregistered trademarks and service marks, including our corporate logo. Solely for convenience, the trademarks, trade names and service marks in this AnnualReport, including those owned by third parties, may be referred to without the ®,TM or SM symbols, but such references should not be construed as any indicator that the owner ofsuch trademarks, trade names and service marks will not assert, to the fullest extent under applicable law, their rights thereto. We do not intend the use or display of othercompanies’ trademarks, trade names and service marks to imply an endorsement or sponsorship of us by any other companies. We are developing companion diagnostic tests designed to expand the eligible patient populations for targeted therapies by discovering new cancer subtypes molecularbasedapproaches cannot detect. Our proprietary CELsignia diagnostic platform is the only commercially ready technology we are aware of that uses a patient’s living tumor cells to identifythe specific abnormal cellular process driving a patient’s cancer and the targeted therapy that best treats it. We believe our CELsignia platform provides two important improvementsover traditional molecular diagnostics. First, molecular diagnostics can only provide a snapshot of the genetic mutations present in a patient’s tumor because they analyze cellfragments. Using cell fragments prevents molecular diagnostics from analyzing the dynamic cellular activities, known as cell signaling, that regulate cell proliferation or survival. Cancercan develop when certain cell signaling activity becomes abnormal, or dysregulated. Since genetic mutations are often only weakly correlated to the dysregulated cell signaling activitydriving a patient’s cancer, a molecular diagnostic is prone to providing an incomplete diagnosis. CELsignia tests overcome this limitation by measuring dynamic cell signaling activity ina cancer patient’s living tumor cells. When a CELsignia test detects abnormal signaling activity, a more accurate diagnosis of the patient’s cancer driver is obtained. Second, moleculardiagnostics can only estimate the probability of a patient’s potential drug response based on a statistical analysis of the drug’s clinical trial results. Instead of this indirect estimate ofdrug response, CELsignia tests confirm that a targeted therapeutic matches the patient’s cancer driver, which significantly increases the likelihood of a positive clinical outcome. Our first analytically validated and commercially ready test using our CELsignia platform is our CELsignia HER2 Pathway Activity Test for breast cancer, which diagnoses twonew subtypes of HER2negative breast cancer that traditional molecular diagnostics cannot detect. Our internal studies show that approximately 15%20% of HER2negative breastcancer patients have abnormal HER2 signaling activity similar to levels found in HER2positive breast cancer cells. As a result, these HER2negative patients have undiagnosed HER2driven breast cancer and would be likely to respond to the same antiHER2 targeted therapies only HER2positive patients receive today. Our CELsignia HER2 Pathway Activity Test istargeting HER2negative breast cancer patients receiving drug treatment. Our second CELsignia test for breast cancer evaluates independent cMet signaling activity and its involvement with HER family signaling in HER2negative breast cancertumor cells. Our internal studies have found that approximately 20%25% of HER2negative breast cancer patients have abnormal cMet signaling activity that is coactivated withabnormal HER family signaling. These studies suggest that this subgroup of HER2negative breast cancer patients may best respond to treatment with a combination of HER family andcMet inhibitors. Our third CELsignia test for breast cancer evaluates PI3K signaling in HER2negative breast cancer tumor cells. Our internal studies demonstrate how measurement of PI3Kinvolved signaling may provide a more sensitive and specific method of identifying patients most likely to benefit from PI3K inhibitors than current genetic tests that measure PI3Kmutations. We intend to combine these three tests to create the CELsignia MultiPathway Activity Test, or CELsignia MP Test. With this next generation CELsignia test, we plan toprovide an analysis of EGFR/HER1, HER2, HER3, cMET, and PI3Knode involved signaling activity for each patient tumor specimen received. We completed development of our first CELsignia test for ovarian cancer in 2020. This test identifies a new subgroup of ovarian cancer patients with tumors that have abnormalcMet and HER2 signaling activity. These findings suggest that a significant subgroup of ovarian cancer patients may respond to treatment with a combination of ErbB and cMetinhibitors. Nearly 15,000 women a year die from ovarian cancer, a disease that has less than a 50% fiveyear survival rate and a limited range of targeted therapy options. There is thus asignificant unmet need for additional therapeutic options for ovarian cancer patients. As a companion diagnostic, our CELsignia test for ovarian cancer will be intended to helppharmaceutical companies obtain new drug indications and expand treatment options for this challenging tumor type. We initiated discussions with pharmaceutical companies aboutcollaborating on clinical trials in late 2020. 4Table of Contents We also made significant progress in 2020 developing a new CELsignia test intended to diagnose breast and ovarian cancers driven by dysregulated RAS signaling.Dysregulation of RAS signaling, which includes the RAF/MEK/ERK and PI3K/AKT/mTOR pathways, is estimated to drive 30%40% of all cancers. Pharmaceutical companies havedeveloped numerous drugs that target RASinvolved pathways. However, the number of interactions amongst RASregulated pathways has made it extremely difficult to use moleculartests to identify patients with dysregulated RAS signaling tumors. The challenge of diagnosing a cancer driven by a dysregulated RAS signaling network is magnified because two ormore different pathways are typically involved. Recent research has also found that RAS mutations play a much less important role in dysregulated RAS signaling than previouslythought. Our CELsignia platform is uniquely suited to untangle the complexity of dysregulated RAS signaling tumors and identify the targeted therapy combination capable of treating it. Once development of the new RAS test is completed, we intend to add it to our current CELsignia MultiPathway Activity tests for breast and ovarian cancer. This nextgeneration CELsignia test would provide an analysis of EGFR/HER1, HER2, HER3, cMET, PI3K, and RASinvolved signaling activity for each patient tumor specimen received. Ourcurrent CELsignia tests have the potential to diagnose oncogenic signaling activity undetectable by molecular tests in up to one in three HER2negative breast cancer patients and onein five ovarian cancer patients. If our efforts to develop a RAS dynamic signaling test are successful, the percentage of cancer patients who could benefit from a CELsignia test wouldfurther increase. In addition to the new breast cancer subtypes our CELsignia test diagnoses, we discovered eight new potential cancer subtypes in lung, ovarian, kidney, and bladder cancers.Approved or investigational drugs are currently available to treat each of these new potential cancer subtypes. CELsignia tests for these additional cancer subtypes are in variousstages of development, and we expect them to become commercially ready on a staggered basis over the next few years. The development process for these additional CELsignia testsincludes completion of internal animal, verification, training set, and validation studies. As new CELsignia tests become commercially ready, we expect to initiate collaborations withpharmaceutical companies to help them obtain new drug indications for the new cancer subtypes our tests identify. In addition, we will continue our research to identify additional newcancer subtypes and to develop the corresponding CELsignia tests to diagnose them. Our overall commercialization strategy is to develop companion diagnostics that expand the patient population eligible for targeted therapies. We expect to collaborate withpharmaceutical companies to advance the clinical development of their targeted therapies with the eventual goal of obtaining FDA approval of a new drug indication. Collaborations areexpected to involve initially Phase I or Phase II interventional clinical trials to evaluate the efficacy of our collaboration partners’ targeted therapies patients selected with one of ourCELsignia tests. We are currently evaluating, or expect to evaluate, a variety of targeted therapies in combination with other targeted therapies, hormonal therapies, of chemotherapies,including: i) panHER and cMet inhibitors; ii) panHER inhibitors and endocrine therapy; iii) panHER inhibitors and chemotherapies; and iv) PI3K inhibitors and endocrine therapy. TheFDA has approved three cMet inhibitors, six HERfamily inhibitors, and four PI3K inhibitors for cancer treatment. Additional cMet, HERfamily, and PI3K inhibitors are being evaluatedin ongoing clinical trials. We have four collaborations underway that rely on a CELsignia Pathway Activity Test to select breast cancer patients for treatment with targeted therapies. For the first one ofthese collaborations, we are fielding a prospective openlabel Phase II clinical trial with Genentech, Inc. (“Genentech”) and NSABP Foundation, Inc. (“NSABP”) to evaluate the efficacyand safety of Genentech’s HER2 targeted therapies, Herceptin and Perjeta, in earlystage HER2negative breast cancer patients with hyperactive HER2 signaling tumors. We expectinterim results from this trial in either the fourth quarter of 2021 or first quarter of 2022 and final results approximately nine months later. For the second of these collaborations, we arefielding a prospective openlabel Phase II clinical trial with Puma Biotechnology, Inc. (“Puma”) and West Cancer Center to evaluate the efficacy and safety of Puma’s drug, Nerlynx, andchemotherapy in earlystage triplenegative breast cancer patients selected with our CELsignia HER2 Pathway Activity Test. We expect to obtain interim results in either the fourthquarter of 2021 or first quarter of 2022 and final results approximately nine months later. For our third collaboration, we are fielding a prospective openlabel Phase II clinical trial with Puma Biotechnology, Inc. (“Puma”), Massachusetts General Hospital, the UCLAJonsson Comprehensive Cancer Center and the VanderbiltIngram Cancer Center to evaluate the efficacy and safety of Puma’s drug, Nerlynx, and Faslodex, an AstraZeneca drug, inpreviously treated metastatic HRpositive, HER2negative breast cancer patients selected with our CELsignia HER2 Pathway Activity Test. For our fourth collaboration, we are fielding aprospective openlabel Phase II clinical trial with Pfizer Inc. and Sarah Cannon Research Institute to evaluate the efficacy and safety of two Pfizer targeted therapies, Vizimpro, a panHERinhibitor, and Xalkori, a cMet inhibitor, in previously treated metastatic HER2negative breast cancer patients selected with our CELsignia MultiPathway Activity Test. An additional collaboration to evaluate tissue samples from a Phase II study evaluating Puma’s panHER inhibitor, Nerlynx, Genentech’s HER2 antibody, Herceptin, and BristolMyers Squibb’s EGFR inhibitor, Erbitux, in metastatic colorectal cancer patients is expected to be completed in late 2022. Unlike the four clinical trial collaborations, our CELsignia testwill be used solely to evaluate tissue samples after they have been enrolled in this trial. We will not receive payment for the testing we perform. We expect our CELsignia test will providecritical insight after the trial is completed about the patient characteristics most correlative to drug response. 5Table of Contents While molecular tests identify increasing numbers of genetic variants in tumor tissue, determining the dysfunction driving most patient’s cancer using molecular tests remainselusive. Less than 20% of Americans who died of cancer in 2018 were eligible for a molecular targeted therapy because they lacked what are currently considered actionable genetic orproteomic mutations. This reflects the limitations of using static measurements of proteins or genetic mutations in cell fragments to characterize the dynamic and complex cell signalingactivity that may be driving a patient’s cancer. Directly measuring dynamic cell signaling activity is an alternative diagnostic approach to identify the cancer driver in patient tumors lacking actionable genomic or proteomicmutations. This approach requires the use of living patient tumor cells as well as technology to quantify signaling activity levels. Efforts to obtain patient tumor cells have previouslybeen limited by the lack of reliable methods to extract and culture cancer cells from patient tumors. Lack of access to living patient tumor cells, in turn, hampered development oftechnology to analyze dynamic signaling activity. Our CELsignia platform addresses the need for better cancer diagnostic tests using two complementary technologies that represent a significant departure from molecularbasedanalyses. Unlike molecular tests that use cell fragments and can only measure the static composition of a cell, our CELsignia platform measures realtime signaling activity in a patient’slive tumor cells. This enables us to (1) identify the cellular signaling dysfunction driving a patient’s cancer; and (2) identify the targeted therapy that matches the dysfunction in thepatient’s cells. Our CELsignia tests are performed in our laboratory in Minneapolis, Minnesota that is certified under the Clinical Laboratory Improvement Amendments of 1988, or CLIA,and accredited by the College of American Pathologies, or CAP. Our platform, comprised of our internally developed cell microenvironment and cell signaling quantification technologies, allows for more accurate diagnoses and the discoveryof new cancer subtypes. We believe our CELsignia platform will fundamentally change the standardofcare many cancer patients receive. Patients with the newly identified cancer subtypes we have discovered have oncogenic pathways that are signaling abnormally, and, we believe, may respond positively to a matching targeted therapy. By identifying patients witha new cancer subtype, each CELsignia test will create, in effect, a proprietary patient population that molecular diagnostics cannot identify. Our initial commercial strategy is to partner with pharmaceutical companies to provide companion diagnostics for the pharmaceutical partners’ existing or investigationaltargeted therapies. We expect such partnerships to involve collaboration on clinical trials, regulatory submissions, and commercialization activities. We will initiate activities to pursuepartnerships as our CELsignia tests become commercially ready and can be matched with a potential partner’s targeted therapies. Our commercialrelated efforts to date have focused onseeking partnerships for our CELsignia tests, the first of which became commercially ready as a laboratory developed test (“LDT”) in 2016. We expect to seek pharmaceuticalpartnerships for a variety of different targeted therapies in other solid tumor types as we are conducting our initial clinical trials with Genentech’s, Pfizer’s, and Puma’s targeted therapies. We believe our CELsignia tests will expand the matching drug’s market size because they can facilitate approval of new drug indications that a pharmaceutical company wouldnot otherwise be able to obtain. We expect that successful pharmaceutical company partnerships will generate significant revenue from the sale of tests to identify patients eligible forclinical trials, from milestone payments, and, potentially, from royalties on the incremental drug revenues our tests enable. A key requirement for success of these partnerships will beclinical trial results that demonstrate the advantages of using a CELsignia test as a companion diagnostic. Once a new drug indication is received that requires use of the CELsignia testto identify eligible patients, we will offer our tests directly to treating physicians and coordinate gotomarket strategies with our partner. This coordination of commercializationstrategies will allow us to significantly leverage the sales, marketing and reimbursement resources of our pharmaceutical partner, unlike traditional molecular diagnostic companies. Our Value Proposition We believe we offer a clear and compelling value proposition to the key healthcare stakeholders: ·Patients & ProvidersImproved patient outcomes. Our CELsignia tests provide a more accurate diagnosis of a patient’s cancer driver. This will enable physicians to matchmore precisely the targeted therapy they use to treat their patients, which we believe will increase the percentage of patients responding to the drug, improving overallpatient outcomes significantly. ·PharmaIncreased revenue & optimized clinical trials. CELsignia tests can significantly increase the revenue potential for many existing targeted therapies by identifyingentirely new pools of patients potentially responsive to their therapy. For some targeted therapies, we estimate a CELsignia test could double the number of patientsapproved to receive treatment, thus driving billions of dollars in incremental sales. Also, by providing more precise selection of patients, our CELsignia tests can increasethe odds a clinical trial meets its trial endpoint, greatly enhancing the likelihood the drug will obtain FDA approval for a new indication. In addition, according to an ARKInvest publication dated August 2016, companion diagnostics that increase the response rates of a drug can reduce Phase 3 clinical trial size as much as tenfold andcosts as much as 60%. 6Table of Contents ·PayorsLower costs per responsive patient. By providing more precise cancer diagnoses and driving higher drug response rates, we will significantly reduce the moneyspent on drugs that do not benefit patients. Many targeted therapies cost more than $50,000 per treatment and only benefit a small fraction of patients receiving them.Calculating drug costs on a costperresponsive patient, and not just costpertreated patient, highlights the true cost of targeted therapies and the expense associatedwith low drug response rates. For instance, a $50,000 targeted therapy with a 30% response rate costs $167,000 per responsive patient; however, that same drug wouldonly cost $83,000 per responsive patient if the response rate was 60%. Our Competitive Strengths We have a number of key strengths that enhance our ability to achieve our mission and build a successful company: ·First mover. We are the first company that we are aware of to launch diagnostic tests that measure the signaling pathway activity in a patient’s live tumor cells, which webelieve gives us a significant first mover advantage. ·High barriers to entry. Our issued and pending patents, as well as our proprietary information and trade secrets, give us a strong intellectual property position that webelieve creates a significant barrier to entry for potential competitors. ·Broad range of applications for our platform. We can develop tests for a wide range of signaling pathways and a wide range of cancer types. This allows us to build adeep new product pipeline that creates multiple paths to build a large and profitable business. ·Diverse revenue streams including pharma partnerships. We anticipate generating significant revenue from companion diagnostic pharmaceutical partners, includingrevenue from the sale of tests to identify patients eligible for clinical trials, milestone payments, and potentially, from royalties on the incremental drug revenues our testsenable. Our most significant revenue opportunity comes from ongoing sales of CELsignia tests to physicians during the commercialization stage of the companiondiagnostic. ·Strong senior leadership team. Our founders and senior leaders have a proven track record of success building, operating and selling several successful companies. Wehave deep and highly relevant and complementary diagnostic, scientific, product development, and commercialization experience that has enabled us to establish marketleadership positions for the companies we previously led. Our Platform Advantages Our unique and proprietary CELsignia functional cellular analysis technology represents a major shift from the diagnostic industry’s reliance on molecular profiling tocharacterize a patient’s cancer subtype. Our goal is to leverage our technology to build a durable competitive advantage that enables us to improve outcomes for a significantpercentage of cancer patients. Our CELsignia platform advantages include: ·Powerful cancer subtype discovery tool. We have already discovered 16 new potential cancer subtypes that are not currently diagnosed and treated with a matchingtargeted therapy. These subtypes are characterized by the dysregulated signaling pathway activity our CELsignia tests identify. By identifying new cancer subtypes, weare creating new patient populations to which pharmaceutical companies can offer new and existing drug therapies. ·Direct patientspecific assessment of disease status. Even though the response rates for many targeted therapeutics are low, for those patients who do respond, theiroutcomes can be improved significantly. The problem is matching the patient to the right drug. Our platform overcomes this problem by directly identifying whether anoncogenic signaling pathway is abnormally active in a patient’s cells. This provides the most complete assessment available today of the intracellular activity driving apatient’s cancer. Existing genomic tests typically can only provide a determination whether cancer is present and an assessment of molecular mutations that may or maynot be associated with the patient’s cancer driver. ·Direct measurement of matching drug effectiveness. An important advantage of the CELsignia platform is its ability to quantify the amount of signaling dysfunction thata matching targeted therapy can inhibit in an individual patient’s cancer cells. This allows us to evaluate whether there are inherent drug resistance mechanisms thatwould prevent the therapy from functioning in the patient’s tumor cells. Molecular tests cannot provide this evaluation. ·Improved response rates. We believe a patient population will have a higher response rate to a matching targeted therapy when it is diagnosed with a CELsignia test thanwith a molecular biomarker. By first identifying whether dysregulated signaling is present and then confirming that a matching targeted therapy can inhibit thedysfunction, a CELsignia test eliminates the two primary variables that confound patient response to targeted therapy signaling: the presence or absence of the diseaseand the drug not functioning as intended. A molecular test provides insight on neither of these variables in most cases. 7Table of Contents ·Identified drug responsive proprietary patient cohorts. Approximately 80% of cancer patients lack a genetic biomarker to guide treatment. For these patients, the cellulardysfunction driving the cancer goes undiagnosed, thus excluding such patients from receiving a potentially beneficial targeted therapy. We believe our CELsignia testswill enable us to identify new proprietary patient populations not currently diagnosable with molecular tests and increase the number of patients likely to respond to amatching targeted therapy. Moreover, we will be the only partner a pharmaceutical company can work with to develop a companion diagnostic for a new indication of atargeted therapy addressing these new patient populations. By contrast, most molecular diagnostic tests are undifferentiated and have little proprietary value, which givespharmaceutical companies a wide range of companies to select from when choosing a molecularbased companion diagnostic partner. ·Streamlined FDA approval of targeted therapeutics. CELsignia tests will enable our pharmaceutical partners to enroll patients in their clinical trial with the same cellulardysfunction their targeted therapy is designed to inhibit. We believe this will improve patient response rates, increasing the likelihood the trial meets its endpoint targetand thus the likelihood the drug receives FDA approval. Improved patient response rates would also help reduce the size, cost, and length of our partner’s clinical trials. Our Industry According to the Centers for Disease Control and Prevention, cancer was the secondleading cause of death in the United States in 2019, responsible for nearly one of everyfour deaths. There are many types of cancer treatment options, including surgery, radiation therapy, chemotherapy, immunotherapy, hormone therapy, stem cell transplant, and targetedtherapy. Targeted therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecular targets involved in the progression of cancer.Targeted therapies differ from standard chemotherapy drugs in that they are often cytostatic (block tumor cell proliferation) rather than cytotoxic (kill tumor cells). According to theNational Cancer Institute, there are currently more than 90 approved targeted oncology therapies, some of which cost more than $100,000 per treatment course. Diagnostic tests to detect single biomarkers are now widely used by pathologists to determine the molecular subtype of a cancer. When a molecular biomarker test is used tosupport the choice of therapy to prescribe, it is often referred to as a “companion diagnostic.” Increasing numbers of targeted therapeutics are prescribed based on the results from acompanion diagnostic test to detect the presence of a molecular biomarker. Only patients testing positive for the biomarker are eligible to receive the associated therapy. Companion diagnostics are becoming increasingly important to the pharmaceutical industry. The use of companion diagnostics to better match patients to effective treatmentspositively impacts clinical outcomes and lowers expenditures on drugs that do not benefit patients. Stratifying the eligible patient population to include only likely responders isparticularly important when the percentage of likely responders is only a fraction of the total cancer population. In these circumstances, narrowing the eligible patient population is oftennecessary to meet the clinical endpoint targets required to receive FDA drug approval. Our Market Opportunities Companion Diagnostic Development Opportunities We believe there at least 50 different potential opportunities for our company to collaborate on companion diagnostic programs with pharmaceutical companies. Our ability todevelop partnering relationships with these pharmaceutical companies will be predicated on a number of factors, including the size of the patient population our CELsignia test identifies,the remaining patent life of the matching targeted therapy, and the success or failure of clinical trials we have conducted with other pharmaceutical companies. Completing clinical trialsrequires, among other things, successful enrollment of patients, meeting trial endpoint goals, and completing the trial in a timely manner. The time to complete a clinical trial can varywidely depending on a number of factors, many of which will be specific to any particular clinical trial. We believe the revenue opportunity per companion diagnostic program will be consistent with other development programs pharmaceutical companies support. In addition, therevenue for an individual companion diagnostic program would represent only a small fraction of the potential value that the new drug indication could create for our pharmaceuticalcompany partner. For some drugs, our tests could double the number of patients eligible for a targeted therapy. CELsignia Testing Opportunities We expect to generate recurring companion diagnostic testing revenues once a CELsignia companion diagnosticlinked drug therapy is approved for patient use. On average,we believe that the lifetime value of providing the companion diagnostic test will significantly exceed the revenue generated from the companion diagnostic development program. Weexpect to offer each CELsignia test to patients at prices ranging from $4,000$7,000, depending on the number of pathways evaluated. No tests directly comparable to the CELsignia testsare available today to offer reference points for pricing purposes. Pricing for several proprietary complex genomic tests, however, fall within this range and we believe this providesguidance on the amount insurance companies are willing to pay for highly informative tests that guide patient care. 8Table of Contents CELsignia Technology Background The Role of Cellular Signaling Pathways in Cancer Cancer is a class of exceedingly complex and diverse diseases characterized by the development of abnormal cells that divide uncontrollably and can infiltrate and destroynormal body tissue and disrupt normal organ function. In normal cells, a series of biochemical activities, known as signal transduction, transmit biochemical signals through aninterconnected network of signaling pathways to control cell proliferation and survival. Cancer arises when alterations occur in one or more of these signaling pathways and normal cellprocesses are disrupted, resulting in uncontrolled cell proliferation. These alterations are driven by a variety of cellular aberrations, including genetic mutations and dysregulatedsignaling pathway mechanisms. Identifying the alteration driving an individual’s cancer is complicated by the immense complexity of these signal transduction processes and thepractically unquantifiable number of pathway variables. As recently as 20 years ago, most cancers were classified and subsequently treated solely on the basis of the anatomical location of the tumor in the body. Chemotherapies thatkill rapidly dividing cells were widely used, but they had only limited efficacy for many patients and caused a wide range of dangerous side effects due to lack of discrimination for tumortissue. As tools to identify molecular mutations became available, scientists began to uncover correlations between certain molecular mutations, cancer tissue type, and a patient’sprognosis. This fostered the development of molecularly targeted therapeutics that were designed to disrupt the specific cellular function of the drug target, typically abnormal signalingpathway activity, associated with the molecular mutation. These targeted therapies greatly improved outcomes for some cancer patients and are a testament to the efficacy of targetedtherapies when effectively prescribed. According to information published by the Journal of Clinical Oncology in July 2017, targeted therapies are oftentimes 10 to 20 times moreexpensive than chemotherapies. In conjunction with the advent of targeted therapies, new molecular diagnostics were developed to help physicians refine the classification of a patient’s cancer into subtypesbased on the presence of specific molecular anomalies, such as genetic mutations or overexpressed proteins. Such mutations or overexpressed proteins are commonly referred to as“biomarkers” when they are used to diagnose a disease and evaluate treatment options. For instance, breast cancer diagnostic tests are performed to determine whether two proteinbiomarkers, human epidermal growth factor receptor 2 (HER2) or estrogen receptors (ER), are overexpressed in the cancer cells. The results of these tests are used to classify thepatient’s cancer molecular subtype and to guide selection of a corresponding targeted drug therapy. The launch and ongoing development of many new targeted therapies and the increasing use of companion molecular diagnostics to guide selection of the most appropriatetherapy for each patient ushered in the era of socalled “precision medicine” in oncology. Advances in genomic and proteomic techniques and drug discovery enabled researchers toidentify new drug targets, new molecular diagnostics, and drugs that would specifically bind to the target. While the increased usage of targeted therapies has improved patient outcomes, there is increasing recognition that the promise of molecularly guided diagnoses and targetedtreatment has fallen far short of expectations. This is generally due to the heterogeneous nature of these diseases from patient to patient and the challenge of identifying the specificcellular dysfunction driving a cancer patient’s tumor growth. No matter how sophisticated or detailed, a pointintime molecular profile can only provide a snapshot of a tumor. As aresult, the genetic mutations many current tests identify are often only weakly correlated to the abnormal signaling driving a patient’s cancer. This is because protein and gene profilingprovide an incomplete assessment of the biochemical activity promoting cancer tumor growth. In fact, when dysregulated, the activity of signaling pathway networks are, we believe, notpossible to assess using current genetic analyses, despite the impressive investments in mapping the human genome and advancements in techniques to identify molecular mutations. The combination of the heterogeneous nature of cancer and the weak correlation of abnormal signaling to many genetic mutations helps explain why the response rates forpatients treated with many targeted therapies are often less than 50%, and in some cases as low as 20%. For a patient to respond to a targeted therapy designed to disrupt diseaserelated signaling activity, two factors must be present: (1) the patient’s diseased cells must have the same signaling pathway dysfunction the drug is designed to inhibit, and (2) the drugaffects its targeted pathway as intended. Current stateoftheart genomic tests use cell fragments, which limits them to evaluating the presence or concentration of a genetic mutation orprotein. These tests cannot evaluate either dynamic signaling activity or whether a drug can affect that activity. When a patient’s genomic biomarker status does not representunderlying signaling pathway dysfunction, this can lead to selection of the wrong targeted therapy to treat the patient. Of particular interest to us are those patients with dysregulatedsignaling who lack a corresponding biomarker; they are not currently eligible to receive any targeted therapy that treats their dysregulated signaling. To measure dynamic cellular activity, living patient tumor cells are required. Until our advancements, efforts to use living patient tumor cells have been limited by the lack ofreliable methods to extract and culture cancer cells from patient tumors. These previously limited efforts reflect the emphasis amongst cancer researchers on creating stable cell lines foruse to model cell function or to study and screen millions of test compounds in drug discovery programs. Pharmaceutical companies driving the commercial development of celltechnologies work primarily with immortalized cells or cell lines genetically modified to express a target or mutation of interest. These cell lines consist of established cell cultures thatproliferate indefinitely and very uniformly. They are used primarily because they provide a highly uniform response when tested with millions of small molecules in the search forpotential new drugs, and because techniques to culture these cells are well known, their properties well understood, and other experimental results using them are available forcomparison purposes. Conversely, live patient tumor cells are difficult to obtain, are only available in small quantities, and according to several articles published in leading cancerjournals between 20172019 , the percentage of tumors that yield proliferative cells with conventional culturing methods has until now been well below 50%. For these reasons,researchers prefer paraffinfixed tissue or cell lines over living tumor cells when studying disease processes or screening drug candidates. This lack of compelling rationale forpharmaceutical companies and academic institutions to work with live tumor cells for research purposes left the field of live tumor cell research in a relatively immature state. 9Table of Contents Our CELsignia Platform We have made significant investments in research and development to build the first commerciallyready cancer diagnostic platform that we are aware of that measures thesignaling pathway activity in a patient’s living tumor cells. To measure dynamic cellular activity, we internally developed two distinct but complementary technologies, which nowcomprise our CELsignia platform: ·our proprietary cell microenvironment; and ·our method to quantify dynamic patient cell signaling dysfunction. We utilize our CELsignia platform to create CELsignia tests that measure specific signaling pathway activity in various tumor types. Cell microenvironment. Previous research has shown that cancer cells extracted from a patient’s tumor share the molecular features of the primary cancers from which they werederived and could provide an ex vivo (outside the patient) model of a patient’s tumor. The technology around tumor cell extraction from individual patients and culturing techniques,however, has largely remained undeveloped. For instance, we are not aware of any competing diagnostic tests that use live patient tumor cells to measure dynamic cell signaling activity.Studies on the topic have historically highlighted the challenges of deriving a viable patient tumor cell sample from an individual patient tumor specimen. We have developed a cell microenvironment to extract and expand viable tumor cells from fresh human tumor tissue, which meets the three critical clinical parameters a patientderived tumor cell sample would need to satisfy in order to meet the regulatory and clinical requirements for a diagnostic test measuring signaling activity: ·The patient cell sample tested must reflect the starting tumor’s composition. If samples do not reflect the original tumor’s composition, test results derived from thatsample may not be representative of the patient’s tumor. ·The sample must be available for testing in less than 21 days. Clinicians generally require test results in cases of complex diseases such as cancer within two to threeweeks so they can begin treatment of their patient as soon as the initial symptoms are evaluated or a preliminary diagnosis is made. ·At least 90% of the tumor specimens obtained from a patient must yield testable samples. Clinicians will only order tests that require a patient specimen when they arehighly likely to receive a test result. Dynamic patient cell signaling quantification. The second component of our CELsignia platform involves methods to quantify specific dynamic signal transduction events inpatient derived tumor cells. The complexity of signal transduction processes is immense, and the permutations of the pathway variables are practically unquantifiable. Current analyticalmethods to assess these variables use cell fragments. Pointintime measurements are limited to assessment of the compositional status (e.g., mutation), concentration level (e.g., proteinamount), or activation status (e.g., phosphorylation) of a finite number of signaling pathway components. A key insight underlying our technology was our observation that, no matterhow sophisticated or detailed, a pointintime molecular profile would only provide a snapshot. These methods could not provide a complete, dynamic assessment of the signalingactivity driving a patient’s cancer. These pointintime molecular analyses would, in many cases, only provide a weak correlation to the presence of the signaling pathway dysfunctiondriving a patient’s cancer. Instead, we concluded that a complete diagnosis of cancer and an assessment of a patient’s response to treating their disease requires measurement of theunderlying activity of signaling pathways in live patient tumor cells. To measure live realtime dynamic cell signaling activity, we utilize an impedance biosensor instrument. An impedance biosensor is an analytical platform that converts changesin cellular activity to a measurable electrical signal. When cells are stimulated and change their function, the accompanying changes alter the electrical signal that is measured. Theoutput value is quantified over time and used to determine a Signaling Function Score. To determine the activity of a specific signaling pathway, an activating agent specific to apathway receptor is used to turn on the pathway and a corresponding inhibitory agent specific to the pathway receptor is used to turn signaling off. When signaling pathways arestimulated in this manner, a change in the electrical signal occurs and Signaling Function Score recorded. By relying on the principle of detecting signaling pathway activity, we believewe can develop tests for a range of disease types and targeted therapies that affect various cellular pathways. We believe our pioneering efforts have substantially advanced the technology of culturing primary tumor cells and analyzing cell signaling activity to guide therapy selection.We have three issued U.S. patents, five issued international patents, five pending U.S. patent applications, 23 pending nonU.S. patent applications, and one pending international PCTpatent application, as well as significant proprietary knowhow and trade secrets for the various cell sample preparation and cellular analysis methods we have developed. 10Table of Contents New Product Development We are leveraging our CELsignia technology to discover new cancer subtypes that a genomic test cannot detect. These new subtypes are characterized by the hyperactivesignaling pathway our test identifies. These subtypes cannot be detected by genomic tests because they lack a corresponding molecular biomarker to identify it. We will translate ourdiscoveries into companion diagnostic tests. We have already discovered several new breast cancer subtypes: HER2negative breast cancers that are ERpositive or ERnegative with either (i) abnormal HER2 signaling, (ii)abnormal HERfamily signaling coincident with abnormal cMet signaling, and (iii) abnormal PI3K signaling. We are currently conducting research to identify additional cancer subtypes in five solid tumor types. Our research studies to date have identified eight potentially new lung,ovarian, kidney, and bladder cancer subtypes that involve dysregulated oncogenic signaling pathways. Multiple dysregulated pathways were active in each of these tumor types.These studies confirm that the CELsignia platform can be a cancer subtype discovery engine and that we can create a multipathway test to identify the specific driver in a patient’stumor. We expect to eventually expand the tumor types we evaluate to include colon, head and neck, leukemia, esophageal, and gastric cancers. We will seek to identify individual signaling pathways that may be driving at least 5% to 10% of the total cancers in each tissue area. Once we have characterized the prevalenceof the different subtypes of signaling dysfunction in each tumor type and validated the tests for the different pathways, our plan will be to launch a corresponding CELsignia test.Eventually, each CELsignia test will analyze multiple pathways in a patient’s tumor to identify the specific pathway dysfunction driving a patient’s cancer. Testing multiple pathways willthus provide a system view of the patient’s cancer using dynamic functional analysis. We believe this will result in more accurate diagnosis of a patient compared to moleculardiagnostics that are using next generation sequencing to assess the status of multiple static biomarkers. Clinical Trial Approach A major component of our development and commercial activities is providing clinical data from interventional clinical trials using our CELsignia tests. The goal of our clinicaltrial strategy is to demonstrate that patients found by a CELsignia test to have abnormal pathway signaling will respond favorably to a matching targeted therapy. Once our first trialdemonstrates that our CELsignia test identifies patients responsive to targeted therapies, we expect pharmaceutical companies to partner with us to fund trials to evaluate new potentialindications for their drugs with patients identified by one of our CELsignia tests. The trials will be designed to confirm that patients with abnormal pathway signaling obtain a superiorclinical response to a therapy targeting that pathway than to the standardofcare therapy they currently receive. For trials involving patients not currently eligible for a cancer drug that targets a certain pathway, we would first obtain a tissue specimen from each subject and perform theCELsignia test to identify subjects who have abnormal signaling. These patients would then be randomly assigned to either an arm that receives the current standardofcare therapy orone that includes the current standardofcare therapy plus the targeted therapy. All patients would be monitored until their disease progresses or until the end of the treatment regimen. CELsignia MultiPathway Activity Test Our CELsignia MP Test is a qualitative LDT that measures HER2, cMet, and PI3K signaling activity in breast and ovarian tumor cells obtained from patients previouslydiagnosed with cancer to determine whether or not the patients have one of the following cancer subtypes: 1.Abnormal HER2 signaling driven cancer 2.Abnormal cMet and HER2 signaling driven cancer 3.Abnormal PI3Kinvolved signaling driven cancer Abnormal HER2 Signaling Driven Cancer Approximately 15% of breast cancer patients are diagnosed with HER2+ breast cancer when their tumor cells are found to have overexpressed or amplified levels of HER2. Thesepatients are treated with antiHER2 targeted therapies in combination with chemotherapies. Results from a number of clinical trial results for HER2 drugs reveal that only about 40% ofHER2positive patients respond to them. In addition, findings from several clinical trials have shown that a subset of HER2negative patients benefit from therapies that target HER2.These results highlight the relatively weak correlation between HER2 receptor or gene amplification status and drug response. Despite the widely recognized role that a dysregulated HER2related signaling network plays in promoting breast cancer, only tests measuring a single reactant, HER2 protein,are performed in the clinic to diagnose it; we believe no diagnostic tests are available today that measure HER2 signaling activity within a patient’s breast tumor epithelial cells. Thisfocus on measuring HER2 expressionlevels reflects the widelyheld view that measuring a patient’s HER2 status is sufficient to diagnose HER2driven breast cancers. When only HER2expression is measured, though, patients classified as HER2negative but whose tumor cells have abnormal HER2 signaling are diagnosed as not having HER2driven breast cancer,when, in fact, they do. 11Table of Contents Since current genomic methods cannot identify HER2negative breast cancer patients who have the HER2driven cancer, a new method was required. Such a method would needto analyze the HER2signaling pathways (MAPK and PI3K) associated with HER2 cancers in a patient’s tumor cells. Our CELsignia MP Test identifies patients whose HER2 status asdetermined by conventional techniques does not represent the correct diagnosis of their breast cancer at a functional level. For the subgroup of HER2negative breast cancer patients diagnosed with abnormal HER2signaling, it would be intended that they receive treatment with HER2 therapies. Abnormal cMet Signaling coincident with Abnormal HER2 signaling Signaling through cMet is necessary for normal cell development. Numerous studies have established the significant role of the cMet pathway in tumor growth and metastasis.Crosstalk between cMet and HER family receptors is also suspected of playing a role in tumor progression and resistance to HER targeted therapies. Numerous clinical trials haveevaluated dual inhibition of cMet and HER pathways in a variety of tumor types, but they have produced mostly negative results. Since subjects enrolled in these trials were primarilyones with cMet protein overexpression or gene amplification, other biological factors, such as cMet and HER signaling activity, are likely more important to measure when identifyingpatients eligible for cMet therapies. Our recent studies found that a subset of HER2negative breast cancer patients have abnormal cMet signaling coincident with abnormal HER2 signaling. The cMet expressionlevel of each patient studied was normal. Strong evidence was found that cMet and HER2 signaling is coinvolved and may explain why a cMet tyrosine kinase inhibitor is not aneffective antagonist when cMet is hyperactive for this patient subset. Additionally, evidence was found that simultaneous inhibition of EGFR/HER1, HER2, and HER3 signaling, inaddition to inhibition of cMet signaling, was necessary to inhibit HER2 and cMet signaling activity most effectively. For the subgroup of HER2negative breast cancer patients and ovarian cancer patients diagnosed with abnormal cMet and HER2signaling, it would be intended that theyreceive treatment with a combination of panHER and cMet inhibitors. Abnormal PI3K Signaling Tumors The PI3K signaling pathway is a key regulator of normal cellular processes involved in cell growth, proliferation, metabolism, motility, survival, and apoptosis. Aberrantactivation of the PI3K pathway promotes the survival and proliferation of tumor cells in many human cancers. In breast cancer, only patients with certain PI3K mutations are eligible fortreatment with a PI3K inhibitor. However, recent clinical trial results suggest that factors other than PIK3CA sequence variance status may be important to measure when identifyingpatients eligible for PI3K inhibitors. In one Phase III clinical trial, the net increase in the objective response rate of PI3KCAmutated late stage breast cancer patients who receivedalpelisib, a PIK3CA inhibitor, and fulvestrant versus those who received fulvestrant alone was less than 20%. Our studies found hyperactive PI3K involved signaling in a subset of HER2negative breast cancer patients. Strong evidence was found that panPI3K inhibitors, rather thaninhibitors targeting PI3Kα, may provide the most effective attenuation of dysregulated signaling involving the PI3Knode. Our studies also found that the signaling activity involvingPI3Kα is likely more important to measure than the mutational status of PI3Kα when selecting patients for treatment with a PI3Kα inhibitor like alpelisib. Interventional Clinical Trials in Process using a CELsignia Test to Select Patients for Treatment FACT1 Clinical Trial to Evaluate Efficacy of Genentech’s HER2 Targeted Therapies In July 2018, we activated the first site in a clinical trial with NSABP to evaluate the efficacy and safety of Genentech’s drugs, Herceptin (trastuzumab) and Perjeta (pertuzumab),and chemotherapy in breast cancer patients selected with our CELsignia test. NSABP serves as the sponsor and principal investigator of the trial and is responsible for, among otherthings, setting up clinical sites, enrolling patients, and managing clinical data. NSABP contracted separately with Genentech to provide Herceptin and Perjeta for the study at no cost.We are performing the CELsignia HER2 Pathway Activity Test to select patients for the trial and are providing the funding for the trial’s patientrelated costs. Completing this trial willrequire, among other things, successful enrollment of patients, meeting trial endpoint goals, and completing the trial in a timely manner. As of February 2021, there were 27 activated sitesparticipating in the FACT1 trial. The enrollment rate of patients has fallen short of the expectations NSABP originally provided. Based on NSABP’s updated estimates of patientenrollment rates to reflect the impact of COVID19, we expect to obtain interim results in the fourth quarter of 2021 or first quarter of 2022 and final results approximately nine monthslater. NSABP is one of the country’s premier clinical research cooperatives. Its members include many of the country’s leading medical centers and their investigators are amongst themost respected in the breast cancer field. Genentech is one of the largest biopharmaceutical companies in the world and was the first company to launch a HER2 targeted therapy; theirantiHER2 targeted therapies have more than 50% market share. 12Table of Contents We submitted an Investigational Device Exemption, or IDE, application to the FDA to obtain approval to use our CELsignia HER2 Pathway Activity Test in a clinical trial setting.The IDE submission included validation test protocols and study reports, manufacturing process summaries, and relevant publications. The FDA approved our IDE in early 2017. The goal is to demonstrate that patients who have an abnormal HER2 signaling pathway, as identified by our CELsignia test, respond to treatment with a matching targetedtherapy. A synopsis of the trial protocol is provided below. FACT1 Clinical Trial Synopsis Primary ObjectiveTo evaluate the efficacy of neoadjuvant HER2 drug treatment in earlystage HER2negative breast cancer patients with abnormalHER2 signalingSites/SponsorSubjectsEndpointInvestigational ArmMulticenter in collaboration with NSABP and Genentech54 HER2negative earlystage breast cancer (26 ER+/28ER)Pathological complete response (ypT0/Tis ypN0)ACT + Trastuzumab + Pertuzumab FACT2 Clinical Trial to Evaluate Efficacy of Puma’s HER2 Targeted Therapy In July 2019, we activated a clinical trial with Puma and West Cancer Center to conduct a Phase II singlearm interventional trial to evaluate the efficacy and safety of Puma’sdrug, Nerlynx (neratinib), and chemotherapy in breast cancer patients selected with our CELsignia test. West Cancer Center serves as the sponsor and principal investigator of the trialand is responsible for enrolling patients and managing clinical data. Puma supplies Nerlynx, its panHER inhibitor currently approved by the FDA for extended adjuvant treatment ofearlystage HER2positive breast cancer. We provide the CELsignia HER2 Pathway Activity Test to select triplenegative breast cancer patients who have hyperactive HER2drivensignaling pathways for the trial and will initially fund the patientrelated trial costs. Based on West Cancer Center estimates to reflect the impact of COVID19, we expect interim resultsfrom this trial in the fourth quarter of 2021 or first quarter of 2022 and final results approximately nine months later. We submitted an IDE application to the FDA to use our CELsignia HER2 Pathway Activity Test for this clinical trial and received approval in mid2018. The goal of the trial is to demonstrate that triplenegative breast cancer patients who have a hyperactive HER2 signaling tumor, as identified by the CELsignia test, respond totreatment with Nerlynx, a matching HER2 therapy. We believe there is significant clinical interest in finding new diagnostic tests and targeted therapies for triplenegative breast cancerpatients because fewer drug treatment options are available to them relative to other breast cancer subtypes. A synopsis of the trial protocol is provided below. FACT2 Clinical Trial Synopsis Primary ObjectiveTo evaluate the efficacy of neoadjuvant HER2 drug treatment in earlystage triplenegative breast cancer patients with abnormalHER2 signalingSites/SponsorSubjectsEndpointInvestigational Multicenter in collaboration with West Cancer Center and Puma27 earlystage triplenegative breast cancer with abnormal HER2 signalingPathological complete response (ypT0/Tis ypN0)Neratinib then Paclitaxel + Carboplatin + Neratinib FACT3 Clinical Trial to Evaluate Efficacy of Pfizer’s panHER and cMet Targeted Therapies In January 2021, we announced a clinical trial collaboration with Sarah Cannon Research Institute, a global leader in cancer research, and Pfizer Inc., a global biopharmaceuticalcompany, to conduct a Phase II clinical trial. This openlabel Phase II trial will evaluate the efficacy and safety of two Pfizer targeted therapies, Vizimpro (dacomitinib), a panHERinhibitor, and Xalkori (crizotinib), a cMet inhibitor, in previously treated metastatic HER2negative breast cancer patients selected with our CELsignia MultiPathway Activity Test.Under the agreement, Sarah Cannon will serve as the sponsor and principal investigator of the trial and will be responsible for enrolling patients and managing clinical data. Pfizer willsupply Vizimpro and Xalkori, targeted therapies currently approved by the FDA to treat metastatic nonsmall cell lung cancer. We will provide our CELsignia MultiPathway ActivityTest to select HER2 metastatic breast cancer patients who have hyperactive HER2 and cMet signaling pathways for the trial and will fund the patientrelated trial costs. Based on theSarah Cannon Research Institute’s estimates of patient enrollment rates, we expect to obtain interim results 12 to 15 months after the protocol is activated and final results 1215 monthslater. We expect enrollment to begin in the second quarter of 2021. 13ArmTable of Contents The Sarah Cannon Research Institute is one of the world’s leading clinical research organizations and has participated in clinical trials for a majority of approved cancertherapies over the last decade. Pfizer is one of the largest biopharmaceutical companies in the world and offers a number of targeted therapies for cancer patients. The goal of the trial is to demonstrate that previously treated HER2negative metastatic breast cancer patients who have hyperactive HER2 and cMet signaling tumors, asidentified by the CELsignia test, respond to treatment with Vizimpro in combination with Xalkori. We believe there is significant clinical interest in finding new diagnostic tests andtargeted therapies for metastatic HER2negative breast cancer patients whose disease progressed on prior therapies. The antitumor effect of blockading EGFR/HER1, HER2, HER3 and cMet pathways when the HER2 and cMet pathways are hyperactive has been demonstrated in animal models. A synopsis of the trial protocol is provided below. FACT3 Clinical Trial Synopsis Primary ObjectiveTo assess the efficacy of combined Vizimpro plus Xalkori in previously treated HER2negative metastatic breast cancer subjectswith hyperactive HER2 and cMet signaling tumorsSites/SponsorSubjectsEndpointInvestigational Multicenter in collaboration with Sarah Cannon Research Institute and Pfizer23 latestage HER2negative breast cancer with abnormal HER2/cMet signalingObjective response using RECIST 1.1 criteriaVizimpro and Xalkori FACT4 Clinical Trial to Evaluate Efficacy of Puma’s HER2 Targeted Therapy In December 2020, we announced a clinical trial collaboration with Massachusetts General Hospital and Puma Biotechnology, a biopharmaceutical company, to conduct a PhaseII clinical trial. This openlabel Phase II trial will evaluate the efficacy and safety of Puma’s drug, Nerlynx (neratinib), and Faslodex (fulvestrant), an AstraZeneca drug, in previouslytreated metastatic HRpositive (HR+), HER2negative breast cancer patients selected with our CELsignia HER2 Pathway Activity Test. Under the agreement, Massachusetts GeneralHospital will serve as the sponsor and the principal investigator of this study, while the UCLA Jonsson Comprehensive Cancer Center and the VanderbiltIngram Cancer Center willserve as cosponsors. Each of these institutions is amongst the United States’ 51 NCIDesignated Comprehensive Cancer Centers tasked with developing new approaches to diagnosingand treating cancer. Puma will supply Nerlynx, its HER2 inhibitor currently approved by the FDA for early and latestage HER2positive breast cancer. We will provide our CELsigniaHER2 Pathway Activity Test to select HR+, HER2negative metastatic breast cancer patients who have hyperactive HER2driven signaling pathways for the trial and will fund thepatientrelated trial costs. Based on Massachusetts General Hospital’s estimates of patient enrollment rates, we expect to obtain interim results 12 to 15 months after the protocol isactivated and final results 12 to 15 months later. We expect enrollment to begin in the second quarter of 2021. The goal of the trial is to demonstrate that previously treated HR+, HER2negative metastatic breast cancer patients who have hyperactive HER2 signaling tumors, as identifiedby the CELsignia test, respond to treatment with Nerlynx in combination with Faslodex, a hormonal therapy that targets the estrogen receptor. We believe there is significant clinicalinterest in finding new diagnostic tests and targeted therapies for metastatic HR+, HER2negative breast cancer patients whose disease progressed on prior therapies. Of particularinterest are new therapeutic combinations that can overcome resistance to antiestrogen therapies like Faslodex. The blockade of estrogen receptor and HER2 pathways when the HER2pathway is hyperactive using a combination of Neratinib and Faslodex has been demonstrated in animal models. A synopsis of the trial protocol is provided below. FACT4 Clinical Trial Synopsis Primary ObjectiveTo assess the efficacy of combining Nerlynx plus Faslodex in previously treated metastatic HRpositive, HER2negative patientswith hyperactive HER2 signaling tumorsSites/SponsorSubjectsEndpointInvestigational Multicenter in collaboration with Mass General and Puma23 latestage HR+/HER2negative breast cancer with abnormal HER2 signalingObjective response using RECIST 1.1 criteriaNerlynx and Faslodex 14ArmArmTable of Contents Commercialization Strategy Our commercial activities will target three complementary groups at various phases of the development of our CELsignia tests. ·Pharmaceutical companies. For each CELsignia test we develop to diagnose a new cancer subtype, we will identify the matching targeted therapies, either currentlyapproved or in the investigational phase, and the manufacturer of those therapies. We will initiate discussions and seek to reach development agreements with each ofthese pharmaceutical companies when we have verified the prevalence of the cancer subtype and completed successful animal studies. ·Medical and surgical oncologists. We will initially target key opinion leaders (KOLs) in each cancer type once we have completed the analytical validation of a CELsigniatest. This will allow us to build awareness and credibility for the CELsignia test as we are generating clinical validation data. When a new drug indication is received thatrequires use of a CELsignia companion diagnostic to identify eligible patients, we will coordinate the pharmaceutical company’s gotomarket activities with our own. Thiscoordination will allow us to significantly leverage the pharmaceutical company’s sales, marketing, and reimbursement activities, unlike traditional molecular diagnosticcompanies. ·Payors. When a new drug indication is received that requires use of a CELsignia companion diagnostic to identify eligible patients, we expect to coordinate thepharmaceutical company’s reimbursement activities with our own. Our CELsignia tests are LDT’s and subject to regulation under CLIA. We completed the analytical validation of our first CELsignia test and received CLIA certification in 2016.Our current focus is to field clinical trials with leading cancer centers in collaboration with pharmaceutical companies to demonstrate that cancer patients diagnosed with an abnormalsignaling pathway by a CELsignia test respond efficaciously to treatment with a matching targeted therapy. Once favorable efficacy data is available, we expect to generate revenuesfrom CELsignia tests performed in conjunction with the clinical trials a pharmaceutical company will field during the registrational phase of our partners’ drug approval process. We alsoexpect that the agreements we enter into with the pharmaceutical companies partnering with us on these registrational trials will include milestone payments at initiation and completionof trials and perhaps at various other negotiated points during the trials. We expect to generate revenue from the sale of CELsignia tests ordered by physicians upon the approval of ourpharmaceutical company’s matching drug, as a companion diagnostic. A key requirement for success of these partnerships will be clinical trial results that demonstrate the advantagesof using a CELsignia test as a companion diagnostic. We intend to position our unique and highly differentiated tests as practice changing advancements in patient care. To inform key stakeholders of the value of our solution inorder to drive adoption and reimbursement, we expect to employ the following diverse commercialization strategies over time: ·leverage our pharmaceutical partnership and their gotomarket initiatives for the drug with which our companion diagnostic is partnered; ·collaborate with oncology thought leaders, KOLs, and leading institutions on clinical research, publications, and product development; ·build an experienced, oncologyfocused sales force in the United States and international distribution channels that are supported by dedicated company personnel; ·integrate into the everyday practice of clinicians through our medical affairs and client services efforts; ·publish important medical and scientific data in peerreviewed journals and present at major industry conferences, conduct clinical trials; and ·work with patient advocacy groups, leading cancer philanthropic organizations, and medical societies to drive awareness of CELsignia tests and the importance ofincorporating functional cellular analysis into cancer treatment. Through these efforts, we will seek to promote our CELsignia test’s unique capabilities throughout the oncology communityfrom patients, to the physicians treating them, tothe thirdparty payors for these treatments and to biopharmaceutical companies developing new treatmentsall with the goal of facilitating betterinformed treatment decisions for thegreatest number of patients. 15Table of Contents A CELsignia test would be launched upon the approval of a pharmaceutical company’s matching drug as a companion diagnostic. We would expect physicians, typically amedical or surgical oncologist, to order our tests in conjunction with the rollout of the pharmaceutical company’s matching drug. The physician will prescribe a CELsignia test andcoordinate provision of a patient specimen from a biopsy or surgical procedure. The fresh tissue would then be shipped overnight directly to our laboratory where we would use ourproprietary methods to extract diseased cell samples from the patient’s tissue and perform the CELsignia tests ordered. Test results would typically be available in 10 to 14 days afterreceipt of the patient specimen. For each patient sample analyzed, a Signaling Function Score would be calculated quantitatively and converted into a final qualitative result: abnormal ornormal. For patients found to have an abnormal signaling pathway, clinicians would use the results of the CELsignia test as a guide to select a targeted drug that inhibits the abnormalsignaling activity identified. United States For our first tests, we will target the estimated 4,300 medical oncologists working in hospitals and cancer centers in the United States. We expect to hire domestic salesprofessionals with typically over 10 years of experience in clinical oncology sales working at leading biopharmaceutical or specialty reference laboratory companies. In general, we intend to focus our initial sales efforts on building relationships with KOLs and researchers at leading academic research institutions to demonstrate the scientificcredibility of our CELsignia tests. We also plan to build relationships in community oncology practice settings through leading physician networks and community hospitals andcommunitybased cancer centers. We will also attend national and regional clinical meetings focused on cancer treatment for our anticancer tests. We believe the unique and important nature of the results our CELsignia tests provide, and their positioning as a companion diagnostic, will drive many medical oncologists toindependently seek out our tests once they become aware of them. We believe this may allow us to achieve our market penetration goals with a sales force and marketing expensessignificantly less costly than has been experienced by molecular diagnostic companies. International We believe we can serve the international market from our laboratory in Minnesota. We expect to establish an international presence using local distributors that sell tophysicians and coordinate shipment of specimens to the United States. To serve international markets, we would expect to add dedicated regional managers located outside the UnitedStates to oversee our relationships at the local level. Pricing and Reimbursement The principal groups that we expect to pay us in the future for our CELsignia tests include: ·commercial thirdparty payors; ·government payors, including Medicare and state Medicaid plans; ·biopharmaceutical customers; ·hospitals, cancer centers, and other institutions; and ·patients. Adequate reimbursement will be an important factor in achieving broad clinical adoption of our CELsignia tests. At the same time, we believe broad clinical adoption will helpdrive favorable reimbursement decisions. To achieve broad reimbursement coverage with commercial thirdparty payors and government payors, including Medicare and Medicaid, weplan to demonstrate the economic and clinical value of our CELsignia tests to payors by employing a multipronged strategy: ·Set a high bar for analytical validation. We expect to present data on the characterization of new cancer subtypes by CELsignia tests at conferences and will seek topublish the results in peerreviewed journals. ·Meet the evidence standards necessary to be consistent with leading clinical guidelines. We believe inclusion in leading clinical practice guidelines plays a critical role inpayers’ coverage decisions. We plan to conduct clinical validation and clinical utility studies that are consistent with the requirements of the widely recognized NationalComprehensive Cancer Network clinical practice guidelines. ·Execute an internal managed care policy and claims adjudication function as part of our core business operations. We plan to make obtaining adequate and widespreadreimbursement a critical component of our business operations. We expect to hire a team of inhouse claims processing and reimbursement specialists who will work withpatients and payers to navigate the claims process and obtain maximum reimbursement. ·Cultivate a network of KOLs. KOLs are able to influence clinical practice by publishing research and determining whether new tests should be integrated into practiceguidelines. We expect to collaborate with KOLs early in the development process to ensure our clinical studies are designed and executed in a way that clearlydemonstrates the benefits of our tests to physicians and payers. ·Compile a growing library of peerreviewed studies that demonstrate the test is effective. We will seek to publish peerreviewed articles and review papers to helpsupport our efforts to obtain widespread adoption and reimbursement of our CELsignia tests. In each disease area we pursue, we intend to conduct studies in order todevelop similar supporting literature. 16Table of Contents ·Reduce expenditures. We intend to build economic models to measure the financial benefits of using our CELsignia test in guiding patient treatment and minimizing theuse of drugs that will not likely have a positive impact. We plan to use the data we gather through the use of these models as we meet with commercial thirdparty payorsand government payors. ·Exploit efforts by commercial thirdparty and government payors to contain healthcare costs. A major cost reduction opportunity is to reduce expenditures for drugcourses that provide no patient benefit. Our technology will enable physicians to prescribe therapies that have significantly higher response rates than has been the casewith targeted therapies to date. Since this will lower the drug cost per responsive patient, we believe widespread use of our CELsignia tests is consistent with payorsgoals of delivering health care more cost effectively. Our Competition At present, we are not aware of any other companies that offer diagnostic tests that use a patient’s live tumor cells to identify the signaling pathway driving a patient’s cancer.There are several companies focused on developing genomic or proteomic analyses of a patient’s diseased cells. Initial efforts identified protein targets or genetic mutations, oftentimesreferred to as “biomarkers,” that are associated with a disease process to enable development of drugs more closely tailored to specific patient populations. As tools for human genome analysis have become less expensive, a number of companies have also recently launched more complex genomic test panels and gene expressionsignatures tests. These tests rely on a static measurement of molecular properties and mathematical analysis to identify statistically significant correlations between the selectedmolecular properties and a clinical condition or outcome of populations of patients with the “same” disease. These genetic tests often have limited predictive success because they only identify some, but not all, of, the molecular and cellular conditions required for a drug therapy tofunction in a patient. They may identify the presence of the genes associated with a disease, but they cannot determine how the gene products function in the context of a particularindividual. Providers of genomic or proteomic tests include diagnostic kit manufacturers, hospitals, and independent laboratories. We do not plan to develop tests where a molecularbiomarker can identify drug responsive patients, so our current tests will not compete directly against the tests provided by these other companies. The table below provides a summaryof the points of differentiation between our signaling function analysis approach and the molecular approaches used by our potential competitors. Current Molecular Methods vs. Our Pathway Activity Analysis Platform Type of Cell Sample Used:Tumor cell fragments(fixed, lysed, DNA) Live tumor cellsType of Analysis PerformedSingle pointintime mutation(s) status or proteinamount, or activation statusQuantify signaling pathway activity over 24hourperiodRelationship to disease driverCorrelativeDirect CauseDisease driver evaluatedNo. Only a single or small set of components of the cellare evaluatedYes. The activity of the entire signaling pathway isassessedDrug function evaluatedNo. Cannot assess drug function with cell fragmentsYes. Drug’s effect on signaling pathway activity inpatient’s cells quantifiedCompaniesFoundation Medicine, Caris Life Sciences,NeoGenomics, LabCorp, Quest, Nanostring, Paradigm,Biocept, Exosome Diagnostics, Guardant Health, RocheDiagnostics, Qiagen, Myriad, Genomic HealthCelcuity We are not aware of any available tests directly comparable to the CELsignia tests. We expect to offer each CELsignia test to patients at list prices ranging from $4,000 to $7,000,depending on the number of pathways evaluated. List prices for several proprietary complex genomic tests fall within this range, and we believe this provides guidance as to the pricingof highly informative tests that guide cancer patient care. 17Table of Contents Intellectual Property We believe one of our core competitive advantages is the strength of our intellectual property portfolio. We developed our CELsignia technology internally. We are seekingboth U.S. and nonU.S. patents to protect our inventions. We have three issued U.S. patents, five issued international patents, five pending U.S. patent applications, 23 pending nonU.S. patent applications, and one pending PCT patent application, as well as numerous corresponding nonU.S. patent applications covering our diagnostic approach using cellsignaling analysis in living patient cells to guide treatment of patients with targeted therapies. The earliest expiration date of patents is 2033. In addition, we have developed significantproprietary knowhow and trade secrets for the various cell sample preparation and cellular analysis methods we have developed. We understand we must develop and maintain protection on the proprietary aspects of our technologies in order to remain competitive. We rely on a combination of patents,copyrights, trademarks, trade secret and other intellectual property laws and confidentiality, material transfer agreements, invention assignment agreements and other contracts toprotect our intellectual property rights. We plan to develop names for new products and apply for trademarks and as appropriate secure trademark protection for them, including domain name registration, in relevantjurisdictions. We also have developed a number of proprietary methods, materials, processes, and techniques related to the preparation of patient samples and performance of theCELsignia test that we believe are most effectively protected as trade secrets rather than as patented subject matter. Principal Suppliers We purchase commercially available reagents and instruments from a variety of suppliers. Our principal reagent suppliers include BioTechne Corporation, Selleck Chemicals,SigmaAldrich, and VWR International. Our principal instrument suppliers include Agilent Technologies, Integra Biosciences, Invitrogen, and Thermo Fisher Scientific. These items arepurchased on a purchase order basis pursuant to the applicable supplier’s standard terms and conditions. The items purchased from these suppliers are standard products sold widelyto the biotechnology industry. All items purchased are typically available within several days after an order is placed. Government Regulation CLIA and CMS The Centers for Medicare & Medicaid Services, or CMS, an agency within the U.S. Department of Health and Human Services, regulates all clinical laboratory testing (exceptresearch) performed on humans in the United States through CLIA. All clinical laboratories that perform clinical lab services on human specimens for the purpose of providinginformation on the diagnosis, prevention or treatment of disease must receive CLIA certification. This covers approximately 175,000 laboratories as of 2017. Laboratories must obtainCLIA certification and demonstrate compliance with CLIA requirements as confirmed by an inspection by CMS. We received our CLIA certification in 2016. We also had our laboratorycertified by the College of American Pathologies, or CAP, in 2016, an organization recognized by CMS as a thirdparty reviewer of clinical laboratories. Several states, including, amongothers, New York and California, require licensure of outofstate labs that receive specimens from the state and compliance with the state’s individual laboratory regulations. If our laboratory is out of compliance with CLIA requirements, we may be subject to sanctions such as suspension, limitation or revocation of our CLIA certificate, as well asdirected plan of correction, state onsite monitoring, civil money penalties, civil injunctive suit or criminal penalties. We must maintain CLIA compliance and certification to be eligible tobill for services provided to Medicare and Medicaid beneficiaries. If we were to be found out of compliance with CLIA program requirements and subjected to sanction, our businesscould be harmed. Failure to comply with state licensure laws, if applicable, could subject us to additional sanctions imposed by state licensing authorities. FDA FDA approval or clearance is not currently required for CELsignia tests offered as a standalone LDT test. If we are partnered with a drug company to launch a CELsignia test asa companion diagnostic for a new drug indication, we would be required to obtain premarket approval, or PMA, in conjunction with the pharmaceutical company seeking a new drugapproval for the matching therapy. Historically, the FDA has exercised enforcement discretion with respect to tests performed solely in a central laboratory, like the CELsignia tests orLDTs. The FDA has not required laboratories that furnish only LDTs to comply with the agency’s requirements for medical devices (e.g., establishment registration, device listing,quality systems regulations, premarket clearance or premarket approval, and postmarket controls). Although the FDA proposed regulations that would apply to LDTs, the FDA recently decided that, at present, those regulations are not moving forward towards approval andimplementation. In mid2014, the FDA published a draft Guidance Document describing a proposed approach for a regulatory framework for LDTs that would have resulted in most of thehighvalue LDT tests marketed today eventually being required to obtain 510(k) clearances or PMAs. If implemented, this regulatory framework would require most hospital clinical labsto abandon a number of tests they perform or to pursue regulatory clearances or approvals to perform them. These proposals met significant resistance from Congress, the hospitalindustry, and independent clinical laboratories. The FDA indicated in late 2016 that it does not intend to finalize the draft Guidance Document at this time. However, the FDA continuesto discuss potential regulatory approaches to LDTs. 18Table of Contents HIPAA and HITECH Under the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996, or HIPAA, as amended by the Health InformationTechnology for Economic and Clinical Health (“HITECH Act”), the U.S. Department of Health and Human Services, or HHS, issued regulations that establish uniform standardsgoverning the conduct of certain electronic healthcare transactions and protecting the privacy and security of protected health information used or disclosed by healthcare providersand other covered entities. HIPAA includes the following primary sets of regulations: privacy regulations, security regulations, and standards for electronic transactions, whichestablish standards for certain healthcare transactions. The privacy and security regulations were extensively amended in 2013 to incorporate new requirements from the HITECH Act. The privacy regulations cover the use and disclosure of protected health information by healthcare providers and other covered entities. They also set forth certain rights thatan individual has with respect to his or her protected health information, including, but not limited to, the right to access or amend certain records containing protected healthinformation, or to request restrictions on the use or disclosure of protected health information. The security regulations establish requirements for safeguarding the confidentiality,integrity, and availability of protected health information that is electronically transmitted or electronically stored. The HITECH Act, among other things, made many of HIPAA’s privacyand security standards applicable to business associates of covered entities, and established certain protected health information security breach notification requirements. A coveredentity must notify affected individual(s) and HHS when there is a breach of unsecured protected health information. HIPAA also governs patient access to laboratory test reports.Effective October 6, 2014, individuals (or their personal representatives, as applicable), have the right to access test reports directly from clinical laboratories and to direct that copies ofthose test reports be transmitted to persons or entities designated by the individual. These laws impose significant fines and other penalties for improper use or disclosure of protected health information. Additionally, to the extent that we submit electronichealthcare claims and payment transactions that do not comply with the electronic data transmission standards established under HIPAA and the HITECH Act, payments to us may bedelayed or denied. In addition to the federal privacy regulations, there are a number of state laws regarding the privacy and security of health information and personal data that are applicable toour operations. The HIPAA privacy and security regulations establish a uniform federal “floor” that covered entities and business associates must meet and do not supersede state lawsthat are more stringent or provide individuals with greater rights with respect to the privacy or security of, and access to, their records containing protected health information. Thecompliance requirements of these various state laws, including additional breach reporting requirements, and the penalties for violation vary widely and new privacy and security laws inthis area are evolving. We believe that we have taken the steps required for us to comply with health information privacy and security statutes and regulations in all jurisdictions, bothstate and federal. However, we may not be able to maintain compliance in all jurisdictions where we do business. Failure to maintain compliance, or changes in state or federal lawsregarding privacy or security, could result in civil and/or criminal penalties and could have a material adverse effect on our business. Federal, State and Foreign Fraud and Abuse Laws In the United States, there are various fraud and abuse laws with which we must comply and we are potentially subject to regulation by various federal, state and localauthorities, including CMS, other divisions of HHS (e.g., the Office of Inspector General), the U.S. Department of Justice, and individual U.S. Attorney offices within the Department ofJustice, and state and local governments. We also may be subject to foreign fraud and abuse laws in connection with our international business activities. In the United States, the federal AntiKickback Statute prohibits, among other things, knowingly and willfully offering, paying, soliciting or receiving remuneration to induce, orin return for patient referrals for, or purchasing, leasing, ordering, recommending or arranging for the purchase, lease or order of, any healthcare item or service reimbursable under agovernmental payor program. Courts have stated that a financial arrangement may violate the AntiKickback Statute if any one purpose of the arrangement is to encourage patientreferrals or other federal healthcare program business, regardless of whether there are other legitimate purposes for the arrangement. The definition of “remuneration” has been broadlyinterpreted to include anything of value, including gifts, discounts, credit arrangements, payments of cash, consulting fees, waivers of copayments, ownership interests, and providinganything at less than its fair market value. Recognizing that the AntiKickback Statute is broad and may technically prohibit many innocuous or beneficial arrangements within thehealthcare industry, HHS issued a series of regulatory “safe harbors.” These safe harbor regulations set forth certain provisions, which, if met, will assure healthcare providers and otherparties that they will not be prosecuted under the federal AntiKickback Statute. Although full compliance with these provisions protects against prosecution under the federal AntiKickback Statute, the failure of a transaction or arrangement to fit within a specific safe harbor does not necessarily mean that the transaction or arrangement is illegal or that prosecutionunder the federal AntiKickback Statute will be pursued. Many states also have antikickback statutes, some of which may apply to items or services reimbursed by any thirdpartypayor, including commercial insurers. 19Table of Contents In addition, federal false claims laws, including the federal civil False Claims Act, prohibit, among other things, any person or entity from knowingly presenting, or causing to bepresented, a false claim for payment to, or approval by, the federal government or knowingly making, using, or causing to be made or used a false record or statement material to a falseor fraudulent claim to the federal government. As a result of a modification made by the Fraud Enforcement and Recovery Act of 2009, a claim includes “any request or demand” formoney or property presented to the U.S. government. Recently, several pharmaceutical and other healthcare companies have been prosecuted under these laws for allegedly providingfree product to customers with the expectation that the customers would bill federal programs for the product. Other companies have been prosecuted for causing false claims to besubmitted because of the companies’ marketing of the product for unapproved, and thus generally nonreimbursable, uses. The civil monetary penalties statute imposes penaltiesagainst any person or entity who, among other things, is determined to have presented or caused to be presented a claim to a federal health program that the person knows or shouldknow is for an item or service that was not provided as claimed or is false or fraudulent. HIPAA created additional federal criminal statutes that prohibit knowingly and willfully executing, or attempting to execute, a scheme to defraud or to obtain, by means of falseor fraudulent pretenses, representations or promises, any money or property owned by, or under the control or custody of, any healthcare benefit program, including private thirdpartypayors and knowingly and willfully falsifying, concealing or covering up by trick, scheme or device, a material fact or making any materially false, fictitious or fraudulent statement inconnection with the delivery of or payment for healthcare benefits, items or services. In addition, various states have enacted false claim laws analogous to the federal False Claims Act, although many of these state laws apply where a claim is submitted to anythirdparty payor and not merely a governmental payor program. If our operations are found to be in violation of any of the federal or state healthcare laws described above or any othergovernmental regulations that apply to us, we may be subject to significant penalties, including without limitation, civil, criminal and/or administrative penalties, damages, fines,disgorgement, exclusion from participation in government programs, such as Medicare and Medicaid, injunctions, private “qui tam” actions brought by individual whistleblowers in thename of the government, or refusal to allow us to enter into government contracts, contractual damages, reputational harm, administrative burdens, diminished profits and futureearnings, and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our business and our results of operations. In Europe, various countries have adopted antibribery laws providing for severe consequences, in the form of criminal penalties and/or significant fines, for individuals and/orcompanies committing a bribery offence. Violations of these antibribery laws, or allegations of such violations, could have a negative impact on our business, results of operations andreputation. For instance, in the United Kingdom, under the Bribery Act 2010, which went into effect in July 2011, a bribery occurs when a person offers, gives or promises to give afinancial or other advantage to induce or reward another individual to improperly perform certain functions or activities, including any function of a public nature. Bribery of foreignpublic officials also falls within the scope of the Bribery Act 2010. Under the new regime, an individual found in violation of the Bribery Act 2010 faces imprisonment of up to 10 years. Inaddition, the individual can be subject to an unlimited fine, as can commercial organizations for failure to prevent bribery. Federal and State Physician SelfReferral Prohibitions Under a federal law directed at “selfreferral,” commonly known as the “Stark Law,” there are prohibitions, with certain exceptions, on referrals for certain designated healthservices, including laboratory services, that are covered by the Medicare and Medicaid programs by physicians who personally, or through a family member, have an investment orownership interest in, or a compensation arrangement with, an entity performing the tests. The prohibition also extends to payment for any testing referred in violation of the Stark Law.A person who engages in a scheme to circumvent the Stark Law’s referral prohibition may be fined up to $100,000 for each such arrangement or scheme. In addition, any person whopresents or causes to be presented a claim to the Medicare or Medicaid programs in violation of the Stark Law is subject to civil monetary penalties of up to $15,000 per bill submission,an assessment of up to three times the amount claimed and possible exclusion from participation in federal governmental payor programs. Bills submitted in violation of the Stark Lawmay not be paid by Medicare or Medicaid, and any person collecting any amounts with respect to any such prohibited bill is obligated to refund such amounts. Many states havecomparable laws that are not limited to Medicare and Medicaid referrals. Other Regulatory Requirements Our operations use small amounts of hazardous materials in research and development and generate regulated medical waste in the normal course of performing our CELsigniatests. This subjects us to a variety of federal, state and local environmental and safety laws and regulations. Some of the regulations under the current regulatory structure provide forstrict liability, holding a party potentially liable without regard to fault or negligence. We could be held liable for damages and fines as a result of our, or others’, business operationsshould contamination of the environment or individual exposure to hazardous substances occur. We cannot predict how changes in laws or development of new regulations will affectour business operations or the cost of compliance. 20Table of Contents New Legislation and Regulations From time to time, legislation is drafted, introduced and passed in Congress that could significantly change the statutory provisions governing the testing, approval,manufacturing and marketing of products that are or will be regulated by the FDA or CMS. In addition to new legislation, FDA and CMS regulations and policies are often revised orinterpreted by the agencies in ways that may significantly affect our business and our products. It is impossible to predict whether further legislative changes will be enacted or FDA orCMS regulations, guidance, policies or interpretations will be changed, or what the impact of such changes, if any, may be. The 2020 presidential election and the resulting change inadministration make it even more difficult to predict if and how federal regulations may change and/or federal agencies might alter their positions. Pharmaceutical Coverage, Pricing and Reimbursement Significant uncertainty exists as to the coverage and reimbursement status of any products we sell. Sales of any of our products will depend, in part, on the extent to which thecosts of the products will be covered by thirdparty payors, including government health programs such as Medicare and Medicaid, commercial health insurers, managed careorganizations or pharmaceutical companies. The process for determining whether a thirdparty payor will provide coverage for a test sometimes is separate from the process for settingthe price of a drug product or for establishing the reimbursement rate that a payor will pay for the drug product. Thirdparty payors may limit coverage to specific testing products on anapproved list, which might not include all of the tests available for a particular indication. In order to obtain coverage and reimbursement for any product, we may need to conduct expensive pharmacoeconomic studies in order to demonstrate the medical necessityand costeffectiveness of the test. Whether or not we conduct such studies, our products may not be considered medically necessary or costeffective. A thirdparty payor’s decision toprovide coverage for a test does not imply that an adequate reimbursement rate will be approved. Further, one payor’s determination to provide coverage for a product does not assurethat other payors will also provide coverage, and adequate reimbursement, for the product. Thirdparty reimbursement may not be sufficient to enable us to maintain price levels highenough to realize an appropriate return on our investment in product development. The containment of healthcare costs has become a priority of federal, state and foreign governments, and the prices of tests and drugs have been a focus in this effort. Thirdparty payors are increasingly challenging the prices charged for medical products and services, examining the medical necessity and reviewing the costeffectiveness of testingproducts, drug products and medical services and questioning safety and efficacy. If these thirdparty payors do not consider our products to be costeffective compared to otheravailable tests, they may not cover our products or, if they do, the level of payment may not be sufficient to allow us to sell our products at a profit. The U.S. government, statelegislatures and foreign governments have shown significant interest in implementing costcontainment programs to limit the growth of governmentpaid healthcare costs, includingprice controls and restrictions on reimbursement. Adoption of such controls and measures, and tightening of restrictive policies in jurisdictions with existing controls and measures,could limit payments for our testing products or drugs that require use of our testing products and could adversely affect our net revenue and results. Pricing and reimbursement schemes vary widely from country to country. Some countries may require the completion of additional studies that compare the costeffectivenessof a particular test to currently available tests. The downward pressure on healthcare costs in general, particularly prescription drugs and testing products, has become intense. As aresult, increasingly high barriers are being erected to the entry of new products. In addition, in some countries, crossborder imports from lowpriced markets exert competitive pressurethat may reduce pricing within a country. Any country that has price controls or reimbursement limitations for testing products may not allow favorable reimbursement and pricingarrangements for any of our products. Coverage policies, thirdparty reimbursement rates and test pricing regulation may change at any time. In particular, in the United States, the Affordable Care Act containsprovisions that have the potential to substantially change healthcare delivery and financing, including impacting the profitability of testing and drugs. For example, the Affordable CareAct revised the methodology by which rebates owed by manufacturers for covered outpatient drugs are calculated under the Medicaid Drug Rebate Program, extended the MedicaidDrug Rebate Program to utilization of covered drugs dispensed to individuals enrolled in Medicaid managed care organizations and subjected manufacturers to new annual fees forcertain branded prescription drugs. As the price of our test may be included in the reimbursement rates for certain drugs, this could significantly impact our pricing. Even if favorablecoverage and reimbursement status is attained for one or more products, less favorable coverage policies and reimbursement rates may be implemented in the future. Corporate History We were organized as a Minnesota limited liability company in 2011 and commenced operations in 2012. On September 15, 2017, we converted from a Minnesota limited liabilitycompany into a Delaware corporation and changed our name from Celcuity LLC to Celcuity Inc. Employees and Labor Relations As of December 31, 2020, we had 30 fulltime employees, most of which were engaged in research and development activities. None of our employees are currently representedby a labor union or covered by a collective bargaining agreement and we believe that our relations with our employees are good. During 2020, our voluntary turnover rate was less than4%. Our human capital resources objectives include identifying, recruiting, retaining, and incentivizing our existing and new employees. We maintain an equity incentive plan, theprincipal purposes of which are to attract, retain and reward personnel through the granting of stockbased compensation awards, in order to increase stockholder value and the successof our company by motivating such individuals to perform to the best of their abilities and achieve our objectives. 21Table of Contents ITEM 1A. Risk Factors Risk factors that could cause actual results to differ from our expectations and that could negatively impact our financial condition and results of operations are discussedbelow and elsewhere in this Annual Report. Additional risks and uncertainties not presently known to us or that are currently not believed to be significant to our business may alsoaffect our actual results and could harm our business, financial condition and results of operations. If any of the risks or uncertainties described below or any additional risks anduncertainties actually occur, our business, results of operations and financial condition could be materially and adversely affected. Risks Relating to Our Business We have a limited operating history and we may never generate revenue or profit. We are an earlystage biotechnology company that commenced activities in January 2012. We only have a limited operating history and our business plan has not been tested.Since inception, we have had no revenue and have incurred significant operating losses. We have financed our operations primarily through equity and debt offerings, including ourIPO. To generate revenue and become and remain profitable, we must continue to develop and commercialize the CELsignia platform. To do so, we need to successfully complete ourfour existing clinical trial collaborations, one with Genentech and NSABP, one with Puma and the West Cancer Center, and one with Puma and the Massachusetts General Hospital forour CELsignia HER2 Pathway Activity Test, and a fourth one with the Sarah Cannon Research Institute and Pfizer for our CELsignia MultiPathway Activity Test, continue to developother CELsignia tests for other cancer subtypes and cultivate partnerships with pharmaceutical companies. We must also build operational and financial infrastructure to supportcommercial operations, train and manage employees, and market and sell our CELsignia tests (as a companion diagnostic and/or as a standalone test). We may never succeed in any of these activities and, even if we do, we may never generate revenue that is sufficient to achieve profitability. We expect to continue to incursignificant expenses and operating losses for the foreseeable future, and the net losses we incur may fluctuate significantly from quarter to quarter. Our failure to become and remainprofitable would decrease our value and could impair our ability to raise capital, maintain or expand our research and development efforts, expand our business, or continue ouroperations. Our initial success is heavily dependent on the success of our first CELsignia tests. Our business strategy is focused on attracting pharmaceutical company partnerships that provide revenue from the sale of CELsignia tests during clinical trials, from milestonepayments during clinical trials, from sales of our CELsignia tests as companion diagnostics or standalone tests thereafter, and, potentially, from royalties on the incremental drugrevenues our tests enable. Our ability to obtain such partnerships and generate such revenue depends in part on the ability of our first CELsignia tests to demonstrate the potentialincremental opportunity available for pharmaceutical companies. We do not expect to receive the first interim results for our prospective clinical trials for the CELsignia HER2 PathwayActivity Test until the fourth quarter of 2021 or first quarter of 2022 and with final results expected approximately nine months later. Success of the clinical trials using the CELsigniaHER2 Pathway Activity Test or CELsignia MultiPathway Activity Test will depend on many factors, such as successfully enrolling patients, meeting trial endpoint goals, andcompleting the trial in a timely manner. Our ability to complete the trial could be delayed or prevented for several reasons that are out of our control, such as the FDA withdrawing itsauthorization and approval to perform the study, NSABP, West Cancer Center, Massachusetts General Hospital, or Sarah Cannon Research Institute determining that the human and/ortoxicology test results do not support continuing the trial, or participants having adverse reactions or sideeffects to the drugs administered in the study. If we are unable to demonstratethat the CELsignia HER2 Pathway Activity Test or CELsignia MultiPathway Activity Test is suitable as a companion diagnostic for the targeted therapy, we will likely not be able togenerate future revenue from our CELsignia HER2 Pathway Activity Test or CELsignia MultiPathway Activity test and may not be able to attract other pharmaceutical companies topartner with us for the development and commercialization of other CELsignia tests. Further, potential pharmaceutical company partners may delay negotiating development agreementsuntil results of the first clinical trial using our CELsignia HER2 Pathway Activity Test trial are available. Even if the ultimate outcome of the first clinical trial using a CELsignia HER2Pathway Activity Test trial is positive, any delays could materially and adversely affect our business. 22Table of Contents We may not be successful in finding pharmaceutical company partners for continuing development of additional CELsignia tests. We intend to develop strategic partnerships with pharmaceutical companies for developing additional CELsignia tests. Many of the potential partners are global, multibilliondollar pharmaceutical companies with sophisticated research and development organizations and multiple priorities. We may not be successful in our efforts to establish such a strategicpartnership or other alternative arrangements for our CELsignia tests because, among other things, our research and development pipeline may be insufficient, such tests may be deemedto be at too early of a stage of development for collaborative effort, or third parties may not view such tests as having the requisite potential to demonstrate efficacy. In addition, we maybe restricted under collaboration agreements from entering into future agreements with other partners. Even if we are able to find suitable partners, we may not be successful innegotiating development agreements with such partners that provide revenue from the sale of our CELsignia tests, from milestone payments, and/or from royalties on the incrementaldrug revenues that our tests enable. If we are unable to reach agreements with suitable strategic partners on a timely basis, on acceptable terms or at all, we may have to curtail thedevelopment of additional CELsignia tests, our expected revenue opportunities may be significantly smaller than expected and our business may fail. While our CELsignia HER2 Pathway Activity Test and CELsignia MultiPathway Activity Test are commercially ready, we have not attempted to market these to physicians ortheir patients as standalone tests and have no ability to determine if these tests or any of our other tests will be commercially viable. While our CELsignia HER2 Pathway Activity Test and CELsignia MultiPathway Activity Test are analytically validated, conducted in our CLIA certified and CAP accreditedlaboratory, and currently ready for commercial use as an LDT, we have not attempted to market them to physicians or their patients. Furthermore, we have commenced only limitedcommunications with KOLs to build awareness and credibility of our CELsignia diagnostic platform and CELsignia tests. Accordingly, we have no ability to determine whether ourCELsignia HER2 Pathway Activity Test, CELsignia MultiPathway Activity Test or any other future CELsignia tests, will be commercially viable as standalone tests. We may never besuccessful in generating revenue from our CELsignia tests as standalone tests, and if we are unable to build pharmaceutical partnerships that enable us to market the CELsignia HER2Pathway Activity Test, the CELsignia MultiPathway Activity Test, and other tests as companion diagnostic tests, we may never generate any revenue and our business may fail. Developing our CELsignia tests involves a lengthy and complex process that may not be successful. Our CELsignia tests may take several years to develop from the time they are discovered to the time they are available for patient use, if ever. In order to develop additionalCELsignia tests into commercially ready products, we need to successfully complete a variety of activities, including, among others, conducting substantial research and development,conducting extensive analytical testing, and maintaining our CLIA certified and CAP accredited laboratory. In addition, our business strategy is focused on our CELsignia tests beingsold as companion diagnostics. This will require obtaining and maintaining partnerships with pharmaceutical companies and successfully completing clinical studies that demonstratethe suitability of the applicable CELsignia test as a companion diagnostic for their targeted therapies. These activities will require us to expend significant resources. Based on comparable companies in this industry, few research and development projects result in commerciallyviable products, and success in early clinical studies often is not replicated in later studies. At any point, we may abandon development of a product candidate for several reasons, suchas a clinical validation study failing to demonstrate the prospectively defined endpoints of the study. We may also be required to expend considerable resources repeating clinicalstudies, which would adversely affect the timing for generating potential revenue from a new product and our ability to invest in other products in our pipeline. Clinical trials are expensive and complex with uncertain outcomes, which may prevent or delay commercialization of our CELsignia tests. For our CELsignia tests to become a companion diagnostic for a matching targeted therapy, we must conduct clinical trials to demonstrate that patients who have an abnormalsignaling pathway, as identified by our CELsignia tests, respond to treatment with a matching targeted therapy. Clinical testing is expensive, is difficult to design and implement, and cantake many years to complete, and its outcome is inherently uncertain. As a company, we have limited experience in conducting or participating in clinical trials. We cannot be certain thatany future clinical trials will conclusively demonstrate that any CELsignia test is effective as a companion diagnostic. If our trials do not yield positive results, we may be unable tomaintain the pharmaceutical company partnerships we build or find additional partners, we may not be able to successfully commercialize our CELsignia tests or generate any revenue,our business may fail, and you may lose part or all of your investment. We cannot be certain that our existing clinical trial or future clinical trials, if any, will begin or be completed on time, if at all. We may experience numerous unforeseen eventsduring, or as a result of, clinical trials that could delay or prevent our ability to commercialize our CELsignia tests, such as: ·delay or failure in reaching agreement on acceptable clinical trial contracts or clinical trial protocols with planned trial sites and/or strategic partners; ·delay or failure in reaching agreement with the FDA or a comparable foreign regulatory authority on a trial design, in obtaining authorization from such authorities tocommence the trial, and/or in complying with conditions or other requirements imposed by such regulatory authorities with respect to the trial; ·delay or failure in recruiting and enrolling suitable subjects to participate in one or more clinical trials, or in such participants completing a trial or returning for followupduring or after the trial; 23Table of Contents ·clinical sites, investigators or other thirdparties deviating from the trial protocol, failing to conduct the trial in accordance with regulatory and contractual requirements,and/or dropping out of a trial; ·regulatory imposition of a clinical hold for any of our clinical trials, where a clinical hold in a trial in one indication would result in a clinical hold for clinical trials in otherindications; and ·changes in governmental regulations or administrative actions. Significant nonclinical or clinical trial delays could prevent us from maintaining and/or developing new pharmaceutical company partnerships. Delays could also shorten anyperiods during which we may have the exclusive right to commercialize our CELsignia tests or allow our competitors to bring products to market before we do. As such, any delays couldimpair our ability to successfully commercialize our CELsignia tests and may materially and adversely affect our business, financial condition, results of operations and prospects. Even if our CELsignia tests achieve positive clinical trial results, they may fail to achieve the degree of market acceptance by physicians, patients, thirdparty payors and others inthe medical community necessary for commercial success. If any of our potential CELsignia tests, including our first CELsignia HER2 Pathway Activity Test and CELsignia MultiPathway Activity Test, achieve positive clinical trialresults, they may nonetheless fail to gain sufficient market acceptance by physicians, patients, thirdparty payors and others in the medical community necessary for commercialsuccess. For example, conventional genomic or proteomicbased analyses are commonly used today to diagnose cancer and prescribe cancer medications, and physicians may continueto rely on these diagnostic tests instead of adopting the use of a CELsignia test. The degree of market acceptance of our CELsignia tests will depend on a number of factors, including: ·their efficacy and other potential advantages compared to alternative diagnostic tests; ·our ability to offer them for sale at competitive prices; ·their convenience and ease of obtaining patient specimens compared to alternative diagnostics; ·the willingness of the target patient population to try new diagnostics and of physicians to initiate such diagnostics; ·the strength of marketing and distribution support; ·the availability of thirdparty coverage and adequate reimbursement for our diagnostic tests; and ·our ability to partner with pharmaceutical companies to develop companion diagnostic programs for the new cancer subtypes we discover. If our CELsignia tests do not achieve an adequate level of acceptance, we may never generate significant product revenues and we may not become profitable. Our business, operational and financial goals may not be attainable if the market opportunities for our CELsignia tests or our pharmaceutical company partners are smaller thanwe expect. Our internal research and estimates on market opportunities have not been verified by independent sources, and we have not independently verified market and industrydata from thirdparties that we have relied on. The total market opportunities that we believe exist are based on a variety of assumptions and estimates, including the number of potential companion diagnostic programs wewill be able to successfully pursue, the amount of potential milestone payments that we could receive in companion diagnostic programs, the number of patients we will test in clinicaltrials, the price we will be able to charge for our tests and the total annual number of cancer patients with undiagnosed abnormal cell signaling. In addition, we have relied on thirdpartypublications, research, surveys and studies for information related to determining market opportunities, including without limitation, information on the number of cancer patients andthose receiving various forms of treatment, the cost of drug therapy, the amount of revenue generated from various types of drug therapy, the objective response rates of drug therapies,the number of deaths caused by cancer and the expected growth in cancer drug therapy and diagnostic markets. Our internal research and estimates on market opportunities have notbeen verified by independent sources, and we have not independently verified market and industry data from thirdparties that we have relied on. Any or all of our assumptions and/orestimates may prove to be incorrect for several reasons, such as inaccurate reports or information that we have relied on, potential patients or providers not being amenable to using ourCELsignia platform for diagnostic testing or such patients becoming difficult to identify and access, limited reimbursement for companion diagnostics, pricing pressure due to availabilityof alternative diagnostic tests, or an inability of the CELsignia tests’ companion drugs to obtain the necessary regulatory approvals for new indications. If any or all of our assumptionsand estimates prove inaccurate, we and our companion diagnostic pharmaceutical partners may not attain our business, operational and financial goals. The expected selling price range of our CELsignia tests is an estimate. We have not yet sold any such tests and the actual price we are able to charge may be substantially lowerthan our expected price range. We have estimated the selling price range of our CELsignia tests based on the pricing of other diagnostic tests currently available and assumptions regarding the efficacy andmarket acceptance of our tests. We have not yet sold our CELsignia tests and cannot be certain of the actual price we may be able to charge. The availability and price of ourcompetitors’ products could limit the demand and the price we are able to charge. We may not achieve our business plan if acceptance is inhibited by price competition, if pharmaceuticalcompanies refuse to pay our expected prices for CELsignia tests in clinical trials, if physicians are reluctant to switch from other diagnostic tests to our CELsignia tests or if physiciansswitch to other new products or choose to reserve our CELsignia tests for use in limited circumstances. Furthermore, reductions in the reimbursement rate of thirdparty payors haveoccurred and may occur in the future. Each of these factors could cause our selling price to be substantially lower than expected, and we may fail to generate revenue or becomeprofitable. 24Table of Contents The insurance coverage and reimbursement status of new diagnostic products is uncertain. Failure to obtain or maintain adequate coverage and reimbursement for CELsigniatests could limit our ability to market those CELsignia tests and decrease our ability to generate revenue. The availability and extent of reimbursement by governmental and private payors is essential for most patients to be able to afford expensive diagnostic tests and treatments.Sales of any of our potential CELsignia tests will depend substantially, both in the United States and internationally, on the extent to which the costs of our CELsignia tests will be paidby health maintenance, managed care, and similar healthcare management organizations, or reimbursed by government health administration authorities, private health coverage insurersand other thirdparty payors. Reimbursement by a payor may depend on a number of factors, including a payor’s determination that the CELsignia tests are neither experimental norinvestigational, appropriate for the specific patient, costeffective, supported by peerreviewed publications, and included in clinical practice guidelines. If reimbursement is not available, or is available only to a limited amount, we may not be able to successfully commercialize our CELsignia tests at expected levels, or potentiallyat all. Even if coverage is provided, the approved reimbursement amount may not be high enough to allow us to establish or maintain pricing sufficient to realize a sufficient return on ourresearch and development investment. There is significant uncertainty related to the insurance coverage and reimbursement of newly approved diagnostic products. In the United States, the principal decisions aboutreimbursement for new diagnostic products and services are typically made by CMS. CMS decides whether and to what extent a new product or service will be covered and reimbursedunder Medicare. Private payors tend to follow CMS to a substantial degree. As such, a significant portion of our potential revenue depends on CMS approving coverage andreimbursement of our CELsignia tests. Outside the United States, international operations are generally subject to extensive governmental price controls and other market regulations, and we believe the increasingemphasis on costcontainment initiatives in Europe, Canada and other countries has and will continue to put pressure on the pricing and usage of diagnostic tests such as our potentialCELsignia tests. In many countries, particularly the countries of the European Union, the prices of medical products are subject to varying price control mechanisms as part of nationalhealth systems. In these countries, pricing negotiations with governmental authorities can take considerable time. To obtain reimbursement or pricing approval in some countries, wemay be required to demonstrate the costeffectiveness of our CELsignia tests relative to other available diagnostic tests. The prices of products under such systems may besubstantially lower than in the United States. Other countries allow companies to fix their own prices for products but monitor and control company profits. Additional foreign pricecontrols or other changes in pricing regulation could restrict the amount that we are able to charge for our CELsignia tests. Accordingly, in markets outside the United States, thereimbursement for our potential CELsignia tests may be reduced compared with the United States and may be insufficient to generate commercially reasonable revenue and profit. Moreover, increasing efforts by governmental and thirdparty payors, in the United States and internationally, to cap or reduce healthcare costs may cause such organizationsto limit both coverage and level of reimbursement for new products approved and, as a result, they may not cover or provide adequate payment for our potential CELsignia tests. Thedownward pressure on healthcare costs in general, particularly prescription drugs and surgical procedures and other treatments, has become very intense. We expect to experiencepricing pressures in connection with the sale of any CELsignia tests due to the trend toward managed healthcare, the increasing influence of health maintenance organizations andadditional legislative changes. We may encounter difficulties in commercializing and marketing our products, including in hiring and retaining a qualified sales force. In order to commercialize any CELsignia test, we must build marketing, sales, managerial and other nontechnical capabilities or make arrangements with third parties to performthese services, and we may not be successful in doing so. For each CELsignia test we develop, we intend to pursue development agreements with the pharmaceutical companies thatprovide matching targeted therapies. Once we have completed the analytical validation of a CELsignia test, we plan to target KOLs to build product awareness. Once we have clinicalvalidation data available, we expect to expand our sales and marketing efforts to target the broader market and coordinate our gotomarket activities with those of our partnerpharmaceutical companies. These activities will be expensive and time consuming and will require significant attention of our executive officers to manage. In particular, there is intensecompetition for qualified sales personnel and our inability to hire or retain an adequate number of sales representatives could limit our ability to maintain or expand our business andincrease sales. Furthermore, there is no guarantee that any new drug indications will require our CELsignia tests as a companion diagnostic or that any pharmaceutical company willeffectively coordinate sales and marketing activities with us. Any failure or delay in these activities, including if we are unable to develop our marketing and sales networks or if our salespersonnel do not perform as expected, would adversely impact the commercialization our CELsignia platform, and our business, financial condition, results of operations and prospectsmay be materially and adversely affected. 25Table of Contents We face significant competition from other diagnostic companies and our operating results will suffer if we fail to compete effectively. The diagnostic testing industry is intensely competitive. We have competitors both in the United States and abroad, including universities and other research institutions andproviders of diagnostics that focus on developing genomic or proteomic analyses of a patient’s diseased cells or theranostic tests to predict specific patient responses to a drugtherapy. Many of our competitors have substantially greater financial, technical and other resources, such as larger research and development staff and wellestablished marketing andsales forces. Our competitors may succeed in developing, acquiring or licensing, on an exclusive basis, products or services that are more effective or less costly than the CELsigniatests that we are currently developing or that we may develop. In addition, established medical technology, biotechnology and/or pharmaceutical companies may invest heavily toaccelerate discovery and development of diagnostic tests that could make our CELsignia tests less competitive. Our ability to compete successfully will depend largely on our ability to: ·discover and develop CELsignia tests for cancer subtypes that are superior to other products in the market; ·demonstrate compelling advantages in the efficacy and convenience of our CELsignia tests on a cost competitive basis; ·attract qualified scientific, product development and commercial personnel; ·obtain and maintain patent and other proprietary protection as necessary for our CELsignia platform; ·obtain required U.S. and international regulatory approvals; ·successfully collaborate with research institutions and pharmaceutical companies in the discovery, development and commercialization of our current and futureCELsignia tests; and ·successfully expand our operations and build a sales force to support commercialization. If our sole laboratory facility becomes inoperable, we will be unable to perform our tests and our business will be harmed. We do not have redundant laboratory facilities. We perform all of our diagnostic services in our laboratory located in Minneapolis, Minnesota. Our facility and the equipmentwe use to perform our tests would be costly to replace and could require substantial lead time to repair or replace. The facility may be harmed or rendered inoperable by physical damagefrom fire, floods, tornadoes, power loss, telecommunications failures, breakins and similar events, which may render it difficult or impossible for us to perform our tests for some periodof time. The inability to perform our tests may result in the loss of customers or harm our reputation, and we may be unable to regain those customers in the future. Although we possessinsurance for damage to our property and the disruption of our business, this insurance may not be sufficient to cover all of our potential losses and may not continue to be available tous on acceptable terms, or at all. In order to rely on a third party to perform our tests, we could only use another facility with established state licensure and CLIA accreditation under the scope of which ourpotential CELsignia tests could be performed following validation and other required procedures. We cannot assure you that we would be able to find another CLIAcertified facilitywilling to adopt CELsignia tests and comply with the required procedures, or that this laboratory would be willing to perform the tests for us on commercially reasonable terms. We will be dependent on our ability to attract and retain key personnel. Our operations will be materially dependent upon the services of our officers and key employees, including Brian F. Sullivan, our Chief Executive Officer, and Dr. Lance G. Laing,our Chief Science Officer. Successful implementation of our business plan will also require the services of other consultants and additional personnel. We cannot assure you that we willbe able to attract and retain such persons as employees, independent contractors, consultants or otherwise. If we are not able to attract individuals with the skills required for ourbusiness, or if we lose the services of either Mr. Sullivan or Dr. Laing, we may be unable to successfully implement our business plan. Our inability to raise additional capital on acceptable terms in the future may limit our ability to develop and commercialize our CELsignia platform. We may require additional capital to finance capital expenditures and operating expenses over the next several years as we launch our CELsignia platform and expand ourinfrastructure, commercial operations and research and development activities. We may seek to raise additional capital through equity offerings, debt financings, collaborations orlicensing arrangements. Additional funding may not be available to us on acceptable terms, or at all. If we raise funds by issuing equity securities, dilution to our stockholders couldresult. Any equity securities issued may also provide for rights, preferences or privileges senior to those of holders of our existing securities. The incurrence of additional indebtednessor the issuance of certain equity securities could result in increased fixed payment obligations and could also include restrictive covenants, such as limitations on our ability to incuradditional debt or issue additional equity, limitations on our ability to acquire or license intellectual property rights, and other operating restrictions that could adversely affect our abilityto conduct our business. In the event that we enter into collaborations or licensing arrangements to raise capital, we may be required to accept unfavorable terms. If we are not able tosecure additional funding when needed, we may have to delay, reduce the scope of or eliminate one or more research and development programs or selling and marketing initiatives. Inaddition, we may have to work with a partner on one or more of our products or market development programs, which could lower the economic value of those programs to our company. 26Table of Contents The COVID19 pandemic may materially and adversely impact our business, including ongoing clinical trials. The outbreak of COVID19 and government measures taken in response have had a significant impact on the global economy, with healthcare systems particularly affected. Inresponse to the COVID19 outbreak, public health measures have been implemented across much of the United States, Europe and Asia, including in the locations of our offices, clinicaltrial sites, and partners. Due to these public health measures, we are allowing employees who do not need to be physically present in the lab to perform their work at home. Our increasedreliance on employees working from home may negatively impact productivity, or disrupt, delay or otherwise adversely impact our business. As a result of the COVID19 outbreak and related public health measures, we have and may in the future experience disruptions that could materially and adversely impact ourclinical trials, business, financial condition and results of operations. Potential disruptions include but are not limited to: ·delays or difficulties in enrolling patients in clinical trials and obtaining the results of completed clinical trials; ·increased rates of patients withdrawing from clinical trials following enrollment as a result of quarantine or concerns about COVID19; ·diversion of healthcare resources away from the conduct of clinical trials; ·delays in prospective clinical trial collaborations with pharmaceutical companies and sponsors; ·interruption or delays in the operations of the FDA or other regulatory authorities, which may impact review and approval timelines; ·limitations on our ability to recruit and hire key personnel due to our inability to meet with candidates because of travel restrictions; and ·limitations on employee resources that would otherwise be focused on the conduct of clinical trials and research as a result of focus addressing COVID19 mitigation andloss of productivity from remote work. The COVID19 pandemic continues to rapidly evolve. The extent to which the outbreak impacts our business will depend on future developments, which are highly uncertainand cannot be predicted with confidence, such as the magnitude of the pandemic, the duration of social distancing in the United States and other countries, business closures orbusiness disruptions, and the effectiveness of actions taken in the United States and other countries to contain and treat the disease. Beyond the direct effect of the pandemic, mitigation efforts have had broad economic effects. The extent of the scope and duration of these economic effects cannot currentlybe predicted, although they are likely to be significant for the near future. The economic impact of COVID19 will affect us in a variety of ways, including without limitation making ourstock price more volatile, making it more difficult to raise additional capital through offerings of equity or debt securities, and reducing the availability of bank loans. As a result, we mayface difficulties raising capital and capital raising efforts may be on terms that are less favorable than would have been previously available. All of the effects of COVID19 described herein are expected to apply to any future recurrences of COVID19 and any other pandemics that may occur in the future. Risks Related to Our Reliance on Third Parties We will rely on collaboration with third parties to conduct our clinical trials, including the current trials involving the CELsignia tests, and those third parties may not performsatisfactorily. We will rely on third parties to conduct clinical trials for our CELsignia tests. For our FACT1 clinical trial, we are collaborating with Genentech and NSABP to conduct a 54patient singlearm interventional trial that is expected to obtain interim results in the fourth quarter of 2021 or first quarter of 2022 and final results approximately nine months later. Wewill rely on NSABP to conduct our clinical trial of patients selected using a CELsignia HER2 Pathway Activity Test, including setting up clinical sites, enrolling patients, and managingclinical data and Genentech will supply the drugs. For our FACT2 clinical trial, we are collaborating with Puma and the West Cancer Center to conduct a 27patient singlearminterventional trial that is expected to obtain interim results in the fourth quarter of 2021 or first quarter of 2022 and final results approximately nine months later. We will rely on WestCancer Center to conduct our clinical trial of patients selected using a CELsignia HER2 Pathway Activity Test, including setting up clinical sites, enrolling patients, and managing clinicaldata and Puma will supply the drugs. For our FACT3 clinical trial, we are collaborating with Pfizer and the Sarah Cannon Research Institute to conduct a 23patient singlearminterventional trial that is expected to obtain interim results 12 to 15 months after the protocol is activated and final results 1215 months later. We expect enrollment to begin in thesecond quarter of 2021. We will rely on the Sarah Cannon Research Institute to conduct our clinical trial of patients selected using a CELsignia MultiPathway Activity Test, includingsetting up clinical sites, enrolling patients, and managing clinical data and Pfizer will supply the drugs. For our FACT4 clinical trial, we are collaborating with Puma and MassachusettsGeneral Hospital to conduct a 23patient singlearm interventional trial that is expected to obtain interim results 12 to 15 months after the protocol is activated and final results 1215months later. We expect enrollment to begin in the second quarter of 2021. We will rely on Massachusetts General Hospital to conduct our clinical trial of patients selected using aCELsignia HER2 Pathway Activity Test, including setting up clinical sites, enrolling patients, and managing clinical data and Puma will supply the drugs. 27Table of Contents We expect to field additional clinical trials to evaluate new potential indications for drugs with patients identified by one of our new CELsignia tests. NSABP, the West CancerCenter, the Sarah Cannon Research Institute, Massachusetts General Hospital, or other contract research organizations or cancer centers that we collaborate with and/or pharmaceuticalcompanies we partner with might not successfully carry out their contractual duties, meet expected deadlines, or conduct our planned clinical trials in accordance with regulatoryrequirements or our stated protocols. Any of them may also terminate their relationship with us for a variety of reasons. Furthermore, these third parties may also have relationships withother entities, some of which may be our competitors. If we need to enter into alternative arrangements, we may not be able to complete our clinical trials and may not be able to, or maybe delayed in our efforts to, successfully commercialize our potential CELsignia tests. The pharmaceutical companies that we partner with may not be successful in receiving regulatory approval for drug indications or may not commercialize their companiontherapies for our expected companion diagnostic programs. While we intend to provide our pharmaceutical company partners with new patient populations for such partners’ existing or investigational targeted therapies, there can be noassurances that such partners will be able to obtain regulatory approval for new indications to treat these patient populations or otherwise be successful in commercializing these newtherapies. The pharmaceutical companies we partner with: ·may not meet clinical trial endpoint targets in evaluating efficacy of a targeted therapy in the patient population; ·may encounter regulatory or production difficulties that could constrain the supply of the companion therapies; ·may have difficulties gaining acceptance of the use of the companion therapies in the clinical community; ·may not pursue commercialization of any companion therapies; ·may elect not to continue or renew commercialization programs based on changes in their strategic focus or available funding, or external factors, such as an acquisition,that divert resources or create competing priorities; ·may not commit sufficient resources to the marketing and distribution of such companion therapies; or ·may terminate their relationship with us. Any of these factors could adversely affect our commercialization strategy, business, results of operations and financial condition. Our instrument or reagent suppliers may fail to meet our quality requirements for the items we purchase or fail to provide a continuous supply of the items we utilize to perform ourCELsignia tests. We utilize highly specialized reagents and instruments to perform our CELsignia tests. We may be unable to find suitable replacement reagents and instruments on a timelybasis, if at all. Interruption in the supply of these items or degradation in their quality could delay analytical and clinical studies, and/or render us unable to deliver CELsignia tests. Thiswould interrupt sales and adversely affect our business, results of operations and financial condition. Performance issues or price increases by our shipping carriers could adversely affect our business, results of operations and financial condition, and harm our reputation andability to provide our CELsignia tests on a timely basis. Expedited, reliable shipping is essential to our operations. Should our shipping carrier encounter delivery performance issues such as loss, damage or destruction of a sample,such occurrences may damage our reputation and lead to decreased demand for our services and increased cost and expense to our business. In addition, any significant increase inshipping rates could adversely affect our operating margins and results of operations. Similarly, strikes, severe weather, natural disasters or other service interruptions by deliveryservices we use would adversely affect our ability to receive and process patient samples on a timely basis. There are only a few providers of overnight nationwide transport services,and there can be no assurance that we will be able to maintain arrangements with providers on acceptable terms, if at all. Risks Related to Government Regulation Our CELsignia tests represent a novel approach to companion diagnostics, which could result in heightened regulatory scrutiny, delays in clinical development, or delays in ourability to commercialize any products. Our unique and proprietary CELsignia technology is the first cancer diagnostic platform we are aware of that can detect the underlying signaling dysfunction driving a patient’scancer. Because this is a novel approach to companion diagnostics, there can be no assurance as to the length of a clinical trial period, the number of patients the FDA or anotherapplicable regulatory authority will require to be enrolled in the trials in order to establish the safety and efficacy of our CELsignia tests and the companion drugs, or that the datagenerated in these trials will be acceptable to the FDA or another applicable regulatory authority to support marketing approval of new indications for the companion drugs. This coulddelay or prohibit our clinical trials and/or commercialization of our CELsignia tests. 28Table of Contents If the FDA were to begin regulating our tests, we could incur substantial costs and delays associated with trying to obtain premarket clearance or approval. Most LDTs are not currently subject to FDA regulation, although reagents, instruments, software or components provided by third parties and used to perform LDTs may besubject to regulation. We believe that the CELsignia tests are LDTs, which is a term that describes tests that are designed and performed within a single laboratory. As a result, webelieve the CELsignia tests are not currently subject to regulation by the FDA in accordance with the FDA’s current policy of exercising enforcement discretion regarding LDTs. Historically, the FDA has not required laboratories that furnish only LDTs to comply with the agency’s requirements for medical devices (e.g., establishment registration, devicelisting, quality systems regulations, premarket clearance or premarket approval, and postmarket controls). In mid2014, the FDA published a draft Guidance Document describing aproposed approach for a regulatory framework for LDTs, but in late 2016, the FDA indicated it did not intend to finalize the LDT Guidance Document at that time. It is not clear when or ifthe FDA will seek to alter the current LDT regulatory framework in the future. We cannot provide any assurance that FDA regulation, including premarket review, will not be required inthe future for our tests, whether through additional guidance issued by the FDA, new enforcement policies adopted by the FDA or new legislation enacted by Congress. We cannotpredict with certainty the timing or content of future legislation enacted or guidance issued regarding LDTs, or how it will affect our business. If premarket review is required by the FDA at a future date or if we decide to voluntarily pursue FDA premarket review of our CELsignia tests, there can be no assurance that ourCELsignia tests or any tests we may develop in the future will be cleared or approved by the FDA on a timely basis, if at all, nor can there be assurance that labeling claims will beconsistent with our current claims or adequate to support continued adoption of and reimbursement for our CELsignia tests. If our CELsignia tests are allowed to remain on the marketbut there is uncertainty in the marketplace about our tests, if they are labeled investigational by the FDA, or if labeling claims the FDA allows us to make are more limited than we expect,reimbursement may be adversely affected and we may not be able to sell our CELsignia tests. Compliance with FDA regulations would increase the cost of conducting our business andsubject us to heightened regulation and scrutiny by the FDA and penalties for failure to comply with these requirements. If we fail to obtain required federal and state laboratory licenses, we could lose the ability to perform our tests. Clinical laboratory tests, including our CELsignia tests, are regulated under CLIA. CLIA is a federal law that regulates clinical laboratories that perform testing on specimensderived from humans for the purpose of providing information for the diagnosis, prevention or treatment of disease. CLIA regulations mandate specific standards for laboratories in theareas of personnel qualifications, administration, and participation in proficiency testing, patient test management and quality assurance. CLIA certification is also required in order forus to be eligible to bill state and federal healthcare programs, as well as many private thirdparty payers, for any tests we launch. We will also be required to maintain state licenses incertain states to conduct testing in our laboratories. While we currently have CLIA certification for our Minnesota laboratory, failure to maintain this certification would adversely affectour ability to launch our CELsignia tests. Failure to comply with the HIPAA security and privacy regulations may increase our operational costs. A portion of the data that we obtain and handle for or on behalf of our clients is considered protected health information, or PHI, subject to HIPAA. Under HIPAA and ourcontractual agreements with our HIPAAcovered entity health plan customers, we are considered a “business associate” to those customers, and are required to maintain the privacyand security of PHI in accordance with HIPAA and the terms of our business associate agreements with our clients, including by implementing HIPAArequired administrative, technicaland physical safeguards. We are also required to maintain similar business associate agreements with our subcontractors that have access to PHI of our customers in rendering servicesto us or on our behalf. We will incur significant costs to establish and maintain these safeguards and, if additional safeguards are required to comply with HIPAA regulations or ourclients’ requirements, our costs could increase further, which would negatively affect our operating results. Furthermore, we cannot guarantee that such safeguards have been and willcontinue to be adequate under applicable laws. If we have failed, or fail in the future, to maintain adequate safeguards, or we or our agents or subcontractors use or disclose PHI in amanner prohibited or not permitted by HIPAA, our subcontractor business associate agreements, or our business associate agreements with our customers, or if the privacy or securityof PHI that we obtain and handle is otherwise compromised, we could be subject to significant liabilities and consequences. 29Table of Contents We will also need to expend a considerable amount of resources complying with other federal, state and foreign laws and regulations. If we are unable to comply or have notcomplied with such laws, we could face substantial penalties or other adverse actions. Our operations are subject, directly or indirectly, to other federal, state and foreign laws and regulations that are complex and their application to our specific products, servicesand relationships may not be clear and may be applied to our business in ways that we do not anticipate. Compliance with laws and regulations will require us to expend considerableresources implementing internal policies and procedures for compliance and ongoing monitoring and will require significant attention of our management team. This will be challengingas an earlystage company with limited financial resources and human capital. These laws include, for example: ·Title XI of the Social Security Act, commonly referred to as the federal AntiKickback Statute, which prohibits the knowing and willful offer, payment, solicitation orreceipt of remuneration, directly or indirectly, in cash or in kind, in return for or to reward the referral of patients or arranging for the referral of patients, or in return for therecommendation, arrangement, purchase, lease or order of items or services that are covered, in whole or in part, by a federal healthcare program such as Medicare orMedicaid; ·The civil False Claims Act, that forbids the knowing submission or “causing the submission” of false or fraudulent information or the failure to disclose information inconnection with the submission and payment of claims for reimbursement to Medicare, Medicaid, federal healthcare programs or private health plans; ·The federal Physician Selfreferral Law, commonly known as the Stark Law, which prohibits physicians from referring Medicare or Medicaid patients to providers of“designated health services” with whom the physician or a member of the physician’s immediate family has an ownership interest or compensation arrangement, unless astatutory or regulatory exception applies, and similar state equivalents that may apply regardless of payor; and ·The U.S. Foreign Corrupt Practices Act of 1977, as amended, or FCPA, the U.S. domestic bribery statute contained in 18 U.S.C. § 201, the U.S. Travel Act, and the USAPATRIOT Act, which among other things, prohibit companies and their employees, agents, thirdparty intermediaries, joint venture partners and collaborators fromauthorizing, promising, offering, or providing, directly or indirectly, improper payments or benefits to recipients in the public or private sector. Many states and foreign governments have adopted similar laws and regulations. Violations of law could subject us to civil or criminal penalties, monetary fines, disgorgement,individual imprisonment, contractual damages, reputational harm, diminished profits and future earnings and curtailment of our operations. We could also be required to change orterminate some portions of operations or business or could be disqualified from providing services to healthcare providers doing business with government programs. Risks Related to Intellectual Property If we are unable to obtain and maintain intellectual property protection for our technology, or if the scope of the intellectual property protection obtained is not sufficiently broad,our competitors could develop and commercialize technology and diagnostic tests similar or identical to ours, and our ability to successfully commercialize our technology anddiagnostic tests may be impaired. Our ability to compete successfully will depend in part on our ability to obtain and enforce patent protection for our products, preserve our trade secrets and operate withoutinfringing the proprietary rights of third parties. We have applied for patents that protect our technology. Our patent portfolio includes three issued U.S. patents, five issuedinternational patents, five pending U.S. patent applications, 23 pending nonU.S. patent applications, one pending international PCT patent application, and numerous correspondingnonU.S. patent applications. Each patent and patent application covers methods of use. However, we cannot assure you that our intellectual property position will not be challenged orthat all patents for which we have applied will be granted. The validity and breadth of claims in patents involve complex legal and factual questions and, therefore, may be highlyuncertain. Uncertainties and risks that we face include the following: ·our pending or future patent applications may not result in the issuance of patents; ·the scope of any existing or future patent protection may not exclude competitors or provide competitive advantages to us; ·our patents may not be held valid if subsequently challenged; ·other parties may claim that our products and designs infringe the proprietary rights of others, and even if we are successful in defending our patents and proprietaryrights, such litigation may be costly; and ·other parties may develop similar products, duplicate our products, or design around our patents. The patent prosecution process is expensive and timeconsuming, and we may not be able to file, prosecute, maintain, enforce or license all necessary or desirable patentapplications at a reasonable cost or in a timely manner, or in all jurisdictions. We may choose not to seek patent protection for certain innovations and may choose not to pursue patentprotection in certain jurisdictions, and under the laws of certain jurisdictions, patents or other intellectual property rights may be unavailable or limited in scope. It is also possible thatwe will fail to identify patentable aspects of our discovery and nonclinical development output before it is too late to obtain patent protection. 30Table of Contents The patent position of companies like ours is highly uncertain, involves complex legal and factual questions and has in recent years been the subject of much litigation. The U.S.Patent and Trademark Office, or U.S. PTO, has not established a consistent policy regarding the breadth of claims that it will allow in medical technology patents. In addition, the laws offoreign jurisdictions may not protect our rights to the same extent as the laws of the United States. For example, India and China do not allow patents for methods of treating the humanbody. Publications of discoveries in the scientific literature often lag behind the actual discoveries, and patent applications in the United States and other jurisdictions are typically notpublished until 18 months after filing, or in some cases not at all. Therefore, we cannot know with certainty whether we were the first to make the inventions claimed in our owned orlicensed patents or pending patent applications, or that we were the first to file for patent protection of such inventions. As a result, the issuance, scope, validity, enforceability andcommercial value of our patent rights are highly uncertain. Our pending and future patent applications may not result in patents being issued that protect our technology or CELsigniatests, in whole or in part, or which effectively prevent others from commercializing competitive technologies and diagnostic tests. Changes in either the patent laws or interpretation ofthe patent laws in the United States and other countries may diminish the value of our patents or narrow the scope of our patent protection. Moreover, we may be subject to a thirdparty preissuance submission of prior art to the U.S. PTO or patent offices in foreign jurisdictions, or become involved in opposition,derivation, reexamination, inter parties review, postgrant review or interference proceedings challenging our patent rights or the patent rights of others. An adverse determination in anysuch submission, proceeding or litigation could reduce the scope of, or invalidate, our patent rights, allow third parties to commercialize our technology and compete directly with us,without payment to us, or result in our inability to commercialize CELsignia platform without infringing thirdparty patent rights. In addition, if the breadth or strength of protectionprovided by our patents and patent applications is threatened, it could dissuade companies from collaborating with us to develop or commercialize current or future CELsignia tests. Even if our owned patent applications issue as patents, they may not issue in a form that will provide us with any meaningful protection, prevent competitors from competingwith us or otherwise provide us with any competitive advantage. Our competitors may be able to circumvent our owned patents by developing similar or alternative technologies orproducts in a noninfringing manner. The issuance of a patent is not conclusive as to its inventorship, scope, validity or enforceability, and our owned patents may be challenged in the courts or patent offices in theUnited States and abroad. Such challenges may result in loss of exclusivity or freedom to operate or in patent claims being narrowed, invalidated or held unenforceable, in whole or inpart, which could limit our ability to stop others from using or commercializing similar or identical technology and product candidates, or limit the duration of the patent protection of ourtechnology and potential diagnostic tests. Given the amount of time required for the development, testing and regulatory review of new diagnostic tests, patents protecting such testsmight expire before or shortly after such candidates are commercialized. As a result, our owned patent portfolio may not provide us with sufficient rights to exclude others fromcommercializing diagnostic tests similar or identical to ours. Patent reform legislation could increase the uncertainties and costs surrounding the prosecution of our patent applications and the enforcement or defense of our issued patents. On September 16, 2011, the LeahySmith America Invents Act, or the LeahySmith Act, was signed into law. The LeahySmith Act includes a number of significant changes toU.S. patent law. These include provisions that affect the way patent applications are prosecuted and may also affect patent litigation. The U.S. PTO recently developed new regulationsand procedures to govern administration of the LeahySmith Act, and many of the substantive changes to patent law associated with the LeahySmith Act, and in particular, the first tofile provisions, only became effective on March 16, 2013. Accordingly, it is not clear what, if any, impact the LeahySmith Act will have on the operation of our business. However, theLeahySmith Act and its implementation could increase the uncertainties and costs surrounding the prosecution of our patent applications and the enforcement or defense of our issuedpatents, all of which could have a material adverse effect on our business and financial condition. Depending on future actions by the U.S. Congress, the federal courts, and the U.S.PTO, the laws and regulations governing patents could change in unpredictable ways that would weaken our ability to obtain new patents or to enforce our existing patents and patentsthat we might obtain in the future. In addition, there may be patent law reforms in foreign jurisdictions that could increase the uncertainties and costs surrounding the prosecution of ourpatent applications and the enforcement or defense of our issued patents in those foreign jurisdictions. Third parties may initiate legal proceedings alleging that we are infringing their intellectual property rights, the outcome of which would be uncertain and could have a materialadverse effect on the success of our business. Our commercial success depends upon our ability, and the ability of our collaborators, to develop, manufacture, market and sell our CELsignia tests and use our proprietarytechnologies without infringing the proprietary rights of third parties. There is considerable intellectual property litigation in the medical technology, biotechnology and pharmaceuticalindustries. We may become party to, or threatened with, future adversarial proceedings or litigation regarding intellectual property rights with respect to our CELsignia platform,including interference or derivation proceedings before the U.S. PTO and similar bodies in other jurisdictions. Third parties may assert infringement claims against us based on existingpatents or patents that may be granted in the future. If we are found to infringe a third party’s intellectual property rights, we could be required to obtain a license from such third party to continue developing and marketing ourCELsignia platform and CELsignia tests. However, we may not be able to obtain any required license on commercially reasonable terms or at all. Even if we were able to obtain a license, itcould be nonexclusive, thereby giving our competitors access to the same technologies licensed to us. We could be forced, including by court order, to cease commercializing theinfringing technology or product. In addition, we could be found liable for monetary damages, including treble damages and attorneys’ fees if we are found to have willfully infringed apatent. A finding of infringement could prevent us from commercializing our CELsignia platform or force us to cease some of our business operations, which could materially harm ourbusiness. Claims that we have misappropriated the confidential information or trade secrets of third parties could have a similar negative impact on our business. 31Table of Contents We may be subject to claims by third parties asserting that our employees or we have misappropriated their intellectual property, or claiming ownership of what we regard as ourown intellectual property. Our current and future employees may have been previously employed at universities or other biotechnology, diagnostic technology or pharmaceutical companies, includingour competitors or potential competitors and strategic partners. Although we try to ensure that our employees do not use the proprietary information or knowhow of others in their workfor us, we may be subject to claims that these employees or we have used or disclosed intellectual property, including trade secrets or other proprietary information, of any suchemployee’s former employer. Litigation may be necessary to defend against these claims. In addition, while it is our policy to require our employees and contractors who may be involved in the development of intellectual property to execute agreements assigningsuch intellectual property to us, we may be unsuccessful in executing such an agreement with each party who in fact develops intellectual property that we regard as our own. Our andtheir assignment agreements may not be selfexecuting or may be breached, and we may be forced to bring claims against third parties, or defend claims they may bring against us, todetermine the ownership of what we regard as our intellectual property. If we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or personnel. Even if we aresuccessful in prosecuting or defending against such claims, litigation could result in substantial costs and be a distraction to management. Any lawsuits relating to infringement of intellectual property rights necessary to defend ourselves or enforce our rights will be costly and time consuming and could beunsuccessful. Because competition in our industry is intense, competitors may infringe or otherwise violate our issued patents, patents of our licensors or other intellectual property. Tocounter infringement or unauthorized use, we may be required to file infringement claims, which can be expensive and time consuming, and could distract our technical and managementpersonnel from their normal responsibilities. Any claims we assert against perceived infringers could provoke these parties to assert counterclaims against us alleging that we infringetheir patents. In addition, in a patent infringement proceeding, a court may decide that a patent of ours is invalid or unenforceable, in whole or in part, construe the patent’s claimsnarrowly or refuse to stop the other party from using the technology at issue on the grounds that our patents do not cover the technology in question. An adverse result in anylitigation proceeding could put one or more of our patents at risk of being invalidated or interpreted narrowly. We may also elect to enter into license agreements in order to settle patentinfringement claims or to resolve disputes prior to litigation, and any such license agreements may require us to pay royalties and other fees that could be significant. Furthermore,because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of our confidential information could be compromisedby disclosure. If we are not able to prevent disclosure of our trade secrets and other proprietary information, the value of our CELsignia platform could be significantly diminished. We rely on trade secret protection to protect our interests in proprietary knowhow and in processes for which patents are difficult to obtain or enforce. We may not be able toprotect our trade secrets adequately. We have a policy of requiring our consultants, advisors and strategic partners to enter into confidentiality agreements and our employees to enterinto invention, nondisclosure and noncompete agreements. However, no assurance can be given that we have entered into appropriate agreements with all parties that have had accessto our trade secrets, knowhow or other proprietary information. There is also no assurance that such agreements will provide meaningful protection of our trade secrets, knowhow orother proprietary information in the event of any unauthorized use or disclosure of information. Furthermore, we cannot provide assurance that any of our employees, consultants,contract personnel, or strategic partners, either accidentally or through willful misconduct, will not cause serious damage to our programs and/or our strategy, for example by disclosingimportant trade secrets, knowhow or proprietary information to our competitors. It is also possible that our trade secrets, knowhow or other proprietary information could be obtainedby third parties as a result of breaches of our physical or electronic security systems. Any disclosure of confidential data into the public domain or to third parties could allow ourcompetitors to learn our trade secrets and use the information in competition against us. In addition, others may independently discover our trade secrets and proprietary information.Any action to enforce our rights is likely to be time consuming and expensive, and may ultimately be unsuccessful, or may result in a remedy that is not commercially valuable. Theserisks are accentuated in foreign countries where laws or law enforcement practices may not protect proprietary rights as fully as in the United States. Any unauthorized disclosure of ourtrade secrets or proprietary information could harm our competitive position. 32Table of Contents Risks Relating to Our Common Stock Provisions in our corporate charter documents and under Delaware law could make an acquisition of our company, which may be beneficial to our stockholders, more difficultand may prevent attempts by our stockholders to replace or remove our current management. Provisions in our certificate of incorporation and our bylaws may discourage, delay or prevent a merger, acquisition or other change in control of our company that stockholdersmay consider favorable, including transactions in which you might otherwise receive a premium for your shares. These provisions could also limit the price that investors might bewilling to pay in the future for shares of our common stock, thereby depressing the market price of our common stock. In addition, because our board of directors will be responsible forappointing the members of our management team, these provisions may frustrate or prevent any attempts by our stockholders to replace or remove our current management by making itmore difficult for stockholders to replace members of our board of directors. Among other things, these provisions: ·allow the authorized number of our directors to be changed only by resolution of our board of directors; ·limit the manner in which stockholders can remove directors from our board of directors; ·establish advance notice requirements for stockholder proposals that can be acted on at stockholder meetings and nominations to our board of directors; ·require that stockholder actions must be effected at a duly called stockholder meeting and prohibit actions by our stockholders by written consent; ·limit who may call stockholder meetings; ·authorize our board of directors to issue preferred stock without stockholder approval, which could be used to institute a “poison pill” that would work to dilute the stockownership of a potential hostile acquirer, effectively preventing acquisitions that have not been approved by our board of directors; and ·require the approval of the holders of at least twothirds of the votes that all our stockholders would be entitled to cast to amend or repeal specified provisions of ourcertificate of incorporation or bylaws. Moreover, we are governed by the provisions of Section 203 of the Delaware General Corporation Law, which prohibits a person who owns in excess of 15% of our outstandingvoting stock from merging or combining with us for a period of three years after the date of the transaction in which the person acquired in excess of 15% of our outstanding votingstock, unless the merger or combination is approved in a prescribed manner. Any of these provisions of our charter documents or Delaware law could, under certain circumstances, depress the market price of our common stock. The price of our common stock may be volatile and fluctuate substantially, which could result in substantial losses for purchasers of our common stock or could subject us tosecurities litigation. Our stock price may be extremely volatile. The stock market in general and the market for smaller medical technology companies in particular have experienced extreme volatilitythat has often been unrelated to the operating performance of particular companies. As a result of this volatility, investors may not be able to sell our common stock at or above the pricethey paid for such stock. The market price for our common stock may be influenced by many factors, including: ·the success of competitive products or technologies; ·results of planned clinical trials of our CELsignia HER2 Pathway Activity Test, CELsignia MultiPathway Activity Test or other CELsignia tests may develop in the future; ·regulatory or legal developments in the United States and other countries; ·developments or disputes concerning patent applications, issued patents or other proprietary rights; ·the recruitment or departure of key personnel; ·the level of expenses related to any of our CELsignia tests or clinical development programs; ·actual or anticipated changes in estimates as to financial results, development timelines or recommendations by securities analysts; ·operating results that fail to meet expectations of securities analysts that cover our company; ·variations in our financial results or those of companies that are perceived to be similar to us; ·changes in the structure of healthcare payment systems; ·market conditions in the pharmaceutical, biotechnology and medical technology sectors; ·sales of our stock by us, our insiders and our other stockholders; ·general economic and market conditions; and ·the other factors described in this “Risk Factors” section. Additionally, companies that have experienced volatility in the market price of their stock have been subject to an increased incidence of securities class action litigation. Wemay be the target of this type of litigation in the future. Securities litigation against us could result in substantial costs and divert our management’s attention from other businessconcerns, which could seriously harm our business. If securities or industry analysts do not publish research or reports about our business, or publish negative reports about our business, our stock price and trading volume coulddecline. The trading market for our common stock depends in part on the research and reports that securities or industry analysts publish about us or our business. We do not have anycontrol over these analysts. There can be no assurance that analysts will cover us or provide favorable coverage. If one or more of the analysts who cover us downgrade our stock orchange their opinion of our stock, our stock price would likely decline. If one or more of these analysts cease coverage of our company or fail to regularly publish reports on us, we couldlose visibility in the financial markets, which could cause our stock price or trading volume to decline. 33Table of Contents We are an “emerging growth company,” and the reduced disclosure requirements applicable to emerging growth companies may make our common stock less attractive toinvestors. We are an “emerging growth company,” as defined in the JOBS Act, and may remain an emerging growth company for up to five years. For so long as we remain an emerginggrowth company, we are permitted and intend to rely on exemptions from certain disclosure requirements that are applicable to other public companies that are not emerging growthcompanies. These exemptions include: ·being permitted to provide only two years of audited financial statements, in addition to any required unaudited interim financial statements, with correspondinglyreduced “Management’s Discussion and Analysis of Financial Condition and Results of Operations” disclosure; ·not being required to comply with the auditor attestation requirements in the assessment of our internal control over financial reporting of Section 404(b) of the SarbanesOxley Act; ·not being required to comply with any requirement that may be adopted by the Public Company Accounting Oversight Board regarding mandatory audit firm rotation or asupplement to the auditor’s report providing additional information about the audit and the financial statements; ·reduced disclosure obligations regarding executive compensation; and ·exemptions from the requirements of holding a nonbinding advisory vote on executive compensation and stockholder approval of any golden parachute payments notpreviously approved. We have taken advantage of reduced reporting burdens in this report. We cannot predict whether investors will find our common stock less attractive if we rely on theseexemptions. If some investors find our common stock less attractive as a result, there may be a less active trading market for our common stock and our stock price may be more volatile. We incur increased costs as a result of operating as a public company, and our management will be required to devote substantial time to new compliance initiatives and corporategovernance practices. As a public company, and particularly after we are no longer an emerging growth company, we will incur significant legal, accounting and other expenses that we did not incuras a private company. The SarbanesOxley Act, the DoddFrank Wall Street Reform and Consumer Protection Act, the continued listing requirements of The Nasdaq Stock Market andother applicable securities rules and regulations impose various requirements on public companies, including establishment and maintenance of effective disclosure and financialcontrols and corporate governance practices. Our management and other personnel will need to devote a substantial amount of time to these compliance initiatives. Moreover, theserules and regulations have increased our ongoing legal and financial compliance costs and will make some activities more timeconsuming and costly. Pursuant to Section 404 of the SarbanesOxley Act, or Section 404, we are required to furnish a report by our management on our internal control over financial reporting. If wecease to be an emerging growth company, we will also be required to include an attestation report on internal control over financial reporting issued by our independent registered publicaccounting firm as required by Section 404(b). While we, as of December 31, 2020, concluded that our internal control over financial reporting was effective, we may need to dedicateadditional internal resources and engage outside consultants to maintain compliance with Section 404 in the future. Any material weaknesses that we may identify in the future couldresult in an adverse reaction in the financial markets due to a loss of confidence in the reliability of our financial statements. 34Table of Contents ITEM 1B. Unresolved Staff Comments None. ITEM 2. Properties We currently lease and occupy approximately 16,000 square feet in Minneapolis, Minnesota, which includes our clinical laboratory and offices. The amended lease expires inApril 2022 and is renewable with the right to extend the term for one additional year and provides for monthly rent, real estate taxes and operating expenses. We believe that this leasedspace is adequate to meet current and anticipated future requirements and that additional or substitute space will be available as needed to accommodate any expansions that ouroperations require. ITEM 3. Legal Proceedings From time to time we may be involved in disputes or litigation relating to claims arising out of our operations. We are not currently a party to any legal proceedings that couldreasonably be expected to have a material adverse effect on our business, financial condition and results of operations. ITEM 4. Mine Safety Disclosures Not applicable. 35Table of Contents PART II ITEM 5. Market For Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities. Market Price Information Our common stock has been listed on The Nasdaq Capital Market under the symbol "CELC" since September 20, 2017. As of February 1, 2021, there were approximately 49 holders of record of our common stock. The actual number of holders of common stock is greater than this number of recordholders and includes stockholders who are beneficial owners, but whose shares are held in street name by brokers and nominees. The number of holders of record also does not includestockholders whose shares may be held in trust by other entities. Dividends We have never declared or paid any cash dividends on our common stock. We currently intend to retain our future earnings, if any, to finance the operation and expansion ofour business. We do not expect to pay cash dividends on our common stock in the foreseeable future. Payment of future cash dividends, if any, will be at the discretion of our board ofdirectors after taking into account various factors, including our financial condition, operating results, current and anticipated cash needs, outstanding indebtedness and plans forexpansion and restrictions imposed by lenders, if any. Recent Sales of Unregistered Securities None. Issuer Purchases of Equity SecuritiesIssuer Purchases of Equity Securities None. Equity Compensation Plan Information The information required by this Item concerning equity compensation plans is incorporated herein by reference from Part III, Item 11 of this Annual Report. Use of Proceeds from Registered Securities On September 22, 2017, we issued and sold 2,760,000 shares of our common stock in the IPO at a public offering price of $9.50 per share, for aggregate gross proceeds of $26.2million. All of the shares issued and sold in the IPO were registered under the Securities Act pursuant to a Registration Statement on Form S1 (File No. 333220128), which was declaredeffective by the SEC on September 19, 2017. CraigHallum Capital Group LLC acted as the sole manager for the offering. The offering terminated on September 22, 2017. The net offering proceeds to us, after deducting underwriting discounts of approximately $1.8 million and offering expenses paid by us totaling approximately $1.1 million, wereapproximately $23.3 million. No offering expenses were paid directly or indirectly to any of our directors or officers (or their associates) or persons owning 10.0% or more of any class ofour equity securities or to any other affiliates. At December 31, 2020, the net proceeds from our IPO were held in a diversified portfolio of bank deposits and government money market funds. All investments are highlyliquid, with liquidity and capital preservation being the primary investment objectives. There has been no material change in our planned uses of the net proceeds from those describedin the Prospectus dated September 19, 2017. From the Effective Date through December 31, 2020, we have used approximately $12.3 million in furtherance of our planned use of proceeds,which includes funding additional research and development for discovery of new cancer subtypes and development and validation of new CELsignia tests; clinical trials to supportclinical claims; development of operational processes and capital expenditures; and working capital and other general corporate purposes. 36Table of Contents ITEM 6. Selected Financial Data The following tables present, as of the dates and for the years indicated, our selected historical financial data, as indicated therein. The statement of operations data for theyears ended December 31, 2020 and 2019 and the balance sheet data as of December 31, 2020 and 2019 are derived from our audited financial statements that are included elsewhere inthis Annual Report. Our historical results are not indicative of the results to be expected in the future. You should read this information together with our financial statements and the related notes, as well as Part II, Item 7, “Management’s Discussion and Analysis of FinancialCondition and Results of Operations” of this Annual Report. Celcuity Inc.Statements of Operations Years Ended December 31, 2020 2019 Operating expenses: Research and development $7,683,522 $6,269,308 General and administrative 1,872,642 1,535,993 Total operating expenses 9,556,164 7,805,301 Loss from operations (9,556,164) (7,805,301) Other income (expense) Interest expense (120) (159)Interest income 82,109 446,096 Other income, net 81,989 445,937 Net loss before income taxes (9,474,175) (7,359,364)Income tax benefits Net loss $(9,474,175) $(7,359,364) Net loss per share, basic and diluted $(0.92) $(0.72) Weighted average common shares outstanding, basic and diluted 10,266,884 10,226,041 As of December 31, 2020 2019 Balance Sheet Data: Total assets $12,956,747 $20,280,800 Total liabilities 1,254,477 983,229 Total stockholders' equity 11,702,270 19,297,571 37Table of Contents ITEM 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations You should read the following discussion and analysis of our financial condition and results of operations together in conjunction with our financial statements and the relatednotes included elsewhere in this Annual Report. Some of the information contained in this discussion and analysis or set forth elsewhere in this Annual Report, including informationwith respect to our plans and strategy for our business and expected financial results, includes forwardlooking statements that involve risks and uncertainties. You should review the“Risk Factors” discussed in Item 1A of Part I of this Annual Report. OVERVIEW We are developing companion diagnostic tests designed to expand the eligible patient populations for targeted therapies by discovering new cancer subtypes molecularbasedapproaches cannot detect. Our proprietary CELsignia diagnostic platform is the only commercially ready technology we are aware of that uses a patient’s living tumor cells to identifythe specific abnormal cellular process driving a patient’s cancer and the targeted therapy that best treats it. We believe our CELsignia platform provides two important improvementsover traditional molecular diagnostics. First, molecular diagnostics can only provide a snapshot of the genetic mutations present in a patient’s tumor because they analyze cellfragments. Using cell fragments prevents molecular diagnostics from analyzing the dynamic cellular activities, known as cell signaling, that regulate cell proliferation or survival. Cancercan develop when certain cell signaling activity becomes abnormal, or dysregulated. Since genetic mutations are often only weakly correlated to the dysregulated signaling activitydriving a patient’s cancer, a molecular diagnostic is prone to providing an incomplete diagnosis. CELsignia tests overcome this limitation by measuring dynamic cell signaling activity ina patient’s living tumor cells. When a CELsignia test detects abnormal signaling activity, a more accurate diagnosis of the patient’s cancer driver is obtained. Second, moleculardiagnostics can only estimate the probability of a patient’s potential drug response based on a statistical analysis of the drug’s clinical trial results. Instead of this indirect estimate ofdrug response, CELsignia tests directly measure the effectiveness of a targeted therapy in a patient’s living tumor cells. This enables physicians to confirm that the therapeutic matchingthe patient’s cancer driver is functional in the patient’s tumor cells before prescribing it, which significantly increases the likelihood of a positive clinical outcome. Our first analytically validated and commercially ready test using our CELsignia platform, the CELsignia HER2 Pathway Activity Test for breast cancer, diagnoses two new subtypes of HER2negative breast cancer that traditional molecular diagnostics cannot detect. Our internal studies show that approximately 1520% of HER2negative breast cancer patientshave abnormal HER2 signaling activity similar to levels found in HER2positive breast cancer cells. As a result, these HER2negative patients have undiagnosed HER2driven breastcancer and would be likely to respond to the same antiHER2 targeted therapies only HER2positive patients receive today. We have three interventional clinical trials underway toevaluate the efficacy of HER2 targeted therapies in breast cancer patients selected with our CELsignia HER2 Pathway Activity Test. Our second CELsignia test for breast cancer evaluates independent cMet signaling activity and its involvement with HER family signaling in HER2negative breast cancertumor cells. Our internal studies show that approximately 20%25% of HER2negative breast cancer patients have abnormal cMet signaling activity that is coactivated with abnormalHER family signaling. These studies suggest that this subgroup of HER2negative breast cancer patients may best respond to treatment with a combination of HER family and cMetinhibitors. Our third CELsignia test for breast cancer evaluates PI3K signaling in HER2negative breast cancer tumor cells. Our internal studies demonstrate how measurement of PI3Kinvolved signaling may provide a more sensitive and specific method of identifying patients most likely to benefit from PI3K inhibitors than current genetic tests that measure PI3Kmutations. We intend to combine these three tests to create the CELsignia MultiPathway Activity Test, or CELsignia MP Test. With this next generation CELsignia test, we plan toprovide an analysis of EGFR/HER1, HER2, HER3, cMET, and PI3Knode involved signaling activity for each patient tumor specimen received. We completed development of our first CELsignia test for ovarian cancer in 2020. This test identifies a new subgroup of ovarian cancer patients with tumors that have abnormalcMet and HER2 signaling activity. These findings suggest that a significant subgroup of ovarian cancer patients may respond to treatment with a combination of ErbB and cMetinhibitors. Nearly 15,000 women a year die from ovarian cancer, a disease that has less than a 50% fiveyear survival rate and a limited range of targeted therapy options. There is thus asignificant unmet need for additional therapeutic options for ovarian cancer patients. As a companion diagnostic, our CELsignia test for ovarian cancer will be intended to helppharmaceutical companies obtain new drug indications and expand treatment options for this challenging tumor type. We initiated discussions with pharmaceutical companies aboutcollaborating on clinical trials in late 2020. 38Table of Contents We also made significant progress in 2020 developing a new CELsignia test intended to diagnose cancers driven by dysregulated RAS signaling. Dysregulation of RASsignaling, which includes the RAF/MEK/ERK and PI3K/AKT/mTOR pathways, is estimated to drive 30%40% of all cancers. Pharmaceutical companies have developed numerous drugsthat target RASinvolved pathways. However, the number of interactions amongst RASregulated pathways has made it extremely difficult to use molecular tests to identify patients withdysregulated RAS signaling tumors. The challenge of diagnosing a cancer driven by a dysregulated RAS signaling network is magnified because two or more different pathways aretypically involved. Recent research has also found that RAS mutations play a much less important role in dysregulated RAS signaling than previously thought. Our CELsignia platformis uniquely suited to untangle the complexity of dysregulated RAS signaling tumors and identify the targeted therapy combination capable of treating it. Once development of the new RAS test is completed, we intend to add it to our current CELsignia MultiPathway Activity test for breast and ovarian cancer. This nextgeneration CELsignia test would provide an analysis of EGFR/HER1, HER2, HER3, cMET, PI3K, and RASinvolved signaling activity for each patient tumor specimen received. Ourcurrent CELsignia test has the potential to diagnose oncogenic signaling activity undetectable by molecular tests in up to one in three HER2negative breast cancer patients. If ourefforts to develop a RAS dynamic signaling test are successful, the percentage of cancer patients who could benefit from a CELsignia test would further increase. In addition to our CELsignia tests for HER2negative breast cancer and ovarian cancer, we expect to develop CELsignia tests to diagnose eight new potential cancer subtypeswe have discovered in lung, ovarian, kidney, and bladder cancers. Approved or investigational drugs are currently available to treat these new potential cancer subtypes. We expect tolaunch these additional tests on a staggered basis over the next few years while continuing our research to identify additional new cancer subtypes. Our overall commercializationstrategy is to develop diagnostics that expand the patient population eligible for targeted therapies. We have four collaborations underway that rely on the CELsignia test for breastcancer to select breast cancer patients for treatment with HER2 or a combination of panHER and cMet targeted therapies. For the first one of these collaborations, we are fielding aprospective clinical trial with Genentech and NSABP (FACT1) to evaluate the efficacy of Genentech’s HER2 targeted therapies in patients with abnormal HER2 signaling. For the secondof these collaborations, we are fielding a prospective clinical trial with Puma and West Cancer Center (FACT2) to evaluate the efficacy and safety of Puma’s drug, Nerlynx, andchemotherapy, in breast cancer patients selected with our CELsignia test. For our third collaboration, we are fielding a prospective openlabel Phase II clinical trial with PumaMassachusetts General Hospital, the UCLA Jonsson Comprehensive Cancer Center and the VanderbiltIngram Cancer Center to evaluate the efficacy of Puma’s drug, Nerlynx, andFaslodex, an AstraZeneca drug, in previously treated metastatic HRpositive, HER2negative breast cancer patients selected with our CELsignia HER2 Pathway Activity Test. For ourfourth collaboration, we are fielding a prospective openlabel Phase II clinical trial with Pfizer Inc. and Sarah Cannon Research Institute to evaluate the efficacy of two Pfizer targetedtherapies, Vizimpro, a panHER inhibitor, and Xalkori, a cMet inhibitor, in previously treated metastatic HER2negative breast cancer patients selected with our CELsignia MultiPathwayActivity Test. An additional collaboration to evaluate tissue samples from a Phase II study evaluating Puma’s panHER inhibitor, Nerlynx, Genentech’s HER2 antibody, Herceptin, and BristolMyers Squibb’s EGFR inhibitor, Erbitux, in metastatic colorectal cancer patients is expected to be completed in late 2022. Unlike the four clinical trial collaborations, our CELsignia testwill be used solely to evaluate tissue samples after they have been enrolled in this trial. We will not receive payment for the testing we perform. We expect our CELsignia test will providecritical insight after the trial is completed about the patient characteristics most correlative to drug response. In conjunction with the development of our CELsignia tests, we will seek collaborations with pharmaceutical companies to field clinical trials to advance the clinical developmentof their targeted therapies with the eventual goal of obtaining U.S. Food and Drug Administration (“FDA”) approval of a new drug indication. Collaborations are expected to involveinitially Phase I or Phase II interventional clinical trials to evaluate the efficacy of our collaboration partners’ targeted therapies patients selected with one of our CELsignia tests. We arecurrently evaluating, or expect to evaluate, a variety of targeted therapies in combination with other targeted therapies, hormonal therapies, or chemotherapies, including: i) panHER andcMet inhibitors; ii) panHER inhibitors and endocrine therapy; iii) panHER inhibitors and chemotherapies; and iv) PI3K inhibitors and endocrine therapy. The FDA has approved threecMet inhibitors, six HERfamily inhibitors, and four PI3K inhibitors for cancer treatment. Additional cMet, HERfamily, and PI3K inhibitors are being evaluated in ongoing clinical trials. We have not generated any revenue from sales to date, and we continue to incur significant research and development and other expenses related to our ongoing operations.As a result, we are not and have never been profitable and have incurred losses in each period since we began operations in 2012. For the years ended December 31, 2020 and 2019, wereported a net loss of approximately $9.5 million and $7.4 million, respectively. As of December 31, 2020, we had a combined accumulated deficit of approximately $12.6 million underCelcuity LLC and $26.3 million under Celcuity Inc. As of December 31, 2020, we had cash and cash equivalents of approximately $11.6 million. 39Table of Contents Impact of COVID19 on our Business A novel strain of coronavirus (COVID19) was first identified in Wuhan, China in December 2019, and subsequently declared a pandemic by the World Health Organization. Theimpact of the COVID19 pandemic on our business is discussed in further detail below: Health and Safety To help protect the health and safety of our employees, suppliers and collaborators, we took proactive, aggressive action from the earliest signs of the outbreak. We enactedrigorous safety measures in our laboratory and administrative offices, including implementing social distancing protocols, allowing working from home for those employees that do notneed to be physically present in a lab to perform their work, suspending travel, implementing temperature checks at the entrances to our facilities, extensively and frequently disinfectingour workspaces and providing masks to those employees who must be physically present. We expect to continue with these measures until the COVID19 pandemic is contained and wemay take further actions as government authorities require or recommend or as we determine to be in the best interests of our employees, suppliers, and collaborators. Clinical Trials and Collaborations As a result of the COVID19 pandemic, governmental authorities have implemented and are continuing to implement numerous and constantly evolving measures to try tocontain the virus, such as travel bans and restrictions, limits on gatherings, quarantines, shelterinplace orders, and business shutdowns. As we continue to advance our clinical trialcollaborations, we are in close contact with our current clinical sponsors, and principal investigators, as well as prospective pharmaceutical company and clinical collaborators, to assessthe impact of COVID19 on our trial enrollment timelines and collaboration discussions. In light of the COVID19 pandemic, the focus of healthcare providers and hospitals on fightingthe virus, and consistent with the FDA’s updated industry guidance for conducting clinical trials issued on March 18, 2020, we are experiencing delays in the enrollment of patients inour ongoing clinical trials. We now expect interim results from the FACT1 and FACT2 trials to be delayed until the fourth quarter of 2021 or first quarter of 2022 and final resultsapproximately nine months later. As the impact of COVID19 on our industry becomes clearer, we may need to reassess the timing of our anticipated clinical milestones. Prospectiveclinical trial collaborations with pharmaceutical companies and sponsors may also be delayed but the impact on the timing of finalizing agreements is not yet known. Research and Development While our facility currently remains operational, the evolving measures to try to contain the virus have impacted and may further impact our workforce and operations, as well asthose of our vendors and suppliers. Our laboratory remains operational as of this date, but, in response to the COVID19 pandemic, we have implemented protective policies that reducethe number of research and development staff operating in our laboratory at any one time. While governmental measures may be modified or extended, we expect that our research anddevelopment and clinical laboratory will remain operational. However, in light of the focus of healthcare providers and hospitals on fighting the virus, several of the clinical sites thatprovide us tumor tissue for research have halted this service, reducing the number of new tumor tissue specimens we would typically expect to receive. These various constraints mayslow or diminish our research and development activities. In addition, cancer researchrelated industry meetings, such as the American Association for Cancer Research (AACR), weredelayed for several months. Our submissions to present research results at these meetings were accepted, but the release of the results was postponed in conjunction with the delayedmeeting schedules. Liquidity Although there is uncertainty related to the anticipated impact of the recent COVID19 outbreak on our future results, we believe our existing balance of cash and cashequivalents will be sufficient to meet our cash needs arising in the ordinary course of business for at least the next twelve months. We continue to monitor the rapidly evolving situationand guidance from federal, state and local public health authorities and may take additional actions based on their recommendations. In these circumstances, there may be developmentsoutside our control requiring us to adjust our operating plan. In addition, see Item 1A of Part I of this Annual Report for additional information on risks associated with pandemics ingeneral and COVID19 specifically and how those risks may impact our business and operations. 40Table of Contents RESULTS OF OPERATIONS Components of Operating Results Revenue To date, we have not generated any revenue. Initially, our ability to generate revenue will depend primarily upon our ability to obtain partnership agreements withpharmaceutical companies to provide companion diagnostics for such pharmaceutical partners’ existing or investigational targeted therapies. We expect these partnerships to generatesignificant revenue from the sale of tests to identify patients eligible for clinical trials, from milestone payments, and, potentially, from royalties on the incremental drug revenues ourtests enable. Once a new drug indication is received that requires use of our companion diagnostic to identify eligible patients, we expect to generate revenues from sales of tests totreating physicians. Research and Development Since our inception, we have primarily focused on research and development of our CELsignia platform, development and validation of our CELsignia tests, and research relatedto the discovery of new cancer subtypes. Research and development expenses primarily include: ·employeerelated expenses related to our research and development activities, including salaries, benefits, recruiting, travel and stockbased compensation expenses; ·laboratory supplies; ·consulting fees paid to third parties; ·clinical trial costs; ·facilities expenses; and ·legal costs associated with patent applications. Internal and external research and development costs are expensed as they are incurred. As we continue to expand clinical trials to evaluate efficacy of targeted therapies incancer patients selected with one of our CELsignia tests, the proportion of research and development expenses allocated to external spending will grow at a faster rate than expensesallocated to internal expenses. General and Administrative General and administrative expenses consist primarily of salaries, benefits and stockbased compensation related to our executive, finance and support functions. Other generaland administrative expenses include professional fees for auditing, tax, and legal services associated with being a public company, director and officer insurance and travel expenses forour general and administrative personnel. Sales and Marketing Sales and marketing expenses consist primarily of professional and consulting fees related to these functions. To date, we have incurred immaterial sales and marketing expensesas we continue to focus primarily on the development of our CELsignia platform and corresponding CELsignia tests. We expect to begin to incur increased selling and marketingexpenses in anticipation of the commercialization of our first CELsignia tests. These increased expenses are expected to include payrollrelated costs as we add employees in thecommercial departments, costs related to the initiation and operation of our sales and distribution network and marketing related costs. Interest Expense Interest expense is the result of finance lease obligations. Interest Income Interest income consists of interest income earned on our cash and cash equivalents. 41Table of Contents Results of Operations Comparison of the Years Ended December 31, 2020 and 2019 Years Ended December 31, Increase (Decrease) 2020 2019 $ Percent Change Statements of Operations Data: Operating expenses: Research and development $7,683,522 $6,269,308 $1,414,214 23%General and administrative 1,872,642 1,535,993 336,649 22 Total operating expenses 9,556,164 7,805,301 1,750,863 22 Loss from operations (9,556,164) (7,805,301) (1,750,863) 22 Other income (expense) Interest expense (120) (159) 39 n/a Interest income 82,109 446,096 (363,987) (82)Other income, net 81,989 445,937 (363,948) (82)Net loss before income taxes (9,474,175) (7,359,364) (2,114,811) 29 Income tax benefits Net loss $(9,474,175) $(7,359,364) $(2,114,811) 29% Research and Development For the year ended December 31, 2020, our total research and development expenses increased approximately $1.41 million, or 23%, to approximately $7.68 million from $6.27million for the prior year. The increase primarily resulted from a $1.15 million increase in compensation related expenses, including approximately $0.49 million in noncash stockbasedcompensation to support development of our CELsignia platform. In addition, other research and development expenses increased $0.26 million due to clinical validation and laboratorystudies, and operational and business development activities. Conducting a significant amount of research and development is central to our business model. We plan to increase our research and development expenses for the foreseeablefuture as we seek to discover new cancer subtypes and to develop and validate additional CELsignia tests to diagnose such subtypes. We also expect to incur increased expenses tosupport companion diagnostic business development activities with pharmaceutical companies as we develop additional CELsignia tests. General and Administrative For the year ended December 31, 2020, our total general and administrative expenses increased approximately $0.34 million, or 22%, to approximately $1.87 million from $1.53million for the prior year. The increase primarily resulted from a $0.28 million increase in compensation related expenses, including approximately $0.24 million of noncash stockbasedcompensation. In addition, other general and administrative expenses increased $0.06 million primarily due to professional fees associated with being a public company. We anticipate that our general and administrative expenses will increase in future periods, reflecting both increased costs in connection with the potential futurecommercialization of CELsignia tests, an expanding infrastructure, and increased professional fees associated with being a public company. Interest Expense For the years ended December 31, 2020 and 2019, interest expense is related to finance lease liabilities. Interest Income For the year ended December 31, 2020, interest income decreased approximately $0.36 million, or 82%, to $0.08 million from $0.44 million for the prior year. The decrease wasprimarily the result of lower market interest rates. LIQUIDITY AND CAPITAL RESOURCES Since our inception, we have incurred losses and cumulative negative cash flows from operations. Through December 31, 2020, we raised capital of approximately $13.7 millionand $7.5 million through private placements of common equity and unsecured convertible notes, respectively. On September 22, 2017, we closed on the IPO of our common stock, whichgenerated approximately $23.3 million of additional cash after taking into account underwriting discounts and commissions and offering expenses. On June 5, 2020, we entered into an AtMarket Issuance Sales Agreement with B. Riley, FBR, Inc (the “ATM Agreement”). The ATM Agreement allows us to sell shares of common stock up to an aggregate offering price of$10.0 million. Through December 31, 2020, we generated approximately $0.08 million of additional cash through sales pursuant to the ATM Agreement, after taking into accountcommissions and offering expenses. Cash from these capital raising activities has been our primary source of funds for our operations since inception. As of December 31, 2020, our cashand cash equivalents were approximately $11.6 million, and we had a combined accumulated deficit of approximately $12.6 million under Celcuity LLC and $26.3 million under Celcuity Inc. We expect that our research and development and general and administrative expenses will increase as we continue to develop our CELsignia platform and additional CELsigniatests, conduct research related to the discovery of new cancer subtypes, conduct clinical trials, and pursue other business development activities. We will also start to incur sales andmarketing expenses as we commercialize our CELsignia tests. We expect to use cash on hand to fund our research and development expenses, capital expenditures, working capital, salesand marketing expenses, and general corporate expenses, as well as for the increased costs associated with being a public company. 42Table of Contents Based on our current business plan, we believe that our current cash on hand will provide sufficient cash to finance operations and pay obligations when due for at least thenext twelve months. We may seek to raise additional capital to expand our business, pursue strategic investments, and take advantage of financing or other opportunities that we believe to be in thebest interests of the Company and our stockholders. Additional capital may be raised through the sale of common or preferred equity or convertible debt securities, entry into debtfacilities or other thirdparty funding arrangements. The sale of equity and convertible debt securities may result in dilution to our stockholders and those securities may have rightssenior to those of our common shares. Agreements entered into in connection with such capital raising activities could contain covenants that would restrict our operations or require usto relinquish certain rights. Additional capital may not be available on reasonable terms, or at all. Cash Flows The following table sets forth the primary sources and uses of cash for the years ended December 31: 2020 2019 Net cash provided by (used in): Operating activities $(7,145,689) $(5,998,711)Investing activities (89,371) 8,529,799 Financing activities 137,969 259,305 Net increase (decrease) in cash and cash equivalents $(7,097,091) $2,790,393 Operating Activities Net cash used in operating activities was approximately $7.14 million for the year ended December 31, 2020 and consisted primarily of a net loss of approximately $9.47 million,adjusted for working capital changes of approximately $0.18 million and noncash items of approximately $2.15 million. The working capital change was primarily due to approximately$0.19 million increase in accrued expenses. Noncash expense items of approximately $2.15 million consisted of depreciation of approximately $0.39 million and stockbased compensationexpense of approximately $1.76 million. Net cash used in operating activities was approximately $6.0 million for the year ended December 31, 2019 and consisted primarily of a net loss of approximately $7.36 million andworking capital changes of approximately $0.06 million, adjusted for noncash items of approximately $1.42 million. The working capital change was primarily due to approximately $0.19million increase in payroll tax receivable, offset by a $0.11 million increase in accrued expenses. Noncash expense items of approximately $1.42 million consisted of depreciation ofapproximately $0.34 million, stockbased compensation expense of approximately $1.04 million and interest income of approximately $0.04 million. Investing Activities Net cash used in investing activities for the year ended December 31, 2020 was approximately $0.09 million and consisted of purchases of property and equipment. Net cash provided by investing activities for the year ended December 31, 2019 was approximately $8.53 million and consisted of approximately $8.91 million of net proceeds frominvestments in certificates of deposit and government securities (U.S. Treasury Notes and U.S. government agency securities), adjusted by approximately $0.38 million in purchases ofproperty and equipment. Financing Activities Net cash provided by financing activities for the year ended December 31, 2020 was approximately $0.14 million and primarily reflects net proceeds from the sale of shares of ourcommon stock through the ATM Agreement and employee stock purchases. Net cash provided by financing activities for the year ended December 31, 2019 was approximately $0.26 million and consisted of proceeds from the exercise of common stockwarrants and stock options, and employee stock purchases. OFFBALANCE SHEET ARRANGEMENTS We do not currently have any offbalance sheet arrangements as defined in Item 303(a)(4) of Regulation SK. 43Table of Contents RECENT ACCOUNTING PRONOUNCEMENTS From time to time new accounting pronouncements are issued by the Financial Accounting Standards Board, or FASB, or other standard setting bodies and adopted by us as ofthe specified effective date. Unless otherwise discussed in Note 2 to our financial statements included elsewhere in this Annual Report, we believe that the impact of recently issuedstandards that are not yet effective will not have a material impact on our financial position or results of operations upon adoption. CRITICAL ACCOUNTING POLICIES AND USE OF ESTIMATES Our management’s discussion and analysis of financial condition and results of operations is based on our financial statements, which have been prepared in accordance withaccounting principles generally accepted in the United States, or Generally Accepted Accounted Principles (“U.S. GAAP”). The preparation of these financial statements requires us tomake estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements, aswell as the reported expenses during the reporting periods. These items are monitored and analyzed by us for changes in facts and circumstances, and material changes in theseestimates could occur in the future. We base our estimates on historical experience and on various other factors that we believe are reasonable under the circumstances; the results ofwhich form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Changes in estimates are reflected inreported results for the period in which they become known. Actual results may differ materially from these estimates. Our significant accounting policies are more fully described in Note 2 to our financial statements included elsewhere in this Annual Report. Of our significant accountingpolicies, we believe that the following is the most critical: StockBased Compensation Our stockbased compensation consists of common stock options and restricted stock issued to certain employees and nonemployees and our Employee Stock Purchase Plan(“ESPP”). We recognize compensation expense based on an estimated grant date fair value using the BlackScholes optionpricing method. We have elected to account for forfeitures asthey occur. The inputs for the BlackScholes valuation model require management’s significant assumptions. Prior to our IPO, the price per share of common stock was determined by ourboard based on recent prices of common stock sold in private offerings. Subsequent to the IPO, the price per share of common stock is determined by using the closing market price onthe Nasdaq Capital Market on the grant date. The riskfree interest rates are based on the rate for U.S. Treasury securities at the date of grant with maturity dates approximately equal tothe expected life at the grant date. The expected life was based on the simplified method in accordance with SEC Staff Accounting Bulletin Nos. 107 and 110. The expected volatility wasestimated based on historical volatility information of peer companies that are publicly available in combination with our calculated volatility since being publicly traded. All assumptions used to calculate the grant date fair value of nonemployee options are generally consistent with the assumptions used for options granted to employees. In theevent we terminate any of our consulting agreements, the unvested options issued in connection with such agreements would also be cancelled. For grants of restricted stock, we record compensation expense based on the quoted fair value of the shares on the grant date over the requisite service period. Compensationexpense for ESPP rights is recorded in line with each respective offering period. ITEM 7A. Quantitative and Qualitative Disclosures About Market Risk As a smaller reporting company, we are not required to provide disclosure pursuant to this item. 44Table of Contents ITEM 8. Financial Statements and Supplementary Data REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM To the Board of Directors andStockholders of Celcuity Inc. Opinion on the Financial Statements We have audited the accompanying balance sheets of Celcuity Inc. (the Company) as of December 31, 2020 and 2019 and the related statements of operations, changes in stockholders’equity, and cash flows for each of the years in the twoyear period ended December 31, 2020, and the related notes (collectively referred to as the financial statements). In our opinion,the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2020 and 2019 and the results of its operations and its cash flowsfor each of the years in the twoyear period ended December 31, 2020, in conformity with accounting principles generally accepted in the United States of America. Basis for Opinion These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audits.We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to theCompany 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 thefinancial 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 controlover 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 onthe effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respondto those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating theaccounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits providea reasonable basis for our opinion. /s/ Boulay PLLP We have served as the Company’s auditor since 2017. Minneapolis, MinnesotaFebruary 16, 2021 45Table of Contents Celcuity Inc.Balance Sheets December 31,2020 December 31,2019 Assets Current Assets: Cash and cash equivalents $11,637,911 $18,735,002 Deposits 22,009 22,009 Deferred transaction costs 28,743 Payroll tax receivable 190,000 190,000 Prepaid assets 317,040 274,600 Total current assets 12,166,960 19,250,354 Property and equipment, net 558,876 833,463 Operating lease rightofuse assets 230,911 196,983 Total Assets $12,956,747 $20,280,800 Liabilities and Stockholders' Equity: Current Liabilities: Accounts payable $217,377 $142,773 Finance lease liabilities 5,810 5,769 Operating lease liabilities 187,518 178,466 Accrued expenses 774,612 584,319 Total current liabilities 1,185,317 911,327 Finance lease liabilities 8,299 14,109 Operating lease liabilities 60,861 57,793 Total Liabilities 1,254,477 983,229 Stockholders' Equity: Preferred stock, $0.001 par value: 2,500,000 shares authorized; 0 shares issued and outstanding as of December 31, 2020 and December 31,2019 Common stock, $0.001 par value: 25,000,000 shares authorized; 10,299,822 and 10,253,988 shares issued and outstanding as of December 31,2020 and December 31, 2019, respectively 10,300 10,254 Additional paidin capital 38,013,551 36,134,723 Accumulated deficit (26,321,581) (16,847,406)Total Stockholders' Equity 11,702,270 19,297,571 Total Liabilities and Stockholders' Equity $12,956,747 $20,280,800 See accompanying notes to the financial statements 46Table of Contents Celcuity Inc.Statements of Operations Years Ended December 31, 2020 2019 Operating expenses: Research and development $7,683,522 $6,269,308 General and administrative 1,872,642 1,535,993 Total operating expenses 9,556,164 7,805,301 Loss from operations (9,556,164) (7,805,301) Other income (expense) Interest expense (120) (159)Interest income 82,109 446,096 Other income, net 81,989 445,937 Net loss before income taxes (9,474,175) (7,359,364)Income tax benefits Net loss $(9,474,175) $(7,359,364) Net loss per share, basic and diluted $(0.92) $(0.72) Weighted average common shares outstanding, basic and diluted 10,266,884 10,226,041 47Table of Contents Celcuity Inc.Statements of Changes in Stockholders' Equity Common Stock AdditionalPaidIn Accumulated Shares Amount Capital Deficit Total Balance at December 31, 2018 10,186,382 $10,186 $34,827,467 $(9,488,042) $25,349,611 Exercise of common stock warrants 395 3,752 3,752 Stockbased compensation 1,040,989 1,040,989 Exercise of common stock options, net of shares withheld for exercise price 58,127 59 174,899 174,958 Employee stock purchases 9,084 9 87,616 87,625 Net loss (7,359,364) (7,359,364)Balance at December 31, 2019 10,253,988 10,254 36,134,723 (16,847,406) 19,297,571 Stockbased compensation 15,686 16 1,763,863 1,763,879 Employee stock purchases 12,423 12 60,291 60,303 Issuance of common stock in an atthemarket ("ATM") offering 17,725 18 182,676 182,694 Issuance costs associated with ATM offering (128,002) (128,002)Net loss (9,474,175) (9,474,175)Balance at December 31, 2020 10,299,822 $10,300 $38,013,551 $(26,321,581) $11,702,270 See accompanying notes to the financial statements 48Table of Contents Celcuity Inc. Statements of Cash Flows Years Ended December 31, 2020 2019 Cash flows from operating activities: Net loss $(9,474,175) $(7,359,364)Adjustments to reconcile net loss to net cash used for operations: Depreciation 385,591 338,996 Stockbased compensation 1,763,879 1,040,989 Noncash interest income, net of cash received 42,907 Changes in operating assets and liabilities: Payroll tax receivable (190,000)Prepaid assets and deposits (42,440) (20,143)Accounts payable 52,971 45,617 Accrued expenses 190,293 111,403 Noncash operating lease, net (21,808) (9,116)Net cash used for operating activities (7,145,689) (5,998,711) Cash flows from investing activities: Proceeds from sale of investments 8,910,000 Purchases of property and equipment (89,371) (380,201)Net cash provided by (used for) investing activities (89,371) 8,529,799 Cash flows from financing activities: Proceeds from exercise of common stock warrants 3,752 Proceeds from exercise of employee stock options 174,958 Proceeds from employee stock purchases 60,303 87,625 Gross proceeds from an ATM offering 182,694 Payments for secondary registration statement costs (99,259) (1,300)Payments for finance leases (5,769) (5,730)Net cash provided by financing activities 137,969 259,305 Net change in cash and cash equivalents (7,097,091) 2,790,393 Cash and cash equivalents: Beginning of period 18,735,002 15,944,609 End of period $11,637,911 $18,735,002 Supplemental disclosures of noncash investing and financing activities: Property and equipment included in accounts payable $24,333 $2,700 See accompanying notes to the financial statements 49Table of Contents CELCUITY INC.NOTES TO FINANCIAL STATEMENTS 1. Organization Nature of Business Celcuity Inc., a Delaware corporation (the “Company”), is a clinical stage biotechnology company translating discoveries of new cancer subtypes into pioneering companiondiagnostics and expanded therapeutic options for cancer patients. The Company’s 3rd generation diagnostic platform, CELsignia, analyzes living tumor cells to untangle the complexityof the cellular activity driving a patient’s cancer. This allows the Company to discover new cancer subtypes molecular diagnostics cannot detect. The Company is driven to improveoutcomes for patients and to transform how pharmaceutical companies define the patient populations for their targeted therapies. The Company’s proprietary CELsignia diagnosticplatform is currently the only commercially ready technology the Company is aware of that uses a patient’s living tumor cells to evaluate the functional status of the cell signalingpathways associated with cancer. The Company was cofounded in 2012 by Brian F. Sullivan and Dr. Lance G. Laing and is based in Minnesota. The Company has not generated anyrevenues to date. 2. Summary of Significant Accounting Policies Basis of Presentation The accompanying financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“U.S. GAAP”) and pursuant to the rulesand regulations of the Securities and Exchange Commission (the “SEC”). Operating results for the year ended December 31, 2020 are not necessarily indicative of results to be expectedfor any future year. Accounting Estimates Management uses estimates and assumptions in preparing these financial statements in accordance with U.S. GAAP. Those estimates and assumptions affect the reported amounts ofassets and liabilities, the disclosure of contingent assets and liabilities, and the reported revenues and expenses. Actual results could differ from those estimates and the difference couldbe significant. Significant items subject to such estimates and assumptions include the valuation of stockbased compensation and prepaid or accrued clinical trial costs. Cash and Cash Equivalents The Company maintains its accounts primarily at one financial institution. At times throughout the year, the Company’s cash balances may exceed amounts insured by the FederalDeposit Insurance Corporation. At December 31, 2020 and December 31, 2019, the Company had $11,378,685 and $18,369,229, respectively, in money market funds that are consideredcash equivalents and not insured by the Federal Deposit Insurance Corporation. Property and Equipment Property and equipment are stated at cost. Depreciation is provided over estimated useful lives using the straightline method. Maintenance and repairs are expensed as incurred; majorimprovements and betterments are capitalized. Estimated useful lives of property and equipment are as follows for the major classes of assets: Asset Description Estimated Lives Furniture and Equipment 45 Leasehold Improvements 23 LongLived Assets Longlived assets, such as property and equipment, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not berecoverable. If circumstances require a longlived asset or asset group be tested for possible impairment, the Company first compares undiscounted cash flows expected to be generatedby that asset or asset group to its carrying value. If the carrying value of the longlived asset or asset group is not recoverable on an undiscounted cash flow basis, an impairment isrecognized to the extent that the carrying value exceeds its fair value. Fair value is determined through various valuation techniques including discounted cash flow models, quotedmarket values, and thirdparty independent appraisals, as considered necessary. 50Table of Contents Deferred Transaction Costs Deferred transaction costs primarily consist of legal fees, SEC filing fees and other fees relating to the Company’s Registration Statement on Form S3 filed on September 21, 2018. Thedeferred transaction costs were capitalized as incurred and were offset against proceeds from the sale of shares of common stock pursuant to the ATM Agreement. Comprehensive Loss Comprehensive loss includes net loss as well as other changes in stockholders’ equity that result from transactions and economic events other than those with stockholders. For allperiods presented, there was no difference between net loss and comprehensive loss. Risks and Uncertainties The Company is subject to risks common to companies in the development stage including, but not limited to, dependency on the clinical and commercial success of its diagnostic tests,ability to obtain regulatory approval of its diagnostic tests, the need for substantial additional financing to achieve its goals, uncertainty of broad adoption of its approved products, ifany, by physicians and consumers, and significant competition. Fair Value of Financial Instruments The Company’s accounting for fair value measurements of assets and liabilities that are recognized or disclosed at fair value in the financial statements on a recurring or nonrecurringbasis adheres to the Financial Accounting Standards Board (“FASB”) fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchygives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurements) and the lowest priority to measurements involvingsignificant unobservable inputs (Level 3 measurements). The three levels of the fair value hierarchy are as follows: ·Level 1 Inputs: Unadjusted quoted prices in active markets for identical assets or liabilities accessible to the Company at the measurement date. ·Level 2 Inputs: Other than quoted prices included in Level 1 inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of theasset or liability. ·Level 3 Inputs: Unobservable inputs for the asset or liability used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations inwhich there is little, if any, market activity for the asset or liability at measurement date. The level in the fair value hierarchy within which a fair value measurement in its entirety falls, is based on the lowest level input that is significant to the fair value measurement in itsentirety. The carrying values of cash equivalents, accounts payable, accrued expenses and other financial working capital items approximate fair value at December 31, 2020 and December 31,2019, due to the short maturity nature of these items. Income Taxes The Company accounts for income taxes using the asset and liability method, as required by the accounting standard for income taxes. Under this method, deferred tax assets andliabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respectivetax bases, as well as net operating loss and tax credit carryforwards. Deferred taxes are measured using enacted tax rates expected to apply to taxable income in the years in which thosetemporary differences are expected to be recovered or settled. The effect on deferred taxes of a change in tax rates is recognized in results of operations in the period that includes theenactment date. The effects of any future changes in tax laws or rates have not been considered. The Company regularly reviews deferred tax assets to assess their potential realizationand establish a valuation allowance for portions of such assets to reduce the carrying value if the Company does not consider it to be more likely than not that the deferred tax assetswill be realized. The Company recognizes the impact of an uncertain tax position in its financial statements if, in management's judgment, the position is morelikelythannot sustainable upon auditbased on the position's technical merits. This involves the identification of potential uncertain tax positions, the evaluation of applicable tax laws and an assessment of whether a liabilityfor an uncertain tax position is necessary. StockBased Compensation The Company’s stockbased compensation consists of stock options and restricted stock issued to certain employees and nonemployees of the Company and the Company’s 2017Employee Stock Purchase Plan. The Company recognizes compensation expense based on an estimated grant date fair value using the BlackScholes optionpricing method. If thefactors change and different assumptions used, the Company’s stockbased compensation expense could be materially different in the future. The Company recognizes stockbasedcompensation expense for these options on a straightline basis over the requisite service period. The Company has elected to account for forfeitures as they occur. 51Table of Contents Research and Development Research and development costs are expensed as incurred. Research and development costs amounted to $7,683,522 for the year ended December 31, 2020 and $6,269,308 for the yearended December 31, 2019. Clinical Trial Costs The Company records prepaid assets or accrued expenses for prepaid or estimated clinical trial costs conducted by thirdparty service providers, which include the conduct of preclinicalstudies and clinical trials. These costs can be a significant component of the Company’s research and development expenses. The Company accrues for these costs based on factorssuch as estimates of the work completed and in accordance with service agreements with its thirdparty service providers. The Company makes significant judgments and estimates indetermining the accrued liabilities balance in each reporting period. As actual costs become known, the Company adjusts its prepaid assets or accrued expenses. The Company has notexperienced any material differences between accrued costs and actual costs incurred. However, the status and timing of actual services performed, number of patients enrolled, and therate of patient enrollments may vary from the Company’s estimates, resulting in an adjustment to expense in future periods. Changes in these estimates that result in material changes tothe Company’s prepaid assets or accrued expenses could materially affect the Company’s results of operations. Segment Data The Company manages its operations as a single segment for the purposes of assessing performance and making operating decisions. Application of New or Revised Accounting Standards Pursuant to the JOBS Act, a company constituting an “emerging growth company” is, among other things, entitled to rely upon certain reduced reporting requirements. The Company isan emerging growth company but has irrevocably elected not to take advantage of the extended transition period afforded by the JOBS Act for the implementation of new or revisedaccounting standards. As a result, the Company will comply with new or revised accounting standards on the relevant dates on which adoption of such standards is required for publiccompanies that are not emerging growth companies. Recently Adopted Accounting Pronouncements Effective January 1, 2019, the Company adopted Accounting Standards Update (“ASU”) No. 201602, Leases (Topic 842), which requires the recognition of lease assets and leaseliabilities by lessees for those leases classified as operating leases under previous guidance. The original guidance required application on a modified retrospective basis with the earliestperiod presented. In August 2018, the FASB issued ASU 201811, Targeted Improvements to ASC 842, which included an option to not restate comparative periods in transition andelect to use the effective date of ASC 842 as the date of initial application of transition, which the Company elected. As a result of the adoption of ASC 842 on January 1, 2019, theCompany recorded both operating lease rightofuse (“ROU”) assets of $356,539 and lease liabilities of $404,931 and eliminated deferred rent of $63,875 and prepaid rent of $15,483. Theadoption of ASC 842 had no impact on the Company’s Statement of Operations and Statement of Cash Flows for the year ended December 31, 2019. In addition, the Company elected thepackage of practical expedients permitted under the transition guidance within the new standard which allowed the Company to carry forward the historical lease classification.Additional information and disclosures required by this new standard are contained in Note 9. 3. Liquidity Based on the Company’s cash and cash equivalents on hand at December 31, 2020 of $11,637,911, the Company believes that its cash will be sufficient to fund the Company’s currentoperating plan through at least the next 12 months from the issuance date of this Annual Report. 4. Net Loss Per Common Share Basic and diluted net loss per common share is determined by dividing net loss attributable to common stockholders by the weightedaverage common shares outstanding during theperiod. For all periods presented, the common shares underlying the options and warrants have been excluded from the calculation because their effect would be antidilutive. Therefore,the weightedaverage shares outstanding used to calculate both basic and diluted loss per common share are the same. For the years ended December 31, 2020 and 2019, potentially dilutive securities excluded from the computations of diluted weightedaverage shares outstanding were options topurchase 849,949 and 585,215 shares of common stock, respectively, warrants to purchase 353,585 shares of common stock, and 15,686 and 0 shares of restricted common stock,respectively. 5. Payroll Tax Receivable The payroll tax receivable initially recorded in 2019, is the result of the Company’s utilization of research and development tax credits as authorized by the Path Act. The balance atDecember 31, 2020 and December 31, 2019 was $190,000. 52Table of Contents 6. Prepaid Assets Prepaid assets consisted of the following at December 31: 2020 2019 Current: Directors & officers' insurance $288,750 $229,167 Other 28,290 45,433 Total $317,040 $274,600 7. Property and Equipment Property and equipment consisted of the following at December 31: 2020 2019 Leasehold improvements $302,848 $302,848 Furniture and equipment 1,461,512 1,350,508 1,764,360 1,653,356 Less: Accumulated depreciation (1,205,484) (819,893)Total $558,876 $833,463 Depreciation expense was $385,591 and $338,996 for the years ended December 31, 2020 and 2019, respectively. 8. Accrued Expenses Accrued expenses consisted of the following at December 31: 2020 2019 Accrued compensation $628,121 $461,452 Employee Stock Purchase Plan 9,471 10,121 Other 137,020 112,746 Total $774,612 $584,319 9. Commitments Operating and Finance Leases The Company leases its corporate space in Minneapolis, Minnesota. In September 2017, the Company entered into a noncancelable operating lease agreement for building space. Thenew lease commenced, and the Company moved to the facility in May 2018, in conjunction with the termination of its then existing lease. Rent expense is recorded on a straightline basisover the lease term. In July 2020 the Company signed an amendment to extend this lease through April 30, 2022. The lease amendment provides for monthly rent, real estate taxes andoperating expenses. As a result of the lease amendment, the Company recorded an incremental $197,211 in the operating ROU asset and lease liability. The lease agreement, as amended, includes the option to extend the term for one additional year. The option to extend is at the Company’s discretion and because the Company has notdetermined if the option to extend will be exercised, the extended lease term is not included in the ROU assets and lease liabilities. The Company regularly evaluates the renewal optionsand when it is reasonably certain of exercise, the Company will include the renewal period in its lease term. In May 2018, the Company entered into a noncancelable finance lease agreement for office equipment with a fiveyear term. The underlying assets are included in furniture andequipment. The lease contains a bargain purchase option at the end of the lease. When an implicit rate is not provided, the Company uses its incremental borrowing rate based on the information available at the lease commencement date in determining the presentvalue of the lease payments. 53Table of Contents Supplemental balance sheet information consisted of the following at December 31, 2020: Operating Lease Rightofuse assets $230,911 Operating lease liability $248,379 Less: short term portion (187,518)Long term portion $60,861 Finance Lease Furniture and equipment $28,932 Less: Accumulated depreciation (14,948)Net book value of property and equipment under finance lease $13,984 Finance lease liability $14,109 Less: short term portion (5,810)Long term portion $8,299 Maturity analysis under lease agreements consisted of the following as of December 31, 2020: Operating Leases Finance Leases 2021 $194,821 $7,255 2022 64,940 7,255 2023 3,022 Total minimum lease payments 259,761 17,532 Less: Present value discount (11,382) (122)Less amount representing services (3,301)Present value of net minimum lease payments $248,379 $14,109 Weighted Average RemainingLease Term DiscountRate Operating lease 1.3 years 4.0%Finance lease 2.4 years 1.0% Lease costs for the year ended December 31: 2020 2019 Operating lease cost $171,530 $164,252 Finance lease cost: Amortization 5,786 5,786 Interest 119 159 Variable lease cost 85,265 82,885 $262,700 $253,082 Supplemental cash flow information related to leases for the year ended December 31: 2020 2019 Cash paid for amounts included in operating and finance leases: Operating cash outflow from operating leases $278,603 $248,450 Operating cash outflow from finance leases 119 159 Financing cash outflow from finance leases 5,769 5,730 $284,491 $254,339 Clinical Research Studies In May 2017, the Company entered into an agreement with a clinical research organization to conduct a clinical research study. The Company made payments of $100,000 and $50,000 in2020 and 2019, respectively, and $550,000 prior to 2019. Additional payments will be due as certain milestones are met and clinical sites are added. The maximum amount of theseadditional payments is estimated to be approximately $2,620,000 over the course of the agreement. 54Table of Contents In October 2018, the Company entered into an agreement with a biopharmaceutical company and a cancer research center to conduct a clinical research study. The Company madepayments of approximately $70,000 in 2019. Additional payments of approximately $112,000 will be due as certain milestones are met. In December 2020, the Company entered into an agreement with a biopharmaceutical company and a cancer research center to conduct a clinical research study. The Company made zeropayments in 2020. Future payments of approximately $740,000 will be due as certain milestones are met. In January 2021, the Company entered into an agreement with a biopharmaceutical company and a cancer research center to conduct a clinical research study. Future payments ofapproximately $1,210,600 will be due as certain milestones are met. 10. Stockholders’ Equity On June 5, 2020, the Company entered into an At Market Issuance Sales Agreement (the “ATM Agreement”) with B. Riley FBR, Inc. (the “Agent”). Pursuant to the ATM Agreement,the Company may offer and sell from time to time, at its option, shares of common stock having an aggregate offering price of up to $10,000,000, par value $0.001 per share (the“Placement Shares”), through the Agent. The Placement Shares have been registered under the Securities Act of 1933, as amended, pursuant to the Registration Statement on Form S3 (File No. 333227466), which was originallyfiled with the SEC on September 21, 2018 and declared effective by the SEC on October 4, 2018, the base prospectus contained within the Registration Statement, and a prospectussupplement that was filed on June 5, 2020. Sales of the Company’s common stock, if any, under this prospectus supplement may be made by any method deemed to be an “at the marketoffering” as defined in Rule 415 promulgated under the Securities Act of 1933, as amended. During the year ended December 31, 2020, the Company sold 17,725 shares of common stock pursuant to the ATM Agreement, at an average selling price of $10.31 per share. On September 15, 2017, in connection with its IPO, Celcuity LLC filed a certificate of conversion, whereby Celcuity LLC effected a corporate conversion from a Minnesota limited liabilitycompany to a Delaware corporation and changed its name to Celcuity Inc. Pursuant to the conversion, units of membership interest in the limited liability company were converted intoshares of common stock of the corporation at a conversion ratio of 40 units for one share of common stock. The Company had 257,604,208 units issued and outstanding as of September15, 2017. After giving effect to the corporate conversion, the number of common shares outstanding as of such date was 6,440,139. As a result of the corporate conversion, accumulateddeficit was reduced to zero on the date of the corporate conversion, and the corresponding amount was credited to additional paidin capital. The corporate conversion was approved bymembers holding a majority of the outstanding units of Celcuity LLC, and in connection with such conversion, the Company filed a certificate of incorporation and adopted bylaws. TheCompany determined that the corporate conversion is equivalent to a change in the Company’s capital structure. On September 22, 2017, the Company completed its IPO whereby it sold 2,760,000 shares of common stock at a public offering price of $9.50 per share. The aggregate net proceedsreceived by the Company from the IPO were approximately $23.3 million, net of underwriting commissions of approximately $1.8 million and offering expenses of approximately $1.1million. Upon the closing of the IPO, 10,082,050 shares of common stock were outstanding, which included 881,911 shares of common stock issued as a result of the conversion of theCompany’s convertible notes. Shares of the Company’s common stock began trading on September 20, 2017 on The Nasdaq Capital Market under the symbol “CELC”. On May 11, 2018, the Company filed an amendment to its certificate of incorporation with the Secretary of State of the State of Delaware to decrease the number of authorized shares ofits common stock and preferred stock. Pursuant to the Company’s amended certificate of incorporation, the Company is authorized to issue up to 25,000,000 shares of common stock,$0.001 par value per share and 2,500,000 shares of preferred stock, $0.001 par value per share. At December 31, 2020 and 2019, the Company had 10,299,822 and 10,253,988 shares of common stock outstanding, respectively. Warrants In connection with the 2016 private placement offering of units, the Company issued tenyear warrants to the placement agent of the private placement. The warrants allow the placementagent to purchase up to 55,249 shares of common stock at $7.56 per share. The warrants were immediately exercisable and expire on January 14, 2026 and May 2, 2026. These warrants areequity classified and the $330,607 fair value of the warrants is reflected as additional paidin capital. In connection with the private placement offering of convertible notes, the Company issued tenyear warrants to the placement agent to purchase 48,615 shares of common stock at aprice of $8.42 per share. The warrants were immediately exercisable and expire on April 28, 2027 and May 17, 2027. These warrants are equity classified and the $286,999 fair value of thewarrants is reflected as additional paidincapital. In addition, the Company granted the purchasers of the convertible notes the right to receive a sevenyear warrant to purchase 131,675 shares of common stock at an exercise price equalto the conversion price of the convertible notes. With the completion of the IPO on September 22, 2017, these warrants were issued. These warrants were immediately exercisable andexpire on September 22, 2024. These warrants are equity classified and the $776,717 fair value of the warrants is reflected as additional paidincapital. 55Table of Contents In connection with the IPO, the Company issued a fiveyear warrant to the underwriter. The warrant allows the underwriter to purchase up to 138,000 shares of common stock at $10.45per share. This warrant was immediately exercisable and expires on September 19, 2022. This warrant is equity classified and the $784,111 fair value of the warrant is reflected as additionalpaidincapital. At December 31, 2020 and 2019, the Company had warrants to purchase 353,585 shares of common stock outstanding, at a weighted average exercise price of $9.42. A total of 0 and 395warrants were exercised in the years ended December 31, 2020 and 2019, respectively. 11. StockBased Compensation 2012 Equity Incentive Plan The 2012 Equity Incentive Plan, as amended, was adopted by the Company’s board and approved by the members of Celcuity LLC on August 10, 2012. The Company reserved amaximum of 625,000 shares of common stock for issuance under the 2012 Equity Incentive Plan. The 2012 Equity Incentive Plan provides for options, restricted stock awards,performance stock awards or stock bonuses. The exercise price of each option granted under the 2012 Equity Incentive Plan is not less than 100% of the fair market value of one share onthe date of grant. The maximum permitted term of options granted under the 2012 Equity Incentive Plan is ten years. The Company’s board administers the 2012 Equity Incentive Planand determines the provisions of incentive awards, including eligible recipients, number of shares subject to an incentive award, exercise price, vesting schedule, duration of an incentiveaward and other restrictions an incentive award may be subject to. The 2012 Equity Incentive Plan was frozen on September 6, 2017 and any new awards will be issued under the terms ofthe 2017 Amended and Restated Stock Incentive Plan. 2017 Stock Incentive Plan The 2017 Amended and Restated Stock Incentive Plan (the “2017 Plan”) was adopted by the Company’s board on September 6, 2017, became effective following the corporateconversion on September 15, 2017, and was approved by stockholders at the Company’s annual stockholder meeting on May 10, 2018. The 2017 Plan was amended and approved bystockholders at the Company’s annual stockholder meeting on May 14, 2020. The Company initially reserved a maximum of 750,000 shares of common stock for issuance under the 2017Plan. The number of shares reserved for issuance was automatically increased by 102,540 shares on January 1, 2020 and will increase automatically on January 1 of each of 2021 through2027 by the number of shares equal to 1.0% of the aggregate number of outstanding shares of Company common stock as of the immediately preceding December 31. However, theCompany’s board may reduce the amount of the increase in any particular year. The 2017 Plan provides for options, restricted stock awards, stock appreciation rights, restricted stockunits, performance awards and stock bonuses. The exercise price of each option granted under the 2017 Plan is not less than 100% of the fair market value of one share on the date ofgrant. The maximum permitted term of options granted under the 2017 Plan is ten years. The 2017 Plan is generally administered by the compensation committee of the Company’s board,which has the authority to interpret the 2017 Plan, grant awards and make all other determinations necessary for the administration of the 2017 Plan. The following table summarizes the activity for all stock options outstanding for the years ended December 31: 2020 2019 Shares WeightedAverage ExercisePrice Shares WeightedAverage ExercisePrice Options outstanding at beginning of year 585,215 $14.37 478,503 $9.73 Granted 277,986 7.17 248,756 19.69 Exercised (66,489) 5.13 Forfeited/Expired (13,252) 11.54 (75,555) 10.55 Balance at December 31 849,949 $9.33 585,215 $14.37 Options exercisable at December 31: 397,425 $10.35 264,280 $9.52 Weighted Average Grant Date Fair Value for Options Granted During the year: $4.63 $13.46 56Table of Contents The following table summarizes additional information about stock options outstanding and exercisable at December 31, 2020: Options Outstanding Options Exercisable Options OutstandingWeightedAverage RemainingContractual Life Weighted AverageExercise Price AggregateIntrinsic Value OptionsExercisable WeightedAverage ExercisePrice AggregateIntrinsic Value 849,949 7.92 $9.33 $2,010,091 397,425 $10.35 $762,234 The Company recognized stockbased compensation expense for stock options of $1,668,859 and $990,839 for the years ended December 31, 2020 and 2019, respectively. In May 2020,the Company modified the exercise price on 203,750 stock option awards to $5.10, the closing market price on the Nasdaq Capital Market on May 14, 2020. No director or officer awardswere modified. The effect on stockbased compensation for the year ended December 31, 2020 was approximately $83,000. The effect on stockbased compensation over the remainingservice period will be approximately $136,000. The BlackScholes optionpricing model was used to estimate the fair value of equitybased awards with the following weightedaverage assumptions for the years ended December 31: 2020 2019 Riskfree interest rate .35% 1.66% 1.42% 2.47% Expected volatility 73.3% 77.1% 76.2%80.0% Expected life (years) 5.5 to 6.1 5.2 to 6.3 Expected dividend yield 0% 0% The inputs for the BlackScholes valuation model require management’s significant assumptions. Prior to the Company’s IPO, the price per share of common stock was determined bythe Company’s board based on recent prices of common stock sold in private offerings. Subsequent to the IPO, the price per share of common stock is determined by using the closingmarket price on the Nasdaq Capital Market on the grant date. The riskfree interest rates are based on the rate for U.S. Treasury securities at the date of grant with maturity datesapproximately equal to the expected life at the grant date. The expected life was based on the simplified method in accordance with SEC Staff Accounting Bulletin Nos. 107 and 110. Theexpected volatility was estimated based on historical volatility information of peer companies that are publicly available in combination with the Company’s calculated volatility sincebeing publicly traded. All assumptions used to calculate the grant date fair value of nonemployee options are generally consistent with the assumptions used for options granted to employees. In the eventthe Company terminates any of its consulting agreements, the unvested options issued in connection with such agreements would also be cancelled. Restricted stock awards were granted to two members of the Company’s board during the year ended December 31, 2020. The Company had 15,686 and 0 shares of restricted stockoutstanding as of December 31, 2020 and 2019, respectively, and 0 and 2,571 shares of restricted stock vested during the years ended December 31, 2020 and 2019. The Companyrecognized stockbased compensation expense for restricted stock of $52,727 and $17,047 for the years ended December 31, 2020 and 2019, respectively. The total remaining shares available for grant under the 2017 Plan is 198,922. Total unrecognized compensation cost related to stock options and restricted stock is estimated to be recognized as follows: 2021 $1,387,174 2022 1,057,679 2023 704,222 2024 200,244 Total estimated compensation cost to be recognized $3,349,319 2017 Employee Stock Purchase Plan The Company’s 2017 Employee Stock Purchase Plan (the “ESPP”) was adopted by the Company’s board on September 6, 2017 and approved by stockholders at the Company’s annualstockholder meeting on May 10, 2018. The Company initially reserved a total of 100,000 shares for issuance under the ESPP. The number of shares reserved for issuance wasautomatically increased by 51,270 shares on January 1, 2020 and will increase automatically on each subsequent January 1 by the number of shares equal to 0.5% of the total outstandingnumber of shares of Company common stock as of the immediately preceding December 31. However, the Company’s board may reduce the amount of the increase in any particular year.The total remaining shares available for issuance under the employee stock purchase plan as of December 31, 2020 is 112,211. 57Table of Contents The ESPP provides participating employees with an opportunity to purchase shares of the Company’s common stock at a discount through payroll deductions. The ESPP is available toall employees unless they are employed for less than 20 hours per week or own 5% or more of the total combined voting power or value of the Company’s common stock. The ESPP isadministered using overlapping 24 month offering periods, referred to as an Offering Period. Each Offering Period has four sixmonth purchase periods. A new Offering Period andpurchase period begin every six months on May 1 and November 1 of each year. Participating employees may purchase common stock, on a voluntary after taxbasis, at a price equal to85% of the fair market value of a share of common stock on either the offering date or the purchase date, whichever is lower. If the purchase date has a lower price, the employee willautomatically be placed in the Offering Period beginning immediately after the purchase date. The Company recognized stockbased compensation expense related to the ESPP of $42,293and $33,103 for the years ended December 31, 2020 and 2019, respectively. The Company recognized total stockbased compensation expense, as follows for the years ended December 31: 2020 2019 Stockbased compensation expense in operating expenses: Research and development $1,055,094 $567,305 General and administrative 708,785 473,684 Total $1,763,879 $1,040,989 12. Income Taxes Following the conversion of Celcuity LLC to Celcuity Inc. on September 15, 2017, Celcuity Inc. began filing federal and state returns where required. No income tax benefit was recordedfor the years 2020 and 2019, due to net losses and recognition of a valuation allowance. The following table presents a reconciliation of the tax expense computed at the statutory federalrate and the Company’s tax expense for the years ending December 31: 2020 2019 Tax benefit at statutory federal rate $(1,990,000) $(1,545,000)State income tax benefit, net of federal tax effect (16,000) (24,000)Change in valuation allowance on deferred tax assets 2,159,000 1,781,000 Research and Development Credits (450,000) (138,000)Other permanent items 297,000 (74,000)Income tax benefits $ $ On December 22, 2017 H.R. 1, commonly referred to as the Tax Cuts and Jobs Act, (the “Tax Act”) was enacted. Among the significant changes to the U.S. Internal Revenue Code, theTax Act lowered the U.S. federal corporate income tax rate (“Federal Tax Rate”) from 35% to 21% effective January 1, 2018. The Act also made changes related to the use and limitation ofnet operating loss carryforwards generated in tax years beginning after December 31, 2017. For years beginning after December 31, 2017 net operating losses have an indefinitecarryforward and the utilization of losses is limited to 80% of taxable income each year. In response to the COVID19 pandemic, the Coronavirus Aid, Relief and Economic Security Act ("CARES Act") was signed into law on March 27, 2020. The CARES Act lifts certaindeduction limitations originally imposed by the Tax Act. Corporate taxpayers may carryback net operating losses originating during 2018 through 2020 for up to five years, which wasnot previously allowed under the Tax Act. The CARES Act also eliminates the 80% of taxable income limitation allowing corporate entities to fully utilize net operating loss carryforwardsto offset taxable income in 2018, 2019 and 2020. The enactment of the CARES Act did not result in any material impact to the Company’s income tax provision. On December 27, 2020 the Consolidated Appropriations Act, 2021 (“CAA”) was signed into law. The CAA includes the COVIDrelated Tax Relief Act of 2020 (“COVID TRA”). TheCompany is continuing to assess the effect of the CAA and does not believe it will result in a material impact to the Company’s income tax benefit. 58Table of Contents Deferred income taxes reflect the net effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used forincome tax purposes. The Company’s deferred tax assets relate primarily to its net operating loss carryforwards and other balance sheet basis differences. In accordance with ASC 740,“Income Taxes,” the Company recorded a valuation allowance to fully offset the net deferred tax asset, because it is more likely than not that the Company will not realize future benefitsassociated with these deferred tax assets at December 31, 2020. The tax effects of temporary differences and carryforwards that give rise to significant portions of the deferred tax assetsare as follows: 2020 2019 Deferred tax assets (liabilities): Accrued expenses $79,000 $8,000 Sharebased compensation 528,000 435,000 Property and equipment 255,000 175,000 Rightofuse assets (49,000) (41,000)Lease liability 53,000 50,000 Startup expenditures 2,610,000 2,038,000 Net operating losses and tax credits 3,242,000 1,894,000 Valuation allowance (6,718,000) (4,559,000)Net deferred tax assets (liabilities) $ $ At December 31, 2020, the Company had federal and state net operating loss carryforwards resulting in deferred tax assets of approximately $10.2 million and $0.5 million, respectively.The federal and state net operating loss carryforwards for 2017 will begin to expire in the year ending December 31, 2037. The federal net operating loss carryforwards starting in 2018have no expiration. These deferred tax assets were subject to a full valuation allowance as of December 31, 2020 and 2019. At December 31, 2020, the Company had federal and state research and development tax credit carryforwards resulting in deferred tax assets of approximately $0.6 million and $0.6 million,respectively. The federal and state credit carryforwards will begin to expire in the years ending December 31, 2037 and December 31, 2032, respectively. These deferred tax assets weresubject to a full valuation allowance as of December 31, 2020 and 2019. Under the provisions of Section 382 of the Internal Revenue Code of 1986, certain substantial changes in the Company's ownership, including a sale of the Company, or significantchanges in ownership due to sales of equity, may limit in the future the amount of net operating loss carryforwards available to offset future taxable income. The Company recognizes uncertain tax positions in accordance with ASC 740 on the basis of evaluating whether it is morelikelythan not that the tax positions will be sustained uponexamination by tax authorities. For those tax positions that meet the morelikelythan not recognition threshold, we recognize the largest amount of tax benefit that is more than 50percent likely to be realized upon ultimate settlement. As of December 31, 2020, and 2019, the Company has no significant uncertain tax positions. There are no unrecognized tax benefitsincluded on the balance sheet that would, if recognized, impact the effective tax rate. The Company does not anticipate there will be a significant change in unrecognized tax benefitswithin the next 12 months. Prior to the conversion, Celcuity was a limited liability company and therefore was taxed as a partnership for income tax purposes. Accordingly, no benefit for income taxes was recordedprior to the conversion. For years prior to 2016, the Company is no longer subject to U.S. federal or state income tax examinations. The Company's policy is to recognize interest and penalties related to uncertaintax positions as a component of general and administrative expenses. 59Table of Contents ITEM 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure None ITEM 9A. Controls and Procedures Evaluation of Disclosure Controls and Procedures Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures as ofDecember 31, 2020. The term “disclosure controls and procedures,” as defined in Rules 13a15(e) and 15d15(e) under the Securities Exchange Act of 1934, as amended (the “ExchangeAct”), means controls and other procedures of a company that are designed to ensure that information required to be disclosed by a company in the reports that it files or submits underthe Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms. Disclosure controls and procedures include, withoutlimitation, controls and procedures designed to ensure that information required to be disclosed by a company in the reports that it files or submits under the Exchange Act isaccumulated and communicated to the company’s management, including its principal executive and principal financial officers, as appropriate to allow timely decisions regardingrequired disclosure. Management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving theirobjectives and management necessarily applies its judgment in evaluating the costbenefit relationship of possible controls and procedures. Based on the evaluation of our disclosure controls and procedures as of December 31, 2020, our Chief Executive Officer and Chief Financial Officer concluded that, as of suchdate, our disclosure controls and procedures were effective. Management 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 Rule 13a15(f) under the SecuritiesExchange Act of 1934. Management has assessed the effectiveness of our internal control over financial reporting as of December 31, 2020 based on criteria set forth by the Committee ofSponsoring Organizations of the Treadway Commission (“COSO 2013”) in Internal ControlIntegrated Framework. Based on this assessment, our Chief Executive Officer and ChiefFinancial Officer concluded that our system of internal control over financial reporting was effective as of such date. This Annual Report does not include an attestation report of our registered public accounting firm regarding internal control over financial reporting. Management’s report wasnot subject to attestation by our registered public accounting firm pursuant to our designation as an “emerging growth company,” as defined in the JOBS Act. Changes in Internal Control over Financial Reporting There were no changes to our system of internal control over financial reporting during the three months ended December 31, 2020 and during the subsequent time periodthrough the filing of this Annual Report that have materially affected, or are reasonably likely to materially affect, our system of controls over financial reporting. ITEM 9B. Other Information None. 60Table of Contents PART III ITEM 10. Directors, Executive Officers and Corporate Governance Directors Brian F. Sullivan, age 59, is our coFounder and has served as Chairman of the Board and Chief Executive Officer since we commenced operations in 2012. Mr. Sullivan has over25 years of experience founding and building successful, high growth technology companies. He was Chairman and CEO of SterilMed, a medical device reprocessing company, from2003, when he led an investment group to acquire a majority interest, until its sale to Ethicon EndoSurgery Inc., a Johnson & Johnson company, for $330 million in 2011. Previously, hewas cofounder and Chief Executive Officer of Recovery Engineering, a filtration company, which he took public and subsequently sold to Procter & Gamble for $265 million in 1999.Since 2003, Mr. Sullivan has served on the board of directors of Entegris, Inc., a publiclyheld company. Mr. Sullivan has received seven U.S. patents and has several pending. Hegraduated magna cum laude with distinction from Harvard College with an A.B. in economics. Among other attributes, skills, and qualifications, the board of directors believes Mr.Sullivan is uniquely qualified to serve as a director based on his extensive operational and business development experience, and his knowledge in building stockholder value, growing acompany from inception and navigating significant corporate transactions and the public company process. Lance G. Laing, Ph.D., age 59, is our coFounder and has served as Chief Science Officer, Vice President, Secretary and Director since we commenced operations in 2012. Dr.Laing’s career spans more than 15 years in drug discovery research and technology development. He received his doctorate in biophysics and biochemistry from The Johns HopkinsUniversity and completed a National Institutes of Health postdoctoral fellowship at Washington University Medical School. He has received 19 U.S. patents and has an additional 24U.S. patents pending. His drug discovery research career began at Scriptgen/Anadys Pharmaceuticals (purchased by Novartis), where he worked under Professor Peter Kim, whobecame President of Merck Research. He also was Director of Chemistry and Bioapplications and Director of Detection Product Development for two companies that each developedinstruments similar to those Celcuity uses to perform the CELsignia tests. His work at these two instrument companies gave him unique expertise and experience in developing a varietyof patented applications for these instruments. Most recently, he served as an executive director for an international drug discovery and development company. Among other attributes,skills, and qualifications, the board of directors believes Dr. Laing is uniquely qualified to serve as a director based on his significant research, medical and scientific expertise. Richard E. Buller, M.D., Ph.D., age 71, was appointed to Celcuity’s board of directors in December 2019. Dr. Buller has over 15 years of experience leading oncology clinicaldevelopment and translational medicine departments at major pharmaceutical companies. He has participated in the development of 15 drugs and several companion diagnostics thatreceived U.S. FDA approval. Dr. Buller most recently served as Head Oncology Clinical Development and Vice President of Translational Oncology at Pfizer, Inc, one of the world’slargest pharmaceutical companies, until he retired in 2016. He had previously served as Vice President of Translational Medicine at Exelixis, a leading biopharmaceutical company, wherehe led efforts to study patients selected by molecular testing for inclusion in their phase 2 and phase 3 clinical trials. He began his pharmaceutical company career at GlaxoSmithKline asDirector of the Oncology Medicine Development Center. Prior to his leadership positions in drug development, he was Professor of Gynecologic Oncology at the University of Iowa,where he led laboratory research focused on identifying genomic variants involved in ovarian cancer. He received his M.D. from the Baylor College of Medicine, where he also receivedhis Ph.D. in cell biology. Among other attributes, skills, and qualifications, the board of directors believes Dr. Buller is uniquely qualified to serve as a director based on his oncologydrug and diagnostic development expertise. David F. Dalvey, age 62, has served as a member of Celcuity’s board of directors since February 2014. Mr. Dalvey has more than 30 years of experience in the fields of corporatefinance and venture capital, working primarily with growthoriented technology and lifescience businesses. He has over 10 years of corporate finance advisory experience with twonational investment banks, completing over 150 individual transactions. He has been the General Partner of Brightstone Venture Capital, a venture capital management company, sinceSeptember 2000. Brightstone is a 25year old venture capital management company that has raised and managed ten venture partnerships. Previously, he held management positionswith R.J. Steichen and Company, an investment bank, from 1995 to 2000, The Food Fund LP, a venture capital firm, from 1992 to 1995 and Wessels, Arnold & Henderson, an investmentbank, from 1987 to 1992. Mr. Dalvey served on the board of directors for Navarre Corporation (now Speed Commerce, Inc.) from 2009 until November 2012, on the board of managers forBlue Rock Market Neutral Fund, a mutual fund registered under the Investment Company Act of 1940 from 2000 to 2014 and on the board of directors for Digitiliti, Inc. from July 2011until October 2012. Mr. Dalvey has significant operational exposure as a board director or advisor to many other public and privately held growth businesses and has served on thesecompanies’ audit, strategic or governance committees, including companies such as HomeSpotter, Definity Health, AppTec Laboratories, CHF Solutions, BiteSquad, Agiliti, and NatureVision. Mr. Dalvey received a B.S. in Business/Management Economics from University of Minnesota. Among other attributes, skills, and qualifications, the board of directors believesMr. Dalvey is uniquely qualified to serve as a director based on his leadership experience in operating both public and private companies and his experience working in the investmentcommunity and with investment firms enable him to bring valuable insight and knowledge to our board of directors. 61Table of Contents Leo T. Furcht, M.D., age 74, was appointed to Celcuity’s board of directors in May 2019. Dr. Furcht is currently AllenPardee Professor of Cancer Biology and Head of theDepartment of Laboratory Medicine and Pathology at the University of Minnesota and a member of the Division of Molecular Pathology and Genomics. He served as Chairman of theBoard of Directors for University of Minnesota Physicians, the Medical School practice plan with approximately 700 physicians, from 20042014. He was also the founding Director of theBiomedical Engineering Center from 19902001, where he led efforts to establish stem cell and molecular diagnostics expertise at the University of Minnesota. He has published more than180 scientific papers and holds more than 30 patents in the fields of polypeptides, biomaterials, and adult stem cells. His business experience includes cofounding two medicaltechnology companies, South Bay Medical, a medical device company that was acquired by Mentor Corporation, and Diascreen, a diagnostics company, which was later acquired byChronimed. Among other attributes, skills, and qualifications, the board of directors believes Dr. Furcht is uniquely qualified to serve as a director based on his research in tumor cellbehavior and extracellular matrix proteins, Head of the University of Minnesota’s Department of Laboratory Medicine and Pathology, and his experience in several biotechnology startups. Richard J. Nigon, age 73, is currently Senior Vice President of Cedar Point Capital, LLC., a private company that raises capital for early stage companies, where he has servedsince 2007. Mr. Nigon has also been a board member for Tactile Systems Technology since September 2012 and Northern Technologies International Corp. since February 2010,including its nonexecutive Chairman of the board of directors since November 2012. Mr. Nigon also serves as a director of several private companies. Mr. Nigon previously served as aboard member for Vascular Solutions, Inc. from November 2000 to February 2017, when it was acquired by Teleflex, Incorporated and as a board member for Virtual RadiologicCorporation from May 2007 until it was acquired in July 2010. From February 2001 until December 2006, Mr. Nigon was a Director of Equity Corporate Finance for Miller JohnsonSteichen Kinnard, a privately held investment firm, which was acquired in December 2006 by Stifel Nicolaus, a brokerage and investment banking firm. After that acquisition, Mr. Nigonbecame a Managing Director of Private Placements of Stifel Nicolaus until May 2007. From February 2000 to February 2001, Mr. Nigon served as the Chief Financial Officer of Dantis,Inc., a web hosting company. Prior to joining Dantis, Mr. Nigon was employed by Ernst & Young LLP from 1970 to 2000, where he served as a partner from 1981 to 2000. While at Ernst &Young, Mr. Nigon served as the Director of Ernst & Young’s Twin Cities Entrepreneurial Services Group and was the coordinating partner on several publiclytraded companies in theconsumer retailing and manufacturing sectors. Among other attributes, skills, and qualifications, the board of directors believes Mr. Nigon is qualified to serve as a director because ofhis extensive public accounting and auditing experience, including particular experience with emerging growth companies. The board of directors also believes that Mr. Nigon will bringto the board of directors a strong background in financial controls and reporting, financial management, financial analysis, SEC reporting requirements and mergers and acquisitions. Hisstrategic planning expertise gained through his management and leadership roles at private investment firms also makes him wellsuited to serve as a member of the board of directors. Executive Officers Information regarding our Chief Executive Officer, Brian F. Sullivan, and our Chief Science Officer, Lance G. Laing, PhD., is included above under the heading “Directors”. Vicky Hahne, age 54, joined as our Chief Financial Officer in July 2017. She has more than 20 years of financial leadership experience, including the most recent 10 years in thehealthcare industry. Prior to joining Celcuity, Ms. Hahne served as Controller of Respiratory Technologies Inc., a medical device manufacturer, from 2015 to 2017. While at RespiratoryTechnologies, she played a key role in the due diligence process to sell the company to Koninklijke Philips. In 2014, she served as Controller for Ability Network Inc., a healthcareinformation technology company. From 2007 to 2012, Ms. Hahne served as Controller of Sterilmed Inc., a medical device reprocessing company, where she was significantly involved inthe sale of the company to Johnson & Johnson. Prior to these roles, Ms. Hahne held several senior financial positions at SimonDelivers Inc., including Chief Financial Officer. Ms.Hahne has extensive experience in early stage, high growth companies with responsibilities including financial controls and stewardship, financial analysis, mergers and acquisitions,building infrastructure and systems. She received a B.S. degree in Finance and Accounting from Northern State University and received her CPA certificate in 1990. Corporate Governance Our board of directors has adopted a Code of Business Conduct and Ethics that applies to our directors, officers and employees. This code is available on the corporategovernance section of our website (which is a subsection of the investor relations section of our website) at the following address: www.celcuity.com. We intend to disclose on ourwebsite any amendments or waivers to the Code of Business Conduct and Ethics that are required to be disclosed by SEC rules. Additional information required by this Item 10 will be contained in our definitive proxy statement for our 2021 Annual Meeting of Stockholders (the “Definitive ProxyStatement”) and is incorporated herein by reference. ITEM 11. Executive Compensation The information required by this Item 11 will be contained in the Definitive Proxy Statement and is incorporated herein by reference. 62Table of Contents ITEM 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters The information required by this Item 12 will be contained in the Definitive Proxy Statement and is incorporated herein by reference. ITEM 13. Certain Relationships and Related Transactions, and Director Independence The information required by this Item 13 will be contained in the Definitive Proxy Statement and is incorporated herein by reference. ITEM 14. Principal Accounting Fees and Services The information required by this Item 14 will be contained in the Definitive Proxy Statement and is incorporated herein by reference. 63Table of Contents PART IV ITEM 15. Exhibits, Financial Statement Schedules. FINANCIAL STATEMENTS Item Page Report of Independent Registered Public Accounting Firm 45 Balance Sheets December 31, 2020 and 2019 46 Statements of Operations Years ended December 31, 2020 and 2019 47 Statements of Stockholders’ Equity Years ended December 31, 2020 and 2019 48 Statements of Cash Flows Years ended December 31, 2020 and 2019 49 Notes to Consolidated Financial Statements 50 FINANCIAL STATEMENT SCHEDULES None. EXHIBITS See Exhibit Index immediately following the signature page hereto, which is incorporated herein by reference. ITEM 16. Form 10K Summary None. 64Table of Contents 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. Dated: February 16, 2021 CELCUITY INC. By/s/ Brian F. Sullivan Brian F. Sullivan Chairman and Chief Executive Officer (Principal Executive Officer) Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and onthe dates indicated. Each person whose signature appears below constitutes and appoints Brian F. Sullivan and Vicky Hahne as the undersigned’s true and lawful attorneysin fact and agents, each actingalone, with full power of substitution and resubstitution, for the undersigned and in the undersigned’s name, place and stead, in any and all amendments to this Annual Report on Form10K and to file the same, with all exhibits thereto, and other documents in connection therewith, with the Securities and Exchange Commission, granted unto said attorneysinfact andagents, each acting alone, full power and authority to do and perform each and every act and thing requisite and necessary to be done in and about the premises, as fully to all intentsand purposes as the undersigned might or could do in person, hereby ratifying and confirming all said attorneysinfact and agents, each acting alone, or his substitute or substitutes,may lawfully do or cause to be done by virtue thereof. Signature Title Date /s/ Brian F. Sullivan Chairman and Chief Executive Officer February 16, 2021Brian F. Sullivan (Principal Executive Officer) /s/ Vicky Hahne Chief Financial Officer February 16, 2021Vicky Hahne (Principal Financial and Accounting Officer) /s/ Lance G. Laing Chief Science Officer, Vice President and Secretary, and February 16, 2021Lance G. Laing Director /s/ Richard E. Buller Director February 16, 2021Richard E. Buller /s/ Dave F. Dalvey Director February 16, 2021Dave F. Dalvey /s/ Leo T. Furcht Director February 16, 2021Leo T. Furcht /s/ Richard J. Nigon Director February 16, 2021Richard J. Nigon 65Table of Contents EXHIBIT INDEXCELCUITY INC.FORM 10K Exhibit No. Description 2.1 Form of Plan of Conversion (incorporated by reference to Exhibit 2.1 to the Company’s Registration Statement on Form S1/A filed with the SEC on September 12,2017). 3.1 Certificate of Incorporation of the Company as amended (incorporated by reference to Exhibit 3.1 to the Company’s Quarterly Report on Form 10Q filed with theSEC on August 9, 2018). 3.2 Bylaws of the Company (incorporated by reference to Exhibit 3.2 to the Company’s Quarterly Report on Form 10Q filed with the SEC on November 13, 2017). 4.1 Specimen Certificate representing shares of common stock of Celcuity Inc. (incorporated by reference to Exhibit 4.1 to the Company’s Registration Statement onForm S1/A filed with the SEC on September 12, 2017). 4.2 Description of Registered Securities (incorporated by reference to Exhibit 4.2 to the Company’s Annual Report on Form 10K filed with the SEC on March 13, 2020). 10.1+ Celcuity Inc. 2017 Employee Stock Purchase Plan (incorporated by reference to Exhibit 10.1 to the Company’s Registration Statement on Form S1/A filed with theSEC on September 12, 2017). 10.2+ Celcuity Inc. Amended and Restated 2017 Stock Incentive Plan (incorporated by reference from Exhibit 10.1 to the Company’s Current Report on Form 8K filedwith the SEC on May 14, 2020). 10.3+ Amendment No. 1 to Celcuity Inc. 2017 Stock Incentive Plan (incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report on Form 10Q filed withthe SEC on August 9, 2018). 10.4+ Form of Stock Option Agreement pursuant to Celcuity Inc. 2017 Stock Incentive Plan (incorporated by reference to Exhibit 10.3 to the Company’s RegistrationStatement on Form S1/A filed with the SEC on September 12, 2017). 10.5+ Form of Restricted Stock Agreement pursuant to Celcuity Inc. 2017 Stock Incentive Plan (incorporated by reference to Exhibit 10.4 to the Company’s RegistrationStatement on Form S1/A filed with the SEC on September 12, 2017). 10.6+ Form of Restricted Stock Unit Agreement pursuant to Celcuity Inc. 2017 Stock Incentive Plan (incorporated by reference to Exhibit 10.5 to the Company’sRegistration Statement on Form S1/A filed with the SEC on September 12, 2017). 10.7+ Form of Stock Appreciation Rights Agreement pursuant to Celcuity Inc. 2017 Stock Incentive Plan (incorporated by reference to Exhibit 10.6 to the Company’sRegistration Statement on Form S1/A filed with the SEC on September 12, 2017). 10.8+ Celcuity LLC 2012 Equity Incentive Plan, adopted August 10, 2012, as amended by First Amendment to the Celcuity LLC 2012 Equity Incentive Plan, adoptedNovember 12, 2015 (incorporated by reference to Exhibit 10.7 to the Company’s Registration Statement on Form S1 filed with the SEC on August 23, 2017). 10.9+ Form of Incentive Plan Unit Option Agreement pursuant to the Celcuity LLC 2012 Equity Incentive Plan (incorporated by reference to Exhibit 10.8 to theCompany’s Registration Statement on Form S1 filed with the SEC on August 23, 2017). 10.10 Form of Warrant to Purchase Units of Membership Interest issued by Celcuity LLC to Cedar Point Capital, LLC, as placement agent of membership units andunsecured convertible promissory notes of Celcuity LLC (incorporated by reference to Exhibit 10.9 to the Company’s Registration Statement on Form S1 filed withthe SEC on August 23, 2017). 66Table of Contents 10.11 Form of Warrant to Purchase Shares of Common Stock issued by Celcuity Inc. in connection with the conversion of 1.25% Unsecured Convertible PromissoryNotes (incorporated by reference to Exhibit 10.2 to the Company’s Current Report on Form 8K filed with the SEC on September 25, 2017). 10.12 Commercial Lease, dated September 28, 2017, between West Glen Development I, LLC and Celcuity, LLC (incorporated by reference to Exhibit 10.11 to theCompany’s Quarterly Report on Form 10Q filed with the SEC on November 13, 2017). 10.13 Commercial Lease, First Amendment to Lease, dated July 28, 2020, between West Glen Development I, LLC and Celcuity Inc. (incorporated by reference fromExhibit 10.3 to the Company’s Quarterly Report on Form 10Q filed with the SEC on August 10, 2020). 10.14 Clinical Trial Agreement, dated May 8, 2017, between NSABP Foundation, Inc. and Celcuity LLC (incorporated by reference to Exhibit 10.13 to the Company’sRegistration Statement on Form S1 filed with the SEC on August 23, 2017). 10.15* Clinical Trial Agreement, Amendment No. 1, between NSABP Foundation, Inc and Celcuity Inc., dated October 15, 2020. 10.16+ Confidentiality, Assignment of Inventions and NonCompetition Agreement, dated November 15, 2011, between Celcuity LLC and Brian F. Sullivan (incorporatedby reference to Exhibit 10.14 to the Company’s Registration Statement on Form S1 filed with the SEC on August 23, 2017). 10.17+ Confidentiality, Assignment of Inventions and NonCompetition Agreement, dated November 15, 2011, between Celcuity LLC and Lance G. Laing (incorporated byreference to Exhibit 10.15 to the Company’s Registration Statement on Form S1 filed with the SEC on August 23, 2017). 10.18+ Confidentiality, NonCompete and Proprietary Rights Agreement, dated May 17, 2017, between Celcuity LLC and Vicky Hahne (incorporated by reference to Exhibit10.16 to the Company’s Registration Statement on Form S1 filed with the SEC on August 23, 2017). 10.19 Form of Indemnification Agreement between Celcuity Inc. and each of its officers and directors (incorporated by reference to Exhibit 10.17 to the Company’sRegistration Statement on Form S1/A filed with the SEC on September 12, 2017). 10.20 Representative’s Warrant to Purchase Common Stock (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8K filed with the SECon September 25, 2017). 10.21 At Market Issuance Sales Agreement, dated June 5, 2020, between Celcuity Inc. and B. Riley FBR, Inc. (incorporated by reference to Exhibit 1.1 to the Company’sCurrent Report on Form 8K filed with the SEC on June 5, 2020). 23.1* Consent of Boulay PLLP. 24.1* Power of Attorney (included on the signature page). 31.1* Certification of principal executive officer required by Rule 13a14(a). 31.2* Certification of principal financial officer required by Rule 13a14(a). 32.1** Section 1350 Certification of principal executive officer. 32.2** Section 1350 Certification of principal financial officer. 101 Financial statements from the Annual Report on Form 10K of the Company for the year ended December 31, 2020, formatted, in Inline XBRL: (i) the Balance Sheets,(ii) the Statements of Operations, (iii) the Statements of Changes in Stockholders’ Equity, (iv) the Statements of Cash Flows, and (v) the Notes to FinancialStatements. 104 Cover Page Interactive Data File (embedded within the Inline XBRL document and included in Exhibit 101).____________ * Filed herewith.** Furnished herewith.+ Management contract or compensatory plan. 67 EXHIBIT 10.15 Amendment No. 1CLINICAL TRIAL AGREEMENT FOR FB12 PHASE II STUDY By and BetweenNSABP Foundation, Inc.andCelcuity, Inc. This Amendment No. 1 (the “Amendment”) to the Clinical Trial Agreement for the FB12 Phase II Study (the “Agreement’) entered into and effective as of May 8, 2017 (the “EffectiveDate”), by and between NSABP Foundation, Inc., (“NSABP”), and Celcuity, Inc., (“Celcuity”), is effective as of _____________, 2020 (“Amendment Effective Date”). WHEREAS, NSABP and Celcuity desire to make certain changes to the Agreement, primarily related to the Study being deemed by the FDA for exemption of IND regulations and theinclusion of additional funding. NOW THEREFORE, in consideration of the covenants and conditions contained herein, the Parties agree as follows: 1.All instances of the term “Celcuity, LLC” found in the Agreement shall be deleted and replaced with the term “Celcuity, Inc.” 2.Section 1.32 shall be replaced in its entirety with the following: ““Sponsor” shall mean NSABP.” 3.Section 3.2 shall be revised by removing the definition of “Applicable Laws” and replacing it with the following: ““Applicable Laws” shall mean, as applicable, (a) all applicablerequirements of the U.S. investigational new drug (“IND”) regulations (Title 21, Part 312.1 et seq., as applicable to an IND exemption); (b) GCP, as may be amended from time totime; (c) the Code of Federal Regulations governing informed consent and IRBs (Title 21, Parts 50 and 56) and privacy of patient health information (Title 45, Parts 160 and 164promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”)); and (d) other applicable federal, state, provincial, and local laws, legallybinding regulations, and guidelines having the force and effect of law.” 4.Section 3.3 shall be replaced in its entirety with the following: “The FDA has deemed FB12 to meet all of the requirements for exemption of IND regulations and, therefore, an INDis not required.” 5.Section 3.6(d) shall be deleted in its entirety. 6.Section 9.4 shall be revised by the deletion of “NSABP agrees to provide Celcuity with copies of the annual reports to the IND filed for the Study.” 7.The Budget and Payment Schedule sections of Appendix B, Budget, Payment Schedule, and Task List, shall be replaced in their entirety with the following Budget and RevisedPayment Schedule, as attached to this Amendment No. 1. 8.Capitalized terms shall have the meaning assigned to them in the Agreement. Except as expressly and unambiguously stated herein, no other changes are made to the Agreement.All other terms and conditions of the Agreement shall remain in full force and effect. The Agreement and this Amendment constitute the entire understanding of the Parties withrespect to the subject matter hereof and supersede any prior understanding, oral or written, between the Parties with respect thereto. 1 BINDING EXECUTION IN WITNESS WHEREOF, the Parties hereto have executed this Agreement in duplicate by proper persons thereunto duly authorized. NSABP FOUNDATION, INC. CELCUITY, INC. By:/S/ RON SUGAR By:/S/ BRIAN SULLIVAN AUTHORIZED SIGNATURE AUTHORIZED SIGNATURE RONALD SUGAR BRIAN SULLIVAN AUTHORIZED REPRESENTATIVE AUTHORIZED REPRESENTATIVE CHIEF FINANCIAL OFFICER CHIEF EXECUTIVE OFFICER TITLE TITLE 10/15/2020 10/15/2020 DATE DATE 2 NSABP Foundation, Inc.Budget: FB12October 15, 2020 Unit Type Unit Volume Cost Per Unit Total Budget Site Costs Site Start Up and Annual Administrative Fees CM sites * 24 $15,000 $360,000 Pharmacy Fees CM sites * 24 2,000 48,000 Site IRB Fees IRBs 27 12,500 337,500 Participating Site Payment Patients 55 6,946 382,030 Participating Site Payment Pregnancy SAE Patients 1 150 150 NonRoutine Patient Care Costs Procedures 275 1,100 302,500 Screen Failures Screen Failures 220 250 55,000 Participating Site Tissue Samples Samples 330 300 99,000 Overhead on Site Payments 396,045 Subtotal Site Costs Patients 55 $41,423 $1,980,225 Specimen Procurement/Storage NSABP Biospecimen Bank $5,500 Subtotal Specimen Procurement/Storage $5,500 Program and Administrative Services NSABP Operations Center $815,489 Biostatistical, Data Management, EDC Support 438,961 Drug Distribution 46,564 NSABP Central IRB Fees 9,519 Travel Reimbursement (PassThrough) 20,000 Subtotal Program and Administrative Services $1,330,532 Total Budget Patients 55 $60,296 $3,316,257 * Central Monitored Sites 3 FB12Payment ScheduleOctober 15, 2020 PAYMENT PERIOD PAYMENT TIMING PATIENTMILESTONES CALENDARYEAR PAYMENTAMOUNT CUMULATIVETOTAL StartUp Activities Initial Payment Within 30 days of execution ofthe Agreement 0 to 5 2020 $300,000 $300,000 Accrual and Treatment Period PerPatient Randomized $34,925.14 6 10 2021 174,626 474,626 11 20 2021 349,251 823,877 amount per patient to be invoiced as actual 21 30 2021 349,251 1,173,129 accrual reaches enrollment milestone (projected 31 40 2021 349,251 1,522,380 payment plan is based upon budgeted accrual) 41 50 2021 349,251 1,871,631 51 55 2021 174,626 2,046,257 Quarterly Payments @ $50,000 Yr 01 2017 (1 quarterly payment) 2017 50,000 2,096,257 Yr 02 2018 (4 quarterly payments) 2018 200,000 2,296,257 Yr 03 2019 (1 quarterly payment) 2019 50,000 2,346,257 Quarterly Payments @ $100,000 Yr 04 2020 (2 quarterly payments) Paid on: 2020 200,000 2,546,257 October 15, 2020 100,000 December 20, 2020 100,000 Quarterly Payments @ $100,000 Yr 05 2021 (2 quarterly payments) Paid on: 2021 200,000 2,746,257 March 20, 2021 100,000 June 20, 2021 100,000 Quarterly Payments @ $50,000 Yr 05 2021 (2 quarterly payments) Paid on: 2021 100,000 2,846,257 September 20, 2021 50,000 December 20, 2021 50,000 Quarterly Payments @ $50,000 Yr 06 2022 (4 quarterly payments) Paid on: 2022 200,000 3,046,257 March 20, 2022 50,000 June 20, 2022 50,000 September 20, 2022 50,000 December 20, 2022 50,000 Primary Endpoint Upon completion of the primary endpointanalysis and submission of the primaryendpoint manuscript to Celcuity 2023 250,000 3,296,257 Pass Through Costs Travel Reimbursement invoice as incurred 20172023 $20,000 $3,316,257 TOTAL CELCUITY SUPPORT $3,316,257 4 EXHIBIT 23.1 CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM We have issued our report, dated February 16, 2021, with respect to the financial statements included in the Annual Report of Celcuity Inc. on Form 10K for the year ended December31, 2020. We hereby consent to the incorporation by reference in the Registration Statements of Celcuity Inc. on Form S8 (File No. 333221117 and 333238787) and on Form S3 (File No.333227466). /s/Boulay PLLP Minneapolis, MinnesotaFebruary 16, 2021 EXHIBIT 31.1 CERTIFICATION UNDER SECTION 302 OF THE SARBANESOXLEY ACT OF 2002 I, Brian F. Sullivan, certify that: 1.I have reviewed this annual report on Form 10K of Celcuity Inc.; 2.Based on my knowledge, this report does not contain any untrue statement of material fact or omit to state a material fact necessary to make the statement made, in light ofthe circumstances under which such statements were made, not misleading with respect to the period covered by this report; 3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition,results of operations and cash flows of the registrant as of, and for, the periods presented in this report; 4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a15(e) and 15d15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a15(f) and 15d15(f)) for the registrant and have: (a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure thatmaterial information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during theperiod in which this report is being prepared; (b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to providereasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generallyaccepted accounting principles; (c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of thedisclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and (d)Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (theregistrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internalcontrol over financial reporting; and 5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditorsand the audit committee of the registrant’s board of directors (or persons performing the equivalent functions): (a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adverselyaffect the registrant’s ability to record, process, summarize and report financial information; and (b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financialreporting. Date: February 16, 2021By/s/ Brian F. Sullivan Brian F. Sullivan Chairman and Chief Executive Officer EXHIBIT 31.2 CERTIFICATION UNDER SECTION 302 OF THE SARBANESOXLEY ACT OF 2002 I, Vicky Hahne, certify that: 1.I have reviewed this annual report on Form 10K of Celcuity Inc.; 2.Based on my knowledge, this report does not contain any untrue statement of material fact or omit to state a material fact necessary to make the statement made, in light ofthe circumstances under which such statements were made, not misleading with respect to the period covered by this report; 3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition,results of operations and cash flows of the registrant as of, and for, the periods presented in this report; 4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a15(e) and 15d15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a15(f) and 15d15(f)) for the registrant and have: (a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure thatmaterial information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during theperiod in which this report is being prepared; (b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to providereasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generallyaccepted accounting principles; (c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of thedisclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and (d)Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (theregistrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internalcontrol over financial reporting; and 5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditorsand the audit committee of the registrant’s board of directors (or persons performing the equivalent functions): (a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adverselyaffect the registrant’s ability to record, process, summarize and report financial information; and (b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financialreporting. Date: February 16, 2021By/s/ Vicky Hahne Vicky Hahne Chief Financial Officer EXHIBIT 32.1 CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTEDPURSUANT TO SECTION 906 OF THE SARBANESOXLEY ACT OF 2002 I, Brian F. Sullivan, certify that: 1.I have reviewed this annual report on Form 10K of Celcuity Inc.; and 2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in lightof the circumstances under which such statements were made, not misleading with respect to the period covered by this report. Date: February 16, 2021By/s/ Brian F. Sullivan Brian F. Sullivan Chairman and Chief Executive Officer EXHIBIT 32.2 CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTEDPURSUANT TO SECTION 906 OF THE SARBANESOXLEY ACT OF 2002 I, Vicky Hahne, certify that: 1.I have reviewed this annual report on Form 10K of Celcuity Inc.; and 2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in lightof the circumstances under which such statements were made, not misleading with respect to the period covered by this report. Date: February 16, 2021By/s/ Vicky Hahne Vicky Hahne Chief Financial Officer
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