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Fennec Pharmaceuticals Inc.

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FY2020 Annual Report · Fennec Pharmaceuticals Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-K

(Mark One)

☒ ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 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: 001-32295

FENNEC PHARMACEUTICALS INC.
(Exact Name of Registrant as Specified in Its Charter)

☐
British Columbia, Canada
(State or Other Jurisdiction of
Incorporation or Organization)

PO Box 13628, 68 TW Alexander Drive
Research Triangle Park, NC
(Address of Principal Executive Offices)

20-0442384
(I.R.S. Employer
Identification No.)

27709
(Zip Code)

(919) 636-4530
(Registrant's telephone number, including area code)

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

Title of each class
Common Shares, no par value

Name of each exchange on which registered
Nasdaq Capital Market

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

Indicate by check mark if the Registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. YES ☐ NO ý

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 ý

Indicate by check mark whether the Registrant: (1) has filed all reports required to be filed by section 13 or 15(d) of the Securities Exchange Act of 1934
during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing
requirements for the past 90 days.  YES ☒ NO ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of
Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).
YES ☒ NO ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an
emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth
company" in Rule 12b-2 of the Exchange Act.

Large accelerated filer ☐  

Accelerated filer ☐  

Non-accelerated filer ☒

  Smaller reporting company ☒ Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new
or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

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

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

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The aggregate market value of the voting stock held by non-affiliates of the Registrant, computed by reference to the closing sales price of the Registrant’s
Common Shares as reported on the Nasdaq Capital Market on June 30, 2020 (the last business day of the Registrant’s most recently completed second
fiscal quarter) was $116,145,143 based upon a total of 13,909,598 shares held as of June 30, 2020 by persons believed to be non-affiliates of the Registrant
(for purposes of this calculation, all of the Registrant’s officers, directors and 10% owners known to the Registrant are deemed to be affiliates of the
Registrant).

As of March 29, 2021, there were 26,002,853 shares of the Registrant’s Common Shares outstanding.

 
 
 
 
 
FENNEC PHARMACEUTICALS INC.
2020 FORM 10-K ANNUAL REPORT
TABLE OF CONTENTS

PART I

Item 1.

Business

Item 1A.

Risk Factors

Item 1B.

Unresolved Staff Comments

Item 2.

Properties

Item 3.

Legal Proceedings

Item 4.

Mine Safety Disclosures

PART II

Item 5.

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

Item 6.

Selected Financial Data

Item 7.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

Item 7A.

Quantitative and Qualitative Disclosures About Market Risk

Item 8.

Financial Statements and Supplementary Data

Item 9.

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

Item 9A.

Controls and Procedures

Item 9B.

Other Information

PART III

Item 10.

Directors, Executive Officers and Corporate Governance

Item 11.

Executive Compensation

Item 12.

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

Item 14.

Principal Accounting Fees and Services

PART IV

Item 15.

Exhibits, Financial Statement Schedules

Item 16.

Form 10-K Summary

SIGNATURES

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NOTE REGARDING FORWARD-LOOKING STATEMENTS

This Annual Report on Form 10-K contains forward-looking statements within the safe harbor provisions of the U.S. Private Securities Litigation Reform
Act of 1995. Our actual results, performance or achievements may be materially different from any results, performance or achievements expressed or
implied by such forward-looking statements. Words such as “may,” “will,” “expect,” “believe,” “anticipate,” “intend,” “could,” “estimate,” “project,”
“plan,” and other similar words are one way to identify such forward-looking statements. Forward-looking statements in this Annual Report include, but
are not limited to, statements with respect to (1) our anticipated sources and uses of cash and cash equivalents; (2) our anticipated commencement dates,
completion dates and results of clinical trials; (3) our efforts to pursue collaborations with the government, industry groups or other companies; (4) our
anticipated progress and costs of our clinical and preclinical research and development programs; (5) our corporate and development strategies; (6) our
expected results of operations; (7) our anticipated levels of expenditures; (8) our ability to protect our intellectual property; (9) our ability to fully comply
with domestic and international governmental regulation; (10) the anticipated applications and efficacy of our drug candidate; (11) our ability to obtain U.S.
Food and Drug Administration (“FDA”) and similar foreign approvals for our drug candidate, (12) the nature and scope of potential markets for our drug
candidate; (13) future legal liability; and (14) our ability to attract and retain key employees. All statements, other than statements of historical fact,
included in this Annual Report that address activities, events or developments that we expect or anticipate will or may occur in the future are forward-
looking statements. We include forward-looking statements because we believe that it is important to communicate our expectations to our
investors. However, all forward-looking statements are based on management’s current expectations of future events and are subject to a number of risks
and uncertainties, including those discussed below in Item 1A., “Risk Factors.” Although we believe the expectations reflected in the forward-looking
statements are based upon reasonable assumptions, we can give no assurance that our expectations will be attained, and we caution you not to place undue
reliance on such statements. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from
time to time, whether as a result of new information, future developments or otherwise.

PART I

Item 1.

Business

Overview

Product Candidate - PEDMARKTM

Our only product candidate in the clinical stage of development is:

PEDMARKTM (sodium thiosulfate (STS) anhydrous injection). We have announced results of two Phase 3 clinical trials for the prevention of
cisplatin induced hearing loss, or ototoxicity in children, including the pivotal Phase 3 study SIOPEL 6, “A Multicentre Open Label Randomised
Phase 3 Trial of the Efficacy of Sodium Thiosulfate in Reducing Ototoxicity in Patients Receiving Cisplatin Chemotherapy for Standard Risk
Hepatoblastoma,” and the proof of concept Phase 3 study in collaboration with the Children’s Oncology Group (“COG ACCL0431”)
“A Randomized Phase 3 Study of Sodium Thiosulfate for the Prevention of Cisplatin-Induced Ototoxicity in Children”. COG ACCL0431 final
results were published in the Lancet Oncology in 2016. SIOPEL 6 final results were published in the New England Journal of Medicine in
June 2018.

We continue to focus our resources on the development of PEDMARKTM.

PEDMARKTM

We have licensed from Oregon Health & Science University (“OHSU”) intellectual property rights for the use of PEDMARKTM as a chemoprotectant and
are developing PEDMARKTM as a protectant against the hearing loss often caused by platinum-based anti-cancer agents in children. Preclinical and
clinical studies conducted by OHSU and others have indicated that PEDMARKTM can effectively reduce the incidence of hearing loss caused by platinum-
based anti-cancer agents.

Hearing loss among children receiving platinum-based chemotherapy is frequent, permanent and often severely disabling. The incidence of hearing loss in
these children depends upon the dose and duration of chemotherapy, and many of these children require lifelong hearing aids. In addition, adults
undergoing chemotherapy for several common malignancies, including ovarian cancer, testicular cancer, and particularly head and neck cancer and brain
cancer, often receive intensive platinum-based therapy and may experience severe, irreversible hearing loss, particularly in the high frequencies.

We estimate in the U.S. and Europe that annually over 10,000 children with solid tumors are treated with platinum agents.  The vast majority of these
newly diagnosed tumors are localized and classified as low to intermediate risk in nature. These localized cancers may have overall survival rates of greater
than 80%, further emphasizing the importance of quality of life after treatment. The incidence of hearing loss in these children depends upon the dose and
duration of chemotherapy, and many of these children require lifelong hearing aids. There is currently no established preventive agent for this hearing loss
and only expensive, technically difficult and sub-optimal cochlear (inner ear) implants have been shown to provide some benefit. Infants and young
children at critical stages of development lack speech language development and literacy, and older children and adolescents lack speech language
development and literacy, and older children and adolescents lack social-emotional development and educational achievement.

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In March 2018, PEDMARKTM received Breakthrough Therapy and Fast Track designations from the U.S. Food and Drug Administration (“FDA”).
Further, PEDMARKTM has received Orphan Drug Designation in the U.S. in this setting.

We initiated our rolling New Drug Application (“NDA”) for PEDMARKTM for the prevention of ototoxicity induced by cisplatin chemotherapy patients 1
month to < 18 years of age with localized, non-metastatic, solid tumors with the FDA in December 2018. We announced that we had submitted full
completion of the NDA in February 2020. On April 13, 2020, we announced that the FDA had accepted for filing and granted Priority Review for our
NDA. The FDA set a Prescription Drug Fee Act (“PDUFA”) target action date of August 10, 2020 for the completion of the FDA’s review. On August 10,
2020, we announced that we received a Complete Response Letter (“CRL”) from the FDA regarding our NDA for PEDMARKTM, which identified
deficiencies in the third-party manufacturing facility that manufactures PEDMARKTM on our behalf. Importantly, no clinical safety or efficacy issues were
identified during the review and there is no requirement for further clinical data. In the fourth quarter of 2020, we engaged in a Type A meeting with the
FDA concerning the CRL that we believe was constructive and collaborative. We are working closely with our third-party drug manufacturer and the FDA
to fully address the CRL, and we plan to resubmit our NDA for PEDMARKTM in the second quarter of 2021.

In August 2018, the Pediatric Committee (“PDCO”) of the European Medicines Agency (“EMA”) accepted our pediatric investigation plan (PIP) for
sodium thiosulfate with the trade name Pedmarqsi for the condition of the prevention of platinum-induced hearing loss. An accepted PIP is a prerequisite
for filing a Marketing Authorization Application (“MAA”) for any new medicinal product in Europe. The indication targeted by our PIP is for the
prevention of platinum-induced ototoxic hearing loss for standard risk hepatoblastoma (SR-HB). Additional tumor types of the proposed indication will be
subject to the Committee for Medicinal Products for Human Use (“CHMP”) assessment at the time of the MAA. No deferred clinical studies were required
in the positive opinion given by PDCO. We were also advised that sodium thiosulfate (tradename to be determined) is eligible for submission of an
application for a Pediatric Use Marketing Authorization (“PUMA”). A PUMA is a dedicated marketing authorization covering the indication and
appropriate formulation for medicines developed exclusively for use in the pediatric population and provides data and market protection up to 10 years.
Therefore, this decision allows us to proceed with the submission of a PUMA in the European Union (EU) with incentives of automatic access to the
centralized procedure and up to 10 years of data and market protection. In February 2020, we announced that we had submitted a MAA for the prevention
of ototoxicity induced by cisplatin chemotherapy patients 1 month to < 18 years of age with localized, non-metastatic, solid tumors.

Clinical Studies

PEDMARKTM has been studied by cooperative groups in two Phase 3 clinical studies of survival and reduction of ototoxicity, COG ACCL0431 and
SIOPEL 6. Both studies have been completed. The COG ACCL0431 protocol enrolled one of five childhood cancers typically treated with intensive
cisplatin therapy for localized and disseminated disease, including newly diagnosed hepatoblastoma, germ cell tumor, osteosarcoma, neuroblastoma, and
medulloblastoma.  SIOPEL 6 enrolled only hepatoblastoma patients with localized tumors.

SIOPEL 6

In October 2007, we announced that our collaborative partner, the International Childhood Liver Tumour Strategy Group, known as SIOPEL, a multi-
disciplinary group of specialists under the umbrella of the International Society of Pediatric Oncology, had launched a randomized Phase 3 clinical trial
SIOPEL 6 to investigate whether STS reduces hearing loss in standard risk hepatoblastoma (liver) cancer patients receiving cisplatin as a monotherapy.

The study was initiated in October 2007 initially in the United Kingdom and completed enrollment at the end of 2014. 52 sites from 11 countries enrolled
109 evaluable patients. Under the terms of our agreement, SIOPEL conducted and funded all clinical activities and we provided drug, drug distribution and
pharmacovigilance, or safety monitoring, for the study. SIOPEL 6 was completed in December 2014 and the final results of SIOPEL 6 were published in
The New England Journal of Medicine in June 2018.

The primary objectives of SIOPEL 6 were:

·
·

To assess the efficacy of STS to reduce the hearing impairment caused by cisplatin.
To carefully monitor any potential impact of STS on response to cisplatin and survival.

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SIOPEL 6 - Results

Background / Objectives:

Bilateral high-frequency hearing loss is a serious permanent side-effect of cisplatin therapy, particularly debilitating when occurring in young children. STS
has been shown to reduce cisplatin induced hearing loss. SIOPEL 6 was a Phase 3 randomized trial to assess the efficacy of STS in reducing ototoxicity in
young children treated with cisplatin (Cis) for Standard Risk Hepatoblastoma (SR-HB).

Design / Methods:

Newly diagnosed patients with SR-HB, defined as tumor limited to PRETEXT I, II or III, no portal or hepatic vein involvement, no intra-abdominal
extrahepatic disease, AFP >100ng/ml and no metastases, were randomized to Cis or Cis+STS for 4 preoperative and 2 postoperative courses. Cisplatin
80mg/m2 was administered over 6 hours, STS 20g/m2 was administered intravenously over 15 minutes exactly 6 hours after stopping cisplatin. Tumor
response was assessed after 2 and 4 preoperative cycles with serum AFP and liver imaging. In case of progressive disease (PD), STS was to be stopped and
doxorubicin 60mg/m2 combined with cisplatin.  The primary endpoint was centrally reviewed absolute hearing threshold, at the age of ≥3.5 years by pure
tone audiometry.

Results:

109 randomized patients (52 Cisplatin only ("Cis") and 57 Cis+STS) were evaluable. The combination of Cis+STS was generally well tolerated. With a
patient follow-up time of 52 months, the three-year Event Free Survival ("EFS") for Cis was 78.8% Cisplatin and 82.1% for the Cis + STS. The three-year
Overall Survival ("OS") is 92.3% for Cis and 98.2% for Cis + STS. Treatment failure defined as Progressive Disease ("PD") at 4 cycles was equivalent in
both arms. Among the first 101 evaluable patients, hearing loss occurred in 29/46=63.0% under Cis and in 18/55=32.7% under Cis +STS, corresponding to
a relative risk of 0.52(P=0.002).

Conclusions:

This  randomized  Phase  3  trial  in  SR-HB  of  cisplatin  versus  cisplatin  plus  STS  shows  that  the  addition  of  STS  significantly  reduces  the  incidence  of
cisplatin-induced hearing loss without any evidence of tumor protection.

COG ACCL0431

In March 2008, we announced the activation of a Phase 3 trial with STS to prevent hearing loss in children receiving cisplatin-based chemotherapy in
collaboration with the Children’s Oncology Group. The goal of this Phase 3 study was to evaluate in a multi-centered, randomized trial whether STS is an
effective and safe means of preventing hearing loss in children receiving cisplatin-based chemotherapy for newly diagnosed germ cell, liver
(hepatoblastoma), brain (medulloblastoma), nerve tissue (neuroblastoma) or bone (osteosarcoma) cancers. Eligible children, one to eighteen years of age,
were to receive cisplatin according to their disease-specific regimen and, upon enrollment in this study, were randomized to receive STS or not. Efficacy of
STS was determined through comparison of hearing sensitivity at follow-up relative to baseline measurements using standard audiometric techniques. The
Children’s Oncology Group was responsible for funding the clinical activities for the study and we were responsible for providing the drug, drug
distribution and pharmacovigilance, or safety monitoring, for the study. The trial completed enrollment of 131 pediatric patients in the first quarter of 2012.
The final results of COG ACCL0431 were published in Lancet Oncology in December 2016.

COG ACCL0431 - Results

COG Study ACCL0431, “A Randomized Phase 3 Study of Sodium Thiosulfate for the Prevention of Cisplatin-Induced Ototoxicity in Children,” finished
enrollment of 131 patients of which 125 were eligible patients. The patients had been previously diagnosed with childhood cancers.

The primary endpoint was to evaluate the efficacy of STS for prevention of hearing loss in children receiving cisplatin chemotherapy (hypothesis: 50%
relative reduction in hearing loss).

3

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Secondary endpoints included:

·
Compare change in mean hearing thresholds.
Compare incidence of other Grade 3/4 toxicities (renal and hematological).
·
· Monitor Event Free Survival (EFS) and Overall Survival (OS) in two groups.

125 eligible subjects were enrolled with germ cell tumor (32), osteosarcoma (29), neuroblastoma (26), medulloblastoma/pnet (26), hepatoblastoma (7), or
other (5). Of these, 104 subjects (64 male and 29 <5 years old) were evaluable for the primary endpoint.

Subjects  were  randomized  either  to  no  treatment  (control)  or  treatment  with  STS  16  grams/m2  IV  over  15  minutes,  6  hours  after  each  cisplatin  dose.
Hearing was measured using standard audiometry for age and data was reviewed centrally using American Speech-Language-Hearing Association criteria.

The proportion of subjects with hearing loss assessed at 4 weeks post the final cisplatin dose (primary endpoint):

·
·

The proportion of hearing loss for STS vs. Control was 28.6% (14/49) vs. 56.4% (31/55), respectively (p=0.004).
In a predefined subgroup of patients less than 5 years old with 29 eligible subjects: STS vs. Control was 21.4% (3/14) vs. 73.3% (11/15),
respectively (p=0.005).

Conclusions:

·

·

STS protects against cisplatin-induced hearing loss in children across a heterogeneous range of tumor types, with even stronger efficacy in the
protocol predefined subgroup of patients under five years old, and is not associated with serious adverse events attributed to its use.
Further potential clinical use will be informed by the final results of SIOPEL 6 study.

Intellectual Property

Patents are important to developing and protecting our competitive position. Our general policy is to seek patent protection in the United States, major
European countries, Japan, Canada and other jurisdictions as appropriate for our compounds and methods. U.S. patents, as well as most foreign patents, are
generally effective for 20 years from the date the earliest (priority) application was filed; however, U.S. patents that issue on applications filed before
June 8, 1995 may be effective until 17 years from the issue date, if that is later than the twenty-year date. In some cases, the patent term may be extended to
recapture a portion of the term lost during the U.S. FDA regulatory review or because of U.S. Patent and Trademark Office, or USPTO, delays in
prosecuting the application. The duration of foreign patents varies similarly, in accordance with local law. Currently, we have licensed from OHSU two
U.S. and nine foreign patents. The patents licensed from OHSU expire in Europe in April of 2021 and expire in the United States in December of 2038.
Further, in September 2020, a U.S. patent was issued to us that captures the unique anhydrous form of the active ingredient in our PEDMARKTM product,
as well as related methods of synthesis.  This patent is eligible for listing in the FDA Orange Book, and reflects our strategy to expand and diversify our
intellectual property portfolio to obtain protection for our PEDMARKTM product. Additionally, there is one patent pending that we license from OHSU
and one additional patent pending owned by us.

In addition, periods of marketing exclusivity for PEDMARKTM may also be possible in the United States under orphan drug status and in Europe under
European Market Exclusivity for Pediatric Use. We obtained U.S. Orphan Drug Designation for the use of PEDMARKTM in the prevention of platinum-
induced ototoxicity in pediatric patients in 2004 which provides 7.5 years of market exclusivity upon FDA approval of our NDA. We plan to pursue
European Market Exclusivity for Pediatric Use upon approval of the MAA which would allow for 10 years of market exclusivity.

Our success is significantly dependent on our ability to obtain and maintain patent protection for PEDMARKTM, both in the United States and abroad. Our
patent position and proprietary rights are subject to various risks and uncertainties. Please read the “Risk Factors” in Item 1A of this Annual Report for
information about certain risks and uncertainties that may affect our patent position and proprietary rights.

We also rely upon unpatented confidential information to remain competitive. We protect such information principally through confidentiality agreements
with our employees, consultants, outside scientific collaborators, and other advisers. In the case of our employees, these agreements also provide, in
compliance with relevant law, that inventions and other intellectual property conceived by such employees during their employment shall be our exclusive
property.

Corporate Relationships

License Agreement with Oregon Health & Science University

On February 20, 2013, we entered into a new exclusive license agreement with OHSU for exclusive worldwide license rights to intellectual property
directed to thiol-based compounds, including PEDMARKTM, and their use in oncology (the "OHSU Agreement"). OHSU will receive certain milestone
payments, royalty on net sales for licensed products and a royalty on any consideration received from sublicensing of the licensed technology.

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On May 18, 2015, we negotiated an amendment ("Amendment 1") to the OHSU Agreement, which expands our exclusive license to include the use of N-
acetylcysteine as a standalone therapy and/or in combination with STS for the prevention of ototoxicity induced by chemotherapeutic agents to treat
cancers. Further, Amendment 1 adjusts select milestone payments entered in the OHSU Agreement including but not limited to the royalty rate on net sales
for licensed products, royalty rate from sublicensing of the licensed technology and the fee payable upon the regulatory approval of a licensed product.

The term of the OHSU Agreement as amended by Amendment 1 expires on the date of the last to expire claim(s) covered in the patents licensed to us or 8
years, whichever is later. In the event a licensed product obtains regulatory approval and is covered by the Orphan Drug Designation, the parties will in
good faith amend the term of the agreement. PEDMARK is currently protected by methods of use patents that we exclusively license from OHSU that
expire in Europe in 2021 and that expire in the United States in 2038. The OHSU Agreement is terminable by either us or OHSU in the event of a material
breach of the agreement by either party after 45 days prior written notice. We also have the right to terminate the OHSU Agreement at any time upon 60
days prior written notice and payment of all fees due to OHSU under the OHSU Agreement.

COVID-19

Our operations may be affected by the ongoing COVID-19 pandemic. The ultimate disruption which may be caused by the outbreak is uncertain; however,
it may result in a material adverse impact on our financial position, operations and cash flows. Possible effects may include, but are not limited to,
disruption to our product launch which includes the ability of sales reps to communicate with oncologists, absenteeism in our labor workforce,
unavailability of products and supplies used in operations, and a decline in value of our assets, including inventories, property and equipment, and
marketable securities.

COVID-19 has not had a material effect on our operations to date as we have historically had a workforce which works remotely, preparations for product
launch have been under the assumption of a virtual launch, and product supplies have not been impacted.

Competition

The biotechnology and pharmaceutical industries are extremely competitive. Our potential competitors are many in number and include major and mid-
sized pharmaceutical and biotechnology companies. Many of our potential competitors have significantly more financial, technical and other resources than
we do, which may give them a competitive advantage. In addition, they may have substantially more experience in effecting strategic combinations, in-
licensing technology, developing drugs, obtaining regulatory approvals and manufacturing and marketing products. We cannot give any assurances that we
can compete effectively with these other biotechnology and pharmaceutical companies. We expect that if PEDMARKTM achieves regulatory approval for
sale, it will compete on the basis of drug efficacy, safety, patient convenience, reliability, ease of manufacture, price, marketing, distribution, and patent
protection, among other variables. Our competitors may develop technologies or drugs that are more effective, safer or more affordable than any we may
develop.

We are not aware of any commercially available agents that reduce the incidence of hearing loss associated with the use of platinum-based anti-cancer
agents, for which purpose we are developing PEDMARKTM. There are several potential competitive agents with activity in preclinical or limited clinical
settings. These include: D-methionine, an amino acid that has been shown to protect against hearing loss in experimental settings but was demonstrated to
be inferior to PEDMARKTM in comparative studies; SPI-3005, an oral agent primarily being developed by Sound Pharmaceuticals for noise and age-
related hearing loss but in early Phase II trials for chemotherapy related hearing loss, which mimics glutathione peroxidase and induces the intracellular
induction of glutathione; N-acetylcysteine and amifostine, which have shown effectiveness (but less than PEDMARKTM) in experimental systems; and
Vitamin E, salicylate and tiopronin, which have all demonstrated moderate activity in rat models to protect against cisplatin-induced ototoxicity, but no
clinical trials have been completed and DB-020 a clinical stage candidate in an ongoing Phase1b trial being developed by Decibel Therapeutics. Cochlear
implants, which are small electronic devices that are surgically placed in the inner ear to assist with certain types of deafness, are utilized to offer some
relief for hearing loss associated with the use of platinum-based anti-cancer agents, but are often suboptimal.

Manufacturing and Clinical Supplies

We do not own or operate manufacturing facilities for the production of commercial or clinical quantities of any product, including PEDMARKTM. We
currently rely on a small number of third-party manufacturers to produce compounds used in our product development and commercial activities and
expect to continue to do so to meet the preclinical and clinical requirements of our potential products and for all of our commercial needs. We currently
have long-term commercial supply agreements with certain third-party manufacturers. Our manufacturing and processing agreements require that all third-
party contract manufacturers and processors produce active pharmaceutical ingredients and finished products in accordance with the FDA’s current Good
Manufacturing Practices (“cGMP”) and all other applicable laws and regulations. We maintain confidentiality agreements with potential and existing
manufacturers in order to protect our proprietary rights related to PEDMARKTM.

5

 
 
 
 
 
 
 
 
 
 
 
 
Some of the critical materials and components used in manufacturing PEDMARKTM are sourced from single suppliers. An interruption in the supply of a
key material could significantly delay our research and development process or increase our expenses for commercialization or development of
PEDMARKTM. Specialized materials must often be manufactured for the first time for use in drug delivery technologies, or materials may be used in the
technologies in a manner that is different from their customary commercial uses. The quality of materials can be critical to the performance of a drug
delivery technology, so a reliable source that provides a consistent supply of materials is important. Materials or components needed for our drug delivery
technologies may be difficult to obtain on commercially reasonable terms, particularly when relatively small quantities are required or if the materials
traditionally have not been used in pharmaceutical products.

Government Regulation

The production and manufacture of our product candidate and our research and development activities are subject to significant regulation for safety,
efficacy and quality by various governmental authorities around the world. Before new pharmaceutical products may be sold in the U.S. and other
countries, clinical trials of the product must be conducted, and the results submitted to appropriate regulatory agencies for approval. Clinical trial programs
must establish efficacy, determine an appropriate dose and regimen, and define the conditions for safe use. This is a high-risk process that requires stepwise
clinical studies in which the candidate product must successfully meet predetermined endpoints. In the U.S., the results of the preclinical and clinical
testing of a product are then submitted to the FDA in the form of a Biologics License Application or a NDA. In response to these submissions, the FDA
may grant marketing approval, request additional information or deny the application if it determines the application does not provide an adequate basis for
approval. Similar submissions are required by authorities in other jurisdictions who independently assess the product and may reach the same or different
conclusions.

The receipt of regulatory approval often takes a number of years, involves the expenditure of substantial resources and depends on a number of factors,
including the severity of the disease in question, the availability of alternative treatments and the risks and benefits demonstrated in clinical trials. On
occasion, regulatory authorities may require larger or additional studies, leading to unanticipated delay or expense. Even after initial approval from the
FDA or other regulatory agencies has been obtained, further clinical trials may be required to provide additional data on safety and effectiveness.
Additional trials are required to gain clearance for the use of a product as a treatment for indications other than those initially approved. Furthermore, the
FDA and other regulatory agencies require companies to disclose clinical trial results. Failure to disclose such results within applicable time periods could
result in penalties, including civil monetary penalties.

In Canada, these activities are subject to regulation by Health Canada’s Therapeutic Products Directorate, or TPD, and the rules and regulations
promulgated under the Food and Drug Act. In the United States, drugs and biological products are subject to regulation by the FDA. The FDA requires
licensing of manufacturing and contract research facilities, carefully controlled research and testing of products and governmental review and approval of
results prior to marketing therapeutic products. Additionally, the FDA requires adherence to “Good Laboratory Practices” as well as “Good Clinical
Practices” during clinical testing and “Good Manufacturing Practices” and adherence to labeling and supply controls. The systems of new drug approvals in
Canada and the United States are substantially similar and are generally considered to be among the most rigorous in the world.

Generally, the steps required for drug approval in Canada and the United States, specifically in cancer related therapies, include:

·

·

·

Preclinical Studies: Preclinical studies, also known as non-clinical studies, primarily involve evaluations of pharmacology, toxic effects,
pharmacokinetics and metabolism of a drug in animals to provide evidence of the relative safety and bioavailability of the drug prior to its
administration to humans in clinical studies. A typical program of preclinical studies takes 18 to 24 months to complete. The results of the
preclinical studies as well as information related to the chemistry and comprehensive descriptions of proposed human clinical studies are then
submitted as part of the Investigational New Drug Application to the FDA, a Clinical Trial Application to the TPD, or similar submission to other
foreign regulatory bodies. This is necessary in Canada, the United States and most other countries prior to undertaking clinical studies. Additional
preclinical studies are conducted during clinical development to further characterize the toxic effects of a drug prior to submitting a marketing
application.
Phase 1 Clinical Trials: Most Phase 1 clinical trials take approximately one year to complete and are usually conducted on a small number of
healthy human subjects to evaluate the drug’s safety, tolerability and pharmacokinetics. In some cases, such as cancer indications, Phase 1 clinical
trials are conducted in patients rather than healthy volunteers.
Phase 2 Clinical Trials: Phase 2 clinical trials typically take one to two years to complete and are generally carried out on a relatively small
number of patients, generally between 15 and 50, in a specific setting of targeted disease or medical condition, in order to provide an estimate of
the drug’s effectiveness in that specific setting. This phase also provides additional safety data and serves to identify possible common short-term
side effects and risks in a somewhat larger group of patients. Phase 2 testing frequently relates to a specific disease, such as breast or lung cancer.
Some contemporary methods of developing drugs, particularly molecularly targeted therapies, do not require broad testing in specific diseases, and
instead permit testing in subsets of patients expressing the particular marker. In some cases, such as cancer indications, the company sponsoring
the new drug may submit a marketing application to seek accelerated approval of the drug based on evidence of the drug’s effect on a “surrogate
endpoint” from Phase II clinical trials. A surrogate endpoint is a laboratory finding or physical sign that may not be a direct measurement of how a
patient feels, functions or survives, but is still considered likely to predict therapeutic benefit for the patient. If accelerated approval is received,
the company sponsoring the new drug must continue testing to demonstrate that the drug indeed provides therapeutic benefit to the patient.

6

 
 
 
 
 
 
 
 
 
·

Phase 3 Clinical Trials: Phase 3 clinical trials typically take two to four years to complete and involve tests on a much larger population of
patients suffering from the targeted condition or disease. These studies involve conducting controlled testing and/or uncontrolled testing in an
expanded patient population, numbering several hundred to several thousand patients, at separate test sites, known as multi-center trials, to
establish clinical safety and effectiveness. These trials also generate information from which the overall benefit-risk relationship relating to the
drug can be determined and provide a basis for drug labeling. Phase 3 trials are generally the most time consuming and expensive part of a clinical
trial program. In some instances, governmental authorities, such as the FDA, will allow a single Phase 3 clinical trial to serve as a pivotal efficacy
trial to support a Marketing Application.

· Marketing Application: Upon completion of Phase 3 clinical trials, the pharmaceutical company sponsoring the new drug assembles all the

chemistry, preclinical and clinical data and submits it to the TPD or the FDA as part of a New Drug Submission in Canada or a NDA in the United
States. The marketing application is then reviewed by the applicable regulatory body for approval to market the product. The review process
generally takes twelve to eighteen months.

Any clinical trials that we conduct may not be successfully completed, either in a satisfactory time period or at all. The typical time periods described
above may vary substantially and may be materially longer. In addition, the FDA and its counterparts in other countries have considerable discretion to
discontinue trials if they become aware of any significant safety issues or convincing evidence that a therapy is not effective for the indication being tested.
It is possible the FDA and its counterparts in other countries may not (i) allow clinical trials to proceed at any time after receiving an Investigational New
Drug, (ii) allow further clinical development phases after authorizing a previous phase, or (iii) approve marketing of a drug after the completion of clinical
trials.

While European, U.S. and Canadian regulatory systems require that medical products be safe, effective, and manufactured according to high quality
standards, the drug approval process in Europe differs from that in the United States and Canada and may require us to perform additional preclinical or
clinical testing regardless of whether FDA or TPD approval has been obtained. The amount of time required to obtain necessary approvals may be longer
or shorter than that required for FDA or TPD approval. European Union Regulations and Directives generally classify health care products either as
medicinal products, medical devices or in vitro diagnostics. For medicinal products, marketing approval may be sought using either the centralized
procedure of the European Agency for the Evaluation of Medicinal Products, or EMEA, or the decentralized, mutual recognition process. The centralized
procedure, which is mandatory for some biotechnology derived products, results in an approval recommendation from the EMEA to all member states,
while the European Union mutual recognition process involves country by country approval.

The NDA Approval Process

Assuming successful completion of the required clinical testing, the results of the preclinical studies and clinical trials, including negative or ambiguous
results as well as positive findings, together with detailed information relating to the product’s chemistry, manufacture, controls and proposed labeling,
among other things, are submitted to the FDA as part of an NDA to support approval to market the product for one or more indications. In most cases, the
submission of an NDA is subject to a substantial application user fee. Fennec anticipates a waiver of the application user fee related to its NDA for
PEDMARK TM.

The FDA is required to conduct a preliminary review of an NDA within the first 60 days after submission, before accepting it for filing, to determine
whether it is sufficiently complete to permit a substantive review. The FDA may accept the NDA for filing, potentially refuse to file the NDA due to
deficiencies but work with the applicant to rectify the deficiencies (in which case the NDA is filed upon resolution of the deficiencies) or refuse to file the
NDA. The FDA must notify the applicant of a refusal to file a decision within 60 days after the original receipt date of the application. If the FDA refuses
to file the NDA the applicant may resubmit the NDA with the deficiencies addressed. The resubmitted NDA is considered a new application subject to a
new review goal, as described below. If the NDA is refused for filing, the FDA will refund 75 percent of the application fee. Upon resubmission, a new
application fee will be required, unless the applicant is eligible for a waiver or reduction. The resubmitted application is also subject to review before the
FDA accepts it for filing. Once an NDA is accepted for filing, the FDA begins an in-depth substantive review. Under the Prescription Drug User Fee Act,
or PDUFA, and the FDA’s commitments under the current PDUFA reauthorization, the FDA has a goal of reviewing and acting on 90% of standard non-
priority NDA applications for drugs that are not new molecular entities within ten months from the FDA’s receipt of the NDA.

The FDA reviews an NDA to determine, among other things, whether the drug is safe and effective for its intended use and whether the facility in which it
is manufactured, processed, packaged or held meets standards designed to assure the product’s continued safety, quality and purity. The FDA is required to
refer an application for a novel drug to an advisory committee or explain why such referral was not made. An advisory committee is a panel of independent
experts, including clinicians and other scientific experts, that reviews, evaluates and provides a recommendation in response to specific questions raised by
the FDA, which may include whether the application should be approved and under what conditions. The FDA is not bound by the recommendations of an
advisory committee, but it considers such recommendations carefully when making decisions.

Before approving an NDA, the FDA may inspect the facility or facilities where the product is manufactured. The FDA will not approve an application
unless it determines that the manufacturing processes and facilities are in compliance with current Good Manufacturing Practices (cGMP) requirements and
adequate to assure consistent production of the product within required specifications. Additionally, before approving an NDA, the FDA will typically
inspect one or more clinical investigational sites to evaluate the integrity of the data and confirm compliance with current Good Clinical Practices (cGCP).

7

 
 
 
 
 
 
 
 
 
 
After the FDA evaluates the NDA and conducts its inspections, it may issue an approval letter or a CRL. An approval letter authorizes the commercial
marketing of the drug subject to specific prescribing information for specific indications and, if applicable, specific post-approval requirements. A CRL
indicates that the review cycle of the application is complete and the application is not ready for approval in its present form. After receiving a CRL, the
applicant must decide within twelve months (subject to extension), if it wants to resubmit the NDA addressing the deficiencies identified by the FDA in the
CRL, withdraw the NDA, or request an opportunity for a hearing to challenge the FDA’s determination. A CRL may require additional clinical data and/or
an additional pivotal Phase 3 clinical trial(s), and/or other significant, expensive and time-consuming requirements related to clinical trials, nonclinical
studies or manufacturing. Even if such data are submitted, the FDA may ultimately decide that the NDA does not satisfy the criteria for approval. Data
from clinical trials are not always conclusive and the FDA may interpret data differently than we interpret data.

The FDA also may require implementation of a Risk Evaluation and Mitigation Strategy, or REMS, to mitigate any identified or suspected serious risks.
The REMS could include a medication guide, physician communication plan, assessment plan and elements to assure safe use, such as restricted
distribution methods, patient registries or other risk minimization tools.

The drug testing and approval process requires substantial time, effort and financial resources, and may take several years to complete. Data obtained from
clinical activities are not always conclusive and may be susceptible to varying interpretations, which could delay, limit or prevent marketing approval. The
FDA may not grant marketing approval on a timely basis, or at all.

Even if the FDA approves a product, it may limit the approved indications for use for the product. The FDA requires that the approved product labeling
include information regarding contraindications, warnings or precautions. It may also require that post-approval studies, including a long-term registry, be
conducted to further assess a drug’s safety after approval, require testing and surveillance programs to monitor the product after commercialization, or
impose other conditions, including distribution restrictions or other risk management mechanisms, which can materially affect the potential market and
profitability of the product. The FDA may prevent or limit further marketing of a product based on the results of post-marketing studies or surveillance
programs. After approval, some types of changes to the approved product, such as adding new indications or labeling claims or manufacturing changes may
be subject to further testing requirements and FDA review and approval. Also after approval, the FDA may require labeling changes as new information
becomes known, particularly if new risks are identified, such as unexpected adverse events. The FDA has the authority to prevent or limit further marketing
of a drug based on the results of these post-marketing studies and programs or other information that may become known after approval.

Other Regulatory Requirements.

Drugs manufactured or distributed pursuant to FDA approvals are subject to pervasive and continuing regulation by the FDA, including, among other
things, annual establishment registration, product listing, user fees, compliance with requirements regarding cGMP, recordkeeping, periodic reporting,
product sampling and distribution, advertising and promotion, and adverse drug experience monitoring and reporting with the product. After approval, most
changes to the approved product labeling, such as adding new indications, are subject to prior FDA review and approval. Also, any post-approval changes
in the drug substance, drug product, production process, quality controls, equipment, or facilities that have a substantial potential to have an adverse effect
on the identity, strength, quality, purity, or potency of the drug product are subject to FDA review and approval. Any such changes that have a moderate
potential to have an adverse effect on the identity, strength, quality, purity, or potency of the drug product may not be implemented until 30 days after the
FDA receives a supplement for the change. All manufacturing facilities, as well as records required to be maintained under FDA regulations, are subject to
inspection or audit by the FDA. In addition, manufacturers generally are required to pay annual user fees for approved products and a user fee for the
submission of each new or supplemental application.

The FDA may impose a number of post-approval requirements as a condition of approval of an NDA. For example, the FDA may require post-approval
testing, including Phase 4 clinical trials, and surveillance to further assess and monitor the product’s safety and effectiveness after commercialization. The
Food and Drug Administration Amendments Act of 2007 gave the FDA the authority to require a REMS from drug manufacturers to manage a known or
potential serious risk associated with the drug and to ensure that the benefits of a drug outweigh its risks. Examples of a REMS include, but are not limited
to, a Medication Guide, a patient package insert to help mitigate a serious risk of the drug, and a communication plan to healthcare providers to support the
implementation of an element of the REMS.

In addition, drug manufacturers and other entities involved in the manufacture and distribution of approved drugs are required to register their
establishments with the FDA and register or obtain permits or licenses in states where they do business, and are subject to periodic unannounced
inspections by the FDA and state regulatory authorities with jurisdiction over their activities to determine compliance with regulatory requirements. A drug
manufacturer is responsible for ensuring that its third-party contractors operate in compliance with applicable laws and regulations including the cGMP
regulation. The failure of a drug manufacturer or any of its third-party contractors to comply with federal or state laws or regulations may subject the drug
manufacturer to possible legal or regulatory action, such as an untitled letter, warning letter, recall, suspension of manufacturing or distribution or both,
suspension of state permit or license, seizure of product, import detention, injunctive action, and civil and criminal penalties.

8

 
 
 
 
 
 
 
 
 
 
Changes to the manufacturing process are strictly regulated and often require prior FDA approval before being implemented. FDA regulations also require
a drug manufacturer to conduct investigations and implement appropriate corrective actions to address any deviations from cGMP requirements and impose
reporting and documentation requirements upon the manufacturer and any third-party contractors (including contract manufacturers and laboratories)
involved in the manufacture of a drug product. Accordingly, manufacturers must continue to expend significant time, money and effort to maintain and
ensure ongoing cGMP compliance and to confirm and ensure ongoing cGMP compliance of their third-party contractors.

Once an approval is granted, the FDA may withdraw the approval if, among other things, there is information that the drug is unsafe for use under the
approved conditions of use; new information or evidence that, evaluated together with evidence available to the FDA at the time of approval, shows that the
drug is not shown to be safe for use under the approved conditions of use; new information that, evaluated together with the evidence available to the FDA
at the time of approval, shows there is a lack of substantial evidence of effectiveness; the approved application contains an untrue statement of material
fact; or that the required patient information was not submitted within 30 days after receiving notice from the FDA of the failure to submit such
information. Later discovery of previously unknown problems with a product, including adverse events of unanticipated severity or frequency, or with
manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved labeling to add new safety and risk
information; imposition of a post-market study requirement to assess new safety risks; or implementation of a REMS that may include distribution or other
restrictions.

The FDA closely regulates drug advertising and promotional activities, including promotion of an unapproved drug, direct-to-consumer advertising,
dissemination of scientific information about a drug not on the approved labeling, off-label promotion, communications with payors and formulary
committees, industry-sponsored scientific and educational activities, and promotional activities involving the internet and social media. A company’s
product claims must be true and not misleading, provide fair balance, provide adequate risk information, and be consistent with the product labeling
approved by the FDA. Failure to comply with these requirements can lead to legal or regulatory actions including, among other things, warning letters,
corrective advertising, injunction, violation and related penalties under the False Claims Act and can result in reputational and economic harm.

Physicians may prescribe FDA-approved drugs for uses that are not described in the product’s labeling and that differ from those uses tested by the
manufacturer. Such off-label uses occur across medical specialties. Physicians may believe that such off-label uses are the best treatment for many patients
in varied circumstances. The FDA does not regulate the behavior of physicians in their choice of treatments for their individual patients. The FDA does,
however, regulate manufacturers’ communications about their drug products and interprets the FFDCA to prohibit pharmaceutical companies from
promoting their FDA-approved drug products for uses that are not specified in the FDA-approved labeling. Companies that market drugs for off-label uses
have been subject to warning letters, related costly litigation, criminal prosecution, and civil liability under the FFDCA and the False Claims Act.

In addition, the distribution of prescription pharmaceutical products is subject to the Prescription Drug Marketing Act, or PDMA, as amended by the Drug
Supply Chain Security Act, which regulates the distribution of drug and drug samples at the federal level, and sets minimum standards for the registration
and regulation of wholesale drug distributors by the states.

Good Clinical Practices

The FDA and other regulatory agencies promulgate regulations and standards, commonly referred to as current Good Clinical Practices, for designing,
conducting, monitoring, auditing and reporting the results of clinical trials to ensure that the data and results are accurate and that the trial participants are
adequately protected. The FDA and other regulatory agencies enforce Good Clinical Practices through periodic inspections of trial sponsors, principal
investigators and trial sites. If our study sites fail to comply with applicable Good Clinical Practices, the clinical data generated in our clinical trials may be
deemed unreliable and relevant regulatory agencies may require us to perform additional clinical trials before approving our marketing applications.

Good Manufacturing Practices

The FDA and other regulatory agencies regulate and inspect equipment, facilities and processes used in the manufacture of pharmaceutical and biological
products prior to approving a product. If, after receiving approval from regulatory agencies, a company makes a material change in manufacturing
equipment, location or process, additional regulatory review and approval may be required. All facilities and manufacturing techniques that may be used
for the manufacture of our products must comply with applicable regulations governing the production of pharmaceutical products known as "Good
Manufacturing Practices."

Orphan Drug Act

Under the Orphan Drug Act, the FDA may grant orphan drug designation to drugs intended to treat a “rare disease or condition,” which generally is a
disease or condition that affects fewer than 200,000 individuals in the U.S. If a product which has an orphan drug designation subsequently receives the
first FDA approval for that drug for the indication for which it has such designation, the product is entitled to orphan exclusivity, i.e., the FDA may not
approve any other application submitted by a different applicant to market the same drug for the same indication for a period of seven years following
marketing approval, except in certain very limited circumstances, such as if the later product is shown to be clinically superior to the approved product with
orphan drug exclusivity. Legislation similar to the Orphan Drug Act has been enacted in other countries, including within the European Union.

9

 
 
 
 
 
 
 
 
 
 
 
 
 
Pediatric Marketing Use Authorization

The PUMA approval is typically granted by the European Commission, based on a review by the European Medecines Agency, and is intended exclusively
for pediatric (patients under 18 years of age) use. Such PUMA approval is ultimately valid in all countries within the European Economic Area (which
excludes the United Kingdom as of February 1, 2020).

The PUMA was introduced by the EU Paediatric Regulation for medicines that are:

·
·
·

Normally contain an already authorized active ingredient;
Are no longer covered by a supplementary protection certificate (SPC) or a patent that qualifies for a SPC;
Are to be exclusively developed for use in children.

The PUMA process was established to make it more efficient for pharmaceutical companies to invest in the development of drugs for children. PUMA
drugs receive 8 plus 2 years of regulatory data and marketing protection. and the applications are, in part, exempt from fees. The regulatory protection does
not prevent off-label use of other drugs with the same active substance and indication for adults, nor pharmacy compounding.

Other Laws

Our present and future business has been and will continue to be subject to various other laws and regulations. Various laws, regulations and
recommendations relating to safe working conditions, laboratory practices, the experimental use of animals, and the purchase, storage, movement, import
and export and use and disposal of hazardous or potentially hazardous substances, including radioactive compounds and infectious disease agents, used in
connection with our research work are or may be applicable to our activities. Certain agreements entered into by us involving exclusive license rights may
be subject to national or supranational antitrust regulatory control, the effect of which cannot be predicted. The extent of government regulation, which
might result from future legislation or administrative action, cannot accurately be predicted.

Research and Development

Our research and development efforts have been focused on the development of PEDMARKTM since 2013.

We have established relationships with contract research organizations, universities and other institutions, which we utilize to perform many of the day-to-
day activities associated with our drug development. Where possible, we have sought to include leading scientific investigators and advisors to enhance our
internal capabilities. Research and development issues are reviewed internally by our executive management and supporting scientific team.

Research and development expenses totaled $5.1 million and $5.6 million for the fiscal years ended December 31, 2020 and 2019, respectively. We have
decreased slightly our research and development expenses related to PEDMARKTM as the Company’s efforts have shifted to pre-commercialization
activities with some continued regulatory and manufacturing expenses associated with the resubmission of the NDA for PEDMARKTM in response to the
CRL discussed above under the heading “Business – Overview – Product Candidate” and elsewhere in this Annual Report.

Our product candidate still requires significant, time-consuming and costly research and development, testing and regulatory clearances. In developing our
product candidate, we are subject to risks of failure that are inherent in the development of products based on innovative technologies. For example, it is
possible that our product candidate will be ineffective or toxic, or will otherwise fail to receive the necessary regulatory clearances. There is a risk that our
product candidate will be uneconomical to manufacture or market or will not achieve market acceptance. There is also a risk that third parties may hold
proprietary rights that preclude us from marketing our product candidate or that others will market a superior or equivalent product. As a result of these
factors, we are unable to accurately estimate the nature, timing and future costs necessary to complete the development of this product candidate. In
addition, we are unable to reasonably estimate the period when material net cash inflows could commence from the sale, licensing or commercialization of
such product candidate, if ever.

Employees

At December 31, 2020, we had nine employees all of which are full time. In addition, we use independent contractors to perform certain of our daily
operations.

Company Information

We incorporated under the Canada Business Corporations Act ("CBCA”) in September 1996. Effective on August 25, 2011, the Company continued from
the CBCA to the Business Corporations Act (British Columbia) (the “Continuance”). We have four wholly-owned subsidiaries: Oxiquant, Inc. and Fennec
Pharmaceuticals, Inc., both Delaware corporations, Cadherin Biomedical Inc., a Canadian company, and Fennec Pharmaceuticals (EU) Limited (“Fennec
Limited”), an Ireland company. With the exception of Fennec Pharmaceuticals, Inc., all subsidiaries are inactive.

10

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our corporate website is www.fennecpharma.com. We make our periodic and current reports, together with amendments to these reports, filed or furnished
pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended, or the Exchange Act, available on our website, free of charge, as
soon as reasonably practicable after such material is electronically filed with, or furnished to, the Securities and Exchange Commission, or the SEC.
Members of the public may also read and copy any materials we file with, or furnish to, the SEC at the SEC’s Public Reference Room at 100 F Street, NE,
Washington, DC 20549. To obtain information on the operation of the Public Reference Room, please call the SEC at 1-800-SEC-0330. The SEC maintains
a website at www.sec.gov that contains the reports, proxy statements and other information that we file or furnish electronically with the SEC. The
Canadian securities regulatory authorities maintain a website at www.sedar.com that contains our filings with the Canadian securities regulatory authorities.
Our website and the information contained therein or connected thereto is not intended to be incorporated into this Annual Report or any other report or
information we file with the SEC or Canadian securities regulatory authorities.

Item 1A.

Risk Factors

An investment in our common shares involves a significant risk of loss. You should carefully read this entire Annual Report and should give particular
attention to the following risk factors. You should recognize that other significant risks may arise in the future, which we cannot reasonably foresee at this
time. Also, the risks that we now foresee might affect us to a greater or different degree than currently expected. There are a number of important factors
that could cause our actual results to differ materially from those expressed or implied by any of our forward-looking statements in this Annual
Report. These factors include, without limitation, the risk factors listed below, and other factors presented throughout this Annual Report and any other
documents filed by us with the SEC and the Canadian securities regulators on SEDAR.

Risk Factors Summary

The following is a summary of the principal risks that could adversely affect our business, operations, and financial results. A more thorough discussion of
these and other risks follows this summary.

Risks Related to Our Business

· We have a history of significant losses and have generated de minimis licensing revenue and no revenue from the sale of products since our

·

inception.
PEDMARKTM is currently our only product candidate. PEDMARKTM is still in development and there is no assurance that it will receive
regulatory approval or that we will successfully develop it into a commercially viable product.

· We may be required to conduct additional clinical trials for PEDMARKTM, which would be costly and time-consuming to complete.
· We may require additional financing to obtain regulatory approval for and commercialize PEDMARKTM, and a failure to obtain this capital when

needed on acceptable terms, or at all, could force us to delay, limit, reduce, or terminate our product development, other operations, or
commercialization efforts.

· We are currently and may in the future be the target of securities litigation, which may be costly and time-consuming to defend.
·
·

Our business may be adversely affected by the ongoing COVID-19 pandemic.
Our business involves environmental risks and potential exposure to environmental liabilities.

Risks Related to the Clinical Development and Marketing Approval of Our Product Candidate

·

·

PEDMARKTM has not received marketing approval from the FDA or any comparable foreign authorities. These approval processes are costly,
time-consuming, and inherently unpredictable, and it is possible that our applications for marketing approval will be denied.
Our NDA for PEDMARKTM received a CRL from the FDA in August 2020, which identified deficiencies in the third-party manufacturing
facility that manufactures PEDMARKTM on our behalf.

Risks Related to Commercialization of Our Product Candidate

·

·

Even if we receive regulatory approvals for PEDMARKTM, it will still be subject to continued regulatory review and could be subject to labeling
and other restrictions.
Sales of PEDMARKTM, assuming it obtains regulatory approval, will depend on reimbursement by payers and these payers are subject to
pressures to contain costs. In addition, coverage and reimbursement for PEDMARKTM may be limited or unavailable in certain market segments.
PEDMARKTM targets diseases with small patient populations and we may not be effective at identifying patients.

·
· We may not be able to gain or maintain market acceptance of PEDMARKTM among the medical community, patients, or payers.
·

If we fail to comply with applicable healthcare laws and regulations, we may be subject to investigations and civil or criminal penalties and could
lose any regulatory approvals that we obtain for PEDMARKTM.

· We have just started to build our commercial team and have limited experience in commercializing pharmaceutical products.
Changes in healthcare laws and regulations, as well as changes in healthcare policy, could adversely affect our business.
·
PEDMARKTM may be subject to product liability claims.
·

11

 
 
 
 
 
 
 
 
 
 
 
 
 
Risks Related to Third Parties

· We rely on third parties to supply raw materials, to conduct clinical trials, and to manufacture PEDMARKTM. If these third parties fail to

satisfactorily perform for us, or if they fail to comply with applicable legal and regulatory requirements, it could have a material adverse effect on
our business. The above-referenced CRL resulted from deficiencies identified by the FDA in the third-party manufacturing facility that
manufactures PEDMARKTM on our behalf.

Risks Related to Our Intellectual Property

·

·

·
·
·

·

PEDMARKTM is based on intellectual property exclusively licensed to us by OHSU, and the license is terminable in the event of a breach by us
under the license agreement. If we were to lose our license from OHSU, we may be required to terminate any development and commercialization
of PEDMARKTM.
If we cannot obtain new patents, maintain our existing patents, and protect our trade secrets and other intellectual property, our business and
competitive position may be harmed.
Patent protection for PEDMARKTM may expire before we are able to realize its commercial value.
Changes in United States patent law could diminish the value of patents in general, thereby impairing our ability to protect PEDMARKTM.
If we are found to be infringing third-party patents, we may be forced to pay damages and/or obtain a license. If we cannot obtain a license, we
may be prevented from the development, manufacture, or commercialization of PEDMARKTM.
It is possible that we could lose market exclusivity for PEDMARKTM earlier than expected.

Risks Related to Our Industry

·

·

Drug development involves a lengthy and expensive process with an uncertain outcome, and results of earlier studies and trials may not be
predictive of future trial results.
The biotechnology and pharmaceutical industry, and in particular the field of cancer therapeutics where we are focused, is highly competitive. We
face significant competition from other pharmaceutical, biopharmaceutical, and biotechnology companies, many of which have significantly
greater financial, technical, and human resources than we do and may be better equipped to develop, manufacture, and market products.

Risks Related to Owning Our Common Shares

· We may be unable to maintain the listing of our common shares on the Nasdaq Capital Market or the TSX, which would make it more difficult for

·
·

·

shareholders to dispose of our common shares.
The market price of our common shares is highly volatile and could cause the value of your investment to significantly decline.
Our existing principal shareholders hold a substantial number of our common shares and may be able to exercise influence in matters requiring
approval of our shareholders.
There are a large number of our common shares underlying outstanding options, and reserved for issuance under our stock option plan, that may
be sold in the market, which could depress the market price of our shares and result in substantial dilution to our shareholders.

· We may need to raise additional funds in the future to continue our operations. Any equity offering could result in significant dilution to our

shareholders and decrease the value of our common shares. Any debt offering will increase our financial risk.

· We have not paid any dividends and do not anticipate declaring any dividends in the foreseeable future.
· We may be a passive foreign investment company, which could result in adverse United States federal income tax consequences to U.S. investors.

Risks Related to Our Business

We have a history of significant losses and have had no revenues to date through the sale of our products. If we do not generate significant
revenues, we will not achieve profitability.

To date, we have been engaged primarily in research and development activities. We have had no revenues through the commercial sale of products, and
we do not expect to have significant revenues until we are able to either sell our product candidate after obtaining applicable regulatory approvals or we
establish collaborations that provide us with up-front payments, licensing fees, milestone payments, royalties or other revenue. We have incurred
significant operating losses every year since our inception on September 3, 1996. We reported a net loss of approximately $18.1 million for the year ended
December 31, 2020 and reported a net loss of approximately $12.8 million for the year ended December 31, 2019. At December 31, 2020, we had an
accumulated deficit of approximately $162.1 million. We anticipate incurring substantial additional losses due to the need to spend substantial amounts on
activities required for regulatory approval of PEDMARKTM, commercial launch preparation of PEDMARKTM, anticipated research and development
activities, and general and administrative expenses, among other factors. We have not commercially introduced any products. Our ability to attain
profitability will depend upon our ability to fund and develop products that are safe, effective and commercially viable, to obtain regulatory approval for
the manufacture and sale of our product candidate and to license or otherwise market our product candidate successfully. Any revenues generated from
such product, assuming it is successfully developed, marketed and sold, may not be realized for a number of years. We may never achieve or sustain
profitability on an ongoing basis.

12

 
  
 
 
 
 
 
 
 
 
 
 
 
PEDMARKTM is currently our only product candidate and there is no assurance that we will successfully develop PEDMARKTM into a
commercially viable product.

Since our formation in September 1996, we have engaged in research and development programs. We have generated no revenue from product sales, do not
have any products currently available for sale, and none are expected to be commercially available for sale until we have completed regulatory approval of
PEDMARKTM. PEDMARKTM is currently our only product candidate. There can be no assurance that the research we fund and manage will lead
PEDMARKTM or any future product candidate to become a commercially viable product. We have completed two-Phase 3 studies for PEDMARKTM. We
anticipate substantial regulatory review prior to the commercialization of PEDMARKTM.

We may require additional financing to obtain marketing approval of PEDMARKTM and commercialize PEDMARKTM and a failure to obtain
this capital when needed on acceptable terms, or at all, could force us to delay, limit, reduce or terminate our product development, other
operations or commercialization efforts.

Based on available resources, we believe that our cash and cash equivalents of $30.3 million available as of December 31, 2020 are sufficient to fund our
anticipated operating and capital requirements to NDA approval and the commencement of commercialization efforts, subject to approval of our NDA.
Moreover, we expect to continue to incur losses for the foreseeable future as we continue our development of and seek marketing approvals for
PEDMARKTM. We may not be able to obtain additional financing in sufficient amounts or on acceptable terms when needed. If we fail to arrange for
sufficient capital on a timely basis, we may be required to curtail our business activities until we can obtain adequate financing. Debt financing must be
repaid regardless of whether or not we generate profits or cash flows from our business activities. Equity financing may result in dilution to existing
shareholders and may involve securities that have rights, preferences, or privileges that are senior to our common shares or other securities. If we cannot
raise sufficient capital when necessary, we will likely have to curtail operations and you may lose part or all of your investment.

If we do not maintain current or enter into new collaborations with other companies, we might not successfully develop our product candidate or
generate sufficient revenues to expand our business.

We currently rely on scientific and research and development collaboration arrangements with academic institutions and other third-party collaborators,
including an exclusive worldwide license from OHSU for PEDMARKTM. We also rely on collaborators for testing PEDMARKTM, including SIOPEL and
the Children’s Oncology Group.

The agreements with OHSU are terminable by either party in the event of an uncured breach by the other party. We may also terminate our agreement with
OHSU at any time upon prior written notice of specified durations to OHSU. Termination of any of our collaborative arrangements could materially
adversely affect our business. For example, if we are unable to make the necessary payments under these agreements, the licensor might terminate the
agreement which might have a material adverse impact. In addition, our collaborators might not perform as agreed in the future.

Since we conduct a significant portion of our research and development through collaborations, our success may depend significantly on the performance
of such collaborators, as well as any future collaborators. Collaborators might not commit sufficient resources to the research and development or
commercialization of our product candidate. Economic or technological advantages of products being developed by others, among other factors, could lead
our collaborators to pursue other product candidates or technologies in preference to those being developed in collaboration with us. The commercial
potential of, development stage of and projected resources required to develop our drug candidate will affect our ability to maintain current collaborations
or establish new collaborators. There is a risk of dispute with respect to ownership of technology developed under any collaboration. Our management of
any collaboration will require significant time and effort as well as an effective allocation of resources. We may not be able to simultaneously manage a
large number of collaborations. Any of these negative impacts on our current or future collaborations could have a material adverse effect on our business
and results of operations.

Our product candidate is still in development. Due to the long, expensive and unpredictable drug development process, we might not ever
successfully develop and commercialize our product candidate.

In order to achieve profitable operations, we, alone or in collaboration with others, must successfully fund, develop, manufacture, introduce and market our
product candidate. The time necessary to achieve market success for any individual product is long and uncertain. Our product candidate and research
programs are in clinical development and require significant, time-consuming and costly research, testing and regulatory clearances. In developing our
product candidate, we are subject to risks of failure that are inherent in the development of therapeutic products based on innovative technologies. The
results of preclinical and initial clinical trials are not necessarily predictive of future results. Our product candidate might not be economical to manufacture
or market or might not achieve market acceptance. In addition, third parties might hold proprietary rights that preclude us from marketing our product
candidate or others might market equivalent or superior products.

13

 
 
 
 
 
 
 
 
 
 
 
 
We may need to conduct additional human clinical trials to assess our product candidate. If these trials are delayed or are unsuccessful, our
development costs will significantly increase, and our business prospects may suffer.

Before obtaining regulatory approvals for the commercial sale of our product candidate, we must demonstrate, through preclinical studies with animals and
clinical trials with humans, that our product candidate is safe and effective for use in each target indication. To date, we have performed only limited
clinical trials. Much of our testing has been conducted on animals or on human cells in the laboratory, and the benefits of treatment seen in animals or on
human cells in a laboratory setting may not ultimately be obtained in human clinical trials. As a result, we may need to perform significant additional
research and development activities and conduct extensive preclinical and clinical testing prior to any application for commercial use. We may suffer
significant setbacks in additional clinical trials, and the trials may demonstrate our product candidate to be unsafe or ineffective. We may also encounter
problems in our clinical trials that will cause us to delay, suspend or terminate those clinical trials, which would increase our development costs and harm
our financial results and commercial prospects. Identifying and qualifying patients to participate in clinical trials of our potential products is critically
important to our success. The timing of our clinical trials depends on, among other things, the speed at which we can recruit patients to participate in testing
our product candidate. We have experienced delays in some of our clinical trials and we may experience significant delays in the future. If patients are
unwilling to participate in our trials because of competing clinical trials for similar patient populations, perceived risk or any other reason, the timeline for
recruiting patients, conducting trials and obtaining regulatory approval of potential products will be delayed. Other factors that may result in significant
delays include obtaining regulatory or ethics review board approvals for proposed trials, reaching agreement on acceptable terms with prospective clinical
trial sites, and obtaining sufficient quantities of drugs for use in the clinical trials. Such delays could result in the termination of the clinical trials altogether.

Regulatory approval of our product candidate is time-consuming, expensive and uncertain, and could result in unexpectedly high expenses and
delay our ability to sell our product.

Development, manufacture and marketing of our product is subject to extensive regulation by governmental authorities in the United States and other
countries. This regulation could require us to incur significant unexpected expenses or delay or limit our ability to sell our product candidate. Our clinical
studies might be delayed or halted, or additional studies might be required, for various reasons, including:

·
·
·
·
·
·

there is a lack of sufficient funding;
the drug is not effective;
patients experience severe side effects during treatment;
appropriate patients do not enroll in the studies at the rate expected;
drug supplies are not sufficient to treat the patients in the studies; or
we decide to modify the drug during testing.

If regulatory approval of our product is granted, it will be limited to those indications for which the product has been shown to be safe and effective, as
demonstrated to the satisfaction of the FDA and foreign regulators through clinical studies. Furthermore, approval might entail ongoing requirements for
post-marketing studies. Even if regulatory approval is obtained, labeling and promotional activities are subject to continual scrutiny by the FDA and state
and foreign regulatory agencies and, in some circumstances, the Federal Trade Commission. FDA enforcement policy prohibits the marketing of approved
products for unapproved, or off-label, uses. These regulations and the FDA’s interpretation of them might impair our ability to effectively market our
product.

We and our third-party manufacturers are also required to comply with the applicable current FDA Good Manufacturing Practices regulations, which
include requirements relating to quality control and quality assurance, as well as the corresponding maintenance of records and documentation. Further,
manufacturing facilities, which we outsource to third parties, must be approved by the FDA before they can be used to manufacture our product, and they
are subject to additional FDA inspection. The CRL that we received from the FDA in August, 2020 as a result of deficiencies in the third-party
manufacturing facility that manufactures PEDMARKTM on our behalf is a specific example of the risks associated with our third-party manufacturers.

If we fail to comply with any of the FDA’s continuing regulations, we could be subject to reputational harm and sanctions, including:

·
·
·
·
·
·

delays, warning letters and fines;
product recalls or seizures and injunctions on sales;
refusal of the FDA to review pending applications;
total or partial suspension of production;
withdrawals of previously approved marketing applications; and
civil penalties and criminal prosecutions.

In addition, identification of side effects after a drug is on the market or the occurrence of manufacturing problems could cause subsequent withdrawal of
approval, reformulation of the drug, additional testing or changes in labeling of the product.

14

 
 
 
 
 
 
 
 
 
 
 
 
We may be unable to effectively deploy the proceeds from our recent financings for the development of PEDMARKTM.

On May 5, 2020, we announced the completion of an underwritten public offering of 4.8 million of our common shares at a public offering price of $6.25
per share. In addition, we issued an additional 0.66 million common shares in connection with the partial exercise of the underwriters’ over-allotment
option. The approximate total gross proceeds from the offering were $34.1 million ($32.2 million net of commissions, fees and issue costs). Any inability
on our part to manage effectively the deployment of this capital could limit our ability to successfully develop PEDMARKTM.

If our licenses to proprietary technology owned by others are terminated or expire, we may suffer increased development costs and delays, and we
may not be able to successfully develop our product candidate.

The development of our drug candidate and the manufacture and sale of any products that we develop will involve the use of processes, products and
information, some of the rights to which are owned by others. PEDMARKTM is licensed under agreements with OHSU. Although we have obtained
licenses or rights with regard to the use of certain processes, products and information, the licenses or rights could be terminated or expire during critical
periods and we may not be able to obtain, on favorable terms or at all, licenses or other rights that may be required. Some of these licenses provide for
limited periods of exclusivity that may be extended only with the consent of the licensor, which may not be granted.

If we are unable to adequately protect or maintain our patents and licenses related to our product candidate, or if we infringe upon the intellectual
property rights of others, we may not be able to successfully develop and commercialize our product candidate.

The value of our technology will depend in part upon our ability, and those of our collaborators, to obtain patent protection or licenses to patents, maintain
trade secret protection and operate without infringing on the rights of third parties. Although we have successfully pursued patent applications in the past, it
is possible that:

·
·
·

·

some or all of our pending patent applications, or those we have licensed, may not be allowed;
proprietary products or processes that we develop in the future may not be patentable;
any issued patents that we own or license may not provide us with any competitive advantages or may be successfully challenged by third parties;
or
the patents of others may have an adverse effect on our ability to do business.

It is not possible for us to be certain that we are the original and first creator of inventions encompassed by our pending patent applications or that we were
the first to file patent applications for any such inventions. Further, any of our patents, once issued, may be declared by a court to be invalid or
unenforceable.

PEMARKTM is currently protected by methods of use patents that we exclusively licensed from OHSU that expire in Europe in 2021 and the United States
in 2038 and a patent owned by us that expires in 2039. Further, patents are currently pending in the United States and other territories. In addition, periods
of marketing exclusivity for PEDMARKTM may also be possible in the United States under orphan drug status.

We may be required to obtain licenses under patents or other proprietary rights of third parties, but the extent to which we may wish or need to do so is
unknown. Any such licenses may not be available on terms acceptable to us or at all. If such licenses are obtained, it is likely they would be royalty
bearing, which would reduce our future income, if any. If licenses cannot be obtained on an economical basis, we could suffer delays in market introduction
of planned products or their introduction could be prevented, in some cases after the expenditure of substantial funds. If we do not obtain such licenses, we
would have to attempt to design around patents of third parties, potentially causing increased costs and delays in product development and introduction or
precluding us from developing, manufacturing or selling our planned products, or our ability to develop, manufacture or sell products requiring such
licenses could be foreclosed.

Litigation may also be necessary to enforce or defend patents issued or licensed to us or our collaborators or to determine the scope and validity of a third
party’s proprietary rights. We could incur substantial costs if litigation is required to defend ourselves in patent suits brought by third parties, if we
participate in patent suits brought against or initiated by our collaborators, or if we initiate such suits. We might not prevail in any such action. An adverse
outcome in litigation or an interference to determine priority or other proceeding in a court or patent office could subject us to significant liabilities, require
disputed rights to be licensed from other parties or require us or our collaborators to cease using certain technology or products. Any of these events would
likely have a material adverse effect on our business, financial condition and results of operations.

Much of our technological know-how that is not patentable may constitute trade secrets. Our confidentiality agreements might not provide for meaningful
protection of our trade secrets, know-how or other proprietary information in the event of any unauthorized use or disclosure of information. In addition,
others may independently develop or obtain similar technology and may be able to market competing products and obtain regulatory approval through a
showing of equivalency to our product that has obtained regulatory approvals, without being required to undertake the same lengthy and expensive clinical
studies that we would have already completed.

15

 
 
 
 
 
 
 
 
 
 
 
 
 
 
The vulnerability to off-label use or sale of our product candidate that are covered only by “method of use” patents may cause downward pricing
pressure on the product candidate if they are ever commercialized and may make it more difficult for us to enter into collaboration or partnering
arrangements for the development of this product candidate.

PEDMARKTM is currently covered by “method of use” patents and “composition of matter” patents. “Method of use” patents cover the use of certain
compounds to treat specific conditions and “composition of matter” patents cover the chemical composition of the compound. Method of use patents
provide less protection than composition of matter patents because of the possibility of off-label competition if other companies develop or market the
compound for other uses. If another company markets a drug that we expect to market under the protection of a method of use patent, physicians may
prescribe the other company’s drug for use in the indication for which we obtain approval and have a patent, even if the other company’s drug is not
approved for such an indication. Off-label use and sales could limit our sales and exert pricing pressure on any product we develop covered only by method
of use patents. Also, it may be more difficult to find a collaborator to license or support the development of our product candidate that is only covered by
method of use patents.

If our third-party manufacturers breach or terminate their agreements with us, or if we are unable to secure arrangements with third party
manufacturers on acceptable terms as needed in the future, we may suffer significant delays and additional costs.

We have no experience manufacturing products and do not currently have the resources to manufacture any products that we may develop. We currently
have agreements with contract manufacturers for clinical supplies of PEDMARKTM, including drug substance providers and drug product suppliers, but
they might not perform as agreed in the future or may terminate our agreements with them before the end of the required term. Significant additional time
and expense would be required to effect a transition to a new contract manufacturer.

We plan to continue to rely on contract manufacturers for the foreseeable future to produce quantities of products and substances necessary for research and
development, preclinical trials, human clinical trials and product commercialization, and to perform their obligations in a timely manner and in accordance
with applicable government regulations. If we develop any product with commercial potential, we will need to develop the facilities to independently
manufacture such product or products or secure arrangements with third parties to manufacture them. We may not be able to independently develop
manufacturing capabilities or obtain favorable terms for the manufacture of our product. While we intend to contract for the commercial manufacture of
our product candidate, we may not be able to identify and qualify contractors or obtain favorable contracting terms. We or our contract manufacturers may
also fail to meet required manufacturing standards, which could result in delays or failures in product delivery, increased costs, injury or death to patients,
product recalls or withdrawals and other problems that could significantly hurt our business. The CRL that we received from the FDA in August, 2020 as a
result of deficiencies in the third-party manufacturing facility that manufactures PEDMARKTM on our behalf is a specific example of the risks associated
with our third-party manufacturers. We intend to maintain a second source for back-up commercial manufacturing, wherever feasible. However, if a
replacement to our future internal or contract manufacturers were required, the ability to establish second-sourcing or find a replacement manufacturer may
be difficult due to the lead times generally required to manufacture drugs and the need for FDA compliance inspections and approvals of any replacement
manufacturer, all of which factors could result in production delays and additional commercialization costs. Such lead times would vary based on the
situation but might be twelve months or longer.

We may lack the resources necessary to effectively market our product candidate, and we may need to rely on third parties over whom we have
little or no control and who may not perform as expected.

We may not have the necessary resources to market our product candidate. If we develop any products with commercial potential, we will either have to
develop a marketing capability, including a sales force, which is difficult and expensive to implement successfully, or attempt to enter into a collaboration,
merger, joint venture, license or other arrangement with third parties to provide a substantial portion of the financial and other resources needed to market
such products. We may not be able to do so on acceptable terms, if at all. If we rely extensively on third parties to market our products, the commercial
success of such products may be largely outside of our control.

We conduct our business internationally and are subject to laws and regulations of several countries which may affect our ability to access
regulatory agencies and may affect the enforceability and value of our licenses.

We have conducted clinical trials in the United States, Canada, Europe and the Pacific Rim and intend to, or may, conduct future clinical trials in these and
other jurisdictions. There can be no assurance that any sovereign government will not establish laws or regulations that will be deleterious to our interests.
There is no assurance that we, as a British Columbia corporation, will continue to have access to the regulatory agencies in any jurisdiction where we might
want to conduct clinical trials or obtain regulatory approval, and we might not be able to enforce our licenses or patent rights in foreign jurisdictions.
Foreign exchange controls may have a material adverse effect on our business and financial condition, since such controls may limit our ability to flow
funds into or out of a particular country to meet obligations under licenses, clinical trial agreements or other collaborations.

16

 
 
 
 
 
 
 
 
 
 
 
Our cash invested in money market funds might be subject to loss.

Even though we believe we take a conservative approach to investing our funds, the nature of financial markets exposes us to investment risk, including the
risks that the value and liquidity of our money market investments (the amounts of which substantially exceed the $250,000 amount insured by the FDIC)
could deteriorate significantly and the issuers of the investments we hold could be subject to credit rating downgrades. While we have not experienced any
loss or write down of our money market investments in the past, we cannot guarantee that such losses will not occur in future periods.

Should the clinical development process be successfully completed, our ability to derive revenues from the sale of therapeutics will depend upon
our first obtaining FDA as well as foreign regulatory approvals, all of which are subject to a number of unique risks and uncertainties.

Even if we are able to demonstrate the safety and efficacy of our product candidate in clinical trials, if we fail to gain timely approval to commercialize
PEDMARKTM from the FDA and other foreign regulatory authorities, we will be unable to generate the revenues we will need to build our business. The
FDA or comparable regulatory authorities in other countries may delay, limit or deny approval of PEDMARKTM for various reasons. For example, such
authorities may disagree with the design, scope or implementation of our clinical trials; or with our interpretation of data from our preclinical studies or
clinical trials; or may otherwise take the position that PEDMARKTM fails to meet the requirements and standards for regulatory approval. There are
numerous FDA personnel assigned to review different aspects of a NDA, and uncertainties can be presented by their ability to exercise judgment and
discretion during the review process. During the course of review, the FDA may request or require additional preclinical, clinical, chemistry,
manufacturing, and control (“CMC”), or other data and information, and the development and provision of these data and information may be time
consuming and expensive. Regulatory approvals may not be granted on a timely basis, if at all, and even if and when they are granted, they may not cover
all the indications for which we seek approval.

On February 10, 2020, we submitted an NDA to the FDA for PEDMARKTM for the prevention of ototoxicity associated with cisplatin chemotherapy in
pediatric patients ≥1 month to 18 years of age with localized, non-metastatic, solid tumors. On April 10, 2020, we received notification from the FDA that
the NDA was accepted for filing and the original application was granted Priority Review with a PDUFA target action date of August 10, 2020. On
August 10, 2020, we received a CRL from the FDA. According to the CRL, after recent completion of a pre-approval inspection of the manufacturing
facility of our drug product manufacturer, the FDA identified deficiencies resulting in a Form 483, which is a list of conditions or practices that are required
to be resolved prior to the approval of PEDMARK™.  We have developed a detailed plan and have dedicated, and continue to commit, significant
resources to addressing the CRL, while, in parallel, working with our third-party drug product manufacturer to be ready for re-inspection by the FDA. If the
FDA determines that these actions were not sufficient, or based on the re-inspection FDA officials do not recommend approval relative to the drug product
manufacturing facility, or if information deemed necessary by the FDA cannot be provided as part of our NDA submission or during the review period as
deemed appropriate on a timely basis, such events could further delay the progress of our NDA and could require additional actions that we cannot
complete during the review period, which may adversely impact our business.

Further, while we may develop a product candidate with the intention of addressing a large, unmet medical need, the FDA may only approve the use of the
drug for indications affecting a relatively small number of patients, thus greatly reducing the market size and our potential revenues. The approvals may
also contain significant limitations in the form of warnings, precautions or contraindications with respect to conditions of use, which could further narrow
the size of the market. In certain countries, even if the health regulatory authorities approve a drug, it cannot be marketed until pricing for the drug is also
approved. Finally, even after approval can be obtained, we may be required to recall or withdraw a product as a result of newly discovered safety or
efficacy concerns, either of which would have a materially adverse effect on our business and results of operations.

We are currently and may in the future be the target of securities litigation, which may be costly and time-consuming to defend.

Following periods of market volatility in the price of a company’s securities or the reporting of unfavorable news, security purchasers have often instituted
class action litigation. This risk is especially relevant for us because pharmaceutical companies like us have experienced significant stock price volatility in
recent years. Specifically, we were named in a putative securities class action complaint as a result of the decline in our stock price following the
August 10, 2020 announcement that we had received a CRL from the FDA regarding our NDA for PEDMARK™. Regardless of the outcome of this or
future litigation, we could incur substantial legal costs and our management’s attention could be diverted from the operation of our business, causing our
business to suffer. Our insurance coverage may be insufficient to cover all legal fees, judgments or settlements. If the outcome of any such litigation is
unfavorable, it could result in us paying significant damages or settlement payments, which could have a material adverse effect on our financial condition.

17

 
 
 
 
 
 
 
 
 
 
There are limitations on the liability of our directors, and we may have to indemnify our officers and directors in certain instances.

Our articles limit, to the maximum extent permitted under British Columbia law, the personal liability of our directors for monetary damages for breach of
their fiduciary duties as directors. Our articles provide that we will indemnify our officers and directors and may indemnify our employees and other agents
to  the  fullest  extent  permitted  by  law.  These  provisions  may  be  in  some  respects  broader  than  the  specific  indemnification  provisions  under  British
Columbia law. The indemnification provisions may require us, among other things, to indemnify such officers and directors against certain liabilities that
may arise by reason of their status or service as directors or officers (other than liabilities arising from willful misconduct of a culpable nature), to advance
their  expenses  incurred  as  a  result  of  certain  proceedings  against  them  as  to  which  they  could  be  indemnified  and  to  obtain  directors’  and  officers’
insurance.

We believe that our limitation of officer and director liability assists us to attract and retain qualified employees and directors. However, in the event an
officer, a director or the board of directors commits an act that may legally be indemnified under British Columbia law, we will be responsible to pay for
such officer(s) or director(s) legal defense and potentially any damages resulting there from. Furthermore, the limitation on director liability may reduce the
likelihood of derivative litigation against directors and may discourage or deter stockholders from instituting litigation against directors for breach of their
fiduciary  duties,  even  though  such  an  action,  if  successful,  might  benefit  our  stockholders  and  us.  Given  the  difficult  environment  and  potential  for
incurring liabilities currently facing directors of publicly-held corporations, we believe that director indemnification is in our and our stockholders’ best
interests because it enhances our ability to attract and retain highly qualified directors and reduce a possible deterrent to entrepreneurial decision-making.

Nevertheless, limitations of director liability may be viewed as limiting the rights of stockholders, and the broad scope of the indemnification provisions
contained in our certificate of incorporation and bylaws could result in increased expenses. Our board of directors believes, however, that these provisions
will provide a better balancing of the legal obligations of, and protections for, directors and will contribute positively to the quality and stability of our
corporate  governance.  Our  board  of  directors  has  concluded  that  the  benefit  to  stockholders  of  improved  corporate  governance  outweighs  any  possible
adverse effects on stockholders of reducing the exposure of directors to liability and broadened indemnification rights.

Our business and operations could be adversely affected by the effects of health epidemics, including the ongoing COVID-19 pandemic.

Our  operational  and  financial  performance  have  already  been  affected  by  the  impact  of  the  COVID-19  pandemic.  The  COVID-19  pandemic  is  also
affecting  the  operations  of  government  entities,  such  as  the  FDA,  as  well  as  contract  research  organizations,  third-party  manufacturers,  and  other  third-
parties upon whom we rely. As a result of “shelter-in-place” orders, quarantines or similar orders or restrictions to control the spread of COVID-19, many
companies, including our own, have implemented work-from-home policies for their employees. The effects of these stay at home orders and work-from-
home policies may negatively impact productivity, resulting in delays in our Product launch. The extent of the impact on our operations depends in part on
the  time  these  restrictions  remain  in  place,  and  whether  restrictions  are  reinstated  as  a  result  of  a  rising  surge  in  COVID-19  cases.  These  and  similar
disruptions in our operations could negatively impact our business, operating results and financial condition.

The spread of COVID-19 has also led to disruption and volatility in the global capital markets, which increases the cost of, and adversely impacts access to
capital  and  increases  economic  uncertainty.  To  the  extent  the  COVID-19  pandemic  adversely  affects  our  business,  financial  results  and  value  of  our
common stock, it may also affect our ability to access capital and obtain financing, which could in the future negatively affect our liquidity and ability to
continue as a going concern.

The global pandemic of COVID-19 continues to evolve rapidly, and the ultimate impact of the COVID-19 pandemic or a similar health epidemic is highly
uncertain and subject to change. We do not yet know the full impact of potential delays or effects on our business, our clinical trials, our ability to access
the capital markets, or supply chains or on the global economy as a whole. However, these effects could have a material impact on our operations, and we
will continue to monitor the COVID-19 situation closely.

Natural disasters, epidemic or pandemic disease outbreaks, trade wars, political unrest or other events could disrupt our business or operations or
those of our development partners, manufacturers, regulators or other third parties with whom we conduct business now or in the future.

A wide variety of events beyond our control, including natural disasters, epidemic or pandemic disease outbreaks (such as the COVID-19 pandemic), trade
wars, political unrest or other events, could disrupt our business or operations or those of our manufacturers, regulatory authorities, or other third parties
with whom we conduct business. These events may cause businesses and government agencies to be shut down, supply chains to be interrupted, slowed, or
rendered  inoperable,  and  individuals  to  become  ill,  quarantined,  or  otherwise  unable  to  work  and/or  travel  due  to  health  reasons  or  governmental
restrictions. These limitations could negatively affect our business operations and continuity, and could negatively impact our development timelines and
ability to timely perform basic business functions, including, without limitation, making SEC filings and preparing financial reports. If our operations or
those of third parties with whom we conduct business are impaired or curtailed as a result of these events, the development and commercialization of our
products and product candidate could be impaired or halted, which could have a material adverse impact on our business.

18

 
 
 
 
 
 
 
 
 
 
 
 
Risks Related to the Clinical Development and Marketing Approval of Our Product Candidate

The marketing approval processes of the FDA and comparable foreign authorities are lengthy, time-consuming and inherently unpredictable, and
if we are ultimately unable to obtain marketing approval for our product candidate, our business will be substantially harmed.

Our current product candidate has not gained marketing approval for sale in the United States or any other country, and we cannot guarantee that we will
ever have any marketable products. Our business is substantially dependent on our ability to complete the development of, obtain marketing approval for,
and successfully commercialize our product candidate in a timely manner. We cannot commercialize our product candidate in the United States without
first obtaining approval from the FDA to market our product candidate. Similarly, we cannot commercialize our product candidate outside of the United
States  without  obtaining  regulatory  approval  from  comparable  foreign  regulatory  authorities.  Our  product  candidate  could  fail  to  receive  marketing
approval for many reasons, including the following:

·
·

·

·

·

·
·
·

·

·

·

the FDA or comparable foreign regulatory authorities may disagree with the design or implementation of our clinical trials;
the FDA or comparable foreign regulatory authorities may find the human subject protections for our clinical trials inadequate and place a clinical
hold on an Investigational New Drug Application, or IND, at the time of its submission precluding commencement of any trials or a clinical hold
on one or more clinical trials at any time during the conduct of our clinical trials;
the  FDA  could  determine  that  we  cannot  rely  on  Section  505(b)(2)  of  the  Federal  Food,  Drug  and  Cosmetic  Act,  or  FFDCA,  for  our  product
candidate;
we may be unable to demonstrate to the satisfaction of the FDA or comparable foreign regulatory authorities that a product candidate is safe and
effective for its proposed indication;
the results of clinical trials may not meet the level of statistical significance required by the FDA or comparable foreign regulatory authorities for
approval;
we may be unable to demonstrate that a product candidate’s clinical and other benefits outweigh its safety risks;
the FDA or comparable foreign regulatory authorities may disagree with our interpretation of data from preclinical studies or clinical trials;
the FDA could determine that our application relies, or must rely, upon a listed drug or drugs that we a failed to identify or that approval of our
505(b)(2) application for our product candidate is blocked by patent or non-patent exclusivity of the listed drug or drugs;
the  data  collected  from  clinical  trials  of  our  product  candidate  may  not  be  sufficient  to  obtain  marketing  approval  in  the  United  States  or
elsewhere;
the FDA or comparable foreign regulatory authorities may find inadequate the manufacturing processes or facilities of third-party manufacturers
with which we contract for clinical and commercial supplies (for example, see the discussion elsewhere concerning the CRL we received from the
FDA in August, 2020); and
the  approval  policies  or  regulations  of  the  FDA  or  comparable  foreign  regulatory  authorities  may  significantly  change  in  a  manner  that  would
delay marketing approval.

Before obtaining marketing approval for the commercial sale of any drug product for a target indication, we must demonstrate in preclinical studies and
well-controlled clinical trials and, with respect to approval in the United States, to the satisfaction of the FDA, that the product is safe and effective for its
intended use and that the manufacturing facilities, processes, and controls are adequate to preserve the drug’s identity, strength, quality and purity. In the
United States, it is necessary to submit and obtain approval of an NDA from the FDA. An NDA must include extensive preclinical and clinical data and
supporting  information  to  establish  the  product’s  safety  and  efficacy  for  each  desired  indication.  The  NDA  must  also  include  significant  information
regarding the chemistry, manufacturing, and controls for the product. After the submission of an NDA, but before approval of the NDA, the manufacturing
facilities  used  to  manufacture  a  product  candidate  generally  must  be  inspected  by  the  FDA  to  ensure  compliance  with  the  applicable  Current  Good
Manufacturing  Practice,  or  cGMP,  requirements  (for  example,  see  the  discussion  elsewhere  concerning  the  CRL  we  received  from  the  FDA  in  August,
2020).  The  FDA  and  the  Competent  Authorities  of  the  Member  States  of  the  European  Economic  Area,  or  EEA,  and  comparable  foreign  regulatory
authorities, may also inspect our clinical trial sites and audit clinical study data to ensure that our studies are properly conducted in accordance with the
IND regulations, human subject protection regulations, and good clinical practice, or cGCP.

Obtaining approval of an NDA is a lengthy, expensive and uncertain process, and approval may not be obtained. Upon submission of an NDA, the FDA
must  make  an  initial  determination  that  the  application  is  sufficiently  complete  to  accept  the  submission  for  filing.  We  cannot  be  certain  that  any
submissions will be accepted for filing and reviewed by the FDA, or ultimately be approved. If the application is not accepted for review, the FDA may
require that we conduct additional clinical studies or preclinical testing, or take other actions before it will reconsider our application. If the FDA requires
additional studies or data, we would incur increased costs and delays in the marketing approval process, which may require us to expend more resources
than we have available. In addition, the FDA might not consider any additional information to be complete or sufficient to support the filing or approval of
the NDA.

19

 
 
 
 
 
 
 
Regulatory authorities outside of the United States, such as in Europe and Japan and in emerging markets, also have requirements for approval of drugs for
commercial sale with which we must comply prior to marketing in those areas. Regulatory requirements can vary widely from country to country and could
delay or prevent the introduction of our product candidate. Clinical trials conducted in one country may not be accepted or the results may not be found
adequate  by  regulatory  authorities  in  other  countries,  and  obtaining  regulatory  approval  in  one  country  does  not  mean  that  regulatory  approval  will  be
obtained in any other country. However, the failure to obtain regulatory approval in one jurisdiction could have a negative impact on our ability to obtain
approval  in  a  different  jurisdiction.  Approval  processes  vary  among  countries  and  can  involve  additional  product  candidate  testing  and  validation  and
additional administrative review periods. Seeking foreign regulatory approval could require additional non-clinical studies or clinical trials, which could be
costly and time-consuming. Foreign regulatory approval may include all of the risks associated with obtaining FDA approval. For all of these reasons, we
may not obtain foreign regulatory approvals on a timely basis, if at all.

The process to develop, obtain marketing approval for, and commercialize product candidates is long, complex and costly, both inside and outside of the
United States, and approval is never guaranteed. The time required to obtain approval by the FDA and comparable foreign authorities is unpredictable but
typically takes many years following the commencement of clinical trials and depends upon numerous factors, including the substantial discretion of the
regulatory authorities. In addition, approval policies, regulations, or the type and amount of clinical data necessary to gain approval may change during the
course of a product candidate’s clinical development and may vary among jurisdictions. Even if our product candidate were to successfully obtain approval
from  regulatory  authorities,  any  such  approval  might  significantly  limit  the  approved  indications  for  use,  including  more  limited  patient  populations,
require  that  precautions,  warnings  or  contraindications  be  included  on  the  product  labeling,  including  black  box  warnings,  require  expensive  and  time-
consuming post-approval clinical studies, risk evaluation and mitigation strategies or surveillance as conditions of approval, or, through the product label,
the  approval  may  limit  the  claims  that  we  may  make,  which  may  impede  the  successful  commercialization  of  our  product  candidate.  Following  any
approval for commercial sale of our product candidate, certain changes to the product, such as changes in manufacturing processes and additional labeling
claims,  as  well  as  new  safety  information,  may  require  new  studies  and  will  be  subject  to  additional  FDA  notification,  or  review  and  approval.  Also,
marketing approval for any of our product candidate may be withdrawn. If we are unable to obtain marketing approval for our product candidate in one or
more jurisdictions, or any approval contains significant limitations, our ability to market to our full target market will be reduced and our ability to realize
the full market potential of our product candidate will be impaired. Furthermore, we may not be able to obtain sufficient funding or generate sufficient
revenue and cash flows to continue or complete the development of any of our current or future product candidates.

Our risk of delay in product approvals is increased if the United States government is fully or partially shut down due to lack of continuity in
funding.

Our business operations, and particularly the timing of the outcome of review of our NDA filing for marketing approval of PEDMARKTM, are directly and
indirectly affected by the operations of the United States government, including but not limited to the FDA. Any interruption in the continuity of funding of
all or a part of government activities could have a significant negative effect on our business, including the timing of that review decision. The United
States government shuts down from time to time, most recently from December 22, 2018 to January 25, 2019. We cannot predict the likelihood, duration,
impact,  or  timing  of  any  future  shutdown.  There  can  be  no  assurance  that  if  such  shutdown(s)  were  to  occur  in  the  future,  adequate  funds  would  be
available to the FDA and other U.S. government agencies to allow them to continue their activities uninterrupted. Even when funding is restored following
one or more shutdowns, we cannot predict the ongoing impact of such shutdowns on our business, or the degree to which funding would be restored to the
FDA or other agencies having an impact on our business.

If we are unable to submit an application for approval under Section 505(b)(2) of the FFDCA or if we are required to generate additional data
related to safety and efficacy in order to obtain approval under Section 505(b)(2), we may be unable to meet our anticipated development and
commercialization timelines.

Our current strategy for seeking marketing authorization in the United States for our product candidate relies primarily on Section 505(b)(2) of the FFDCA,
which permits use of a marketing application, referred to as a 505(b)(2) application, where at least some of the information required for approval comes
from studies not conducted by or for the applicant and for which the applicant has not obtained a right of reference or use. The FDA interprets this to mean
that  an  applicant  may  rely  for  approval  on  such  data  as  that  found  in  published  literature  or  the  FDA’s  finding  of  safety  or  effectiveness,  or  both,  of  a
previously approved drug product owned by a third party. There is no assurance that the FDA would find the published literature or third-party data relied
upon by us in a 505(b)(2) application sufficient or adequate to support approval, and the FDA may require us to generate additional data to support the
safety and efficacy of our product candidate. Consequently, we may need to conduct substantial new research and development activities beyond those we
currently plan to conduct. Such additional new research and development activities would be costly and time-consuming and there is no assurance that such
data generated from such additional activities would be sufficient to obtain approval.

If the data to be relied upon in a 505(b)(2) application are related to drug products previously approved by the FDA and covered by patents that are listed in
the FDA’s Orange Book, we would be required to submit with our 505(b)(2) application an appropriate patent certification or statement. The type of patent
certification that would enable us to obtain approval of our application before a listed patent expires, known as a Paragraph IV Certification, would require
us to certify that we do not infringe the listed patent or that such patent is invalid or unenforceable. We would be required to provide timely notice to the
patent owner and the holder of the approved NDA. If a patent infringement action is initiated against us within 45 days from receipt of our Paragraph IV
Certification, the approval of our NDA would be subject to a stay of up to 30 months or more while we defend against such a suit. Approval of our product
candidate under Section 505(b)(2) may, therefore, be delayed until patent exclusivity expires or until we successfully challenge those patents. Alternatively,
we may elect to generate sufficient clinical data so that we would no longer need to rely on third-party data, which would be costly and time-consuming
and there would be no assurance that such data generated from such additional activities would be sufficient to obtain approval.

20

 
 
 
 
 
 
 
 
 
We may not be able to obtain shortened review of our applications, and the FDA may not agree that our product candidate qualifies for marketing approval.
If we are required to generate additional data to support approval, we may be unable to meet anticipated or reasonable development and commercialization
timelines,  may  be  unable  to  generate  the  additional  data  at  a  reasonable  cost,  or  at  all,  and  may  be  unable  to  obtain  marketing  approval  of  our  product
candidate.  If  the  FDA  changes  its  interpretation  of  Section  505(b)(2)  allowing  reliance  on  data  in  published  literature  or  a  previously  approved  drug
application owned by a third party, or there is a change in the law affecting Section 505(b)(2), this could delay or even prevent the FDA from approving
any Section 505(b)(2) application that we submit.

Even if we receive marketing approval for our product candidate, such approved products will be subject to ongoing obligations and continued
regulatory  review,  which  may  result  in  significant  additional  expense.  Additionally,  our  product  candidate,  if  approved,  could  be  subject  to
labeling  and  other  restrictions,  and  we  may  be  subject  to  penalties  and  legal  sanctions  if  we  fail  to  comply  with  regulatory  requirements  or
experience unanticipated problems with our approved products.

If the FDA approves our product candidate, the manufacturing processes, labeling, packaging, distribution, adverse event reporting, storage, advertising,
promotion and recordkeeping for the product will be subject to extensive and ongoing regulatory requirements. These requirements include submissions of
safety and other post-marketing information and reports, registration, as well as continued compliance with cGMP regulations and GCP for any clinical
trials that we conduct post-approval. Any marketing approvals that we receive for our product candidate may also be subject to limitations on the approved
indicated uses for which the product may be marketed or to conditions of approval, or contain requirements for potentially costly post-marketing testing,
including Phase 4 clinical trials, and surveillance to monitor safety and efficacy.

Later  discovery  of  previously  unknown  problems  with  an  approved  product,  including  adverse  events  of  unanticipated  severity  or  frequency,  or  with
manufacturing operations or processes, or failure to comply with regulatory requirements, or evidence of acts that raise questions about the integrity of data
supporting the product approval, may result in, among other things:

·

·
·

·
·

restrictions  on  the  marketing  or  manufacturing  of  the  product,  withdrawal  of  the  product  from  the  market,  or  voluntary  or  mandatory  product
recalls;
fines, warning letters, or holds on clinical trials;
refusal by the FDA to approve pending applications or supplements to approved applications filed by us, or suspension or revocation of product
approvals;
product seizure or detention, or refusal to permit the import or export of products; and
injunctions or the imposition of civil or criminal penalties.

The  FDA’s  policies  may  change,  and  additional  government  regulations  may  be  enacted  that  could  prevent,  limit  or  delay  marketing  approval,
manufacturing or commercialization of our product candidate. We cannot predict the likelihood, nature or extent of government regulation that may arise
from future legislation or administrative action, either in the United States or abroad. If we are slow or unable to adapt to changes in existing requirements
or the adoption of new requirements or policies, or we are not able to maintain regulatory compliance, we may lose any marketing approval that may have
been obtained and we may not achieve or sustain profitability, which would adversely affect our business.

Agencies like the FDA and national competition regulators in European countries regulate the promotion and uses of drugs not consistent with
approved product labeling requirements. If we are found to have improperly promoted our current product candidate for uses beyond those that
are approved, we may become subject to significant liability.

Regulatory authorities like the FDA and national competition laws in Europe strictly regulate the promotional claims that may be made about prescription
products, such as PEDMARKTM,  if  approved.  In  particular,  a  product  may  not  be  promoted  for  uses  that  are  not  approved  by  the  FDA  or  comparable
foreign regulatory authorities as reflected in the product’s approved labeling, known as “off-label” use, nor may it be promoted prior to obtaining marketing
approval. If we receive marketing approval for our product candidate for our proposed indications, physicians may nevertheless use our products for their
patients in a manner that is inconsistent with the approved label if the physicians personally believe in their professional medical judgment it could be used
in such manner. Although physicians may prescribe legally available drugs for off-label uses, manufacturers may not market or promote such off-label uses.

In addition, the FDA requires that promotional claims not be “false or misleading” as such terms are defined in the FDA’s regulations. For example, the
FDA  requires  substantial  evidence,  which  generally  consists  of  two  adequate  and  well-controlled  head-to-head  clinical  trials,  for  a  company  to  make  a
claim that its product is superior to another product in terms of safety or effectiveness. Generally, unless we perform clinical trials meeting that standard
comparing our product candidate to competitive products and these claims are approved in our product labeling, we will not be able promote our current
product candidate as superior to other products. If we are found to have made such claims, we may become subject to significant liability. In the United
States,  the  federal  government  has  levied  large  civil  and  criminal  fines  against  companies  for  alleged  improper  promotion  and  has  enjoined  several
companies from engaging in improper promotion. The FDA has also requested that companies enter into consent decrees or corporate integrity agreements.
The FDA could also seek permanent injunctions under which specified promotional conduct is monitored, changed or curtailed.

21

 
 
 
 
 
 
 
 
 
 
Our current and future relationships with healthcare professionals, investigators, consultants, collaborators, actual customers, potential customers
and  third-party  payors  in  the  United  States  and  elsewhere  may  be  subject,  directly  or  indirectly,  to  applicable  anti-kickback,  fraud  and  abuse,
false  claims,  physician  payment  transparency,  health  information  privacy  and  security  and  other  healthcare  laws  and  regulations,  which  could
expose us to sanctions.

Healthcare providers, physicians and third-party payors in the United States and elsewhere will play a primary role in the recommendation and prescription
of  our  drug  candidates  if  it  obtains  marketing  approval.  Our  current  and  future  arrangements  with  healthcare  professionals,  investigators,  consultants,
collaborators, actual customers, potential customers and third-party payors may expose us to broadly applicable fraud and abuse and other healthcare laws,
including, without limitation, the federal Anti-Kickback Statute and the federal False Claims Act, that may constrain the business or financial arrangements
and relationships through which we sell, market and distribute any drug candidates for which we obtain marketing approval. In addition, we may be subject
to  physician  payment  transparency  laws  and  patient  privacy  and  security  regulation  by  the  federal  government  and  by  the  U.S.  states  and  foreign
jurisdictions in which we conduct our business. The applicable federal, state and foreign healthcare laws that may affect our ability to operate include the
following:
·

·

·

·

·

·

·

the  federal  Anti-Kickback  Statute,  which  prohibits,  among  other  things,  persons  from  knowingly  and  willfully  soliciting,  offering,  receiving  or
providing remuneration, directly or indirectly, in cash or in kind, to induce or reward, or in return for, either the referral of an individual for, or the
purchase,  lease,  order  or  recommendation  of,  any  good,  facility,  item  or  service,  for  which  payment  may  be  made,  in  whole  or  in  part,  under
federal and state healthcare programs such as Medicare and Medicaid;
federal civil and criminal false claims laws and civil monetary penalty laws, including the federal False Claims Act, which impose criminal and
civil penalties, including civil whistleblower or qui tam actions, against individuals or entities for, among other things, knowingly presenting, or
causing to be presented, to the federal government, including the Medicare and Medicaid programs, claims for payment that are false or fraudulent
or making a false statement to avoid, decrease or conceal an obligation to pay money to the federal government;
the  civil  monetary  penalties  statute,  which  imposes  penalties  against  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 should know is for an item or service that was not
provided as claimed or is false or fraudulent;
the  federal  Health  Insurance  Portability  and  Accountability  Act  of  1996,  or  HIPAA,  which  created  new  federal  criminal  statutes  that  prohibit
knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or
fraudulent  pretenses,  representations  or  promises,  any  of  the  money  or  property  owned  by,  or  under  the  custody  or  control  of,  any  healthcare
benefit  program,  regardless  of  the  payor  (e.g.,  public  or  private),  knowingly  and  willfully  embezzling  or  stealing  from  a  healthcare  benefit
program, willfully obstructing a criminal investigation of a healthcare offense and knowingly and willfully falsifying, concealing or covering up
by  any  trick  or  device  a  material  fact  or  making  any  materially  false  statements  in  connection  with  the  delivery  of,  or  payment  for,  healthcare
benefits, items or services relating to healthcare matters;
HIPAA,  as  amended  by  the  Health  Information  Technology  for  Economic  and  Clinical  Health  Act  of  2009,  or  HITECH,  and  its  implementing
regulations, which impose obligations on covered entities, including healthcare providers, health plans, and healthcare clearinghouses, as well as
their  respective  business  associates  that  create,  receive,  maintain  or  transmit  individually  identifiable  health  information  for  or  on  behalf  of  a
covered entity, with respect to safeguarding the privacy, security and transmission of individually identifiable health information;
the federal Open Payments program, created under Section 6002 of the Patient Protection and Affordable Care Act, as amended by the Health
Care  and  Education  Reconciliation  Act,  or  the  Affordable  Care  Act,  and  its  implementing  regulations,  which  imposed  annual  reporting
requirements  for  manufacturers  of  drugs,  devices,  biologicals  and  medical  supplies  for  certain  payments  and  “transfers  of  value”  provided  to
physicians and teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members, where
failure  to  submit  timely,  accurately  and  completely  the  required  information  for  all  covered  payments,  transfers  of  value  and  ownership  or
investment interests may result in civil monetary penalties; and
analogous  state  and  foreign  laws,  such  as  state  anti-kickback  and  false  claims  laws,  which  may  apply  to  sales  or  marketing  arrangements  and
claims  involving  healthcare  items  or  services  reimbursed  by  non-governmental  third-party  payors,  including  private  insurers;  state  laws  that
require  pharmaceutical  companies  to  comply  with  the  pharmaceutical  industry’s  voluntary  compliance  guidelines  and  the  relevant  compliance
guidance promulgated by the federal government or otherwise restrict payments that may be made to healthcare providers; state and foreign laws
that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers
or marketing expenditures; and state and foreign laws governing the privacy and security of health information in certain circumstances, many of
which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.

22

 
 
 
 
Further, the Affordable Care Act, among other things, amended the intent requirement of the federal Anti-Kickback Statute and certain criminal statutes
governing  healthcare  fraud.  A  person  or  entity  no  longer  needs  to  have  actual  knowledge  of  the  statute  or  specific  intent  to  violate  it.  In  addition,  the
Affordable  Care  Act  provided  that  the  government  may  assert  that  a  claim  including  items  or  services  resulting  from  a  violation  of  the  federal  Anti-
Kickback Statute constitutes a false or fraudulent claim for purposes of the False Claims Act.

Efforts  to  ensure  that  our  future  business  arrangements  with  third  parties  will  comply  with  applicable  healthcare  laws  and  regulations  may  involve
substantial  costs.  It  is  possible  that  governmental  authorities  will  conclude  that  our  business  practices  may  not  comply  with  current  or  future  statutes,
regulations or case law involving applicable fraud and abuse or other healthcare laws. If our operations are found to be in violation of any of these laws or
any other governmental regulations that may apply to us, we may be subject to significant civil, criminal and administrative penalties, including, without
limitation,  damages,  fines,  imprisonment,  exclusion  from  participation  in  government  healthcare  programs,  such  as  Medicare  and  Medicaid,  and  the
curtailment or restructuring of our operations, which could significantly harm our business. If any of the physicians or other healthcare providers or entities
with whom we expect to do business, including our current and future collaborators, if any, are found not to be in compliance with applicable laws, those
persons or entities may be subject to criminal, civil or administrative sanctions, including exclusion from participation in government healthcare programs,
which could also affect our business.

The impact of recent healthcare reform legislation and other changes in the healthcare industry and healthcare spending on us is currently
unknown and may adversely affect our business model.

In the United States and some foreign jurisdictions, legislative and regulatory changes and proposed changes regarding the healthcare system could prevent
or delay marketing approval of our drug candidates, restrict or regulate post-approval activities and affect our ability to profitably sell any drug candidates
for which we obtain marketing approval.

Our revenue prospects could be affected by changes in healthcare spending and policy in the United States and abroad. We operate in a highly regulated
industry and new laws and judicial decisions, or new interpretations of existing laws or decisions, related to healthcare availability, the method of delivery
or  payment  for  healthcare  products  and  services  could  negatively  impact  our  business,  financial  condition,  results  of  operations  and  prospects.  There  is
significant interest in promoting healthcare reform, as evidenced by the enactment in the United States of the Affordable Care Act. Among other things, the
Affordable Care Act contains provisions that may reduce the profitability of drug products, including, for example, revising the methodology by which
rebates owed by manufacturers for covered outpatient drugs under the Medicaid Drug Rebate Program are calculated, extending the Medicaid Drug Rebate
Program to utilization of prescriptions of individuals enrolled in Medicaid managed care plans, imposing mandatory discounts for certain Medicare Part D
beneficiaries, and subjecting drug manufacturers to payment of an annual fee.

We  expect  that  the  Affordable  Care  Act,  as  well  as  other  healthcare  reform  measures  that  may  be  adopted  in  the  future,  may  result  in  more  rigorous
coverage  criteria  and  in  additional  downward  pressure  on  the  price  that  we  receive  for  our  product  if  it  is  approved  for  marketing.  Any  reduction  in
reimbursement from Medicare or other government programs may result in a similar reduction in payments from private payors. The implementation of
cost containment measures or other healthcare reforms may prevent us from being able to generate revenue or commercialize our drugs.

It  is  likely  that  federal  and  state  legislatures  within  the  United  States  and  foreign  governments  will  continue  to  consider  changes  to  existing  healthcare
legislation.  We  cannot  predict  the  reform  initiatives  that  may  be  adopted  in  the  future  or  whether  initiatives  that  have  been  adopted  will  be  repealed  or
modified. The continuing efforts of the government, insurance companies, managed care organizations and other payors of healthcare services to contain or
reduce costs of healthcare may adversely affect:
the demand for our product;
our ability to set a price that we believe is fair for our product;
our ability to obtain coverage and reimbursement approval for our product;
our ability to generate revenues and achieve or maintain profitability; and
the level of taxes that we are required to pay.

·
·
·
·
·

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

Our research and development activities and our third-party manufacturers’ and suppliers’ activities involve the controlled storage, use, and disposal of
hazardous  materials,  including  the  components  of  our  product  candidate  and  other  hazardous  compounds.  We  and  our  manufacturers  and  suppliers  are
subject  to  laws  and  regulations  governing  the  use,  manufacture,  storage,  handling,  and  disposal  of  these  hazardous  materials.  In  some  cases,  these
hazardous  materials  and  various  wastes  resulting  from  their  use  are  stored  at  our  and  our  manufacturers’  facilities  pending  their  use  and  disposal.  We
cannot  eliminate  the  risk  of  contamination,  which  could  cause  an  interruption  of  our  commercialization  efforts,  research  and  development  efforts  and
business operations, environmental damage resulting in costly clean-up and liabilities under applicable laws and regulations governing the use, storage,
handling, and disposal of these materials and specified waste products. Although we believe that the safety procedures utilized by us and our third-party
manufacturers  for  handling  and  disposing  of  these  materials  generally  comply  with  the  standards  prescribed  by  these  laws  and  regulations,  we  cannot
guarantee that this is the case or eliminate the risk of accidental contamination or injury from these materials. In such an event, we may be held liable for
any resulting damages and such liability could exceed our resources and state or federal or other applicable authorities may curtail our use of specified
materials and/or interrupt our business operations. Furthermore, environmental laws and regulations are complex, change frequently, and have tended to
become more stringent. We cannot predict the impact of such changes and cannot be certain of our future compliance. We do not currently carry biological
or hazardous waste insurance coverage.

23

 
 
 
 
 
 
 
 
 
 
 
Risks Related to Commercialization of Our Product Candidate

Even if we obtain the required regulatory approvals in the United States and other territories, the commercial success of our product candidate
will depend on market awareness and acceptance of our product candidates.

Even if we obtain marketing approval for PEDMARKTM, it may not gain market acceptance among physicians, key opinion leaders, healthcare payors,
patients and the medical community. Market acceptance of PEDMARKTM depends on a number of factors, including:

·
·
·

the timing of market introduction;
its efficacy and safety, as demonstrated in clinical trials;
the  clinical  indications  for  which  it  is  approved,  and  the  label  approved  by  regulatory  authorities  for  use  with  the  product,  including  any
precautions, warnings or contraindications that may be required on the label;
acceptance by physicians, key opinion leaders and patients of PEDMARKTM as a safe and effective treatment;
the cost, safety and efficacy of treatment in relation to alternative treatments;
the availability of coverage and adequate reimbursement and pricing by third-party payors and government authorities;
the number and clinical profile of competing products;
the growth of drug markets in our various indications;
relative convenience and ease of administration;

·
·
·
·
·
·
· marketing and distribution support;
·
·

the prevalence and severity of adverse side effects; and
the effectiveness of our sales and marketing efforts.

Market  acceptance  is  critical  to  our  ability  to  generate  revenue.  PEDMARKTM,  if  approved  and  commercialized,  may  be  accepted  in  only  limited
capacities  or  not  at  all.  If  PEDMARKTM  is  not  accepted  by  the  market  to  the  extent  that  we  expect,  we  may  not  be  able  to  generate  revenue  and  our
business would suffer.

If the market opportunities for our product candidate are smaller than we believe they are, then our revenues may be adversely affected, and our
business may suffer.

The  market  opportunities  that  our  product  candidate  is  being  developed  to  address  are  rare.  Our  projections  of  both  the  number  of  people  who  are
administered Cisplatin, as well as the subset of people who have the potential to benefit from treatment with our product candidate, and our assumptions
relating to pricing are based on estimates. Given the small number of patients that we are targeting, our eligible patient population and pricing estimates
may differ significantly from the actual market addressable by our product candidate.

Coverage and reimbursement may be limited or unavailable in certain market segments for our product candidate, which could make it difficult
for us to sell our products profitably.

There is significant uncertainty related to third-party coverage and reimbursement of newly approved pharmaceuticals. Market acceptance and sales of our
product candidate, should it receive marketing approval, will depend significantly on the availability of coverage and adequate reimbursement from third-
party  payors  and  may  be  affected  by  existing  and  future  healthcare  reform  measures.  Patients  who  are  prescribed  treatments  for  their  conditions  and
providers performing the prescribed services generally rely on third-party payors to reimburse all or part of the associated healthcare costs. Government
authorities and third-party payors, such as private health insurers, health maintenance organizations, and government payors like Medicare and Medicaid,
decide which drugs they will pay for and establish reimbursement levels. Increasingly, third-party payors are requiring that drug companies provide them
with  predetermined  discounts  from  list  prices  and  are  challenging  the  prices  charged  for  drugs  and  products.  Coverage  and  reimbursement  may  not  be
available  for  any  product  that  we  commercialize  and,  even  if  coverage  is  provided,  the  level  of  reimbursement  may  not  be  satisfactory.  Inadequate
reimbursement levels may adversely affect the demand for, or the price of, our drug candidate if it obtains marketing approval.

Reimbursement  by  a  third-party  payor  may  depend  upon  a  number  of  factors,  including  the  third-party  payor’s  determination  that  use  of  a  product  is,
among other things:

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·
·
·
·

a covered benefit under its health plan;
safe, effective and medically necessary;
appropriate for the specific patient;
cost-effective; and
neither experimental nor investigational.

24

 
 
 
 
 
 
 
 
 
 
 
Obtaining  coverage  and  adequate  reimbursement  approval  for  a  product  from  a  government  or  other  third-party  payor  is  a  time  consuming  and  costly
process that could require us to conduct expensive pharmacoeconomic studies and provide supporting scientific, clinical and cost-effectiveness data for the
use of our product to the payor. We may not be able to provide data sufficient to gain acceptance with respect to coverage and adequate reimbursement. In
addition to examining the medical necessity and cost-effectiveness of new products, coverage may be limited to specific drug products on an approved list,
or formulary, which might not include all of the FDA-approved drug products for a particular indication. There may also be formulary placements that
result in lower reimbursement levels and higher cost-sharing borne by patients, any of which could have an adverse effect on our revenues and profits.
Moreover,  a  third-party  payor’s  decision  to  provide  coverage  for  a  drug  product  does  not  imply  that  an  adequate  reimbursement  rate  will  be  approved.
Adequate third-party reimbursement may not be available to enable us to maintain price levels sufficient to realize an appropriate return on our investment
in product development. Additionally, coverage and reimbursement for drug products can differ significantly from payor to payor. One third-party payor’s
decision  to  cover  a  particular  drug  product  does  not  ensure  that  other  payors  will  also  provide  coverage  for  the  drug  product,  or  even  if  coverage  is
available, establish an adequate reimbursement rate.

We  cannot  be  sure  that  coverage  or  adequate  reimbursement  will  be  available  for  our  product  candidate.  Also,  we  cannot  be  sure  that  reimbursement
amounts will not reduce the demand for, or the price of, our product. If reimbursement is not available or is available only to limited levels, we may not be
able to commercialize certain of our products. In the United States, third-party payors are increasingly attempting to contain healthcare costs by limiting
both coverage and the level of reimbursement of new drugs. Third-party payors are increasingly challenging the prices charged for medical products and
services, examining the medical necessity and reviewing the cost-effectiveness of drug products and medical services and questioning safety and efficacy.
As a result, significant uncertainty exists as to whether and how much third-party payors will reimburse patients for their use of newly approved drugs,
which  in  turn  will  put  pressure  on  the  pricing  of  drugs.  Additionally,  emphasis  on  managed  care  in  the  United  States  has  increased  and  we  expect  will
continue  to  increase  the  pressure  on  drug  pricing.  If  third-party  payors  do  not  consider  our  product  to  be  cost-effective  compared  to  other  available
therapies, they may not cover our product or, if they do, the level of payment may not be sufficient to allow us to sell our product at a profit.

Coverage policies, third-party reimbursement rates and drug pricing regulation may change at any time, and there is the potential for significant movement
in these areas in the foreseeable future. Even if favorable coverage and reimbursement status is attained for our product, less favorable coverage policies
and reimbursement rates may be implemented in the future.

We face substantial competition, which may result in others discovering, developing or commercializing products before, or more successfully, than we
do.

The  life  sciences  industry  is  highly  competitive,  and  we  face  significant  competition  from  many  pharmaceutical,  biopharmaceutical  and  biotechnology
companies  that  are  generally  developing  and  marketing  therapeutic  products.  Such  competition  may  include  large  pharmaceutical  and  biotechnology
companies, specialty pharmaceutical and generic companies and medical technology companies. Our future success depends on our ability to demonstrate
and maintain a competitive advantage with respect to the design, development and commercialization of our product candidate for the treatment of orphan
and ultra-orphan diseases for which there is a small patient population in both the United States and in all other potential markets. A drug designated an
orphan drug may receive up to seven years of exclusive marketing in the United States for that indication.

Many of our potential competitors have significantly greater financial, manufacturing, marketing, development, technical and human resources than we do.
Large pharmaceutical and biotechnology companies, in particular, have extensive experience in clinical testing, obtaining regulatory approvals, recruiting
patients and in manufacturing clinical products. These companies also have significantly greater research and marketing capabilities than we do and may
also have products that have been approved or are in late stages of development, and have collaborative arrangements in our target markets with leading
companies  and  research  institutions.  Established  companies  may  also  invest  heavily  to  accelerate  discovery  and  development  of  compounds  that  could
make our product candidate obsolete. As a result of all of these factors, maintaining orphan drug designation for our product candidate is essential to our
viability since our competitors may, among other things:

·
·
·
·
·
·
·

have greater name and brand recognition, financial and human resources;
develop and commercialize products that are safer, more effective, less expensive, or more convenient or easier to administer;
obtain quicker marketing approval;
establish superior proprietary positions;
have access to more manufacturing capacity as well as to more cost-effective manufacturing capacity;
implement more effective approaches to sales and marketing; or
form more advantageous strategic alliances.

Should any of these events occur, our business, financial condition, results of operations, and prospects could be materially adversely affected. If we are not
able to compete effectively against potential competitors, our business will not grow and our financial condition and operations will suffer.

25

 
 
 
 
 
 
 
 
 
We believe that our ability to successfully compete will depend on our ability to maintain orphan drug designation as well as:

·
·
·
·
·
·
·
·
·
·
·
·

our ability to design and successfully execute appropriate clinical trials;
our ability to recruit and enroll patients for our clinical trials;
the results of our clinical trials and the efficacy and safety of our product candidate;
the speed at which we develop our product candidate;
achieving and maintaining compliance with regulatory requirements applicable to our business;
the timing and scope of regulatory approvals, including labeling;
adequate levels of reimbursement under private and governmental health insurance plans, including Medicare and Medicaid;
our ability to protect intellectual property rights related to our product candidate;
our ability to commercialize and market our product candidate if it obtains marketing approval;
our ability to manufacture and sell commercial quantities of any approved our product candidate;
acceptance of our product candidate by physicians, other healthcare providers and patients; and
the cost of treatment in relation to alternative therapies.

If our competitors are able to obtain orphan drug exclusivity for their products that are for the same indication as our product candidate, we may
not be able to have our product approved by the applicable regulatory authority for a significant period of time or benefit from that exclusivity.

We have orphan drug designation in the United States for PEDMARKTM for the prevention of platinum induced ototoxicity in pediatric patients.

Generally,  if  a  product  with  an  orphan  drug  designation  subsequently  receives  the  first  marketing  approval  for  the  indication  for  which  it  has  such
designation,  that  product  is  entitled  to  a  period  of  marketing  exclusivity,  which  precludes  the  applicable  regulatory  authority  from  approving  another
marketing application for the same drug for the same indication for that time period. The applicable period is seven and a half years in the United States.
Maintaining  orphan  drug  designation  for  PEDMARKTM  may  be  important  to  its  success.  Even  with  orphan  drug  designation,  we  may  not  be  able  to
maintain it. For example, if a competitive product that treats the same disease as our product candidate is shown to be clinically superior to our product
candidate, any orphan drug designation we have obtained will not block the approval of such competitive product and we may effectively lose what had
previously been orphan drug designation. Orphan drug designation for PEDMARKTM also will not bar the FDA from approving another STS drug product
for another indication. In the United States, reforms to the Orphan Drug Act, if enacted, could also materially affect our ability to maintain orphan drug
designation for PEDMARKTM for cisplatin induced ototoxicity in pediatric cancer.

Price controls may be imposed in foreign markets, which may adversely affect our future profitability.

In  some  countries,  particularly  member  states  of  the  European  Union,  the  pricing  of  prescription  drugs  is  subject  to  governmental  control.  In  these
countries, pricing negotiations with governmental authorities can take considerable time after receipt of marketing approval for a product. In addition, there
can be considerable pressure by governments and other stakeholders on prices and reimbursement levels, including as part of cost containment measures.
Political, economic and regulatory developments may further complicate pricing negotiations, and pricing negotiations may continue after reimbursement
has been obtained. Reference pricing used by various European Union member states and parallel distribution, or arbitrage between low-priced and high-
priced member states, can further reduce prices. In some countries, we may be required to conduct a clinical trial or other studies that compare the cost-
effectiveness  of  our  product  candidate  to  other  available  therapies  in  order  to  obtain  or  maintain  reimbursement  or  pricing  approval.  Publication  of
discounts by third-party payors or authorities may lead to further pressure on the prices or reimbursement levels within the country of publication and other
countries. If reimbursement of our products is unavailable or limited in scope or amount, or if pricing is set at unsatisfactory levels, our business could be
adversely affected.

Rapid technological change could make our products obsolete.

Pharmaceutical technologies have undergone rapid and significant change, and we expect that they will continue to do so. As a result, there is significant
risk that our product candidate may be rendered obsolete or uneconomical by new discoveries before we recover any expenses incurred in connection with
their development. If our product candidate is rendered obsolete by advancements in pharmaceutical technologies, our prospects will suffer.

We face a risk of product liability claims and may not be able to obtain adequate insurance.

Our business exposes us to potential liability risks that may arise from the clinical testing, manufacture, and/or sale of our pharmaceutical products. Patients
have received substantial damage awards in some jurisdictions against pharmaceutical companies based on claims for injuries allegedly caused by the use
of pharmaceutical products used in clinical trials or after FDA approval. Liability claims may be expensive to defend and may result in large judgments
against us. We currently carry liability insurance that we believe to be adequate. However, our insurance may not reimburse us for certain claims or the
coverage may not be sufficient to cover claims made against us. We cannot predict all of the possible harms or side effects that may result from the use of
our drug candidate and, therefore, the amount of insurance coverage we currently hold may not be adequate to cover all liabilities we might incur. If we are
sued for any injury allegedly caused by our products, our liability could exceed our ability to pay the liability. Whether or not we are ultimately successful
in any adverse litigation, such litigation could consume substantial amounts of our financial and managerial resources, all of which could have a material
adverse effect on our business, financial condition, results of operations, prospects and stock price.

26

 
 
 
 
 
 
 
 
 
 
 
 
Risks Related to Third Parties

We rely on third-party suppliers and other third parties for production of our product candidate and our dependence on these third parties may impair
the advancement of our research and development programs and the development of our product candidate.

We do not currently own or operate manufacturing facilities for clinical or commercial production of our product candidate. We lack the resources and the
capability to manufacture our product candidate on a clinical or commercial scale. Instead, we rely on, and expect to continue to rely on, third parties for
the supply of raw materials and manufacture of drug supplies necessary to conduct our preclinical studies and clinical trials. Our reliance on third parties
may expose us to more risk than if we were to manufacture our current product candidate or other products ourselves. Delays in production by third parties
could delay our clinical trials or have an adverse impact on any commercial activities. In addition, the fact that we are dependent on third parties for the
manufacture of and formulation of our product candidate means that we are subject to the risk that the products may have manufacturing defects that we
have limited ability to prevent or control. Although we oversee these activities to ensure compliance with our quality standards, budgets and timelines, we
have  had  and  will  continue  to  have  less  control  over  the  manufacturing  of  our  product  candidate  than  potentially  would  be  the  case  if  we  were  to
manufacture  our  product  candidate.  Further,  the  third  parties  we  deal  with  could  have  staffing  difficulties,  might  undergo  changes  in  priorities  or  may
become financially distressed, which would adversely affect the manufacturing and production of our product candidate. In addition, a third party could be
acquired by, or enter into an exclusive arrangement with, one of our competitors, which would adversely affect our ability to access the formulations we
require.

The facilities used by our current contract manufacturers and any future manufacturers to manufacture our product candidate must be inspected by the FDA
during  the  review  of  our  NDA.  We  do  not  control  the  manufacturing  process  of,  and  are  completely  dependent  on,  our  contract  manufacturers  for
compliance with the regulatory requirements, known as cGMPs, for manufacture of both active drug substances and finished drug products. If our contract
manufacturers cannot successfully manufacture material that conforms to our specifications and the strict regulatory requirements of the FDA or others, the
FDA may refuse to approve our NDA. The CRL that we received from the FDA in August 2020, as a result of deficiencies in the third-party manufacturing
facility that manufactures PEDMARKTM on our behalf is a specific example of the risks associated with our third-party manufacturers. If the FDA or a
comparable foreign regulatory authority does not approve our NDA because of concerns about the manufacture of our product candidate or if significant
manufacturing issues arise in the future, we may need to find alternative manufacturing facilities, which would significantly impact our ability to develop
our product candidate, to obtain marketing approval of our NDA or to continue to market our product candidate, if approved. Although we are ultimately
responsible  for  ensuring  compliance  with  these  regulatory  requirements,  we  do  not  have  day-to-day  control  over  a  contract  manufacturing  organization
(“CMO”) or other third-party manufacturer’s compliance with applicable laws and regulations, including cGMPs and other laws and regulations, such as
those related to environmental health and safety matters. Any failure to achieve and maintain compliance with these laws, regulations and standards could
subject us to the risk that we may have to suspend the manufacturing of our product candidate or that obtained approvals could be revoked, which would
adversely  affect  our  business  and  reputation.  In  addition,  third-party  contractors,  such  as  our  CMOs,  may  elect  not  to  continue  to  work  with  us  due  to
factors beyond our control. Although we have contracts in place, they may also refuse to work with us because of their own financial difficulties, business
priorities or other reasons, at a time that is costly or otherwise inconvenient for us. If we were unable to find adequate replacement or another acceptable
solution in time, our clinical trials could be delayed or our commercial activities could be harmed.

On August 10, 2020, we received a CRL. According to the CRL, after recent completion of a pre-approval inspection of the manufacturing facility of our
drug  product  manufacturer,  the  FDA  identified  deficiencies  resulting  in  a  Form  483,  which  is  a  list  of  conditions  or  practices  that  are  required  to  be
resolved prior to the approval of PEDMARK™.   The Company has developed a detailed plan and has dedicated, and continues to commit, significant
resources to addressing the CRL, while, in parallel, working with our third-party drug product manufacturer to be ready for re-inspection by the FDA. If the
FDA determines that these actions were not sufficient, or based on the re-inspection FDA officials do not recommend approval relative to the drug product
manufacturing facility, or if information deemed necessary by the FDA cannot be provided as part of our NDA submission or during the review period as
deemed appropriate on a timely basis, such events could further delay the progress of our NDA and could require additional Company actions that cannot
be completed during the review period which may adversely impact our business.

Problems with the quality of the work of third parties may lead us to seek to terminate our working relationships and use alternative service providers.
However, making this change may be costly and may delay clinical trials. In addition, it may be very challenging, and in some cases impossible, to find
replacement service providers that can develop and manufacture our drug candidates in an acceptable manner and at an acceptable cost and on a timely
basis. The sale of products containing any defects or any delays in the supply of necessary services could adversely affect our business, financial condition,
results of operations, and prospects.

27

 
 
 
 
 
 
 
 
Growth in the costs and expenses of components or raw materials may also adversely affect our business, financial condition, results of operations, and
prospects. Supply sources could be interrupted from time to time and, if interrupted, supplies may not be resumed (whether in part or in whole) within a
reasonable timeframe and at an acceptable cost or at all.

We plan to rely on third parties to conduct clinical trials for our product candidate. If these third parties do not successfully carry out their contractual
duties or meet expected deadlines, it may cause delays in commencing and completing clinical trials of our product candidate or we may be unable to
obtain marketing approval for or commercialize our product candidate.

Clinical trials must meet applicable FDA and foreign regulatory requirements. We do not have the ability to independently conduct clinical trials for our
product candidate. We expect to rely on third parties, such as CROs, medical institutions, clinical investigators and contract laboratories, to conduct all of
our clinical trials of our product candidate; however, we remain responsible for ensuring that each of our clinical trials is conducted in accordance with our
investigational plan and protocol. Moreover, the FDA and other foreign regulatory authorities require us to comply with IND and human subject protection
regulations and current good clinical practice standards, commonly referred to as GCPs, for conducting, monitoring, recording, and reporting the results of
clinical trials to ensure that the data and results are scientifically credible and accurate and that the trial subjects are adequately informed of the potential
risks of participating in clinical trials. Our reliance on third parties does not relieve us of these responsibilities and requirements. Regulatory authorities
enforce these GCPs through periodic inspections of trial sponsors, principal investigators and trial sites. If we or any of our third-party contractors fail to
comply with applicable GCPs, the clinical data generated in our clinical trials may be deemed unreliable and the FDA or comparable foreign regulatory
authorities may require us to perform additional clinical trials before approving our marketing applications. There is no assurance that upon inspection by a
given  regulatory  authority,  such  regulatory  authority  will  determine  that  any  of  our  clinical  trials  comply  with  GCPs.  Our  failure  to  comply  with  these
regulations may require us to repeat clinical trials, which would delay the marketing approval process.

There are significant requirements imposed on us and on clinical investigators who conduct clinical trials that we sponsor. Although we are responsible for
selecting qualified CROs or clinical investigators, providing them with the information they need to conduct the clinical trials properly, ensuring proper
monitoring  of  the  clinical  trials,  and  ensuring  that  the  clinical  trials  are  conducted  in  accordance  with  the  general  investigational  plan  and  protocols
contained in the IND, we cannot ensure that the CROs or clinical investigators will maintain compliance with all regulatory requirements at all times. The
pharmaceutical industry has experienced cases where clinical investigators have been found to incorrectly record data, omit data, or even falsify data. We
cannot ensure that the CROs or clinical investigators in our trials will not make mistakes or otherwise compromise the integrity or validity of data, any of
which would have a significant negative effect on our ability to obtain marketing approval, our business, and our financial condition.

We or the third parties we rely on may encounter problems in clinical trials that may cause us or the FDA or foreign regulatory agencies to delay, suspend
or terminate our clinical trials at any phase. These problems could include the possibility that we may not be able to manufacture sufficient quantities of
materials for use in our clinical trials, conduct clinical trials at our preferred sites, enroll a sufficient number of patients for our clinical trials at one or more
sites, or begin or successfully complete clinical trials in a timely fashion, if at all. Furthermore, we, the FDA or foreign regulatory agencies may suspend
clinical trials of our product candidate at any time if we or they believe the subjects participating in the trials are being exposed to unacceptable health
risks, whether as a result of adverse events occurring in our trials or otherwise, or if we or they find deficiencies in the clinical trial process or conduct of
the investigation.

The FDA and foreign regulatory agencies could also require additional clinical trials before or after granting of marketing approval for any products, which
would result in increased costs and significant delays in the development and commercialization of such products and could result in the withdrawal of
such products from the market after obtaining marketing approval. Our failure to adequately demonstrate the safety and efficacy of a product candidate in
clinical development could delay or prevent obtaining marketing approval of the product candidate and, after obtaining marketing approval, data from post-
approval studies could result in the product being withdrawn from the market, either of which would likely have a material adverse effect on our business.

Risks Related to Our Intellectual Property

We are dependent on our relationships and license agreements, and we rely upon the patent rights granted to us pursuant to the license agreements.

Our  commercial  success  will  depend  in  large  part  on  our  ability  to  use  patents  and  regulatory  exclusivity  to  exclude  others  from  competing  with  our
products. The patent position of emerging pharmaceutical companies like us can be highly uncertain and involve complex legal and technical issues. Until
our  licensed  patents  are  interpreted  by  a  court,  either  because  we  have  sought  to  enforce  them  against  a  competitor  or  because  a  competitor  has
preemptively challenged them, we will not know the breadth of protection that they will afford us. Our patents may not contain claims sufficiently broad to
prevent others from practicing our technologies or marketing competing products. Third parties may intentionally attempt to design around our patents or
design around our patents so as to compete with us without infringing our patents. Moreover, the issuance of a patent is not conclusive as to its validity or
enforceability, and so our patents may be invalidated or rendered unenforceable if challenged by others.

28

 
 
 
 
 
 
 
 
 
 
 
 
 
 
As a result of the foregoing factors, we cannot be certain how much protection from competition patent rights will provide us.

Our success will depend significantly on our ability to operate without infringing the patents and other proprietary rights of third parties.

While we are not currently aware of any third-party patents which we may infringe, there can be no assurance that we do not or will not infringe on patents
held by third parties or that third parties will not claim that we have infringed on their patents. In the event that our technologies infringe or violate the
patent or other proprietary rights of third parties, we may be prevented from pursuing product development, manufacturing or commercialization of our
products that utilize such technologies. There may be patents held by others of which we are unaware that contain claims that our products or operations
infringe. In addition, given the complexities and uncertainties of patent laws, there may be patents of which we are aware that we may ultimately be held to
infringe, particularly if the claims of the patent are determined to be broader than we believe them to be. Adding to this uncertainty, in the United States,
patent  applications  filed  in  recent  years  are  confidential  for  18  months,  while  older  applications  are  not  publicly  available  until  the  patent  issues.  As  a
result, avoiding patent infringement may be difficult.

If a third-party claims that we infringe its patents, any of the following may occur:

·

·

·

we  may  be  required  to  pay  substantial  financial  damages  if  a  court  decides  that  our  technologies  infringe  a  competitor’s  patent,  which  can  be
tripled if the infringement is deemed willful, or be required to discontinue or significantly delay development, marketing, selling and licensing of
our product and intellectual property rights;
a  court  may  prohibit  us  from  selling  or  licensing  our  product  without  a  license  from  the  patent  holder,  which  may  not  be  available  on
commercially acceptable terms or at all, or which may require us to pay substantial royalties or grant cross-licenses to our patents; and
we may have to redesign our product so that it does not infringe others’ patent rights, which may not be possible or could require substantial funds
or time and require additional studies.

In addition, employees, consultants, contractors and others may use the proprietary information of others in their work for us or disclose our proprietary
information to others. If our employees, consultants, contractors or others disclose our data to others or use data belonging to others in connection with our
business, it could lead to disputes over the ownership of inventions derived from that information or expose us to potential damages or other penalties.

The occurrence of any of these events could have a material adverse effect on our business, financial condition, results of operations or prospects.

We may incur substantial costs as a result of litigation or other proceedings relating to patent and other intellectual property rights.

There is substantial history of litigation and other proceedings regarding patent and intellectual property rights in the pharmaceutical industry. We may be
forced to defend claims of infringement brought by our competitors and others, and we may institute litigation against others who we believe are infringing
our  intellectual  property  rights.  The  outcome  of  intellectual  property  litigation  is  subject  to  substantial  uncertainties  and  may,  for  example,  turn  on  the
interpretation of claim language by the court, which may not be to our advantage, or on the testimony of experts as to technical facts upon which experts
may reasonably disagree.

Under our license agreements, we have the right to bring legal action against any alleged infringers of the patents we license. However, we are responsible
for all costs relating to such potential litigation. We have the right to any proceeds received as a result of such litigation, but, even if we are successful in
such litigation, there is no assurance we would be awarded any monetary damages.

Our involvement in intellectual property litigation could result in significant expense to us. Some of our competitors have considerable resources available
to  them  and  may  have  a  strong  economic  incentive  to  undertake  substantial  efforts  to  stop  or  delay  us  from  commercializing  our  product.  Moreover,
regardless of the outcome, intellectual property litigation against or by us could significantly disrupt our development and commercialization efforts, divert
our management’s attention and quickly consume our financial resources.

In  addition,  if  third  parties  file  patent  applications  or  issue  patents  claiming  technology  that  is  also  claimed  by  us  in  pending  applications,  we  may  be
required to participate in interference proceedings with the USPTO or in other proceedings outside the United States, including oppositions, to determine
priority  of  invention  or  patentability.  Even  if  we  are  successful  in  these  proceedings,  we  may  incur  substantial  costs,  and  the  time  and  attention  of  our
management and scientific personnel will be diverted from product development or other more productive matters.

29

 
 
 
 
 
 
 
 
 
 
 
 
 
Our proprietary rights may not adequately protect our technologies and product candidate.

Our  commercial  success  will  depend  in  part  on  our  ability  to  obtain  patents  and  protect  our  existing  patent  position  as  well  as  our  ability  to  maintain
adequate protection of other intellectual property for our technologies, product candidate, and any future products in the United States and other countries.
If we do not adequately protect our intellectual property, competitors may be able to use our technologies and erode or negate any competitive advantage
we may have, which could harm our business and ability to achieve profitability. The laws of some foreign countries do not protect our proprietary rights to
the same extent or in the same manner as United States laws, and we may encounter significant problems in protecting and defending our proprietary rights
in  these  countries.  We  will  be  able  to  protect  our  proprietary  rights  from  unauthorized  use  by  third  parties  only  to  the  extent  that  our  proprietary
technologies and product candidate are covered by valid and enforceable patents or are effectively maintained as trade secrets.

We  apply  for  patents  covering  both  our  technologies  and  product  candidate,  as  we  deem  appropriate.  However,  we  may  fail  to  apply  for  patents  on
important technologies or product candidate in a timely fashion, or at all. Our existing patents and any future patents we obtain may not be sufficiently
broad to prevent others from practicing our technologies or from developing competing products and technologies. We cannot be certain that our patent
applications will be approved or that any patents issued will adequately protect our intellectual property.

While we are responsible for and have control over the filing and prosecuting of patent applications and maintaining patents which cover making, using or
selling PEDMARKTM, we may lose any such rights if we decide to allow any licensed patent to lapse. If we fail to appropriately prosecute and maintain
patent protection for any of our product candidate, our ability to develop and commercialize those product candidate may be adversely affected and we may
not be able to prevent competitors from making, using and selling competing products.

Moreover, the patent positions of pharmaceutical companies are highly uncertain and involve complex legal and factual questions for which important legal
principles are evolving and remain unresolved. As a result, the validity and enforceability of patents cannot be predicted with certainty. In addition, we do
not know whether:

·
·
·

·
·
·
·
·
·

we or our licensors were the first to make the inventions covered by each of our issued patents and pending patent applications;
we or our licensors were the first to file patent applications for these inventions;
any  of  the  patents  that  cover  our  product  candidate  will  be  eligible  to  be  listed  in  the  FDA’s  compendium  of  “Approved  Drug  Products  with
Therapeutic Equivalence Evaluation,” sometimes referred to as the FDA’s Orange Book;
others will independently develop similar or alternative technologies or duplicate any of our technologies;
any of our or our licensors’ pending patent applications will result in issued patents;
any patents issued to us or our licensors and collaborators will provide us with any competitive advantages, or will be challenge by third parties;
we will develop additional proprietary technologies that are patentable;
the United States government will exercise any of its statutory rights to our intellectual property that was developed with government funding; or
our business may infringe the patents or other proprietary rights of others.

The actual protection afforded by a patent varies based on products or processes, from country to country and depends upon many factors, including the
type  of  patent,  the  scope  of  its  coverage,  the  availability  of  regulatory  related  extensions,  the  availability  of  legal  remedies  in  a  particular  country,  the
validity and enforceability of the patents and our financial ability to enforce our patents and other intellectual property. Our ability to maintain and solidify
our  proprietary  position  for  our  products  will  depend  on  our  success  in  obtaining  effective  claims  and  enforcing  those  claims  once  granted.  Our  issued
patents and those that may issue in the future, or those licensed to us, may be challenged, narrowed, invalidated or circumvented, and the rights granted
under any issued patents may not provide us with proprietary protection or competitive advantages against competitors with similar products. Due to the
extensive amount of time required for the development, testing and regulatory review of a potential product, it is possible that, before any of our product
candidate can be commercialized, any related patent may expire or remain in force for only a short period following commercialization, thereby reducing
any advantage of the patent.

We may also rely on trade secrets to protect some of our technology, especially where we do not believe patent protection is appropriate or obtainable.
However, trade secrets are difficult to maintain. While we use reasonable efforts to protect our trade secrets, we or any of our collaborators’ employees,
consultants, contractors or scientific and other advisors may unintentionally or willfully disclose our proprietary information to competitors and we may not
have adequate remedies in respect of that disclosure. Enforcement of claims that a third party has illegally obtained and is using trade secrets is expensive,
time consuming and uncertain. In addition, foreign courts are sometimes less willing than United States courts to protect trade secrets. If our competitors
independently develop equivalent knowledge, methods and know-how, we would not be able to assert our trade secrets against them and our business could
be harmed.

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

Filing,  prosecuting  and  defending  patents  on  our  product  candidate  in  all  countries  throughout  the  world  would  be  prohibitively  expensive,  and  our
intellectual property rights in some countries outside the United States can be less extensive than those in the United States. In addition, the laws of some
foreign countries do not protect intellectual property rights to the same extent as federal and state laws in the United States. For example, many foreign
countries have compulsory licensing laws under which a patent owner must grant licenses to third parties. Consequently, we may not be able to prevent
third parties from practicing our inventions in all countries outside the United States, or from selling or importing products made using our inventions in
and into the United States or other jurisdictions. Competitors may use our technologies in jurisdictions where we have not obtained patent protection to
develop their own products and further, may export otherwise infringing products to territories where we have patent protection, but enforcement rights are
not  as  strong  as  those  in  the  United  States.  These  products  may  compete  with  our  product  candidate  in  jurisdictions  where  we  do  not  have  any  issued
patents and our patent claims or other intellectual rights may not be effective or sufficient to prevent them from so competing.

30

 
 
 
 
 
 
 
 
 
 
 
 
Many companies have encountered significant problems in protecting and defending intellectual property rights in foreign jurisdictions. The legal systems
of  certain  countries  do  not  favor  the  enforcement  of  patents  and  other  intellectual  property  protection,  which  could  make  it  difficult  for  us  to  stop  the
infringement of our patents generally. Proceedings to enforce our patent rights in foreign jurisdictions could result in substantial costs and divert our efforts
and attention from other aspects of our business, could put our patents at risk of being invalidated or interpreted narrowly and our patent applications at risk
of not issuing and could provoke third parties to assert claims against us. We may not prevail in any lawsuits that we initiate and the damages or other
remedies awarded, if any, may not be commercially meaningful. Accordingly, our efforts to enforce our intellectual property rights around the world may
be inadequate to obtain a significant commercial advantage from the intellectual property that we develop or license.

The patent protection for our product candidate may expire before we are able to maximize their commercial value, which may subject us to increased
competition and reduce or eliminate our opportunity to generate product revenue.

The patents for our product candidate have varying expiration dates and, if these patents expire, we may be subject to increased competition and we may
not be able to recover our development costs or market any of our approved products profitably. In some of the larger potential market territories, such as
the  United  States  and  Europe,  patent  term  extension  or  restoration  may  be  available  to  compensate  for  time  taken  during  aspects  of  the  product’s
development and regulatory review. For example, depending on the timing, duration and specifics of FDA marketing approval of our product candidate, if
any,  one  of  the  United  States  patents  covering  each  of  such  approved  product(s)  or  the  use  thereof  may  be  eligible  for  up  to  five  years  of  patent  term
restoration under the Hatch-Waxman Act. The Hatch-Waxman Act allows a maximum of one patent to be extended per FDA-approved product. Patent term
extension also may be available in certain foreign countries upon regulatory approval of our product candidate.

Nevertheless, we may not be granted patent term extension either in the United States or in any foreign country because of, for example, failing to apply
within applicable deadlines, failing to apply prior to expiration of relevant patents or otherwise failing to satisfy applicable requirements. Moreover, the
term  of  extension,  as  well  as  the  scope  of  patent  protection  during  any  such  extension,  afforded  by  the  governmental  authority  could  be  less  than  we
request. In addition, even though some regulatory authorities may provide some other exclusivity for a product under their own laws and regulations, we
may  not  be  able  to  qualify  the  product  or  obtain  the  exclusive  time  period.  If  we  are  unable  to  obtain  patent  term  extension/restoration  or  some  other
exclusivity, we could be subject to increased competition and our opportunity to establish or maintain product revenue could be substantially reduced or
eliminated. Furthermore, we may not have sufficient time to recover our development costs prior to the expiration of our United States and foreign patents.

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

The  USPTO  and  various  foreign  governmental  patent  agencies  require  compliance  with  a  number  of  procedural,  documentary,  fee  payment  and  other
similar provisions during the patent prosecution process. Periodic maintenance fees, renewal fees, annuity fees and various other governmental fees on any
issued patent and/or pending patent applications are due to be paid to the USPTO and foreign patent agencies in several stages over the lifetime of a patent
or patent application. We employ an outside firm and rely on our outside counsel to pay these fees. While an inadvertent lapse may sometimes be cured by
payment  of  a  late  fee  or  by  other  means  in  accordance  with  the  applicable  rules,  there  are  many  situations  in  which  noncompliance  can  result  in
abandonment  or  lapse  of  the  patent  or  patent  application,  resulting  in  partial  or  complete  loss  of  patent  rights  in  the  relevant  jurisdiction.  If  we  fail  to
maintain  the  patents  and  patent  applications  directed  to  our  product  candidate,  our  competitors  might  be  able  to  enter  the  market  earlier  than  should
otherwise have been the case, which would have a material adverse effect on our business.

We  may  become  involved  in  lawsuits  to  protect  our  patents  or  other  intellectual  property  rights,  which  could  be  expensive,  time-consuming  and
ultimately unsuccessful.

Competitors  may  infringe  our  patents  or  other  intellectual  property  rights.  To  counter  infringement  or  unauthorized  use,  we  may  be  required  to  file
infringement claims, directly or through our licensors, which can be expensive and time consuming. In addition, in an infringement proceeding, a court
may decide that a patent of ours or of our licensors is not valid or is unenforceable, or may 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 any litigation or defense proceedings could put one or more of
our patents or the patents we license at risk of being invalidated or interpreted narrowly and could put our ot our licensors’ patent applications at risk of not
issuing.

31

 
 
 
 
 
 
 
 
 
 
Interference proceedings brought by the USPTO may be necessary to determine the priority of inventions with respect to our patents or the patents of our
licensors. An unfavorable outcome could require us to cease using the technology or to attempt to license rights to it from the prevailing party. Our business
could be harmed if a prevailing party does not offer us a license on terms that are acceptable to us. Litigation or interference proceedings may fail and, even
if successful, may result in substantial costs and distraction of our management and other employees. We may not be able to prevent, alone or with our
licensors, misappropriation of our proprietary rights, particularly in countries where the laws may not protect those rights as fully as in the United States. In
addition, potential infringers of our intellectual property rights may have substantially more resources than we do to defend their position, which could
adversely affect the outcome of any such dispute.

Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of our
confidential  and  proprietary  information  could  be  compromised  by  disclosure  during  this  type  of  litigation.  In  addition,  there  could  be  public
announcements of the results of hearings, motions or other interim proceedings or developments. If securities analysts or investors perceive these results to
be negative, it could have a substantial adverse effect on the price of our common stock.

Third-party claims of intellectual property infringement or misappropriation may adversely affect our business and could prevent us from developing
or commercializing our product candidate.

Our commercial success depends in part on us not infringing the patents and proprietary rights of third parties. There is a substantial amount of litigation,
both  within  and  outside  the  United  States,  involving  patent  and  other  intellectual  property  rights  in  the  biotechnology  and  pharmaceutical  industries,
including patent infringement lawsuits, interferences, oppositions, ex-parte review and inter partes reexamination and post-grant review proceedings before
the USPTO and corresponding foreign patent offices. Numerous United States and foreign issued patents and pending patent applications owned by third
parties exist in the fields in which we are developing and may develop our product candidate. As the biotechnology and pharmaceutical industries expand
and more patents are issued, the risk increases that our product candidate may be subject to claims of infringement of the patent rights of third parties. If a
third party claims that we infringe on their products or technology, we could face a number of issues, including:

·

·
·

·
·

infringement and other intellectual property claims which, with or without merit, can be expensive and time-consuming to litigate and can divert
management’s attention from our core business;
substantial damages for past infringement, which we may have to pay if a court decides that our product infringes on a competitor’s patent;
a court prohibiting us from selling or licensing our product unless the patent holder licenses the patent to us, which the collaborator would not be
required to do;
if a license is available from a patent holder, we may have to pay substantial royalties or grant cross licenses to our patents; and
redesigning our processes so they do not infringe, which may not be possible or could require substantial funds and time.

Third parties may assert that we are employing their proprietary technology without authorization. There may be third-party patents or patent applications
with claims to materials, formulations, methods of manufacture or methods for treatment related to the use or manufacture of our product candidate that we
failed to identify. For example, applications filed before November 29, 2000 and certain applications filed after that date that will not be filed outside the
United States remain confidential until issued as patents. Except for the preceding exceptions, patent applications in the United States and elsewhere are
generally published only after a waiting period of approximately 18 months after the earliest filing. Therefore, patent applications covering our product
candidate  could  have  been  filed  by  others  without  the  knowledge  of  us  or  our  licensors.  Additionally,  pending  patent  applications  which  have  been
published can, subject to certain limitations, be later amended in a manner that could cover our product candidate or the use or manufacture of our product
candidate. We may also face a claim of misappropriation if a third party believes that we inappropriately obtained and used trade secrets of such third party.
If we are found to have misappropriated a third party’s trade secrets, we may be prevented from further using such trade secrets, limiting our ability to
develop our product candidate, and we may be required to pay damages.

If  any  third-party  patents  were  held  by  a  court  of  competent  jurisdiction  to  cover  aspects  of  our  materials,  formulations,  methods  of  manufacture  or
methods for treatment, the holders of any such patents would be able to block our ability to develop and commercialize the applicable product candidate
until such patent expired or unless we obtain a license. These licenses may not be available on acceptable terms, if at all. Even if we were able to obtain a
license, the rights may be nonexclusive, which could result in our competitors gaining access to the same intellectual property.

Ultimately, we could be prevented from commercializing a product, or be forced to cease some aspect of our business operations, if, as a result of actual or
threatened patent infringement claims, we are unable to enter into licenses on acceptable terms.

Parties  making  claims  against  us  may  obtain  injunctive  or  other  equitable  relief,  which  could  effectively  block  our  ability  to  further  develop  and
commercialize one or more of our product candidates. Defending against claims of patent infringement or misappropriation of trade secrets could be costly
and time-consuming, regardless of the outcome. Thus, even if we were to ultimately prevail, or to settle at an early stage, such litigation could burden us
with  substantial  unanticipated  costs.  In  addition,  litigation  or  threatened  litigation  could  result  in  significant  demands  on  the  time  and  attention  of  our
management team, distracting them from the pursuit of other company business. In the event of a successful claim of infringement against us, we may have
to pay substantial damages, including treble damages and attorneys’ fees for willful infringement, pay royalties, redesign our infringing products or obtain
one  or  more  licenses  from  third  parties,  which  may  be  impossible  or  require  substantial  time  and  monetary  expenditure.  In  addition,  the  uncertainties
associated with litigation could have a material adverse effect on our ability to raise the funds necessary to continue our clinical trials, continue our research
programs,  license  necessary  technology  from  third  parties,  or  enter  into  development  collaborations  that  would  help  us  bring  our  product  candidate  to
market.

32

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

As  is  the  case  with  other  pharmaceutical  companies,  our  success  is  heavily  dependent  on  intellectual  property,  particularly  on  obtaining  and  enforcing
patents  and  patent  rights.  Obtaining  and  enforcing  patents  and  patent  rights  in  the  pharmaceutical  industry  involves  both  technological  and  legal
complexity,  and  therefore,  is  costly,  time-consuming  and  inherently  uncertain.  In  addition,  the  United  States  has  recently  enacted  and  is  currently
implementing wide-ranging patent reform legislation. Further, several recent United States Supreme Court rulings have either narrowed the scope of patent
protection available in certain circumstances or weakened the rights of patent owners in certain situations. In addition to increasing uncertainty with regard
to our ability to obtain patents in the future, this combination of events has created uncertainty with respect to the value of patents and patent rights, once
obtained.

For our United States patent applications containing a claim not entitled to priority before March 16, 2013, there is a greater level of uncertainty in the
patent  law.  In  September  2011,  the  Leahy-Smith  America  Invents  Act  (the  “America  Invents  Act”  or  “AIA”)  was  signed  into  law.  The  AIA  includes  a
number of significant changes to United States patent law, including provisions that affect the way patent applications will be prosecuted, reviewed after
issuance, and may also affect patent litigation. The USPTO is currently developing regulations and procedures to govern administration of the AIA, and
many of the substantive changes to patent law associated with the AIA. It is not clear what other, if any, impact the AIA will have on the operation of our
business. Moreover, the AIA and its implementation could increase the uncertainties and costs surrounding the prosecution of patent applications and the
enforcement or defense of patent rights, all of which could have a material adverse effect on our business and financial condition.

An important change introduced by the AIA is that, as of March 16, 2013, the United States transitioned to a “first-inventor-to-file” system for deciding
which party should be granted a patent when two or more patent applications are filed by different parties claiming the same invention. A third party that
files a patent application in the USPTO after that date but before a licensor or us could therefore be awarded a patent covering an invention of ours even if
said  licensor  or  we  had  made  the  invention  before  it  was  made  by  the  third  party. This  will  require  us  to  be  cognizant  going  forward  of  the  time  from
invention  to  filing  of  a  patent  application.  Furthermore,  our  ability  to  obtain  and  maintain  valid  and  enforceable  patent  rights  depends  on  whether  the
differences between the licensor’s or our technology and the prior art allow our technology to be patentable over the prior art. Since patent applications in
the United States and most other countries are confidential for a period of time after filing, we cannot be certain that a licensor or we were the first to either
(a) file any patent application related to our product candidate or (b) invent any of the inventions claimed in our patents or patent applications.

Among  some  of  the  other  changes  introduced  by  the  AIA  are  changes  that  limit  where  a  patentee  may  file  a  patent  infringement  suit  and  providing
opportunities for third parties to challenge any issued patent in the USPTO. This applies to all United States patents, even those issued before March 16,
2013.  Because  of  a  lower  evidentiary  standard  in  USPTO  proceedings  compared  to  the  evidentiary  standard  in  United  States  federal  court  necessary  to
invalidate  a  patent  claim,  a  third  party  could  potentially  provide  evidence  in  a  USPTO  proceeding  sufficient  for  the  USPTO  to  hold  a  claim  invalid  as
unpatentable even though the same evidence may be insufficient to invalidate the claim if first presented in a district court action. Accordingly, a third party
may  attempt  to  use  the  USPTO  procedures  to  invalidate  patent  rights  that  would  not  have  been  invalidated  if  first  challenged  by  the  third  party  as  a
defendant in a district court action.

Depending on decisions by the United States Congress, the federal courts, and the USPTO, the laws and regulations governing patents could change in
unpredictable ways that would weaken our ability to obtain new patents or to enforce our existing patents and patents that we might obtain in the future.

Intellectual property rights do not address all potential threats to our competitive advantage.

The degree of future protection afforded by our intellectual property rights is uncertain because intellectual property rights have limitations, and may not
adequately protect our business, or permit us to maintain our competitive advantage. The following examples are illustrative:

·

·

·

·

Others may be able to make products that are similar to our product candidate but that are not covered by the claims of the patents that we license
from others or may license or own in the future;
Others  may  independently  develop  similar  or  alternative  technologies  or  otherwise  circumvent  any  of  our  technologies  without  infringing  our
intellectual property rights;
Any  of  our  collaborators  might  not  have  been  the  first  to  conceive  and  reduce  to  practice  the  inventions  covered  by  the  patents  or  patent
applications that we license or will, in the future, own or license;
Issued patents that have been licensed to us may not provide us with any competitive advantage, or may be held invalid or unenforceable, as a
result of legal challenges by our competitors;

33

 
 
 
 
 
 
 
 
 
 
·

·
·

Our  competitors  might  conduct  research  and  development  activities  in  countries  where  we  do  not  have  license  rights,  or  in  countries  where
research and development safe harbor laws exist, and then use the information learned from such activities to develop competitive products for
sale in our major commercial markets;
Ownership of patents or patent applications licensed to us may be challenged by third parties;
The patents of third parties or pending or future applications of third parties, if issued, may have an adverse effect on our business.

Confidentiality agreements with employees, consultants and others may not adequately prevent disclosure of trade secrets and protect other proprietary
information.

We  consider  proprietary  trade  secrets  and/or  confidential  know-how  and  unpatented  know-how  to  be  important  to  our  business.  We  may  rely  on  trade
secrets and/or confidential know-how to protect our technology, especially where patent protection is believed by us to be of limited value. However, trade
secrets and/or confidential know-how can be difficult to maintain as confidential.

To protect this type of information against disclosure or appropriation by competitors, our policy is to require our employees, consultants, contractors and
advisors to enter into confidentiality agreements with us. However, current or former employees, consultants, contractors and advisers may unintentionally
or  willfully  disclose  our  confidential  information  to  competitors,  and  confidentiality  agreements  may  not  provide  an  adequate  remedy  in  the  event  of
unauthorized disclosure of confidential information. Enforcing a claim that a third party obtained illegally and is using trade secrets and/or confidential
know-how is expensive, time consuming and unpredictable. The enforceability of confidentiality agreements may vary from jurisdiction to jurisdiction.

Failure to obtain or maintain trade secrets and/or confidential know-how trade protection could adversely affect our competitive position. Moreover, our
competitors may independently develop substantially equivalent proprietary information and may even apply for patent protection in respect of the same. If
successful in obtaining such patent protection, our competitors could limit our use of our trade secrets and/or confidential know-how.

We may need to license certain intellectual property from third parties, and such licenses may not be available or may not be available on commercially
reasonable terms.

A third party may hold intellectual property, including patent rights, that are important or necessary to the development or commercialization of our product
candidate. It may be necessary for us to use the patented or proprietary technology of third parties to commercialize our product candidate, in which case
we would be required to obtain a license from these third parties. Such a license may not be available on commercially reasonable terms or at all, which
could materially harm our business.

We may be subject to claims that our employees, consultants or independent contractors have wrongfully used or disclosed confidential information of
third parties.

We have received confidential and proprietary information from third parties. In addition, we employ individuals who were previously employed at other
biotechnology  or  pharmaceutical  companies.  We  may  be  subject  to  claims  that  we  or  our  employees,  consultants  or  independent  contractors  have
inadvertently or otherwise improperly used or disclosed confidential information of these third parties or our employees’ former employers.

Further, we may be subject to ownership disputes in the future arising, for example, from conflicting obligations of consultants or others who are involved
in developing our product candidate. We may also be subject to claims that former employees, consultants, independent contractors, collaborators or other
third parties have an ownership interest in our patents or other intellectual property. Litigation may be necessary to defend against these and other claims
challenging  our  right  to  and  use  of  confidential  and  proprietary  information.  If  we  fail  in  defending  any  such  claims,  in  addition  to  paying  monetary
damages, we may lose our rights therein. Such an outcome could have a material adverse effect on our business.

Even  if  we  are  successful  in  defending  against  these  claims,  litigation  could  result  in  substantial  cost  and  be  a  distraction  to  our  management  and
employees.

Our reliance on third parties requires us to share our trade secrets, which increases the possibility that a competitor will discover them or that our trade
secrets will be misappropriated or disclosed.

Because we rely on third parties to assist with research and development and to manufacture our product candidate, we must, at times, share trade secrets
with  them.  We  seek  to  protect  our  proprietary  technology  in  part  by  entering  into  confidentiality  agreements  and,  if  applicable,  material  transfer
agreements,  consulting  agreements  or  other  similar  agreements  with  our  advisors,  employees,  third-party  contractors  and  consultants  prior  to  beginning
research  or  disclosing  proprietary  information.  These  agreements  typically  limit  the  rights  of  the  third  parties  to  use  or  disclose  our  confidential
information, including our trade secrets. Despite the contractual provisions employed when working with third parties, the need to share trade secrets and
other  confidential  information  increases  the  risk  that  such  trade  secrets  become  known  by  our  competitors,  are  inadvertently  incorporated  into  the
technology of others, or are disclosed or used in violation of these agreements. Given that our proprietary position is based, in part, on our know-how and
trade secrets, a competitor’s discovery of our trade secrets or other unauthorized use or disclosure would impair our competitive position and may have a
material adverse effect on our business.

34

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In  addition,  these  agreements  typically  restrict  the  ability  of  our  advisors,  employees,  third-party  contractors  and  consultants  to  publish  data  potentially
relating to our trade secrets, although our agreements may contain certain limited publication rights. For example, any academic institution that we may
collaborate  with  in  the  future  will  usually  expect  to  be  granted  rights  to  publish  data  arising  out  of  such  collaboration,  provided  that  we  are  notified  in
advance and given the opportunity to delay publication for a limited time period in order for us to secure patent protection of intellectual property rights
arising from the collaboration, in addition to the opportunity to remove confidential or trade secret information from any such publication. In the future, we
may also conduct joint research and development programs that may require us to share trade secrets under the terms of our research and development or
similar agreements. Despite our efforts to protect our trade secrets, our competitors may discover our trade secrets, either through breach of our agreements
with third parties, independent development or publication of information by any of our third-party collaborators. A competitor’s discovery of our trade
secrets would impair our competitive position and have an adverse impact on our business.

Risks Related to Our Industry

Drug development involves a lengthy and expensive process with an uncertain outcome, and results of earlier studies and trials may not be predictive of
future trial results.

Conducting  clinical  trials  is  a  lengthy,  time-consuming  and  expensive  process.  Before  obtaining  regulatory  approvals  for  the  commercial  sale  of  any
products, we, or our potential partners, must demonstrate through preclinical testing and clinical trials that our product candidates are safe and effective for
their  intended  uses  in  humans.  We  have  incurred  and  may  continue  to  incur  substantial  expense  and  devote  a  significant  amount  of  time  to  preclinical
testing and clinical trials.

The outcome of clinical testing is inherently uncertain. Failure can occur at any time during the clinical trial process. The results of preclinical studies and
early  clinical  trials  of  product  candidates  may  not  be  predictive  of  the  results  of  later-stage  clinical  trials.  In  addition,  regulations  are  not  static,  and
regulatory agencies, including the FDA, alter their staff, interpretations and practices and may in the future impose more stringent requirements than are
currently  in  effect,  which  may  adversely  affect  our  planned  drug  development  and/or  our  commercialization  efforts.  Satisfying  regulatory  requirements
typically takes a significant number of years and can vary substantially based on the type, complexity and novelty of the product candidate. Our business,
results of operations and financial condition may be materially adversely affected by any delays in, or termination of, our clinical trials. Factors that could
impede our ability to generate commercially viable products through the conduct of clinical trials include:

·
·
·

·

·

·
·

·
·

insufficient funds to conduct clinical trials;
the inability to find partners, if necessary, for support, including research, development, manufacturing or clinical needs;
the  failure  of  tests  or  studies  necessary  to  submit  an  NDA,  such  as  clinical  studies,  bioequivalence  studies  in  support  of  a  505(b)
(2) regulatory filing, or stability studies;
the failure of clinical trials to demonstrate the safety and efficacy of our product candidate to the extent necessary to obtain regulatory
approvals;
the failure by us or third-party investigators, CROs, or other third parties involved in the research to adhere to regulatory requirements
applicable to the conduct of clinical trials;
the failure of preclinical testing and early clinical trials to predict results of later clinical trials;
any delay in completion of clinical trials caused by a regional disturbance where we or our collaborative partners are enrolling patients in
clinical studies, such as pandemic, terrorist activities, or war, or political unrest, a natural disaster or any other reason or event, resulting
in increased costs;
any delay in obtaining advice from the FDA or similar regulatory authorities; and
the inability to obtain regulatory approval of our product candidate following completion of clinical trials, or delays in obtaining such
approvals.

There can be no assurance that if our clinical trials are successfully initiated and completed, we will be able to obtain approval by the FDA in the U.S. or
similar regulatory authorities elsewhere in the world in a timely manner, if at all. For example, as described elsewhere, we received a CRL from the FDA in
August,  2020,  regarding  our  NDA  for  PEDMARKTM,  stating  that  it  was  unable  to  approve  the  application  in  its  current  form  based  on  deficiencies
identified by the FDA after completion of a pre-approval inspection of the manufacturing facility of our third-party drug product manufacturer. Even if we
are successful in resolving some or all of the matters raised by the FDA in the CRL, there is significant risk that we will be unable to obtain FDA approval
for PEDMARKTM on a timely basis or at all. If we fail to successfully develop and commercialize PEDMARKTM we may be unable to generate sufficient
revenues to attain profitability, and our reputation in the industry and in the investment community would likely be damaged, each of which would cause
our stock price to decrease.

35

 
 
 
 
 
 
 
 
We use hazardous materials and chemicals in our research and development, and our failure to comply with laws related to hazardous materials
could materially harm us.

Our research and development processes, while outsourced, does involve the controlled use of hazardous materials, such as flammable organic solvents,
corrosive acids and corrosive bases. Accordingly, we are subject to federal, state, local and foreign laws and regulations governing the use, manufacture,
storage, handling and disposal of such materials and certain waste products. The risk of accidental contamination or injury from these materials cannot be
completely eliminated. We could be held liable for any damages that result and any such liability could exceed our resources and may not be covered by
our general liability insurance. We currently do not carry insurance specifically for hazardous materials claims. We may be required to incur significant
costs to comply with environmental laws and regulations, which may change from time to time.

Efforts  to  reduce  product  pricing  and  health  care  reimbursement  and  changes  to  government  policies  could  negatively  affect  the
commercialization of our product candidate.

If our product candidate achieves regulatory approval, we may be materially adversely affected by the continuing efforts of governmental and third-party
payers to contain or reduce health care costs. For example, if we succeed in bringing one or more products to market, such products may not be considered
cost-effective and the availability of consumer reimbursement may not exist or be sufficient to allow the sale of such products on a competitive basis. The
constraints on pricing and availability of competitive products may further limit our pricing and reimbursement policies as well as adversely impact market
acceptance and commercialization of our product candidate.

In many markets, the pricing or profitability of healthcare products is subject to government control. In recent years, federal, state, provincial and local
officials  and  legislators  have  proposed  or  are  proposing  a  variety  of  price-based  reforms  to  the  healthcare  systems  in  the  United  States,  Canada  and
elsewhere.  Some  proposals  include  measures  that  would  limit  or  eliminate  payments  from  third-party  payors  to  the  consumer  for  certain  medical
procedures and treatments or allow government control of pharmaceutical pricing. The adoption of any such proposals or reforms could adversely affect the
commercial viability of our product candidate.

In the United States, there have been and continue to be a number of legislative initiatives to contain healthcare costs. For example, in 2010, the Affordable
Care Act was passed, which substantially changes the way health care is financed by both governmental and private insurers, and significantly impacts the
U.S. pharmaceutical industry.

Some states are also considering legislation that would control the prices of drugs, and state Medicaid programs are increasingly requesting manufacturers
to pay supplemental rebates and requiring prior authorization by the state program for use of any drug for which supplemental rebates are not being paid.
Managed care organizations continue to seek price discounts and, in some cases, to impose restrictions on the coverage of particular drugs. Government
efforts to reduce Medicaid expenses may lead to increased use of managed care organizations by Medicaid programs. This may result in managed care
organizations influencing prescription decisions for a larger segment of the population and a corresponding constraint on prices and reimbursement for our
products.

Since its enactment, there have been judicial and Congressional challenges to numerous aspects of the Affordable Care Act. There may also be federal and
state regulatory changes that impact the Affordable Care Act or healthcare programs, insurance coverage or reimbursement generally. These efforts have
increased  uncertainty  regarding  the  availability  of  healthcare  programs,  insurance  coverage  and  reimbursement  as  a  general  matter  as  well  as  for  our
product candidate, and we cannot predict how these events will impact our business.

In addition, there has been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which have
resulted in several recent Congressional inquiries and proposed bills designed to, among other things, bring more transparency to product pricing, review
the  relationship  between  pricing  and  manufacturer  patient  programs,  reduce  the  price  of  drugs  under  Medicare  and  reform  government  program
reimbursement methodologies for products. We expect that additional state and federal healthcare reform measures will be adopted in the future, any of
which could limit the amounts that federal and state governments will pay for healthcare products and services, which could result in reduced demand for
our product candidate or additional pricing pressures.

Any significant changes in the healthcare system in the United States, Canada or abroad would likely have a substantial impact on the manner in which we
conduct business and could have a material adverse effect on our ability to raise capital and the viability of product commercialization.

36

 
 
 
 
 
 
 
 
 
 
 
 
Risks Related to Owning Our Common Shares

We may be unable to maintain the listing of our common shares on the Nasdaq Capital Market or the TSX and that would make it more difficult
for shareholders to dispose of our common shares.

Our common shares are currently listed on the Nasdaq Capital Market and the Toronto Stock Exchange (the “TSX”). Both the Nasdaq Capital Market and
the TSX have rules for continued listing, including minimum market capitalization and other requirements that we might not meet in the future. While we
are exercising diligent efforts to maintain the listing of our common shares on the NASDAQ Capital Market and TSX, there can be no assurance that we
will be able to do so, and our securities could be delisted.

Delisting from the Nasdaq Capital Market or the TSX would make it more difficult for shareholders to dispose of our common shares and more difficult to
obtain accurate quotations on our common shares. This could have an adverse effect on the price of our common shares. There can be no assurances that a
market maker will make a market in our common shares on the OTCQB or any other stock quotation system after delisting. Furthermore, securities quoted
over-the-counter generally have significantly less liquidity than securities traded on a national securities exchange, not only in the number of shares that
can  be  bought  and  sold,  but  also  through  delays  in  the  timing  of  transactions  and  lower  market  prices  than  might  otherwise  be  obtained.  As  a  result,
shareholders might find it difficult to resell shares at prices quoted in the market or at all. Furthermore, because of the limited market and generally low
volume  of  trading  in  our  common  shares,  our  common  shares  are  more  likely  to  be  affected  by  broad  market  fluctuations,  general  market  conditions,
fluctuations in our operating results, changes in the market’s perception of our business, and announcements made by us, our competitors or parties with
whom we have business relationships. Our ability to issue additional securities for financing or other purposes, or to otherwise arrange for any financing we
may need in the future, may also be materially and adversely affected by the limited market and low trading volume of our common shares.

The market price of our common shares is highly volatile and could cause the value of your investment to significantly decline.

Historically, the market price of our common shares has been highly volatile and the market for our common shares has from time-to-time experienced
significant price and volume fluctuations, some of which are unrelated to our operating performance. From January 1, 2018 to March 29, 2021, the closing
trading  price  of  our  stock  fluctuated  from  a  high  of  $18.45  Canadian  dollars  (“CAD”)  per  share  to  a  low  of  CAD$4.38  per  share  on  the  TSX.  From
September 13, 2017 (the date our common shares were first listed on the Nasdaq Capital Market) to March 29, 2021, the closing trading price of our stock
fluctuated  from  a  high  of  $14.33  per  share  to  a  low  of  $3.30  on  the  Nasdaq  Capital  Market.  Historically,  our  common  shares  have  had  a  low  trading
volume, and may continue to have a low trading volume in the future. This low volume may contribute to the volatility of the market price of our common
shares. It is likely that the market price of our common shares will continue to fluctuate significantly in the future.

The market price of our common shares may be significantly affected by many factors, including without limitation:

·
·
·
·

·
·
·
·
·
·
·
·

the development of our sole product candidate, PEDMARKTM;
the need to raise additional capital and the terms of any transaction we are able to enter into;
other external factors generally or stock market trends in the pharmaceutical or biotechnology industries specifically;
announcements  of  licensing  agreements,  joint  ventures,  collaborations  or  other  strategic  alliances  that  involve  our  product  or  those  of  our
competitors;
innovations related to our or our competitors’ products;
actual or potential clinical trial results related to our or our competitors’ products;
the status, timing and outcome of regulatory approvals;
our financial results or those of our competitors;
reports of securities analysts regarding us or our competitors;
developments or disputes concerning our licensed or owned patents or those of our competitors;
developments with respect to the efficacy or safety of our product or those of our competitors; and
health care reforms and reimbursement policy changes nationally and internationally.

Our existing principal shareholders hold a substantial number of our common shares and may be able to exercise influence in matters requiring
approval of our shareholders.

At March 29, 2021, our current shareholders separately representing more than 5% ownership of our common shares collectively represented beneficial
ownership of approximately 47.06% of our common shares. In particular, Southpoint Capital Advisors LP (“Southpoint Capital”) owns or exercises control
over  approximately  4.0  million  shares,  representing  approximately  15.68%  of  our  issued  and  outstanding  common  shares;  Essetifin  SpA,  owns
approximately  4.0  million  shares,  or  approximately  15.36%  of  our  issued  and  outstanding  common  shares;  Sonic  Fund  II,  LP,  owns  approximately  2.5
million shares, or approximately 9.60% of our issued and outstanding common shares; and Avoro Capital Advisors owns approximately 1.7 million shares,
or approximately 6.42% of our issued and outstanding common shares. Southpoint Capital, Essetifin SpA, Sonic Fund II, LP, Avoro Capital Advisors, and
our other significant shareholders, and other insiders, acting alone or together, might be able to influence the outcomes of matters that require the approval
of our shareholders, including but not limited to certain equity transactions (such as a financing), an acquisition or merger with another company, a sale of
substantially  all  of  our  assets,  the  election  and  removal  of  directors,  or  amendments  to  our  incorporating  documents.  These  shareholders  might  make
decisions that are adverse to your interests. The concentration of ownership could have the effect of delaying, preventing or deterring a change of control of
our  Company,  which  could  adversely  affect  the  market  price  of  our  common  shares  or  deprive  our  other  shareholders  of  an  opportunity  to  receive  a
premium for our common shares as part of a sale of our Company.

37

 
 
 
 
 
 
 
 
 
 
 
There are a large number of our common shares underlying outstanding options, and reserved for issuance under our stock option plan, that may
be sold in the market, which could depress the market price of our shares and result in substantial dilution to the holders of our common shares.

The sale or issuance of a substantial amount of our common shares in the future could cause the market price of our common shares to decline. It may also
impair our ability to obtain additional financing. At March 29, 2021, we had outstanding warrants to purchase approximately 0.04 million shares of our
common  shares  at  an  exercise  price  of  $6.80  per  common  share.  In  addition,  at  March  29,  2021,  there  were  approximately  3.0  million  common  shares
issuable  upon  the  exercise  of  outstanding  stock  options  with  a  weighted  average  exercise  price  of  $4.82  per  common  share.  We  may  also  issue  further
warrants as part of any future financings in addition to the additional 3.5 million options to acquire our common shares currently remaining and available
for future awards under our stock option plan.

We  may  need  to  raise  additional  funds  in  the  future  to  continue  our  operations.  Any  equity  offering  could  result  in  significant  dilution  to  the
ownership interests of shareholders and may result in dilution of the value of such interests and any debt offering will increase financial risk.

In order to satisfy our anticipated capital requirements to develop our product, we may need to raise additional funds through either the sale of additional
equity, the issuance of securities convertible into equity, the issuance of debt, the establishment of collaborations that provide us with funding, the out-
license or sale of certain aspects of our intellectual property portfolio, or from other sources. The most likely sources of financing that may be available to
us in the near term are the sale of common shares and/or securities convertible or exercisable into common shares and the issuance of debt.

We cannot predict the size of future issues of common shares or the future issue of securities convertible or exercisable into common shares or the effect
that any such future issues and sales of common shares or other securities will have on the market price of our common shares. Any transaction involving
the issue of common shares, or securities convertible or exercisable into common shares, could result in immediate and substantial dilution to present and
prospective holders of our common shares. Alternatively, we may rely on debt financing and assume debt obligations that require us to make substantial
interest and capital payments and to pledge some or all of our assets as collateral to secure such debt obligations. Failure to meet out debt obligations could
result in an acceleration of the debt and enforcement against our assets pledged as collateral, either of which would have an adverse effect on our operations
and prospects.

Our management has significant flexibility in using the current available cash.

In  addition  to  general  corporate  purposes  (including  working  capital,  research  and  development,  business  development  and  operational  purposes),  we
currently intend to use our available cash to continue the development of our drug candidate PEDMARK™, to seek regulatory approval for PEDMARK™,
and to invest in precommercial activities for PEDMARK™. Depending on future developments and circumstances, we may use some of our available cash
for other purposes, which may have the potential to decrease our cash runway. Notwithstanding our current intentions regarding use of our available cash,
our management will have significant flexibility with respect to such use. The actual amounts and timing of expenditures will vary significantly depending
on a number of factors, including the amount and timing of cash used in our operations and our research and development efforts. Management’s failure to
use these funds effectively would have an adverse effect on the value of our common stock and could make it more difficult and costlier to raise funds in
the future.

We have not paid any dividends since incorporation and do not anticipate declaring any dividends in the foreseeable future. As a result, you may
not  be  able  to  recoup  your  investment  through  the  payment  of  dividends  on  your  common  shares  and  the  lack  of  a  dividend  payable  on  our
common shares might depress the value of your investment.

For the foreseeable future, we plan to use all available funds to finance the development of our product candidate and operate our business. Our directors
will determine if and when dividends should be declared and paid in the future based on our financial position at the relevant time, but since we have no
present plans to pay dividends, you should not expect receipt of dividends either for your cash needs or to enhance the value of our common shares held by
you.

We may be a passive foreign investment company, or “PFIC,” which could result in adverse United States federal income tax consequences to U.S.
investors.

If we are a PFIC for any taxable year (or portion thereof) that is included in the holding period of a U.S. Holder (as such term is defined in the section of
this Annual Report entitled “Material U.S. Federal Income Tax Considerations”) of our common shares, the U.S. Holder may be subject to adverse U.S.
federal income tax consequences and may be subject to additional reporting requirements. We have not made the analysis necessary to determine whether
or not we are currently a PFIC or whether we have ever been a PFIC, and there can be no assurances with respect to our status as a PFIC for our current
taxable year or any subsequent taxable year. If we are a PFIC for any taxable year, we intend to provide to a U.S. Holder such information as the Internal
Revenue Service (“IRS”) may require, including a PFIC annual information statement, in order to enable the U.S. Holder to make and maintain a “qualified
electing  fund”  election.  For  a  more  detailed  explanation  of  the  tax  consequences  of  PFIC  classification  to  U.S.  Holders,  see  the  section  of  this Annual
Report entitled “Material U.S. Federal Income Tax Considerations.” This paragraph is qualified in its entirety by the discussion under that heading. Each
U.S. shareholder should consult its own tax advisors regarding the PFIC rules and the U.S. federal income tax consequences of the acquisition, ownership,
and disposition of our common shares.

38

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Failure to maintain effective internal controls in accordance with Section 404 of the Sarbanes-Oxley Act of 2002 could have an adverse effect on
our business.

Pursuant  to  Section  404  of  the  Sarbanes-Oxley  Act  of  2002  (“Section  404”)  and  the  rules  and  regulations  promulgated  by  the  SEC  to  implement
Section 404, we are required to include in our Form 10-K a report by our management regarding the effectiveness of our internal control over financial
reporting. The report includes, among other things, an assessment of the effectiveness of our internal control over financial reporting. The assessment must
include disclosure of any material weakness in our internal control over financial reporting identified by management.

As part of the evaluation undertaken by management pursuant to Section 404, our management concluded that our internal control over financial reporting
was  effective  as  of  December  31,  2020.  However,  if  we  fail  to  maintain  an  effective  system  of  disclosure  controls  or  internal  controls  over  financial
reporting, we may discover material weaknesses that we would then be required to disclose. Any material weaknesses identified in our internal controls
could  have  an  adverse  effect  on  our  business.  We  may  not  be  able  to  accurately  or  timely  report  on  our  financial  results,  and  we  might  be  subject  to
investigation by regulatory authorities. This could result in a loss of investor confidence in the accuracy and completeness of our financial reports, which
may have an adverse effect on our stock price.

No evaluation process can provide complete assurance that our internal controls will detect and correct all failures within our Company to disclose material
information otherwise required to be reported. The effectiveness of our controls and procedures could also be limited by simple errors or faulty judgments.
In addition, if we continue to expand, through either organic growth or through acquisitions (or both), the challenges involved in implementing appropriate
controls  will  increase  and  may  require  that  we  evolve  some  or  all  of  our  internal  control  processes.  Under  applicable  SEC  rules,  our  management’s
assessment of the effectiveness of our internal control over financial reporting are not attested to by our registered public accounting firm.

It is also possible that the overall scope of Section 404 may be revised in the future, thereby causing ourselves to review, revise or reevaluate our internal
control processes, which may result in the expenditure of additional human and financial resources.

Item 1B.

Unresolved Staff Comments

None.

Item 2.

Properties

We  have  an  operating  lease  in  Research  Triangle  Park,  North  Carolina  utilizing  small  space  within  a  commercial  building.  The  operating  lease  has
payments  of  $400  per  month  with  no  scheduled  increases.  This  operating  lease  is  terminable  with  30  days’  notice  and  has  no  penalties  or  contingent
payments due.

On January 23, 2020, we entered into an Office Service Agreement (the “Office Service Agreement”) with Regus to lease office space at in Hoboken, New
Jersey. Per the terms of the Office Service Agreement, the monthly rent payments are $1,150. The Office Service Agreement commenced on January 27,
2020 and terminated on July 31, 2020, when it automatically renewed for a successive period equal to the original term. Either party is able to terminate the
agreement by providing no less than three months' advance written notice of termination.

Item 3.

Legal Proceedings

On  September  2,  2020,  a  putative  class  action  lawsuit,  Chapman  v.  Fennec  Pharmaceuticals  Inc.,  was  filed  against  us,  our  Chief  Executive  Officer,
Rostislav  Raykov,  and  our  Chief  Financial  Officer,  Robert  Andrade,  in  the  United  States  District  Court  for  the  Middle  District  of  North  Carolina.  The
complaint alleged that prior to our August 10, 2020 receipt of a CRL from the FDA concerning our NDA for PEDMARKTM, we made materially false or
misleading statements and failed to disclose material facts about the status of our PEDMARKTM manufacturing facility, its compliance with current good
manufacturing practices, and the impact its status and compliance would have on regulatory approval for PEDMARKTM . On December 3, 2020, the court
appointed a lead plaintiff to represent the putative class. On February 1, 2021, the lead plaintiff filed an amended complaint. The amended complaint added
members  of  our  board  of  directors  as  defendants,  asserts  a  putative  class  period  from  December  10,  2018  through  August  10,  2020,  makes  allegations
similar to those in the original complaint, and claims the defendants violated Section 10(b) of the Securities Exchange Act of 1934. Defendants’ response to
the amended complaint was submitted on March 3, 2021.

We believe that the suit is without merit and intend to defend it vigorously. We cannot predict the outcome of this suit. Failure by us to obtain a favorable
resolution of the suit could have a material adverse effect on our business, results of operations and financial condition. We have not recorded a liability as
of December 31, 2020, because we believe a potential loss is not probable or reasonably estimable given the preliminary nature of the proceedings.

39

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 4.

Mine Safety Disclosures

Not applicable.

40

 
 
 
 
PART II

Item 5.

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

Our common shares currently trade in the U.S. on the Nasdaq Capital Market under the trading symbol “FENC” and in Canada on the TSX under the
trading symbol “FRX”. The following table sets forth the quarterly high and low market closing prices, and average daily trading volume on the Nasdaq
Capital Market , and the TSX, for the two most recent full fiscal years:

Fiscal 2020:
Quarter ended 12/31/20
Quarter ended 09/30/20
Quarter ended 06/30/20
Quarter ended 03/31/20

Fiscal 2019:
Quarter ended 12/31/19
Quarter ended 09/30/19
Quarter ended 06/30/19
Quarter ended 03/31/19

  $

  $

  $

  $

Nasdaq Capital Market 
(in U.S. dollars)
Low $

High $

Volume

High $

Toronto Stock Exchange 
(in Canadian dollars)
Low $

Volume

8.55    $
10.17     
9.39     
8.10    $

5.99     
5.19     
5.43     
4.89     

120,722    $
418,223     
216,324     
64,745    $

11.24    $
13.51     
12.70     
10.79    $

8.00     
6.54     
8.00     
6.91     

775 
2,640 
1,144 
1,113 

High $

Low $

Volume

High $

Low $

Volume

6.49    $
4.95     
5.09     
7.58    $

4.25     
3.85     
3.30     
4.64     

30,248    $
34,336     
107,826     
45,072    $

8.45    $
6.55     
6.80     
10.00    $

5.65     
5.00     
4.38     
6.22     

321 
489 
1,622 
1,502 

As of March 29, 2021, the last reported sale on the TSX was CAD$7.80 per share and the last reported sale on the Nasdaq Capital Market was $6.21 per
share.

Record Holders

As of March 29, 2020, there were approximately 38 shareholders of record of our common shares, one of which was Cede & Co., a nominee for Depository
Trust Company, or DTC, and one of which was The Canadian Depository for Securities Limited, or CDS. All of our common shares held by brokerage
firms, banks and other financial institutions in the U.S. or Canada as nominees for beneficial owners are considered to be held of record by Cede & Co. in
respect of brokerage firms, banks and other financial institutions located in Canada. Cede & Co. and CDS are each considered to be one shareholder of
record.

Dividend Policy

We have never declared or paid cash dividends on our common shares. We currently expect to retain future earnings, if any, for use in the operation and
expansion of business and do not anticipate paying any cash dividends in the foreseeable future.

Material United States Federal and Canadian Income Tax Consequences

Material U.S. Federal Income Tax Considerations

The following summary describes the material U.S. federal income tax consequences to U.S. Holders (as defined below) of acquiring, owning, and

disposing of our common shares, subject to the qualifications set forth herein.

General

Tax Consequences Not Addressed

This summary does not address all potential U.S. federal income tax considerations that may be relevant to a particular U.S. Holder. In addition,
this summary does not take into account the individual facts and circumstances that may affect the U.S. federal income tax consequences to a particular
U.S. Holder, including specific tax consequences under an applicable income tax treaty. Accordingly, this summary is not intended to be, and should not be
construed  as,  legal  or  U.S.  federal  income  tax  advice  with  respect  to  any  U.S.  Holder.  This  summary  does  not  address  any  U.S.  federal  alternative
minimum, U.S. federal estate and gift, U.S. state and local, or non-U.S. tax considerations, and does not discuss tax reporting requirements that may be
applicable to any particular U.S. Holder. Each prospective investor should consult a professional tax advisor with respect to the U.S. federal income, U.S.
alternative minimum, U.S. federal estate and gift, U.S. state and local, and non-U.S. tax consequences of acquiring, owning, and disposing of our common
shares.

41

 
 
 
 
 
 
 
   
 
 
   
   
   
   
   
 
   
   
 
   
      
      
      
      
      
  
 
 
   
   
   
   
   
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
Authorities

This  summary  is  based  upon  the  provisions  of  the  United  States  Internal  Revenue  Code  (the  “Code”),  the  United  States  Treasury  Regulations
(whether final, temporary, or proposed) promulgated thereunder, the Convention Between Canada and the United States of America with Respect to Taxes
on Income and on Capital, signed September 26, 1980, as amended (the “Canada-U.S. Tax Convention”), and administrative rulings and judicial decisions
interpreting the Code and the United States Treasury Regulations, all as currently in effect, and all subject to differing interpretations or change, possibly on
a retroactive basis. We have not sought, and will not seek, a ruling from the IRS regarding any matter discussed herein, and no assurance can be given that
the  IRS  would  not  assert,  or  that  a  court  would  not  sustain,  a  position  that  is  different  from,  and  contrary  to,  the  positions  taken  in  this  summary.  This
summary does not discuss the potential effects, whether adverse or beneficial, of any proposed legislation.

U.S. Holders

For purposes of this summary, the term “U.S. Holder” means a beneficial owner of our common shares that is for U.S. federal income tax purposes:

·

·

·

·

an individual who is a citizen or resident of the United States (as determined under U.S. federal income tax rules);

a corporation (or other entity treated as a corporation for U.S. federal income tax purposes) created or organized in or under the laws of
the United States or of any political subdivision of the United States;

an estate, the income of which is subject to U.S. federal income taxation regardless of its source; or

a trust that (i) is subject to the primary supervision of a court within the United States and the control of one or more U.S. persons for all
substantial  decisions  or  (ii)  has  a  valid  election  in  effect  under  applicable  United  States  Treasury  Regulations  to  be  treated  as  a  U.S.
person.

An individual may be a resident for U.S. federal income tax purposes in any calendar year if the individual was present in the United States for at least 31
days in that calendar year and for an aggregate of at least 183 days during the three-year period ending with the current calendar year. For purposes of this
calculation, all of the days present in the current year, one-third of the days present in the immediately preceding year, and one-sixth of the days present in
the second preceding year are counted. Residents are taxed for U.S. federal income tax purposes as if they were U.S. citizens.

Non-U.S. Holders Not Addressed

For purposes of this summary, a “non-U.S. Holder” is a beneficial owner of common shares that is not a U.S. Holder and is not a partnership for U.S.
federal  income  tax  purposes. This  summary  does  not  address  the  U.S.  federal  income  tax  consequences  to  non-U.S.  Holders  of  acquiring,  owning,  and
disposing  our  common  shares.  Each  non-U.S.  Holder  investor  should  consult  a  professional  tax  advisor  with  respect  to  the  U.S.  federal  income,  U.S.
alternative minimum, U.S. federal estate and gift, U.S. state and local, and non-U.S. tax consequences of acquiring, owning, and disposing of our common
shares.

Certain U.S. Holders Not Addressed

This summary does not address the U.S. federal income tax considerations applicable U.S. Holders that are subject to special provisions under the Code,
including, but not limited to, U.S. Holders that:

·

·

·

·

·

·

·

·

·

are tax-exempt organizations, qualified retirement plans, individual retirement accounts, or other tax-deferred accounts;

are financial institutions, underwriters, insurance companies, real estate investment trusts, or regulated investment companies;

are broker-dealers, dealers, or traders in securities or currencies that elect to apply a mark-to-market accounting method;

have a “functional currency” other than the U.S. dollar;

own common shares as part of a straddle, hedging transaction, conversion transaction, constructive sale, or other arrangement involving
more than one position;

acquired common shares in connection with the exercise of employee stock options or otherwise as compensation for services;

hold common shares other than as a capital asset within the meaning of section 1221 of the Code (generally, property held for investment
purposes);

are partnerships or other “pass-through” entities for U.S. federal income tax purposes (or investors in such partnerships or entities);

own, have owned, or will own (directly, indirectly, or by attribution) 10% or more of the total combined voting power of the outstanding
shares of your company;

42

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
·

·

·

·

·

are U.S. expatriates who are former citizens or long-term residents of the United States;

have been, are, or will be residents or deemed to be residents in Canada for purposes of the Income Tax Act (Canada) (the “Tax Act”);

use or hold, will use or hold, or that are or will be deemed to use or hold common shares in connection with carrying on a business in
Canada;

are persons whose common shares constitute “taxable Canadian property” under the Tax Act; or

have a permanent establishment in Canada for the purposes of the Canada-U.S. Tax Convention.

U.S. Holders that are subject to special provisions under the Code, including, but not limited to, U.S. Holders described immediately above, should consult
their own tax advisors regarding the U.S. federal income, U.S. federal alternative minimum, U.S. federal estate and gift, U.S. state and local, and non-U.S.
tax consequences of acquiring, owning, and disposing of our common shares.

The following summary is not a substitute for careful tax planning and advice. U.S. Holders of common shares are urged to consult their own tax
advisors concerning the U.S. federal income tax consequences of the issues discussed herein, in light of their particular circumstances, as well as
any considerations arising under the laws of any foreign, state, local, or other taxing jurisdiction.

General Rules Applicable to the Ownership and Disposition of Common Shares

The following discussion describes the general rules applicable to the ownership and disposition of the common shares but is subject in its entirety to the
special rules described below under the headings entitled “Tax Consequences if We Are a Passive Foreign Investment Company” and “Tax Consequences if
We are a Controlled Foreign Corporation.”

Distributions on Common Shares

The gross amount of any distribution (including amounts, if any, withheld in respect of Canadian withholding tax) actually or constructively received by a
U.S. Holder with respect to our common shares will be taxable to the U.S. Holder as a dividend to the extent of our current or accumulated earnings and
profits as determined under U.S. federal income tax principles. Distributions to a U.S. Holder in excess of earnings and profits will be treated first as a
return of capital that reduces a U.S. Holder’s tax basis in such common shares (thereby increasing the amount of gain or decreasing the amount of loss that
a U.S. Holder would recognize on a subsequent disposition of our common shares), and then as gain from the sale or exchange of such common shares (see
“Sale or Other Taxable Disposition of Our Common Shares”). The amount of any distribution of property other than cash will be the fair market value of
that property on the date of distribution. In the event we make distributions to holders of common shares, we may or may not calculate our earnings and
profits under U.S. federal income tax principles. If we do not do so, any distribution may be required to be regarded as a dividend, even if that distribution
would  otherwise  be  treated  as  a  non-taxable  return  of  capital  or  as  capital  gain.  The  amount  of  the  dividend  will  generally  be  treated  as  foreign-source
dividend income to U.S. Holders.

Non-corporate U.S. Holders, including individuals, will generally be eligible for the preferential U.S. federal rate on “qualified dividend income,” provided
that we are a “qualified foreign corporation,” the stock on which the dividend is paid is held for a minimum holding period, and other requirements are
satisfied. A “qualified foreign corporation” includes a foreign corporation that is not a PFIC in the year of the distribution or in the prior taxable year and
that is eligible for the benefits of an income tax treaty with the United States that contains an exchange of information provision and has been determined
by the United States Treasury Department to be satisfactory for purposes of the legislation (such as the Canada-U.S. Tax Convention).

Distributions  to  U.S.  Holders  generally  will  not  be  eligible  for  the  “dividends  received  deduction”  generally  allowed  to  U.S.  corporations  in  respect  of
dividends received from other U.S. corporations.

Sale or Other Taxable Disposition of Our Common Shares

Upon the sale, exchange, or other taxable disposition of our common shares, a U.S. Holder generally will recognize gain or loss equal to the difference
between  the  amount  realized  upon  the  sale,  exchange,  or  other  disposition  and  such  U.S.  Holder’s  tax  basis  in  such  common  shares  sold  or  otherwise
disposed  of.  If  the  U.S.  holder  receives  Canadian  dollars  in  the  transaction,  the  amount  realized  will  be  the  U.S.  dollar  value  of  the  Canadian  dollars
received, which is determined for cash basis taxpayers on the settlement date for the transaction and for accrual basis taxpayers on the trade date (although
accrual basis taxpayers can also elect the settlement date). A U.S. Holder’s tax basis in common shares generally will be such holder’s U.S. dollar cost for
such common shares. Gain or loss recognized on such sale or other disposition generally will be long-term capital gain or loss if, at the time of the sale or
other disposition, the common shares have been held for more than one year.

Preferential tax rates currently apply to long-term capital gain of a U.S. Holder that is an individual, estate, or trust. There are currently no preferential tax
rates for long-term capital gain of a corporate U.S. Holder. Deductions for capital losses are subject to significant limitations under the Code. The gain or
loss will generally be U.S.-source gain or loss for foreign tax credit purposes.

43

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Additional Medicare Tax on Net Investment Income

Certain  U.S.  Holders  that  are  individuals,  estates,  or  trusts  (other  than  trusts  that  are  exempt  from  tax)  are  subject  to  a  tax  of  3.8%  on  “net  investment
income” (or undistributed “net investment income,” in the case of estates and trusts) for each taxable year, with such tax applying to the lesser of such
income or the excess of such person’s adjusted gross income (with certain adjustments) over a specified amount. Net investment income includes dividends
on the common shares and net gains from the disposition of the common shares.

U.S.  Holders  that  are  individuals,  estates,  or  trusts  should  consult  their  own  tax  advisors  regarding  the  applicability  of  this  tax  to  any  of  their
income or gains in respect of the common shares.

Receipt of Foreign Currency

The amount of any distribution paid to a U.S. Holder in foreign currency, or on the sale, exchange, or other taxable disposition of common shares, generally
will be equal to the U.S. dollar value of such foreign currency based on the exchange rate applicable on the date of receipt (regardless of whether such
foreign currency is converted into U.S. dollars at that time). If the foreign currency received is not converted into U.S. dollars on the date of receipt, a U.S.
Holder  will  have  a  tax  basis  in  the  foreign  currency  equal  to  its  U.S.  dollar  value  on  the  date  of  receipt.  Any  U.S.  Holder  who  converts  or  otherwise
disposes of the foreign currency after the date of receipt may have a foreign currency exchange gain or loss that would be treated as ordinary income or
loss, and generally will be U.S. source income or loss for foreign tax credit purposes. Different rules apply to U.S. Holders who use the accrual method of
tax accounting. Each U.S. Holder should consult its own U.S. tax advisors regarding the U.S. federal income tax consequences of receiving, owning, and
disposing of foreign currency.

Foreign Tax Credit

Subject  to  the  PFIC  rules  discussed  below,  a  U.S.  Holder  that  pays  (whether  directly  or  through  withholding)  Canadian  income  tax  with  respect  to
dividends  paid  on  the  common  shares  generally  will  be  entitled,  at  the  election  of  such  U.S.  Holder,  to  receive  either  a  deduction  or  a  credit  for  such
Canadian income tax paid. Generally, a credit will reduce a U.S. Holder’s U.S. federal income tax liability on a dollar-for-dollar basis, whereas a deduction
will reduce a U.S. Holder’s income that is subject to U.S. federal income tax. This election is made on a year-by-year basis and applies to all foreign taxes
paid (whether directly or through withholding) by a U.S. Holder during a year.

Complex limitations apply to the foreign tax credit, including the general limitation that the credit cannot exceed the proportionate share of a U.S. Holder’s
U.S.  federal  income  tax  liability  that  such  U.S.  Holder’s  “foreign  source”  taxable  income  bears  to  such  U.S.  Holder’s  worldwide  taxable  income.  In
applying this limitation, a U.S. Holder’s various items of income and deduction must be classified, under complex rules, as either “foreign source” or “U.S.
source.”  Generally,  dividends  paid  by  a  foreign  corporation  (including  constructive  dividends)  should  be  treated  as  foreign  source  for  this  purpose,  and
gains  recognized  on  the  sale  of  stock  of  a  foreign  corporation  by  a  U.S.  Holder  should  be  treated  as  U.S.  source  for  this  purpose,  except  as  otherwise
provided in an applicable income tax treaty, and if an election is properly made under the Code. However, the amount of a distribution with respect to the
common  shares  that  is  treated  as  a  “dividend”  may  be  lower  for  U.S.  federal  income  tax  purposes  than  it  is  for  Canadian  federal  income  tax  purposes,
resulting in a reduced foreign tax credit allowance to a U.S. Holder. In addition, this limitation is calculated separately with respect to specific categories of
income. The foreign tax credit rules are complex, and each U.S. Holder should consult its own U.S. tax advisors regarding the foreign tax credit rules.

Information Reporting and Backup Withholding

Under U.S. federal income tax law, certain categories of U.S. Holders must file information returns with respect to their investment in, or involvement in, a
foreign corporation. For example, certain U.S. Holders who hold certain “specified foreign financial assets” that exceed certain thresholds are required to
report information relating to such assets. The definition of “specified foreign financial assets” generally includes not only financial accounts maintained in
foreign financial institutions, but also, unless held in accounts maintained by a financial institution, any stock or security issued by a non-U.S. person, any
financial instrument or contract held for investment that has an issuer or counterparty other than a U.S. person, and any interest in a foreign entity. U.S.
Holders  may  be  subject  to  these  reporting  requirements  unless  their  common  shares  are  held  in  an  account  at  certain  financial  institutions.  Significant
penalties may apply for failure to satisfy applicable reporting obligations.

Distributions paid with respect to common shares and proceeds from a sale, exchange, or redemption of common shares made within the United States or
through certain U.S.-related financial intermediaries may be subject to information reporting to the IRS and possible U.S. backup withholding (at a rate of
28%). Backup withholding will not apply, however, to a U.S. Holder who furnishes a correct U.S. taxpayer identification number and makes any other
required certification on IRS Form W-9 or that is a corporation or other entity that is otherwise exempt from backup withholding. Each U.S. Holder should
consult  its  own  tax  advisors  regarding  the  application  of  the  U.S.  information  reporting  and  backup  withholding  rules.  Backup  withholding  is  not  an
additional tax. Amounts withheld as backup withholding may be credited against a holder’s U.S. federal income tax liability, and such holder may obtain a
refund  of  any  excess  amounts  withheld  under  the  backup  withholding  rules  by  filing  an  appropriate  claim  for  refund  with  the  IRS  and  furnishing  any
required information in a timely manner.

44

 
 
 
 
 
 
 
 
 
 
 
 
 
The discussion of reporting requirements set forth above is not intended to constitute a complete description of all reporting requirements that may apply to
a U.S. Holder. A failure to satisfy certain reporting requirements may result in an extension of the time period during which the IRS can assess a tax and,
under  certain  circumstances,  such  an  extension  may  apply  to  assessments  of  amounts  unrelated  to  any  unsatisfied  reporting  requirement.  U.S.  Holders
should  consult  with  their  own  tax  advisors  regarding  their  reporting  obligations,  if  any,  as  a  result  of  their  acquisition,  ownership,  or  disposition  of  our
common shares.

Tax Consequences if We are a Passive Foreign Investment Company

A  foreign  corporation  generally  will  be  treated  as  a  PFIC  if,  after  applying  certain  “look-through”  rules,  either  (i)  75%  or  more  of  its  gross  income  is
passive income or (ii) 50% or more of the average value of its assets is attributable to assets that produce or are held to produce passive income. Passive
income for this purpose generally includes dividends, interest, rents, royalties and gains from securities and commodities transactions. The look-through
rules require a foreign corporation that owns at least 25% by value of the stock of another corporation to treat a proportionate amount of assets and income
as held or received directly by the foreign corporation.

We have not made the analysis necessary to determine whether or not we are currently a PFIC or whether we have ever been a PFIC. There can be no
assurance that we are not, have never been or will not in the future be a PFIC. If we were to be treated as a PFIC, any gain recognized by a U.S. shareholder
upon the sale (or certain other dispositions) of our common shares (or the receipt of certain distributions) generally would be treated as ordinary income,
and  a  U.S.  shareholder  may  be  required,  in  certain  circumstances,  to  pay  an  interest  charge  together  with  tax  calculated  at  maximum  rates  on  certain
“excess  distributions,”  including  any  gain  on  the  sale  or  certain  dispositions  of  our  common  shares.  In  order  to  avoid  this  tax  consequence,  a  U.S.
shareholder (i) may be permitted to make a “qualified electing fund” election, in which case, in lieu of such treatment, such shareholder would be required
to include in its taxable income certain undistributed amounts of our income or (ii) may elect to mark-to-market our common shares and recognize ordinary
income (or possible ordinary loss) each year with respect to such investment and on the sale or other disposition of the common shares. Additionally, if we
are deemed to be a PFIC, a U.S. shareholder who acquires our common shares from a decedent will be denied the normally available step-up in tax basis to
fair market value for the common shares at the date of the death and instead will have a tax basis equal to the decedent’s tax basis if lower than fair market
value.  Neither  we  nor  our  advisors  have  the  duty  to  or  will  undertake  to  inform  U.S.  shareholders  of  changes  in  circumstances  that  would  cause  us  to
become a PFIC. U.S. shareholders should consult their own tax advisors regarding the application of the PFIC rules including eligibility for and the manner
and advisability of making certain elections in the event we are determined to be a PFIC at any point in time. We intend to take the action necessary for a
U.S. shareholder to make a “qualified electing fund” election in the event we are a PFIC.

Further, excess distributions treated as dividends, gains treated as excess distributions and mark-to-market inclusions and deductions, all under the PFIC
rules  discussed  above,  are  all  included  in  the  calculation  of  net  investment  income  for  purposes  of  the  3.8%  tax  described  above  under  the  subheading
entitled  “Additional  Medicare  Tax  on  Net  Investment  Income”.  United  States  Treasury  Regulations  provide,  subject  to  the  election  described  in  the
following paragraph, that solely for purposes of this additional tax, distributions of previously taxed income will be treated as dividends and included in net
investment income subject to the additional 3.8% tax. Additionally, to determine the amount of any capital gain from the sale or other taxable disposition of
common shares that will be subject to the additional tax on net investment income, a U.S. Holder who has made a “qualified electing fund” election will be
required to recalculate its basis in the common shares excluding basis adjustments resulting from the “qualified electing fund” election. Alternatively, a
U.S. Holder may make an election which will be effective with respect to all interests in a PFIC for which a “qualified electing fund” election has been
made  and  which  is  held  in  that  year  or  acquired  in  future  years.  Under  this  election,  a  U.S.  Holder  pays  the  additional  3.8%  tax  on  income  inclusions
resulting from the “qualified electing fund” election and on gains calculated after giving effect to related tax basis adjustments.

Tax Consequences if We are a Controlled Foreign Corporation

A foreign corporation will be treated as a “controlled foreign corporation” (“CFC”) for U.S. federal income tax purposes if, on any day during the taxable
year of such foreign corporation, more than 50% of the equity interests in such corporation, measured by reference to the combined voting power or value
of the equity of the corporation, is owned directly or by application of the attribution and constructive ownership rules of Sections 958(a) and 958(b) of the
Code by United States Shareholders. For this purpose, a “United States Shareholder” is any United States person that possesses directly, or by application
of the attribution and constructive ownership rules of Sections 958(a) and 958(b) of the Code, 10% or more of the combined voting power of all classes of
equity in such corporation or 10% or more of the total value of shares of all classes in such corporation. If a foreign corporation is a CFC on any day during
any taxable year, each United States Shareholder of our Company who owns, directly or indirectly, our common shares on the last day of the taxable year
on which we are a CFC will be required to include in its gross income for United States federal income tax purposes its pro rata share of our “Subpart F
income,” even if the Subpart F income is not distributed. Subpart F income generally includes passive income but also includes certain related party sales,
manufacturing and services income.

45

 
 
 
 
 
 
 
 
 
In addition to the inclusion of “Subpart F income” of a CFC in the gross income of a United States Shareholder, there may be exposure to an additional tax
under  the  recently  enacted  Global  Intangible  Low  Tax  Income  regime  (“GILTI”).  Specifically,  the  GILTI  rules  impose  an  annual  minimum  tax  on  U.S.
Holders of their share of GILTI income generated through CFCs. This GILTI income very generally equals a CFC’s income over a 10% return on the CFCs
tangible depreciable trade or business assets. The GILTI tax is 10.5% (until 2026 and 13.12% for tax years after) on U.S. Holders who are C corporations,
as they are entitled to a 50% deduction (37.5% after 2025) of the GILTI income as well as a reduced foreign tax credit on foreign taxes paid on the GILTI
income.  U.S.  Holders  who  are  individuals,  estates  or  trusts  may  pay  substantially  more  tax  on  GILTI  income,  as  they  are  subject  to  ordinary  tax  rates
(ranging from 10% to 37% plus the net investment income tax of 3.8%). Such U.S. Holders are not entitled to a deduction on GILTI income or a reduced
foreign tax credit. There is, however, an election available to such U.S. Holders to mitigate the tax impact.

If we are a CFC, the PFIC rules set forth above, even if we are otherwise considered to be a PFIC, will not be applicable.

United States persons who might, directly, indirectly or constructively, acquire 10% or more of our common shares, and therefore might be a United States
Shareholder, should consider the possible application of the CFC rules and GILTI rules and consult a tax advisor with respect to such matters.

Material Canadian Federal Income Tax Considerations

Non-Residents of Canada

The following portion of the summary is generally applicable to a U.S. Holder. Special rules, which are not discussed in this summary, may apply to a U.S.
Holder that is an insurer that carries on an insurance business in Canada and elsewhere.

Disposition of Common Shares

Upon the disposition by a U.S. Holder of common shares in our Company, the U.S. Holder will not be subject to tax under the Tax Act in respect of any
capital gain realized unless the common shares disposed of constitutes “taxable Canadian property” of the U.S. Holder and the U.S. Holder is not entitled to
relief under an applicable tax treaty or convention. Common shares will generally not constitute “taxable Canadian property” of such U.S. Holder unless at
any time in the preceding 60 months both of the following statements were true: (a) the U.S. Holder, together with either (i) persons with whom the U.S.
Holder does not deal at arm’s length or (ii) partnerships in which the U.S. Holder or a person in (a) directly or indirectly hold membership interests, held
shares and/or rights to acquire shares representing 25% or more of the issued shares of any class of our capital stock; and (b) more than 50% of the fair
market value of our common stock was derived directly or indirectly from one or any combination of (i) real or immovable property situated in Canada,
(ii) Canadian resource properties, (iii) timber resource properties, and (iv) options in respect of, or interests in, or for civil law rights in, property described
in any of (i) to (iii).

U.S.  Holders  whose  common  shares  constitute  “taxable  Canadian  property”  should  consult  their  own  tax  advisors  for  advice  having  regard  to  their
particular circumstances.

Dividends Paid on Common Shares

Dividends paid, credited or deemed to have been paid or credited on our common shares held by a U.S. Holder will be subject to a Canadian withholding
tax  under  the  Tax  Act  at  a  rate  of  25%  of  the  gross  amount  of  the  dividends,  subject  to  reduction  by  any  applicable  tax  convention.  Under  the  tax
convention between Canada and the United States (the “Tax Treaty”), the rate of withholding tax on dividends generally applicable to U.S. Holders who
beneficially own the dividends is reduced to 15%. In the case of U.S. Holders that are corporations that beneficially own at least 10% of our voting shares,
the  rate  of  withholding  tax  on  dividends  generally  is  reduced  to  5%.  So-called  “fiscally  transparent”  entities,  such  as  United  States  limited  liability
companies,  or  LLCs,  are  not  entitled  to  rely  on  the  terms  of  the  Tax  Treaty,  however  a  member  of  such  entity  will  be  considered  to  have  received  the
dividend directly and to benefit from the reduced rates under the Tax Treaty, where the member is considered under U.S. taxation law to have derived the
dividend through that entity and by reason of the entity being a fiscally transparent entity, the treatment of the dividend is the same as its treatment would
be  if  the  amount  had  been  derived  directly  by  the  member.  Members  of  such  entities  are  regarded  as  holding  their  proportionate  share  of  our  common
shares held by the entity for the purposes of the Tax Treaty.

Item 6.

Selected Financial Data

Not applicable.

46

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 7.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

CAUTIONARY STATEMENT

The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our consolidated financial
statements  and  related  notes  appearing  at  the  end  of  this  Annual  Report.  Some  of  the  information  contained  in  this  discussion  and  analysis  or  set  forth
elsewhere in this Annual Report, including information with respect to our plans and strategy for our business, includes forward looking statements that
involve risks and uncertainties. As a result of many factors, including those factors set forth in the “Risk Factors” section of this Annual Report, our actual
results  could  differ  materially  from  the  results  described  in,  or  implied  by,  the  forward-looking  statements  contained  in  the  following  discussion  and
analysis.

Overview

Our  only  product  candidate  in  the  clinical  stage  of  development  is  PEDMARKTM  (sodium  thiosulfate  (STS)  anhydrous  injection).  We  have  announced
results  of  two  Phase  3  clinical  trials  for  the  prevention  of  cisplatin  induced  hearing  loss,  or  ototoxicity  in  children  including  the  pivotal  Phase  3  study
SIOPEL 6 , “A Multicentre Open Label Randomised Phase 3 Trial of the Efficacy of Sodium Thiosulfate in Reducing Ototoxicity in Patients Receiving
Cisplatin Chemotherapy for Standard Risk Hepatoblastoma,” and the proof of concept Phase 3 study “A Randomized Phase 3 Study of Sodium Thiosulfate
for the Prevention of Cisplatin-Induced Ototoxicity in Children”.

We have announced results of two Phase 3 clinical trials for the prevention of cisplatin induced hearing loss, or ototoxicity in children including the pivotal
Phase 3 study SIOPEL 6 , “A Multicentre Open Label Randomised Phase 3 Trial of the Efficacy of Sodium Thiosulfate in Reducing Ototoxicity in Patients
Receiving Cisplatin Chemotherapy for Standard Risk Hepatoblastoma,” and the proof of concept Phase 3 study “A Randomized Phase 3 Study of Sodium
Thiosulfate for the Prevention of Cisplatin-Induced Ototoxicity in Children”.

We continue to focus our resources on the development of PEDMARKTM.

We  have  licensed  from  OHSU  intellectual  property  rights  for  the  use  of  PEDMARKTM  as  a  chemoprotectant  and  are  developing  PEDMARKTM  as  a
protectant against the hearing loss often caused by platinum-based anti-cancer agents in children. Preclinical and clinical studies conducted by OHSU and
others have indicated that PEDMARKTM can effectively reduce the incidence of hearing loss caused by platinum-based anti-cancer agents.

Hearing loss among children receiving platinum-based chemotherapy is frequent, permanent and often severely disabling. The incidence of hearing loss in
these  children  depends  upon  the  dose  and  duration  of  chemotherapy,  and  many  of  these  children  require  lifelong  hearing  aids.  In  addition,  adults
undergoing chemotherapy for several common malignancies, including ovarian cancer, testicular cancer, and particularly head and neck cancer and brain
cancer, often receive intensive platinum-based therapy and may experience severe, irreversible hearing loss, particularly in the high frequencies.

We  estimate  in  the  U.S.  and  Europe  that  annually  over  10,000  children  with  solid  tumors  are  treated  with  platinum  agents.    The  vast  majority  of  these
newly diagnosed tumors are localized and classified as low to intermediate risk in nature. These localized cancers may have overall survival rates of greater
than 80%, further emphasizing the importance of quality of life after treatment. The incidence of hearing loss in these children depends upon the dose and
duration of chemotherapy, and many of these children require lifelong hearing aids. There is currently no established preventive agent for this hearing loss
and  only  expensive,  technically  difficult  and  sub-optimal  cochlear  (inner  ear)  implants  have  been  shown  to  provide  some  benefit.  Infants  and  young
children  at  critical  stages  of  development  lack  speech  language  development  and  literacy,  and  older  children  and  adolescents  lack  speech  language
development and literacy, and older children and adolescents lack social-emotional development and educational achievement.

In March 2018, PEDMARKTM received Breakthrough Therapy and Fast Track designations from the FDA. Further, PEDMARKTM has received Orphan
Drug Designation in the U.S. in this setting.

We initiated our rolling New Drug Application (“NDA”) for PEDMARKTM for the prevention of ototoxicity induced by cisplatin chemotherapy patients 1
month  to  <  18  years  of  age  with  localized,  non-metastatic,  solid  tumors  with  the  FDA  in  December  2018.  We  announced  that  we  had  submitted  full
completion of the NDA in February 2020. On April 13, 2020, we announced that the FDA had accepted for filing and granted Priority Review for our
NDA. The FDA set a Prescription Drug Fee Act (“PDUFA”) target action date of August 10, 2020 for the completion of the FDA’s review. On August 10,
2020,  we  announced  that  we  received  a  CRL  from  the  FDA  regarding  our  NDA  for  PEDMARKTM,  which  identified  deficiencies  in  the  third-party
manufacturing facility that manufactures PEDMARKTM on our behalf. Importantly, no clinical safety or efficacy issues were identified during the review
and there is no requirement for further clinical data. In the fourth quarter of 2020, we engaged in a Type A meeting with the FDA concerning the CRL that
we believe was constructive and collaborative. We are working closely with our third-party drug manufacturer and the FDA to fully address the CRL, and
we plan to resubmit our NDA for PEDMARKTM in the second quarter of 2021.

47

 
 
 
 
 
 
 
 
 
 
 
 
 
 
In  August  2018,  the  Pediatric  Committee  (“PDCO”)  of  the  European  Medicines  Agency  (“EMA”)  accepted  our  pediatric  investigation  plan  (PIP)  for
sodium thiosulfate with the trade name Pedmarqsi for the condition of the prevention of platinum-induced hearing loss. An accepted PIP is a prerequisite
for  filing  a  Marketing  Authorization  Application  (“MAA”)  for  any  new  medicinal  product  in  Europe.  The  indication  targeted  by  our  PIP  is  for  the
prevention of platinum-induced ototoxic hearing loss for standard risk hepatoblastoma (SR-HB). Additional tumor types of the proposed indication will be
subject to the Committee for Medicinal Products for Human Use (“CHMP”) assessment at the time of the MAA. No deferred clinical studies were required
in  the  positive  opinion  given  by  PDCO.  We  were  also  advised  that  sodium  thiosulfate  (tradename  to  be  determined)  is  eligible  for  submission  of  an
application  for  a  Pediatric  Use  Marketing  Authorization  (“PUMA”).  A  PUMA  is  a  dedicated  marketing  authorization  covering  the  indication  and
appropriate formulation for medicines developed exclusively for use in the pediatric population and provides data and market protection up to 10 years.
Therefore,  this  decision  allows  us  to  proceed  with  the  submission  of  a  PUMA  in  the  European  Union  (EU)  with  incentives  of  automatic  access  to  the
centralized procedure and up to 10 years of data and market protection. In February 2020, we announced that we had submitted a MAA for the prevention
of ototoxicity induced by cisplatin chemotherapy patients 1 month to < 18 years of age with localized, non-metastatic, solid tumors.

We have not received and do not expect to have significant revenues from our product candidate until we are either able to sell our product candidate after
obtaining  applicable  regulatory  approvals  or  we  establish  collaborations  that  provide  us  with  up-front  payments,  licensing  fees,  milestone  payments,
royalties  or  other  revenue.  We  generated  a  net  loss  of  $18.1  million  for  the  year  ended  December  31,  2020.  We  generated  a  net  loss  of  approximately
$12.8 million for the year ended December 31, 2019. As of December 31, 2020, our accumulated deficit was approximately $162.1 million.

Our  projections  of  our  capital  requirements  are  subject  to  substantial  uncertainty,  and  more  capital  than  we  currently  anticipate  may  be  required
thereafter. To finance our continuing operations, we may need to raise substantial additional funds through either the sale of additional equity, the issuance
of debt, the establishment of collaborations that provide us with funding, the out-license or sale of certain aspects of our intellectual property portfolio or
from other sources. We may not be able to raise the necessary capital or such funding may not be available on financially acceptable terms if at all. If we
cannot  obtain  adequate  funding  in  the  future,  we  might  be  required  to  further  delay,  scale  back  or  eliminate  certain  research  and  development  studies,
consider business combinations or even shut down some, or all, of our operations.

Our operating expenses will depend on many factors, including the progress of our drug development efforts and efficiency of our operations and current
resources.  Our  research  and  development  expenses,  which  include  expenses  associated  with  our  clinical  trials,  drug  manufacturing  to  support  clinical
programs, stock-based compensation, consulting fees, sponsored research costs, toxicology studies, license fees, milestone payments, and other fees and
costs related to the development of our product candidate, will depend on the availability of financial resources, the results of our clinical trials, and any
directives  from  regulatory  agencies,  which  are  difficult  to  predict.  Our  general  and  administration  expenses  include  expenses  associated  with  the
compensation of employees, stock-based compensation, professional fees, consulting fees, insurance and other administrative matters associated in support
of our drug development programs.

On May 5, 2020, we announced the completion of an underwritten public offering of 4,800,000 of our common shares at a public offering price of $6.25
per share. In addition, we issued an additional 660,204 common shares in connection with the partial exercise of the underwriters’ over-allotment option.
The approximate total gross proceeds from the offering were $34,100 ($32,189 net of commissions, fees and issue costs).

On  February  1,  2019,  our  wholly  owned  subsidiary  Fennec  Pharmaceuticals,  Inc.  entered  into  a  Loan  and  Security  Agreement  (the  “Loan  and  Security
Agreement”) with Bridge Bank, a division of Western Alliance Bank, an Arizona corporation (“Bridge Bank”), pursuant to which Bridge Bank agreed to
loan $12.5 million to Fennec Pharmaceuticals, Inc., to be made available upon NDA approval of PEDMARKTM by no later than September 30, 2020. The
Loan and Security Agreement was amended on June 26, 2020 to increase the total potential amount of the loan to $18 million and to extend the outside
date for us to receive NDA approval of PEDMARKTM to December 31, 2020. In connection with this facility, we issued the Bridge Bank a warrant to
purchase up to 39,000 of our common shares at an exercise price of $6.80 per share, with an exercise period of ten years from the date of issuance subject
to certain early termination conditions. Under Accounting Standards Codification ("ASC") 470-50, Modifications and Extinguishments, the amendment to
the facility was considered a modification. As such, we had been amortizing the loan fee and the value of the warrant over the remainder of the loan term.
Following the receipt of the FDA’s CRL in August 2020, we decided to fully amortize the remaining portions of the loan fee and the value of the warrants.
The Loan and Security Agreement expired on December 31, 2020 as a result of us not obtaining NDA approval of PEDMARKTM by that date, with no
amounts advanced under the facility prior to its termination.

We believe that the funds raised in our May 2020 public offering provides us sufficient funding to carry-out our planned activities, including potential NDA
approval  and  the  commencement  of  commercialization  efforts,  for  at  least  the  next  twelve  months  as  we  continue  our  strategic  development  of
PEDMARKTM.

48

 
 
 
 
 
 
 
 
 
 
Results of Operations

Fiscal 2020 versus Fiscal 2019

In thousands of U.S. Dollars
Revenue
Operating expenses:
Research and development
General and administration
Total operating expense
Loss from operations
Amortization expense
Unrealized gain on securities
Other loss
Interest income and other, net
Net loss

  Fiscal Year Ended    
  December 31, 2020   
  $

170     

%

  Fiscal Year Ended    
  December 31, 2019   
  $

-     

%

Increase
(Decrease)

  $

170 

5,105     
12,950     
18,055     
17,885     
(402)    
100     
(9)    
87     
(18,109)    

29%   
71%   
100%   

  $

5,607     
7,402     
13,009     
13,009     
(64)    
-     
(17)    
315     
(12,775)    

43%   
57%   
100%   

  $

(502)
5,548 
5,046 
4,876 
(338)
100 
8 
(228)
(5,334)

  $

·

·

·

·

·
·

Revenues reported represent royalties related to Elion deal with Processa Pharmaceuticals, Inc. Fennec received $0.005 million in cash and 41,250
in restricted shares of Processa Pharmaceuticals, Inc.
Research and development expense decreased by $0.5 million in fiscal 2020 as compared to fiscal 2019, primarily due to the shift from research
and development to pre-commercialization efforts for PEDMARKTM which took place in the first nine months of 2020.
The $5.5 million increase in general and administrative expenses is attributed to the increase in pre-commercialization expenses. Further there was
a small rise in compensation to officers, directors and key contract employees in fiscal 2020 as compared to fiscal 2019.
Amortization expense relates to the Bridge Bank loan facility as the loan origination fees were capitalized in fiscal 2019 and 2020. After receiving
the CRL from the FDA in August 2020, management decided to amortize the remaining amounts associated with the loan facility. The facility
expired on December 31, 2020.
Interest income decreased in fiscal 2020 as compared to 2019, due to lower interest rates on money market accounts for the comparable periods.
There was an unrealized gain of $0.1 million on the Processa shares between the date acquired, October 30, 2020, and December 31, 2020. Going
forward, the Processa shares will be marked to market at each balance sheet date. The resulting change in value will result in an unrealized gain or
loss.

Quarterly Information

The following table presents selected consolidated financial data for each of the last eight quarters through December 31, 2020, as prepared under generally
accepted accounting principles within the United States, or U.S. GAAP (dollars in thousands, except per share information).

Period

  March 31, 2019
  June 30, 2019
  September 30, 2019
  December 31, 2019
  March 31, 2020
  June 30, 2020
  September 30, 2020
  December 31, 2020

Net (Loss)/Income for the 
Period

Basic Net (Loss)/Income per
Common Share

Diluted Net (Loss)/Income per
Common Share

(2,626)    
(4,730)    
(1,809)    
(3,610)    
(3,826)    
(4,845)    
(6,200)    
(3,238)    

(0.13)    
(0.24)    
(0.09)    
(0.18)    
(0.19)    
(0.21)    
(0.24)    
(0.13)    

(0.13)
(0.24)
(0.09)
(0.18)
(0.19)
(0.21)
(0.24)
(0.13)

Quarter ended December 31, 2020 versus 2019

In thousands of U.S. Dollars
Revenue
Operating expenses:
Research and development
General and administration
Total operating expense
Loss from operations
Unrealized gain on securities
Interest income
Amortization expense
Other(loss)/income, net
Net loss

  Quarter Ended    
  December 31, 2020   
  $

170     

%

  Quarter Ended    
  December 31, 2019   
  $

-     

%

1,223     
2,293     
3,516     
3,346     
100     
13     
-     
(5)    
(3,238)    

49

  $

36%   
64%   
100%   

  $

1,172     
2,481     
3,653     
3,653     
-     
69     
(18)    
(8)    
(3,610)    

Increase
(Decrease)

170 

51 
(188)
(137)
(307)
100 
(56)
18 
3 
372 

  $

32%   
68%   
100%   

  $

 
 
 
 
 
  
  
 
 
 
 
 
 
  
  
   
      
  
   
      
  
   
  
   
   
   
   
  
   
  
   
   
  
   
  
   
   
  
   
  
   
   
  
   
  
   
   
  
   
  
   
  
  
 
 
 
 
 
   
   
   
 
     
     
     
     
     
     
     
     
 
 
 
  
  
 
 
 
 
 
 
  
  
   
      
  
   
      
  
   
  
   
   
   
   
  
   
  
   
   
  
   
  
   
   
  
   
  
   
   
  
   
  
   
   
  
   
  
   
  
  
 
Revenues  reported  represent  royalties  related  to  Elion  deal  with  Processa  Pharmaceuticals,  Inc.  Fennec  received  $0.005  million  in  cash  and  41,250  in
restricted  shares  of  Processa  Pharmaceuticals,  Inc.  We  reported  a  loss  from  operations  of  $3.3  million  for  the  three  months  ended  December  31,  2020,
compared to a loss from operations of $3.7 million for the same period in 2019. Research and development expenses totaled $1.2 million for the three
months ended December 31, 2020, which was the same for the same period in 2019. General and administrative expenses decreased by $0.2 million in the
three months ended December 31, 2020, as compared to the same period in 2019. The decrease arises from our reduced pre-commercialization activities for
PEDMARKTM as we focus on preparing to resubmit our NDA application to the FDA. There was an unrealized gain of $0.1 million on the Processa shares
between the date acquired, October 30, 2020, and December 31, 2020. Going forward, the Processa shares will be marked to market at each balance sheet
date. The resulting change in value will result in an unrealized gain or loss.

Selected Asset and Liability Data (thousands):
Cash and equivalents
Other current assets
Current liabilities
Working capital [current assets – current liabilities]

Selected Equity:
Common stock and additional paid in capital
Accumulated deficit
Shareholders’ equity

Liquidity and Capital Resources

As at
December 31, 2020   

As at 
December 31,
2019

  $

  $

30,344    $
1,073     
2,347     
29,070     

13,650 
234 
2,271 
11,613 

189,967    $
(162,140)    
29,070     

154,663 
(144,031)
11,875 

·

·

·

There was a $16.7 million increase in cash and cash equivalents between December 31, 2020 and December 31, 2019. The net increase was the
result of our May 2020 public offering of common shares, which raised net proceeds of $32.0 million, as well as $0.5 million from various stock
option exercises, offset by cash used for operating activities. During the period ended December 31, 2020, cash for operations was used mainly on
the pre-commercialization activities of PEDMARKTM and regulatory submission activities relating to the NDA.
The increase in other current assets between December 31, 2020 and December 31, 2019 primarily relates to the value of the Processa shares and
an increase in the prepaid amount for Director and Officer insurance premiums and costs associated with our at the market offering agreement,
which was disclosed on October 20, 2020.
Current  liabilities  at  December  31,  2020  increased  $0.076  million  compared  to  December  31,  2019  primarily  due  to  a  minor  rise  in  accounts
payable associated with our commercialization and manufacturing activities for the production of PEDMARKTM and related regulatory expenses
at year-end 2020.

· Working  capital  increased  between  December  31,  2020  and  December  31,  2019  by  $17.5  million.  The  increase  was  a  result  of  cash  used  in
operations  offset  by  $32.0  million  from  our  May  2020  public  offering  of  common  shares,  $0.5  million  from  stock  option  exercises  and  $0.1
million in interest income. Cash outflows related to the regulatory and pre-commercial development activities of PEDMARKTM and general and
administrative expenses.

Selected Cash Flow Data
(dollars and shares in thousands)

Net cash used in operating activities
Net cash provided from investing activities
Net cash provided by financing activities
Net cash flow

Year Ended
December 31, 2020   

Year Ended
December 31,
2019

  $

  $

(15,595)   $
-     
32,289     
16,694    $

(9,060)
- 
(71)
(9,131)

The  net  cash  flow  used  in  operating  activities  for  the  year  ended  December  31,  2020  was  approximately  $15.6  million  as  compared  to  $9.1  million  in
2019.  This  increase  relates  to  the  commercial  development  of  PEDMARKTM,  preparation  for  product  launch  and  regulatory  activities.  Net  financing
activities provided approximately $32.0 million from a public offering in May of 2020, and approximately $0.5 million from the exercise of stock options.

50

 
 
 
 
 
 
   
   
   
 
   
      
  
   
      
  
   
   
 
 
 
 
 
 
   
   
 
 
We continue to pursue various strategic alternatives including collaborations with other pharmaceutical and biotechnology companies. Our projections of
further  capital  requirements  are  subject  to  substantial  uncertainty.  Our  working  capital  requirements  may  fluctuate  in  future  periods  depending  upon
numerous  factors,  including:  our  ability  to  obtain  additional  financial  resources;  our  ability  to  enter  into  collaborations  that  provide  us  with  up-front
payments,  milestones  or  other  payments;  results  of  our  research  and  development  activities;  progress  or  lack  of  progress  in  our  preclinical  studies  or
clinical  trials;  unfavorable  toxicology  in  our  clinical  programs,  our  drug  substance  requirements  to  support  clinical  programs;  change  in  the  focus,
direction,  or  costs  of  our  research  and  development  programs;  headcount  expense;  the  costs  involved  in  preparing,  filing,  prosecuting,  maintaining,
defending and enforcing our patent claims; competitive and technological advances; the potential need to develop, acquire or license new technologies and
products;  our  business  development  activities;  new  regulatory  requirements  implemented  by  regulatory  authorities;  the  timing  and  outcome  of  any
regulatory review process; and commercialization activities, if any.

We had cash and cash equivalents of approximately $30.3 million as of December 31, 2020. We currently anticipate that our available capital resources,
including  our  existing  cash  and  cash  equivalents  and  accounts  receivable  balances,  will  be  sufficient  to  meet  our  expected  working  capital  and  capital
expenditure requirements as our business is currently conducted for at least the next 12 months.

Financial Instruments

We  invest  excess  cash  and  cash  equivalents  in  high  credit  quality  investments  held  by  financial  institutions  in  accordance  with  our  investment  policy
designed to protect the principal investment. At December 31, 2020, we had approximately $0.7 million in our cash accounts and $29.6 million in savings
and money market accounts. While we have never experienced any loss or write down of our money market investments since our inception, the amounts
we hold in money market accounts are substantially above the $250,000 amount insured by the FDIC and may lose value.

Our investment policy is to manage investments to achieve, in the order of importance, the financial objectives of preservation of principal, liquidity and
return  on  investment.  Investments  may  be  made  in  U.S.  or  Canadian  obligations  and  bank  securities,  commercial  paper  of  U.S.  or  Canadian  industrial
companies, utilities, financial institutions and consumer loan companies, and securities of foreign banks provided the obligations are guaranteed or carry
ratings appropriate to the policy. Securities must have a minimum Dun & Bradstreet rating of A for bonds or R1 low for commercial paper. The policy also
provides for investment limits on concentrations of securities by issuer and maximum-weighted average time to maturity of twelve months. This policy
applies to all of our financial resources. The policy risks are primarily the opportunity cost of the conservative nature of the allowable investments. As our
main purpose is research and development, we have chosen to avoid investments of a trading or speculative nature.

We  classify  investments  with  original  maturities  at  the  date  of  purchase  greater  than  three  months  which  mature  at  or  less  than  twelve  months  as
current. We carry investments at their fair value with unrealized gains and losses included in other comprehensive income (loss); however, we have not held
any instruments that were classified as short-term investments during the periods presented in this Annual Report.

Off-Balance Sheet Arrangements

Since our inception, we have not had any material off-balance sheet arrangements.

Contractual Obligations and Commitments

None.

Critical Accounting Policies and Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates that affect the reported amounts of assets
and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenue and expense
during the reporting period. These estimates are based on assumptions and judgments that may be affected by commercial, economic and other factors.
Actual results could differ from these estimates.

An  accounting  policy  is  considered  to  be  critical  if  it  requires  an  accounting  estimate  to  be  made  based  on  assumptions  about  matters  that  are  highly
uncertain  at  the  time  the  estimate  is  made,  and  if  different  estimates  reasonably  could  have  been  used,  or  changes  in  the  accounting  estimates  that  are
reasonably  likely  to  occur  periodically,  could  materially  impact  the  financial  statements.  The  following  description  of  critical  accounting  policies,
judgments and estimates should be read in conjunction with our December 31, 2020 consolidated financial statements.

Stock-based Compensation

The calculation of the fair values of our stock-based compensation plans requires estimates that require management’s judgments. Under ASC 718, the fair
value  of  each  stock  option  is  estimated  on  the  grant  date  using  the  Black-Scholes  option-pricing  model.  The  valuation  models  require  assumptions  and
estimates to determine expected volatility, expected life, expected dividends and expected risk-free interest rates. The expected volatility was determined
using historical volatility of our stock based on the contractual life of the award. The risk-free interest rate assumption was based on the yield on zero-
coupon U.S. Treasury strips at the award grant date. We also used historical data to estimate forfeiture experience. In valuing options granted in the fiscal
years ended December 31, 2020 and 2019, we used the following weighted average assumptions:

51

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Expected dividend
Risk-free interest rate
Expected volatility
Expected life

Common shares and warrants

Year Ended
December 
31, 2020

Year Ended
December 
31, 2019

0%   
0.63 – 1.90%   
136 – 148%   
10.0 years 

0%
1.63 – 2.70%
125 – 179%

4.3 – 10.0 years 

Common shares are recorded as the net proceeds received on issuance after deducting all share issuance costs and the relative fair value of investor
warrants. Warrants are recorded at relative fair value and are deducted from the proceeds of common shares and recorded on the consolidated statements of
shareholders’ equity as additional paid-in capital.

Outstanding Share Information

Our outstanding comparative share data at December 31, 2020 and December 31, 2019 is as follows (in thousands):

Outstanding Share Type
Common shares
Warrants to purchase common shares
Options to purchase common shares

Total

Newly Adopted and Recent Accounting Pronouncements

  December 31, 2020   

December 31,
2019

26,003     
39     
2,952     
28,994     

19,896 
39 
3,088 
23,023 

In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for
Fair Value Measurement. ASU 2018-13 removes certain disclosures, modifies certain disclosures and adds additional disclosures.  The Company adopted
this ASU on January 1, 2020. Certain disclosures in ASU 2018-13 would need to be applied on a retrospective basis and others on a prospective basis. We
concluded after evaluation that ASU 2018-13 has no significant effect on our consolidated financial statements.

In January 2021, the FASB issued ASU No. 2021-01, Reference Rate Reform (Topic 848). In this ASU, the FASB refines the scope of Topic 848 to clarify
that  certain  optional  expedients  and  exceptions  therein  for  contract  modifications  and  hedge  accounting  apply  to  contracts  that  are  affected  by  the
discounting transition. Specifically, modifications related to reference rate reform would not be considered an event that requires reassessment of previous
accounting  conclusions.  The  ASU  also  amends  the  expedients  and  exceptions  in  Topic  848  to  capture  the  incremental  consequences  of  the  scope
clarification and to tailor the existing guidance to derivative instruments affected by the discounting transition. The amendments in the ASU are effective
immediately  for  all  entities.  Entities  may  choose  to  apply  the  amendments  retrospectively  as  of  any  date  from  the  beginning  of  an  interim  period  that
includes or is subsequent to March 12, 2020, or prospectively to new modifications from any date within an interim period that includes or is subsequent to
January 7, 2021, up to the date that financial statements are available to be issued. The Company chose to apply amendments prospectively and concluded
after evaluation that ASU 2021-01 has no significant effect on our consolidated financial statements.

Item 7A.

Quantitative and Qualitative Disclosures About Market Risk

Money Market Investments

We maintain an investment portfolio consisting of U.S. or Canadian obligations and bank securities and money market investments in compliance with our
investment  policy.  We  do  not  hold  any  mortgaged-backed  investments  in  our  investment  portfolio.  Securities  must  have  a  minimum  Dun  &  Bradstreet
rating  of  A  for  bonds  or  R1  low  for  commercial  paper.  The  policy  also  provides  for  investment  limits  on  concentrations  of  securities  by  issuer  and
maximum-weighted average time to maturity of twelve months. This policy applies to all of our financial resources.

At December 31, 2020, we had $29.6 million in money market investments and savings accounts as compared to $13.3 million at December 31, 2019;
these investments typically have minimal risk.  We have not experienced any loss or write down of our money market investments for the years ended
December 31, 2020 and 2019; however, the amounts we hold in money market accounts are substantially above the $250,000 amount insured by the FDIC
and may lose value.

52

 
 
 
 
 
 
 
   
   
   
   
   
 
 
 
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
Our investment policy is to manage investments to achieve, in the order of importance, the financial objectives of preservation of principal, liquidity and
return on investment. Our risk associated with fluctuating interest rates on our investments is minimal and not significant to the results of operations. We
currently do not use interest rate derivative instruments to manage exposure to interest rate changes. As our main purpose is research and development, we
have chosen to avoid investments of a trade or speculative nature.

Foreign Currency Exposure

We are subject to foreign currency risks as we purchase goods and services which are denominated in Canadian dollars. To date, we have not employed the
use  of  derivative  instruments;  however,  we  do  hold  Canadian  dollars  which  we  use  to  pay  vendors  in  Canada  and  other  corporate  obligations.  At
December 31, 2020, we held approximately Can$59,000.

Item 8.

Financial Statements and Supplementary Data

The financial statements required to be filed pursuant to this Item 8 are appended to this Annual Report on Form 10-K. A list of the financial statements
filed herewith is found at “Index to Financial Statements” on Page F-1.

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 Chief Executive Officer (our principal executive officer) and Chief Financial Officer (our principal financial officer) have concluded based on their
evaluation  as  of  December  31,  2020  that  our  “disclosure  controls  and  procedures”  (as  defined  in  Rules  13a-15(e)  and  15d-15(e)  under  the  Securities
Exchange Act of 1934, as amended (“Exchange Act”)) are effective. The term “disclosure controls and procedures,” as defined in Rules 13a-15(e) and 15d-
15(e) under the Exchange Act, means controls and other procedures of a company that are designed to ensure that information required to be disclosed by
the company in the reports it files or submits under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in
the SEC’s rules and forms. Disclosure controls and procedures also include, without limitation, controls and procedures designed to ensure that information
required to be disclosed by a company in the reports that it files or submits under the Exchange Act is accumulated and communicated to the company’s
management,  including  its  principal  executive  officer  and  principal  financial  officer  and  principal  accounting  officer,  or  persons  performing  similar
functions, as appropriate, to allow timely decisions regarding required disclosure.

Management's Annual Report on Internal Control over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting. Internal control over financial reporting,
as  defined  in  rules  promulgated  under  the  Exchange  Act,  is  a  process  designed  by,  or  under  the  supervision  of,  our  Chief  Executive  Officer  and  Chief
Financial  Officer  and  affected  by  our  Board  of  Directors,  management  and  other  personnel  to  provide  reasonable  assurance  regarding  the  reliability  of
financial reporting and the preparation of Consolidated Financial Statements for external purposes in accordance with GAAP. Internal control over financial
reporting includes those policies and procedures that:

·
·

·

Pertain to the maintenance of records that in reasonable detail accurately and fairly reflect the transactions and dispositions of our assets;
Provide reasonable assurance that transactions are recorded as necessary to permit preparation of Consolidated Financial Statements in accordance
with GAAP, and that our receipts and expenditures are being made only in accordance with authorizations of our management and our Board of
Directors; and
Provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of our assets that could have
a material effect on our Consolidated Financial Statements.

Internal control over financial reporting cannot provide absolute assurance of achieving financial reporting objectives because of its inherent limitations.
Internal control over financial reporting is a process that involves human diligence and compliance and is subject to lapses in judgment and breakdowns
resulting  from  human  failures.  Internal  control  over  financial  reporting  can  also  be  circumvented  by  collusion  or  improper  override.  Because  of  such
limitations,  there  is  a  risk  that  material  misstatements  may  not  be  prevented  or  detected  on  a  timely  basis  by  internal  control  over  financial  reporting.
However, these inherent limitations are known features of the financial reporting process, and it is possible to design into the process safeguards to reduce,
though not eliminate, this risk.

Our  management  assessed  the  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December  31,  2020.  In  making  its  assessment,
management  used  the  criteria  established  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission,  or  COSO,  in  its  2013  Internal
Control — Integrated Framework. Based on its assessment, management has concluded that our internal control over financial reporting was effective as of
December  31,  2020.  Because  we  are  a  non-accelerated  filer  and  smaller  reporting  company,  Haskell  &  White  LLP,  our  independent  registered  public
accounting firm, is not required to attest to or issue a report on the effectiveness of our internal control over financial reporting.

53

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Changes in Internal Control over Financial Reporting

There was no change in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) identified in
connection with the evaluation of our internal control over financial reporting that occurred during the last fiscal quarter covered by this Annual Report that
has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

Inherent Limitation on the Effectiveness of Internal Controls

The  effectiveness  of  any  system  of  internal  control  over  financial  reporting  is  subject  to  inherent  limitations,  including  the  exercise  of  judgment  in
designing, implementing, operating, and evaluating the controls and procedures, and the inability to eliminate misconduct completely. Accordingly, any
system  of  internal  control  over  financial  reporting  can  only  provide  reasonable,  not  absolute,  assurances.  In  addition,  projections  of  any  evaluation  of
effectiveness  to  future  periods  are  subject  to  the  risk  that  controls  may  become  inadequate  because  of  changes  in  conditions,  or  that  the  degree  of
compliance with the policies or procedures may deteriorate. We intend to continue to monitor and upgrade our internal controls as necessary or appropriate
for our business, but cannot assure that such improvements will be sufficient to provide us with effective internal control over financial reporting.

Item 9B.

Other Information

None.

54

 
 
 
 
 
 
 
 
PART III

Item 10.

Directors, Executive Officers and Corporate Governance

The  following  table  sets  forth  the  name  of  each  of  our  executive  officers  and  directors,  such  person’s  principal  occupation  or  employment,  all  other
positions with us held by such person, if any, the year in which such person became a director of Fennec and such person’s age.

Our Board has an Audit Committee, a Compensation Committee, and a Governance Committee. The current members of such committees are noted in the
table below:

Name and Province/State and 
Country of Residence, Position

Current Principal Occupation and Principal Occupation 
For Previous Five Years

Director Since

Age

Rostislav Raykov, New Jersey, USA
Chief Executive Officer, Director

Robert Andrade, Texas, USA
Chief Financial Officer
Shubh Goel, New Jersey, USA
Chief Commercial Officer

Chris A. Rallis, North Carolina, USA
Director(1)(2)
Marco Brughera, Milano, Italy
Director(2)(3)

Adrian J. Haigh, Dublin, Ireland
Director(1)(3)

Khalid Islam, Zug, Switzerland
Chairman of Board, Director(1)
Jodi Cook, Pennsylvania, USA, Director(2)(3)

CEO of Fennec Pharmaceuticals Inc.; Co-Founder and Manager, DCML
LLC; previously Portfolio Manager at Alchem Partners; previously
Portfolio Manager at John Levin & Company
CFO of Fennec Pharmaceuticals; previously senior analyst at Magnetar
Capital; previously Portfolio Manager at Millennium Partners
CCO of Fennec Pharmaceuticals Inc.; previously VP of Commercial
Strategy and Operations at Odonate Therapeutics, Inc.; previously
Executive Director, Global Early Commercialization at Celgene
Corporation
Executive in-residence at Pappas Capital; previously CEO of
ImmunoBiosciences
CEO of Leadiant Biosciences SpA; previously Global Head Rare Disease
and R&D at Sigma-tau; VP Preclinical Development at Nerviano Medical
Sciences.
Senior Vice President and General Manager of EMEA Region at PTC
Therapeutics; previously Chief Operating Officer at Gentium GmbH;
previously Regional VP Commercial Operations at Biogen Idec
Founder/co-founder of Sirius Healthcare Partners GMbH; previously
Chairman and CEO of Gentium S.p.A.; previously CEO of Arpida AG
Former SVP, Head of Gene Therapy Strategy PTC Therapeutics, Inc,
Former COO Agilis Biotherapeutics, Former Assistant Professor of
Audiology Mayo Clinic

July 2009

N/A

N/A

August 2011

August, 2016

April 2014

April 2014

September 2019

45

45

47

67

64

60

64

53

(1)            Member of the Audit Committee
(2)            Member of the Compensation Committee
(3)            Member of the Governance Committee

Rostislav Raykov

Mr. Raykov has served as a director of Fennec since July 2009 and as Chief Executive Officer since July 2009. From January 2006 to December 2007,
Mr.  Raykov  was  a  portfolio  manager  for  Alchem  Investment  Partners  and  John  Levin  &  Co.  Prior  to  founding  Alchem,  Mr.  Raykov  was  a  portfolio
manager  and  securities  analyst  for  John  A.  Levin  &  Co.  Event  Driven  Fund  (2002-2005).  Prior  to  joining  John  A.  Levin  &  Co.,  Mr.  Raykov  was  a
securities  analyst  for  the  Merger  Fund  at  Tiedemann  Investment  Group  (1999-2002)  and  an  investment  banking  analyst  at  Bear  Stearns  (1998-
1999).    Mr.  Raykov  earned  a  B.S.  in  Business  Administration  from  the  University  of  North  Carolina  at  Chapel  Hill.  As  a  result  of  these  and  other
professional experiences, Mr. Raykov has financial expertise and experience with the Corporation as it has developed within the drug development industry
and, as such, is able to provide the Corporation with unique insight and guidance.

Robert Andrade

Mr. Andrade has served as Chief Financial Officer since November 2015. Mr. Andrade was previously Chief Financial Officer and Director of Fennec from
September  2009  until  August  2013.  In  addition  to  his  role  with  Fennec,  Mr. Andrade  was  a  private  investor  in  2015,  and  a  senior  analyst  at  Magnetar
Capital from 2013 - 2014. Mr. Andrade graduated from University of Southern California, where he earned a Masters of Arts degree and Bachelor of Arts
degree in economics.

55

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Shubh Goel

Ms. Goel has been employed by us since September 2019. Ms. Goel is a proven leader with 20 years of global commercial experience successfully building
and executing the launch of several oncology products. Most recently, she served as Vice President of Commercial Strategy and Operations at Odonate
Therapeutics, Inc. Prior to Odonate, Ms. Goel previously served in multiple leadership positions at Celgene Corporation, including serving as Executive
Director, Global Early Commercialization and previously as Head of U.S. Marketing, Oncology. While at Celgene, she oversaw the successful execution of
the U.S. launch of Abraxane® in pancreatic cancer and had overall responsibility for marketing the U.S. solid tumor franchise. Ms. Goel received a B.Sc.
degree in biochemistry from the University of Bath.

Chris A. Rallis

Mr. Rallis has served as a director of Fennec since August 2011. Mr. Rallis has been an executive-in-residence at Pappas Capital, a life science venture
capital  firm  since  January  2008.  Previously,  Mr.  Rallis  was  the  President  and  Chief  Executive  Officer  of  ImmunoBiosciences,  Inc.  (“IBI”),  a
vaccine technology company formerly located in Raleigh, North Carolina from April 2006 through June 2007. Prior to joining IBI, Mr. Rallis served as an
executive in residence (part-time) for Pappas Capital, and as a consultant for Duke University and Panacos Pharmaceuticals, Inc. Mr. Rallis is the former
President and Chief Operating Officer (“COO”) and director of Triangle Pharmaceuticals, Inc., which was acquired by Gilead Sciences in January 2003 for
approximately $465 million. Prior to assuming the role of President and COO in March 2000, he was Executive Vice President, Business Development and
General Counsel. While at Triangle, Mr. Rallis participated in 11 equity financings generating gross proceeds of approximately $500 million. He was also
primarily  responsible  for  all  business  development  activities  which  included  a  worldwide  alliance  with  Abbott  Laboratories  and  the  in-licensing  of  ten
compounds. Before joining Triangle in 1995, Mr. Rallis served in various business development and legal management roles with Burroughs Wellcome Co.
over  a  13-year  period,  including  Vice  President  of  Strategic  Planning  and  Business  Development.  Mr.  Rallis  also  serves  on  the  board  of  Tenax
Therapeutics, Inc., a biopharmaceutical company located in Morrisville, North Carolina. Mr. Rallis received his A.B. degree in economics from Harvard
College  and  a  J.D.  from  Duke  University.  As  a  result  of  these  and  other  professional  experiences,  Mr.  Rallis  possesses  particular  healthcare  industry
knowledge and experience which strengthens the Board’s collective qualifications, skills, and experience.

Dr. Marco Brughera

Dr. Brughera has been a director of Fennec since August 2016. Since January 2011, Dr. Brughera has been CEO of Lediant Biosciences SpA and has held
several positions for the Sigma-Tau Group, including CEO and Global Head of Sigma Tau Rare Disease, President of Sigma-Tau Research and President of
Sigma-Tau  Pharmaceuticals.  He  drove  the  commercial  revival  of  a  lead  oncology  product  line  resulting  in  its  successful  sale  for  a  total  of  around
$900M. He also successfully out-licensed the Defibrotide US rights to Jazz Pharmaceuticals. From 2004 to 2010, Dr. Brughera served as the Vice President
of Preclinical Development at Nerviano Medical Sciences (NMS), a pharmaceutical oncology-focused integrated discovery and development company. He
also served as the Managing Director at Accelera, an independent contract research organization with the NMS Group. From 1999 to 2004, Dr. Brughera
held  several  senior  level  positions  in  the  areas  of  research  and  development  with  Pharmacia  and  Pfizer.  Prior  to  1999,  he  held  various  positions  at
Pharmacia & Upjohn and Farmitalia Carlo Erba SpA, an Italian pharmaceutical company. He currently serves on the Board of Exelead and Naicons and
previously was Board member of Soligenix, Lee’s Pharmaceuticals and Gentium.

Dr. Brughera earned his degree in veterinary medicine from the University of Milan and is a European Registered Toxicologist. Dr. Brughera has wide-
spread  experience  and  knowledge  of  pharmaceutical  drug  development  in  international  companies.  His  knowledge  in  particular,  of  clinical  drug
development in Europe, deepens the Board’s collective qualifications, skills and experience.

Adrian J. Haigh

Mr.  Haigh  has  been  a  director  of  Fennec  since  April  2014.  Mr.  Haigh  has  been  Senior  Vice  President  and  Head  of  International  Operations  at  PTC
Therapeutics  since  September  2014.  Previously  Mr.  Haigh  served  as  Chief  Operating  Officer  at  Gentium  GmbH  since  March  2011.  Prior  to  joining
Gentium,  Mr.  Haigh  served  as  Regional  VP  Commercial  Operations  at  Biogen  Idec  where  he  managed  several  affiliates  and  also  the  global  distributor
business and prior to that was the General Manager of Amgen Nordis and Portugal. He served as the Executive Vice President of Global Marketing and
Corporate Planning at EUSA Pharma and joined EUSA from Amgen where he led the international oncology franchise. Mr. Haigh previously has held
senior  commercial  and  marketing  positions  at  SmithKline  Beecham,  Schering  Plough,  Organon  and  Novo  Nordisk.  He  has  been  a  Director  of  Fennec
Pharmaceuticals Inc. since April 28, 2014 and a Director at Arch Biopartners Inc. since August 21, 2014. He received a Bachelor of Arts with Honors in
Economic History from Huddersfield Polytechnic, West Yorkshire, England and a Diploma in Marketing from the Institute of Marketing. As a result of
these and other professional experiences, Mr. Haigh has extensive international oncology development expertise which strengthens the Board’s collective
qualifications, skills and experience.

Dr. Khalid Islam

Dr. Islam has been a director of Fennec since April 2014 and is our current Chairman of the Board. Dr. Islam was the Chairman and CEO of Gentium
S.p.A. (a Nasdaq-listed company; 2009-2014) where he led the transition from a loss-making to a cash-flow positive and profitable company. Under his
leadership,  the  company  value  increased  from  US$25  million  leading  to  a  successful  all  cash  US$1  billion  merger  with  Jazz  Pharmaceuticals,  plc.
Subsequent  to  the  sale  of  Gentium,  Dr.  Islam  has  been  involved  from  both  an  advisory  and  board  level  in  several  public  and  private  healthcare  related
companies. From 1999-2008, Dr. Islam was President and CEO of Arpida AG where he transitioned the early-stage start-up to a SWX-listed company and
raised US$300 million in the IPO and follow-ons. From 1987-1999, he held various positions in HMR & MMD (now Sanofi-Aventis). From 1977-1987,
Dr. Islam worked in academia at Imperial College (Univ. of London) and in Milan University, where he was a contract professor. Dr. Islam is a graduate of
Chelsea  College  and  received  his  Ph.D.  from  Imperial  College,  University  of  London.  He  holds  several  patents  and  has  published  over  80  articles  in
leading journals. He is an advisor to the venture group Kurma Biofund (Paris). He is a founder/co-founder of Sirius Healthcare Partners GmbH (Zurich),
PrevAbr LLC (D.C.), BioAim LLC (L.A.) & Life Sciences Management GmbH (Zug). Dr. Islam is Board Chair at Minoryx Therapeutics (Spain) and Gain
Therapeutics (Switzerland), a public company. He currently serves on the board of Gain Therapeutics (GAIN) and Processa Pharmaceuticals (PCSA), both
of  which  are  publicly  traded.  In  the  past,  he  has  served  as  Chairman  of  the  Board  of  Directors  of  Immunomedics  (USA),  Pcovery  Aps  (Copenhagen),
Adenium Aps (Copenhagen) and C10 Pharma AS (Oslo) and on the board of Karolinska Development (Sweden) and MolMed S.p.A. (Italy). Dr. Islam’s
extensive  international  pharmaceutical  expertise  in  transitioning  companies  from  development  to  production  strengthens  the  Board’s  collective
qualifications, skills and experience.

 
 
 
 
 
 
 
 
 
 
 
 
 
56

Dr. Jodi Cook

Dr.  Cook  has  been  a  director  of  Fennec  since  September  2019.  Dr.  Cook  previously  served  as  SVP  and  Head  of  Gene  Therapy  Strategy  at  PTC
Therapeutics  from  August  2018  until  February  2020.  Previously  she  was  one  of  the  founding  members  and  Chief  Operating  Officer  of  Agilis
Biotherapeutics,  a  clinical-stage  company  focused  on  gene  therapies  for  rare  diseases  of  the  central  nervous  system,  from  December  2013  until  its
acquisition by PTC Therapeutics in August 2018. While at Agilis she led the sale of the company to PTC in a deal that represented significant value to all
parties. Dr. Cook’s career spans a wide range of experiences including VP of Clinical Research at InSound Medical and Director of Audiology at Songbird
Hearing,  both  successful  biotech  start-up  companies  within  the  hearing  industry.  She  has  been  Assistant  Professor  of  Audiology  and  Director  of  the
Hearing Aid Program at Mayo Clinic. Dr Cook earned a BA from Loyola University in Maryland, M.Aud. from University of South Carolina, and PhD
from  Arizona  State  University  in  Hearing  Science.  She  completed  a  clinical  fellowship  at  Johns  Hopkins  School  of  Medicine  in  Baltimore,  MD.  Her
extensive scientific, clinical and executive business experience strengthens the Board’s collective qualifications, skills and expertise.

Audit Committee

On behalf of the Board, the Audit Committee of the Board retains, oversees and evaluates our independent auditors, reviews the financial reports and other
financial  information  provided  by  us,  including  audited  financial  statements,  and  discusses  the  adequacy  of  disclosure  with  management  and  the
auditors. The Audit  Committee  also  reviews  the  performance  of  the  independent  auditors  in  the  annual  audit  and  in  assignments  unrelated  to  the  audit,
assesses the independence of the auditors, and reviews their fees. The Audit Committee is also responsible for reviewing our internal controls over financial
reporting and disclosure. The Audit Committee operates under a written charter adopted by the Board.

The  directors  have  appointed  an  Audit  Committee  consisting  of  three  directors:  Chris  A.  Rallis,  Khalid  Islam  and  Adrian  Haigh,  each  of  whom  is
independent and financially literate within the meaning of National Instrument 52-110 – Audit Committees and is independent under Rule 5605(a)(2) of the
Nasdaq listing standards. In addition, the Board has determined that Mr. Rallis qualifies as an “audit committee financial expert,” as defined in Item 407(d)
(5) of Regulation S-K promulgated by the SEC based on his business and financial experience described above.

Code of Ethics

In February 2004, our Board adopted a Mandate of the Board of Directors, Corporate Governance Guidelines and a Code of Business Conduct and Ethics
(the “Conduct and Ethics Code”) applicable to all of our officers, directors and employees. We are committed to adhering to applicable legal requirements
and maintaining the highest standards of conduct and integrity. The Conduct and Ethics Code sets out the legal and ethical standards of conduct for our
personnel  and  addresses  topics  such  as:  reporting  obligations  and  procedures;  honest  and  ethical  conduct  and  conflicts  of  interest;  compliance  with
applicable laws and Company policies and procedures; confidentiality of corporate information; use of corporate assets and opportunities; public disclosure
and  books  and  records;  and  non-retaliation.    The  Conduct  and  Ethics  Code  was  updated  in  June  of  2019  and  is  available  on  our  website  at
www.fennecpharma.com.

We  will  post  any  amendment  to  this  code,  as  well  as  any  waivers  that  are  required  to  be  disclosed  by  the  rules  of  the  SEC,  on  our  website  promptly
following the date of such amendment or waiver. We undertake to provide to any person without charge, upon request, a copy of the Conduct and Ethics
Code by writing to Attn: Code of Ethics Request, Fennec Pharmaceuticals Inc., 68 TW Alexander Drive, PO Box 13628, Research Triangle Park, North
Carolina 27709.

Delinquent Section 16(a) Reports

Under Section 16(a) of the Exchange Act, our directors and executive officers and any person who beneficially owns more than 10% of our outstanding
common shares (“reporting persons”) are required to report their initial beneficial ownership of our common shares and any subsequent changes in that
ownership to the SEC and Nasdaq. Reporting persons are required by SEC regulations to furnish to us copies of all reports they file in accordance with
Section 16(a). Based solely upon our review of the copies of such reports received by us, or written representations from certain reporting persons that no
other  reports  were  required,  we  believe  that  during  the  fiscal  year  ended  December  31,  2020,  all  Section  16(a)  filing  requirements  applicable  to  our
reporting persons were met.

57

 
 
 
 
 
 
 
 
 
 
 
 
Item 11.

Executive Compensation

Summary Compensation Table

The  following  table  sets  out  certain  information  respecting  the  compensation  paid  to  our  Chief  Executive  Officer,  our  Chief  Financial  Officer,  and  our
Chief Commercial Officer (“Named Executive Officers”) for the fiscal years ended December 31, 2020 and December 31, 2019.

Name and Principal Position

Year

Salary ($)

Bonus ($)

Rostislav Raykov, CEO

Robert Andrade, CFO

Shubh Goel, CCO(2)

2020     
2019     
2020     
2019     
2020     
2019     

430,000     
488,692     
311,750     
325,211     
360,000     
98,000     

Option Awards
($)(1)
1,694,216     
830,944     
847,108     
438,555     
169,422     
816,538     

-     
157,500     
-     
100,000     
-     
115,000     

Total ($)

2,124,216 
1,477,136 
1,158,858 
863,766 
529,422 
1,029,538 

(1) Represents the aggregate grant date fair value computed in accordance with FASB ASC Topic 718. Dollar value amounts are based on individual
grants  to  each  of  Mr.  Raykov  and  Mr. Andrade  of  250,000  and  150,000  and  125,000  and  80,000  options,  respectively,  on  May  15,  2020  and
April 4, 2019, at an exercise price of $6.93 and $4.38 per common share, respectively. Grants to Ms. Goel were for 25,000 and 175,000 options
granted on May 15, 2020 and September 9, 2019, respectively, at an exercise price of $6.93 and $4.74, respectively. All option grants expire 10
years  after  grant  date.  One-third  of  these  options  shall  vest  and  may  be  exercised  one  year  after  the  grant  date  (the  “Vesting  Commencement
Date”). The remaining two-thirds of the options shall vest monthly at a rate of 1/24th of the remaining grant and shall be exercisable as of the last
day  of  each  following  month  after  the  Vesting  Commencement  Date.  As  of  the  third  anniversary  of  the  grant  date,  all  of  the  options  shall  be
vested.

(2) Ms. Goel was hired as our Chief Commercial Officer in September 2019.

Rostislav Raykov
Mr.  Raykov  has  been  employed  by  us  since  July  2009.  Pursuant  to  an  employment  agreement  dated  May  3,  2010  between  Mr.  Raykov  and  Fennec,
Mr. Raykov is employed as our Chief Executive Officer and: (a) received an initial annual salary in the amount of $140,000, subject to annual adjustment
by our Board of Directors, (b) upon approval by shareholders of our amended stock option plan was granted options to purchase up to 5.0% of our common
shares  estimated  by  us  to  be  outstanding  upon  completion  of  our  2010  rights  offering,  and  (c)  may  receive  annual  bonuses  at  the  sole  discretion  of  the
Board. If Mr. Raykov’s employment terminates due to a change of control of Fennec, Mr. Raykov’s remaining unvested options shall immediately vest and
be  fully  exercisable.  If  Mr.  Raykov  is  dismissed  from  employment  by  us  for  any  reason  other  than  “for  cause,”  we  are  obligated  to  pay  Mr.  Raykov
severance compensation equal to twelve months of salary. The initial term of the agreement was for one year and the agreement automatically extends for
additional  one-year  periods  unless  terminated  by  either  party  in  accordance  with  the  agreement.  Effective  February  10,  2020,  Mr.  Raykov’s  salary  was
increased from $400,000 to $430,000 per year.

Robert Andrade
Mr. Andrade has been employed by us since November 2015. Pursuant to an employment agreement dated November 13, 2015, Mr. Andrade is employed
as  our  Chief  Financial  Officer  and:  (a)  received  an  initial  annual  salary  in  the  amount  of  $165,000,  and  (b)  may  receive  annual  bonuses  at  the  sole
discretion of the Board.  If Mr. Andrade’s employment terminates due to a change of control of the Fennec, Mr. Andrade’s remaining unvested options shall
immediately vest and be fully exercisable. If Mr. Andrade is dismissed from employment by us for any reason other than “for cause,” we are obligated to
pay Mr. Andrade severance compensation equal to six months of salary. Effective February 10, 2020, Mr. Andrade’s salary was increased from $290,000 to
$311,750 per year.

Shubh Goel
Ms.  Goel  has  been  employed  by  us  since  September  2019.  Pursuant  to  an  employment  agreement  dated  September  9,  2019,  Ms.  Goel  is  employed  as
Fennec’s  Chief  Commercial  Officer  and:  (a)  receives  an  initial  annual  salary  in  the  amount  of  $360,000,  subject  to  annual  adjustment  by  our  Board  of
Directors,  and  (b)  may  receive  annual  bonus  of  up  to  40%  of  her  base  salary  per  twelve  month  period,  at  the  discretion  of  the  CEO  and  the  Board  of
Directors.  If  Ms.  Goel’s  employment  is  terminated  by  us  for  any  reason  other  than  “for  cause”,  we  are  obligated  to  pay  Ms.  Goel  (i)  severance  in  the
amount of three months of employees base salary, (ii) prorate share of any target bonus earned by Ms. Goel and, (iii) accelerated vesting of stock options.
The initial term of the agreement was for one year and the agreement automatically extends for additional one-year periods unless terminated by either
party in accordance with the agreement.

In addition to their employment agreements, Mr. Raykov, Mr. Andrade and Ms. Goel are a party to a confidentiality and intellectual property agreement
with the Company.

In the employment agreements for each of Mr. Raykov, Mr. Andrade and Ms. Goel, “for cause” is generally defined as (1) material breach of the terms of
the employment or intellectual property agreements; (2) failure to perform the duties inherent in their position in good faith and in a reasonable and
appropriate manner; or (3) acts of fraud or embezzlement or other intentional misconduct which adversely affects our business.

58

 
 
 
 
 
 
   
   
   
   
 
   
 
   
   
 
   
   
 
   
 
 
 
 
 
 
 
Payments on Termination

The  following  table  provides  details  regarding  the  estimated  incremental  payments  from  us  to  each  of  the  current  Named  Executive  Officers  assuming
termination without cause on December 31, 2020.

Name
Rostislav Raykov, CEO
Robert Andrade, CFO
Shubh Goel, CCO

Payments on Change of Control

  $
  $
  $

Severance

    Estimated Bonus    Value of benefits 
430,000 
155,875 
90,000 

-    $
              -    $
-    $

430,000    $
 155,875    $
90,000    $

The following table provides details regarding the estimated incremental payments from us to each of the current Named Executive Officers upon change
of control.

Name
Rostislav Raykov, CEO
Robert Andrade, CFO

Change of Control
Multiple

  Estimated Bonus(1)    Value of benefits 
1,030,000 
448,594 

1,030,000    $
448,594    $

 2 X  $
 1.25 X  $

  (1) Change of control payments are calculated based on the two-year annualized average salary plus cash bonus as calculated as of December 31, 2020.

In addition to the payments above, an incentive plan has been established pursuant to which, upon completion of a change in control transaction, 1% of the
transaction value (up to a maximum of $2,000,000) be set aside and paid to key personnel upon completion of such change in control transaction, with 50%
of such incentive pool being payable to the CEO and the balance to other key personnel as determined by the CEO in consultation with the Compensation
Committee.

Equity Grants, Exercises and Holdings

The following table sets forth information concerning the number and value of unexercised options held by each Named Executive Officer as of
December 31, 2020. All executive awards, with the exception of those expiring 06/27/2027, 02/06/2028, 04/04/2029 and 05/15/2030, vest and are
exercisable immediately. Our current stock option plan provides for grants denominated in US and CAD dollars.

Name
Rostislav Raykov

Robert Andrade

Shubh Goel

Compensation of Directors

Director Compensation Table

Number of Options

Granted

    Exercisable

Option Exercise Price

    Expiration Date

250,000     
150,000     
100,000     
100,000     
150,000     
25,000     
83,333     
16,666     
50,000     
125,000     
80,000     
50,000     
50,000     
75,000     
25,000     
175,000     

-      USD$
87,500      USD$
97,222      USD$
100,000      USD$
150,000      USD$
25,000      USD$
83,333      USD$
16,666      USD$
50,000      USD$
-      USD$
46,666      USD$
48,611      USD$
50,000      USD$
75,000      USD$
-      USD$
77,778      USD$

6.93   
4.83   
8.38   
5.10   
2.45   
2.69   
1.59   
0.72   
1.05   
6.93   
4.83   
8.38   
5.10   
2.45   
6.93   
4.74   

05/15/2030
04/04/2029
02/06/2028
06/27/2027
07/05/2026
12/31/2024
01/24/2024
08/23/2023
11/20/2022
05/15/2030
04/04/2029
02/06/2028
06/27/2027
07/05/2026
05/15/2030
09/09/2029

The following table summarizes the compensation earned by our non-executive directors for the year ended December 31, 2020.

59

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
     
 
   
   
     
 
   
     
 
   
     
 
   
     
 
   
     
 
   
     
 
   
     
 
   
     
 
   
     
   
     
 
   
     
 
   
     
 
   
     
 
   
     
   
     
 
   
     
 
 
 
 
Name
Dr. Islam
Mr. Brughera
Mr. Haigh
Dr. Cook
Mr. Rallis

  Fees paid in Cash    

Stock Awards

85,000     
40.000     
40,000     
75,000     
42,500     
282,500    $

Total  $

    Option Awards(1)(2)   
150,406     
–     
120,325     
–     
120,325     
–     
120,325     
–     
120,325     
–     
631,706    $
–    $

Total

235,406 
160,325 
160,325 
195,325 
162,825 
914,206 

(1) Represents the aggregate grant date fair value computed in accordance with FASB ASC Topic 718.
(2) Detail of option grants are presented in the following table:

Name
Mr. Rallis
Mr. Brughera
Mr. Haigh
Dr. Islam
Jodi Cook

  Date of Grant     Number of Options Granted    Option Exercise Price $USD 
6.17 
    August 13, 2020     
6.17 
    August 13, 2020     
6.17 
    August 13, 2020     
6.17 
    August 13, 2020     
    August 13, 2020     
6.17 
    $

20,000     
20,000     
20,000     
25,000     
20,000     
105,000     

Total   

The annual compensation considerations for non-executive directors also include the awarding of stock options. We believe that granting of options to the
non-executive directors serves three primary purposes: (1) to recognize the significant time and effort commitments of being a member of our Board; (2) to
provide  long-term  incentives  for  future  efforts  since  the  value  of  the  options  is  directly  dependent  on  our  market  valuation;  and  (3)  to  retain  quality
individuals. When determining whether and how many new option grants will be made, the Compensation Committee takes into account the amount and
terms of any outstanding options. We do not require our non-executive directors to own a specific amount of our common shares.

Each  of  Adrian  J.  Haigh,  Khalid  Islam,  Marco  Brughera,  Jodi  Cook  and  Chris A. Rallis has  entered  into  an  Independent  Director  Agreement  with  the
Company,  which  provides  for  cash  compensation  as  set  forth  by  the  Compensation  Committee  commensurate  with  that  member’s  responsibilities.  The
Compensation  Committee  may  also  remunerate  members  in  the  form  of  a  grant  of  options  to  purchase  shares  of  our  common  shares.  The  options
immediately  vest  when  granted  and  are  otherwise  subject  to  the  terms  and  conditions  of  our  stock  option  plan,  as  amended.  The  Independent  Director
Agreements  also  provide  for  the  reimbursement  of  such  director’s  reasonable  travel  and  related  expenses  incurred  in  the  course  of  attending  board
meetings.

Item 12.

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

The following table sets forth information regarding our common shares beneficially owned as of March 29, 2021 by: (i) each of our officers and directors;
(ii) all officers and directors as a group; and (iii) each person known by us to beneficially own five percent or more of our outstanding common shares.
Except  as  indicated  below,  the  security  holders  listed  possess  sole  voting  and  investment  power  with  respect  to  the  shares  beneficially  owned  by  that
person. Except as otherwise indicated below, the address for each listed shareholder is c/o Fennec Pharmaceuticals Inc., 68 TW Alexander Drive, PO Box
13628, Research Triangle Park, North Carolina 27709.

Name

Adrian J. Haigh
Dr. Khalid Islam
Robert Andrade
Marco Brughera
Jodi Cook
Chris A. Rallis
Shubh Goel
Rostislav Raykov
All Officers and Directors as a Group
Southpoint Capital Advisors, LP.(2)
Essetifin SpA(3)
Avoro Capital Advisors(4)
Sonic Fund II, LP.(5)

Common
shares
Options
Exercisable
Within 60 Days    

Common
shares
Purchase
Warrants
Exercisable
Within 60 Days    

Common
shares

Total Stock and
Stock Based
Holdings(1)

%
Ownership(1)

233,579     
313,825     
380,000     
115,545     
40,000     
191,850     
200,000     
924,999     
2,399,798     
–     
–     
-     
-     

–     
–     
153,273     
–     
-     
–     
-     
196,578     
349,851     
4,077,214     
3,993,694     
1,670,000     
2,495,753     

60

-     
–     
–     
–     
-     
–     
-     
–     
–     
–     
–     
-     
-     

233,579     
313,825     
682,183     
115,545     
40,000     
191,850     
200,000     
1,268,819     
2,749,649     
4,077,214     
3,993,694     
1,670,000     
2,495,753     

0.89%
1.19%
2.02%
0.44%
0.15%
0.73%
0.76%
4.17%
9.68%
15.68%
15.36%
6.42%
9.60%

 
 
 
   
   
   
   
   
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
 
(1) For purposes of this table “beneficial ownership” is determined in accordance with Rule 13d-3 under the Securities Exchange Act of 1934, pursuant to
which a person or group of persons is deemed to have “beneficial ownership” of any common shares that such person or group has the right to acquire
within  60  days  after  March  29,  2021.  For  purposes  of  computing  the  percentage  of  outstanding  common  shares  held  by  each  person  or  group  of
persons named above, any shares that such person or group has the right to acquire within 60 days after February 11, 2020 are deemed outstanding but
are not deemed to be outstanding for purposes of computing the percentage ownership of any other person or group. As of March 29, 2021, there were
26,002,853 common shares issued and outstanding.

(2) Southpoint Capital Advisors, LP, 623 Fifth Avenue, Suite 2503, New York, New York 10022. John S. Clark, II holds dispositive power over the shares

owned by Southpoint Capital Advisors, LP.

(3) Essetifin SpA, Via Sudafrica 20, Rome, Italy 00144. Mario Artali holds dispositive power over the shares owned by Essetifin SpA.
(4) Avoro Capital Advisors, 110 Greene Street, Suite 800, New York, NY 10012. Scott Esptein holds dispositive power over the shares held by Avoro

Capital Advisors

(5) Sonic Fund II, LP, 400 Hobron Lane, Suite 3709, Honolulu, HI 96815. Lawrence Kam holds dispositive power over the shares held by Sonic Fund II,

LP.

Equity Compensation Plan Information

The following table provides certain information with respect to securities authorized for issuance under equity incentive plans as of December 31, 2020.
(share amounts are in thousands):

(a)
Number of securities to be issued
upon exercise of outstanding
options warrants and rights

(b)
Weighted-average exercise price of
outstanding options, warrants and
rights

(c)
Number of securities remaining
available for future issuance under
equity compensation plans
(excluding securities reflected in
Column (a))

2,952     
2,952     

USD $ 4.82     
–     

3,549 
3,549 

Plan Category
Equity compensation plans approved
by security holders

Total   

* Our current stock option plan allows for the issuance of stock options denominated in both U.S. dollars and Canadian dollars. At December 31, 2020,

there were 3.55 million common shares available for future grants under our current stock option plan.

Item 13.

Certain Relationships and Related Transactions, and Director Independence

Related Party Transactions

There were no reportable transactions with related parties during the year ended December 31, 2020 in which the amount involved exceeded the lesser of
$120,000 or one percent of the average of our total assets at year-end for the last two completed fiscal years.

Indemnifications Related to Officers and the Board of Directors.
We have agreed to indemnify members of our Board of Directors (the “Board”) and certain of our officers if they are named or threatened to be named as a
party to any proceeding by reason of the fact that they acted in such capacity. We maintain directors’ and officers’ (“D&O”) insurance coverage to protect
against such losses. We have not historically incurred any losses related to these types of indemnifications. Presently, we are defending a suit against our
board and certain named officers. Management is unable to estimate a dollar value related to the suit, nor can it determine the probability of an outcome
either in favour or against the Company. As a result, we have not recorded any liabilities related to such indemnifications as of December 31, 2020. In
addition, as a result of the insurance policy coverage, we believe these indemnification agreements are not significant to our results of operations.

Director Independence

The Board of Directors is composed of a majority of independent directors. The Board applies the definition of independence found in the Nasdaq listing
standards and in Canadian National Instrument 58-101 and National Policy 58-201. The Board has determined that Mr. Brughera, Haigh, Islam, Rallis and
Ms.  Cook  are  “independent.”  Mr.  Raykov,  our  Chief  Executive  Officer,  is  considered  to  have  a  material  relationship  with  us  by  virtue  of  his  executive
officer position and is therefore not independent. We are of the view that the composition of our Board reflects a diversity of background and experience
that are important for effective corporate governance. Other directorships held by Board members are described in this Annual Report under the heading
“Directors and Executive Officers.”

61

 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
   
 
 
 
 
 
 
 
 
Item 14.

Principal Accounting Fees and Services

The following presents the aggregate fees for professional services and other services rendered by our independent auditors, Haskell & White LLP in fiscal
year 2020 and 2019:

Audit Fees(1)
Audit-Related Fees(2)
Tax Fees(3)
All Other Fees(4)

Fiscal Year
2020

Fiscal Year
2019

51,600     
40,000     
-     
-     
91,600    $

74,500 
– 
- 
2,500 
77,000 

Total  $

(1) Audit Fees include fees for the standard audit work that needs to be performed each year in order to issue an opinion on the consolidated financial
statements of the Company. It also includes fees for services that can only be provided by the Company’s auditor such as auditing of non-recurring
transactions.

(2) Audit-Related Fees include fees assurance and related services that are reasonably related to the performance of the audit or review and are

traditionally performed by the independent accountant.

(3) Tax Fees
(4) All Other Fees include fees for products and services other than Audit Fees, Audit Related Fees and Tax Fees.

The Audit Committee does not have formal pre-approval policies and procedures; however, prior to their engagement by us, the Audit Committee approved
all of the services performed by Haskell & White LLP as required by SEC regulation.

62

 
 
 
 
 
 
   
 
   
   
   
   
 
 
 
PART IV

Item 15.

Exhibits, Financial Statement Schedules

(a) The following documents are included as part of this Annual Report filed on Form 10-K:

1. Financial Statements – See Index to Financial Statements on page F-1.

2. All schedules are omitted as the information required is inapplicable or the information is presented in the financial statements.

3. Exhibits:

Exhibit
No.

3.1

3.2

3.3

10.1

10.2

10.3

10.7

10.9

10.10

10.11

Description

Location

  Notice of Articles dated August 25, 2011

  Exhibit 3.2I to the Form 8-K of the Company filed August 26,

2011

  Articles dated August 25, 2011

  Exhibit 3.2II to the Form 8-K of the Company filed August 26,

2011

  Notice of Alteration Dated September 3, 2014

  Exhibit 3.1 to the Form 8-K of the Company filed September 9,

2014

  Fennec Amended and Restated Stock Option Plan*

  Exhibit 10.1 to the Form 8-K of the Company filed September 29,

2017

  Executive  Employment  Agreement  dated  May  3,  2010  by  and

  Exhibit  10.28  to  the  Form  10-Q  of  the  Company  filed  May  14,

between Fennec and Rostislav Raykov*

2010

  Form of Independent Director Agreement, dated May 3, 2010

  Exhibit 10.31 to the Form 10-Q of the Company filed May 14,

2010

  Executive Employment Agreement dated November 12, 2015 by and

the  Form  10-Q  of 

the  Company  filed

between Fennec and Robert Andrade*

  Exhibit  10.40 

to 
November 12, 2015

  Purchase  Agreement,  dated  May  9,  2016,  between  Fennec

  Exhibit 10.42 to the Form 10-Q of the Company filed May 12,

Pharmaceuticals Inc. and Elion Oncology, LLC.

2016

  Loan  and  Security  Agreement  dated  as  of  February  1,  2019  by  and
between Fennec Pharmaceuticals, Inc. and Western Alliance Bank

  Exhibit  10.1  to  the  Form  8-K  of  the  Company  filed  February  4,

2019

  First  Amendment  to  Loan  and  Security  Agreement  dated  as  of
June  25,  2020  by  and  between  Fennec  Pharmaceuticals,  Inc.  and
Western Alliance Bank

  Exhibit 10.1 to the Form 8-K of the Company filed June 26, 2020

10.12

  At The Market Offering Agreement, dated October 30, 2020, between

  Exhibit  1.1  to  the  Form  8-K  of  the  Company  filed  October  30,

Fennec Pharmaceuticals Inc. and H.C. Wainwright & Co., LLC

2020

16.1

21

23.1

  Letter Regarding Change in Certifying Accountant

  Exhibit 16.1 to the Form 8-K of the Company filed May 17, 2017

  Subsidiaries

  Exhibit 21 to the 10-K of the Company filed February 14, 2020

  Consent of Haskell & White LLP Independent Registered Public

  Filed herewith

Accounting Firm

63

 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
   
   
 
Exhibit
No.

Description

Location

31.1

31.2

32.1

99.1

101.1

* 

**

  Certification  of  Chief  Executive  Officer  of  the  Company  in

  Filed herewith

accordance with Section 302 of the Sarbanes-Oxley Act of 2002

  Certification  of  Chief  Financial  Officer  of 

the  Company 

in

  Filed herewith

accordance with Section 302 of the Sarbanes-Oxley Act of 2002

  Certification  of  Chief  Executive  Officer  and  Chief  Financial  Officer
of  the  Company  in  accordance  with  Section  906  of  the  Sarbanes-
Oxley Act of 2002

  Filed herewith

  Press Release for Fiscal Year Ended December 31, 2020

  Filed herewith

  Interactive Data File

  Filed herewith

Indicates a management contract or compensatory plan.

The  Company  has  received  confidential  treatment  with  respect  to  certain  portions  of  this  exhibit.  Those  portions  have  been  omitted  from  this
exhibit and are filed separately with the U.S. Securities and Exchange Commission.

Item 16.

Form 10-K Summary

None.

64

 
 
 
 
 
   
   
 
   
   
 
   
   
 
   
   
 
 
 
 
 
 
SIGNATURES

Pursuant to the requirements of Section 13 of 15(d) the Securities Exchange Act of 1934, the registrant has duly caused this Annual Report to be signed on
its behalf by the undersigned, thereunto duly authorized.

Fennec Pharmaceuticals Inc.

By:

Date:  March 30, 2021

/s/ Rostislav Raykov
Rostislav Raykov
Chief Executive Officer and Director

We,  the  undersigned  directors  and  officers  of  Fennec  Pharmaceuticals  Inc.,  do  hereby  constitute  and  appoint  Rostislav  Raykov,  as  our  true  and  lawful
attorney-in-fact and agent with power of substitution, to do any and all acts and things in our name and behalf in our capacities as directors and officers and
to execute any and all instruments for us and in our names in the capacities indicated below, which such attorney-in-fact and agent may deem necessary or
advisable to enable said corporation to comply with the Securities Exchange Act of 1934, as amended, and any rules, regulations and requirements of the
Securities  and  Exchange  Commission,  in  connection  with  this  Annual  Report  on  Form  10-K,  including  specifically  but  without  limitation,  power  and
authority to sign for us or any of us in our names in the capacities indicated below, any and all amendments hereto; and we do hereby ratify and confirm all
that said attorney-in-fact and agent, shall do or cause to be done by virtue hereof.

Pursuant to the requirements of the Securities Exchange Act of 1934, this Annual Report has been signed below by the following persons on behalf of the
registrant and in the capacities and on the dates indicated.

Signatures

Title

/s/     Rostislav Raykov
Rostislav Raykov

/s/     Robert Andrade
Robert Andrade

/s/  Adrian J. Haigh
Adrian J. Haigh

/s/  Dr. Khalid Islam
Dr. Khalid Islam

/s/     Chris A. Rallis
Chris A. Rallis

/s/     Marco Brughera
Marco Brughera

/s/     Jodi Cook
Jodi Cook

Chief Executive Officer
(principal executive officer) and Director

Chief Financial Officer
(principal financial officer and principal
accounting officer)

Director

Director

Director

Director

Director

65

Date

March 30, 2021

March 30, 2021

March 30, 2021

March 30, 2021

March 30, 2021

March 30, 2021

March 30, 2021

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FENNEC PHARMACEUTICALS INC.
INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

Report of Independent Registered Public Accounting Firm

Consolidated Balance Sheets

Consolidated Statements of Operations

Consolidated Statements of Cash Flows

Consolidated Statements of Shareholders’ Equity

Notes to the Consolidated Financial Statements

F-1

F-2 

F-4 

F-5 

F-6 

F-7 

F-8 

 
 
 
   
 
   
  
   
 
   
  
   
 
   
  
   
 
   
  
   
 
   
  
   
 
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Shareholders and Board of Directors and
Fennec Pharmaceuticals Inc.

Opinion on the Consolidated Financial Statements

We have audited the accompanying consolidated balance sheets of Fennec Pharmaceuticals Inc. and subsidiaries (the “Company”) as of December 31, 2020
and 2019, and the related consolidated statements of operations, shareholders’ equity, and cash flows for each of the years then ended, and the related notes
(collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements referred to above present fairly, in
all material respects, the consolidated financial position of the Company as of December 31, 2020 and 2019, and the consolidated results of its operations
and its cash flows for each of the years then ended, in conformity with accounting principles generally accepted in the United States of America.

Basis for Opinion

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

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

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

Critical Audit Matters

The  critical  audit  matter  communicated  below  is  a  matter  arising  from  the  current  period  audit  of  the  consolidated  financial  statements  that  was
communicated or required to be communicated to the audit committee and that: (1) relates to accounts or disclosures that are material to the consolidated
financial statements and (2) involved our especially challenging, subjective, or complex judgments. The communication of the critical audit matter does not
alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below,
providing separate opinions on the critical audit matter or on the accounts or disclosures to which they relate.

Fair Value of Stock Options – Refer to Note 4 to the Consolidated Financial Statements

Critical Audit Matter Description:

The Company uses the Black-Scholes option-pricing model to estimate the fair value of its stock options. The Black-Scholes option-pricing model involves
the use of significant estimates, including the following:

§

Expected dividend yield;

§ Risk-free interest rate;

F-2

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
§

§

Expected share price volatility; and

Expected life of the award.

Given  the  significant  estimates  involved  in  estimating  the  fair  value  of  stock  options,  the  related  audit  effort  in  evaluating  management’s  estimates  in
determining the fair value of stock options was extensive and required a high degree of auditor judgment.

How the Critical Audit Matter was Addressed in the Audit:

We obtained an understanding over the Company’s process to estimate the fair value of stock options, including how the Company develops each of the
estimates required to utilize the Black-Scholes option-pricing model. We applied the following audit procedures related to testing the Company’s estimates
utilized in the Black-Scholes option-pricing model:

§ We performed a look-back at the Company’s previously issued dividends, noting there were none. We inquired with management of the Company

who informed us that no future dividends were currently anticipated.

§ We compared the Company’s risk-free interest rate used to the comparable United States treasury yield for a term comparable to the stock options’

expected term.

§ We recalculated the Company’s historical share price volatility for a term comparable to the stock options’ expected term.

§ We recalculated the expected term of stock options granted to employees and non-employee directors using the simplified method, whereby, the

expected term equals the average of the vesting term and the original contractual term of the option.

We have served as the Company’s auditor since 2017.

Irvine, California
March 30, 2021

/s/ Haskell & White LLP
HASKELL & WHITE LLP

F-3

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fennec Pharmaceuticals Inc.
Consolidated Balance Sheets
(U.S. dollars and shares in thousands)

Assets
Current assets

Cash and cash equivalents
Prepaid expenses
Other current assets

Non-Current assets

Deferred issuance cost
Deferred issuance cost (amortization)

Total assets

Liabilities and Shareholders' Equity
Current liabilities:

Accounts payable
Accrued liabilities

Total current liabilities

Total liabilities

Commitments and Contingencies (Note 7)

Shareholders' equity:

Common  stock,  no  par  value;  unlimited  shares  authorized;  26,003  shares  issued  and  outstanding  (2019-
19,896)
Additional paid-in capital
Accumulated deficit
Accumulated other comprehensive income

Total shareholders’ equity
Total liabilities and shareholders’ equity

  December 31,

    December 31,

2020

2019

  $

  $

  $

  $

30,344    $
797     
276     
31,417     

466     
(466)    
-     
31,417    $

1,571    $
776     
2,347     

2,347     

13,650 
226 
8 
13,884 

326 
(64)
262 
14,146 

1,612 
659 
2,271 

2,271 

140,733     
49,234     
(162,140)    
1,243     
29,070     
31,417    $

106,392 
48,271 
(144,031)
1,243 
11,875 
14,146 

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

F-4

 
 
 
 
 
 
 
 
   
 
   
      
  
   
      
  
   
   
 
   
   
      
  
   
   
 
   
 
   
      
  
   
      
  
   
      
  
   
   
 
   
      
  
   
 
   
      
  
   
      
  
 
   
      
  
   
      
  
   
   
   
   
   
 
 
Fennec Pharmaceuticals Inc.
Consolidated Statements of Operations
(U.S. dollars and shares in thousands, except per share information)

Revenue

Eniluracil royalty

Operating expenses:

Research and development
General and administrative

Total operating expenses
Loss from operations

Other income/(expense):
Amortization expense
Unrealized gain on securities
Other (loss)/income
Interest income

Total other (expense)/income

Net loss

Loss per common share, basic and diluted

Weighted-average number of common shares outstanding basic and diluted (Note 3)

Year Ended

  December 31,

    December 31,

2020

2019

  $

170    $

- 

5,105     
12,950     

18,055     
(17,885)    

(402)    
100     
(9)    
87     
(224)    

5,607 
7,402 

13,009 
(13,009)

(64)
- 
(17)
315 
234 

  $

  $

(18,109)   $

(12,775)

(0.76)   $
23,704     

(0.64)
19,896 

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

F-5

 
 
 
 
 
 
 
 
 
 
   
 
   
      
  
 
   
      
  
   
      
  
   
   
 
   
      
  
   
   
 
   
      
  
   
      
  
   
   
   
   
   
 
   
      
  
 
   
      
  
   
 
 
Fennec Pharmaceuticals Inc.
Consolidated Statements of Cash Flows
(U.S. dollars in thousands)

Cash flows (used in) provided by:
Operating activities:
Net loss
Adjustments to reconcile net loss to net cash used in operating activities:
Amortization of deferred issuance costs
Stock-based compensation - consultants
Stock-based compensation - employees
Changes in operating assets and liabilities:

Prepaid expenses
Other assets
Accounts payable
Accrued liabilities

Net cash used in operating activities

Financing activities:
Cash paid for issuance costs
Issuance of shares, options exercise
Issuance of shares, net of issuance costs
Net cash provided by/used in financing activities

Increase  in cash and cash equivalents
Cash and cash equivalents - Beginning of year
Cash and cash equivalents - End of year

Supplemental disclosures of cash flow information:
Non-cash investing and financing activities:
Non-cash financing (insurance policy)
Non-cash deferred issuance cost (warrant value)

Year Ended

  December 31,

    December 31,

2020

2019

  $

(18,109)   $

(12,775)

402     
84     
2,791     

(163)    
(268)    
(41)    
(291)    
(15,595)    

(140)    
462     
31,967     
32,289     

16,694     
13,650     
30,344    $

64 
417 
2,665 

(58)
(7)
580 
54 
(9,060)

(71)
- 
- 
(71)

(9,131)
22,781 
13,650 

408    $
-    $

- 
255 

  $

  $
  $

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

F-6

 
 
 
 
 
 
 
 
 
 
   
 
   
      
  
   
      
  
   
      
  
   
   
   
   
      
  
   
   
   
   
   
 
   
      
  
   
      
  
   
   
   
   
 
   
      
  
   
   
 
   
      
  
   
      
  
   
      
  
 
 
Fennec Pharmaceuticals Inc.
Consolidated Statements of Shareholders' Equity
(U.S. dollars and shares in thousands)

Common Stock

  Number (Note 7)   

Amount

    Additional

Paid-in
Capital

    Accumulated      
Other
    Accumulated     Comprehensive    Stockholders' 
Income

Deficit

Equity

Total

Balance at December 31, 2018
Stock options issued to consultants
Stock options issued to employees
Warrants issued to consultants
Net loss
Balance at December 31, 2019
Stock options issued to consultants
Stock options issued to employees
Issuance of securities
Exercise of stock options
Net loss
Balance at December 31, 2020

19,896    $
-     
-     
-     
-     
19,896    $
-     
-     
5,460     
647     
-     
26,003    $

106,392    $
-     
-     
-     
-     
106,392    $
-     
-     
31,967     
2,374     
-     
140,733    $

44,934    $
417     
2,665     
255     
-     
48,271    $
84     
2,791     
-     
(1,912)    
-     
49,234    $

(131,256)   $
-     
-     
-     
(12,775)    
(144,031)   $
-     
-     
-     
-     
(18,109)    
(162,140)   $

1,243    $
-     
-     
-     
-     
1,243    $
-     
-     
-     
-     
-     
1,243    $

21,313 
417 
2,665 
255 
(12,775)
11,875 
84 
2,791 
31,967 
462 
(18,109)
29,070 

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

F-7

 
 
 
 
   
     
     
     
 
 
   
     
     
   
   
 
 
 
   
 
   
   
   
   
 
   
   
   
   
   
   
   
   
   
   
   
   
 
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

1.            Nature of Business and Liquidity

Fennec Pharmaceuticals Inc. (“Fennec,” “the Company,” “we,” “us,” or “our”) was originally formed as a British Columbia corporation under the name
Adherex Technologies Inc. and subsequently changed its name on September 3, 2014. Fennec, together with its wholly owned subsidiaries Oxiquant, Inc.
(“Oxiquant”) and Fennec Pharmaceuticals, Inc., both Delaware corporations, and Cadherin Biomedical Inc. (“CBI”), a Canadian corporation and Fennec
Pharmaceuticals  (EU)  Limited  (“Fennec  Limited”),  collectively  referred  to  herein  as  the  “Company,”  is  a  biopharmaceutical  company  with  a  product
candidate under development for use in the treatment of cancer. With the exception of Fennec Pharmaceuticals, Inc., all subsidiaries are inactive.

These consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America
(“US GAAP”) that are applicable to a going concern which contemplates that the Company will continue in operation for the foreseeable future and will be
able to realize its assets and discharge its liabilities in the normal course of business.

During the year ended December 31, 2020, the Company incurred a loss from operations of $17,885 and still has not earned any significant revenue in its
history from the commercial sale of its product candidate. At December 31, 2020 it had an accumulated deficit of $162,140 and had experienced negative
cash flows from operating activities in the amount of $15,595 for the year ended December 31, 2020.

On  May  5,  2020,  the  Company  announced  the  completion  of  an  underwritten  public  offering  of  4,800,000  common  shares  at  a  public  offering  price  of
$6.25 per share. In addition, Fennec issued an additional 660,204 common shares in connection with the partial exercise of the underwriters’ over-allotment
option. The approximate total gross proceeds from the offering was $34,100 ($32,189 net of commissions, fees and issue costs).

On February 1, 2019, Fennec entered into a Loan and Security Agreement with Bridge Bank, a division of Western Alliance Bank, an Arizona corporation,
pursuant  to  which  the  Bank  agreed  to  loan  $12.5  million  to  the  Company,  to  be  made  available  upon  New  Drug  Application  (“NDA”)  approval  of
PEDMARKTM by no later than September 30, 2020. The proceeds from the loan will be used for working capital purposes and to fund general business
requirements in accordance with the terms of the Loan and Security Agreement. Interest under the Term Loans shall bear interest, on the outstanding daily
balance thereof, at a floating per annum rate equal to the Effective Interest Rate (as defined in the Loan and Security Agreement) which is equal to the sum
of  the  Prime  Rate  published  in  the  Wall  Street  Journal  (currently  3.25%)  plus  one  percent  (1.00%).  The  debt  facility  is  to  have  interest-only  monthly
payments due for the first eighteen months from the funding date and then monthly principal and interest payments are due through the remainder of the
term which has a maturity date of October 1, 2023. In connection with the facility, Fennec has agreed to grant Bridge Bank a warrant to purchase up to
39,130 common shares at an exercise price of $6.80 per common share, for a term of ten years from the date of issuance, subject to early termination under
certain conditions.

On June 26, 2020, Fennec announced an amendment to the Loan and Security Agreement with Bridge Bank. This amendment provides Fennec with an
$18.0 million debt facility comprised of two term loans. Term Loan A consists of $12.5 million to be funded upon NDA approval of PEDMARKTM in the
U.S. to be made available upon NDA approval of PEDMARKTM by no later than December 31, 2020 and Term Loan B consists of $5.5 million to be
funded upon the occurrence of a revenue event in 2021. The interest-only period for the facility has the ability to be extended from 18 months to 24 months
from the funding of Term Loan A, provided that Term Loan B is funded, and certain conditions are met. The fee in connection with Loan B, can either be
2.13% of the Loan B amount in cash, or the Company can issue a warrant with a value equal to 3.25% of the Loan B amount. On August 6, 2020, the
Company paid cash for the extended facility. These statements reflect that fee being settled with cash instead of a warrant. Under Accounting Standards
Codification  ("ASC")  470-50,  Modifications  and  Extinguishments,  the  amendment  was  considered  a  modification.  As  such,  the  Company  had  been
amortizing the loan fee and the value of the warrant over the remainder of the loan term. Following the receipt of the U.S. Food and Drug Administration’s
(“FDA”) Complete Response Letter (“CRL”), management decided to fully amortize the remaining portions of the loan fee and the value of the warrants.

On August 10, 2020, the Company received a CRL from the FDA regarding its NDA for PEDMARKTM. According to the CRL, after recent completion of
a pre-approval inspection of the manufacturing facility of our drug product manufacturer, the FDA identified deficiencies that are required to be resolved
prior to the approval of PEDMARKTM. Importantly, no clinical safety or efficacy issues were identified during the review and there is no requirement for
further  clinical  data.  The  Company  plans  to  work  closely  with  the  third-party  drug  manufacturer  and  the  FDA  to  fully  address  the  CRL  and  plans  to
resubmit the NDA for PEDMARKTM in the second quarter of 2021.

The  Company  believes  the  funds  raised  in  the  public  offering  which  closed  in  May  2020  provide  sufficient  funding  for  the  Company  to  carry  out  its
planned activities including potential NDA approval and the commencement of commercialization efforts for at least the next twelve months as it continues
its strategic development of PEDMARKTM.

F-8

 
 
 
 
 
 
 
 
 
 
 
 
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

These financial statements do not reflect the potentially material adjustments in the carrying values of assets and liabilities, the reported expenses, and the
balance sheet classifications used, that would be necessary if the going concern assumption were not appropriate.

2.            Significant Accounting Policies

Basis of presentation

The consolidated financial statements include the accounts of Fennec and of all its wholly-owned subsidiaries. All inter-company transactions and balances
have been eliminated upon consolidation.

Use of estimates

The preparation of financial statements in conformity with US GAAP requires management to make estimates and assumptions that impact the reported
amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the consolidated financial statements and the reported
amounts of revenue and expense during the reporting period. Significant estimates include the valuation of stock-based compensation. Actual results could
differ from those estimates.

Cash and Cash Equivalents

Cash equivalents consist of highly liquid investments with original maturities at the date of purchase of three months or less.

The  Company  places  its  cash  and  cash  equivalents  in  investments  held  by  highly  rated  financial  institutions  in  accordance  with  its  investment  policy
designed to protect the principal investment. At December 31, 2020, the Company had $30.3 million in cash and money market accounts (2019- $13.7
million). Money market investments typically have minimal risks. While the Company has not experienced any loss or write-down of its money market
investments, the amounts it holds in money market accounts are substantially above the $250,000 amount insured by the FDIC and may lose value.

Financial instruments

Financial  instruments  recognized  on  the  balance  sheets  at  December  31,  2020  and  December  31,  2019  consist  of  cash  and  cash  equivalents,  accounts
receivable, accounts payable and accrued liabilities, the carrying values of which, approximate fair value due to their relatively short time to maturity. The
Company does not hold or issue financial instruments for trading.

The Company’s investment policy is to manage investments to achieve, in the order of importance, the financial objectives of preservation of principal,
liquidity  and  return  on  investment.  Investments,  when  made,  are  made  in  U.S.  or  Canadian  bank  securities,  commercial  paper  of  U.S.  or  Canadian
industrial companies, utilities, financial institutions and consumer loan companies, and securities of foreign banks provided the obligations are guaranteed
or carry ratings appropriate to the policy. Securities must have a minimum Dun & Bradstreet rating of A for bonds or R1 low for commercial paper.

The policy risks are primarily the opportunity cost of the conservative nature of the allowable investments. As the main purpose of the Company is research
and development, the Company has chosen to avoid investments of a trading or speculative nature.

Common shares and warrants

The Company has 0.04 million warrants with a weighted average strike price of $6.80 outstanding to purchase common shares that were denominated in
United States dollars (“USD”).

Revenue

The  Company's  revenue  is  generated  through  sales  of  intellectual  property  (“IP”).  The  Company  generates  its  revenue  through  one  segment  and  the
revenue recognized under each of the Company's arrangements during the current period is described below. The terms of these agreements may contain
multiple promised goods or services or optional goods and services, including licenses to product candidates, referred to as exclusive licenses, as well as
research and development activities to be performed by the Company on behalf of the collaboration partner related to the licensed product candidates.

F-9

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

Revenue recognition

Revenue  is  recognized  when  control  of  the  promised  goods  or  services  are  transferred  to  customers  in  an  amount  that  reflects  the  consideration  the
Company  expects  to  be  entitled  to  in  exchange  for  transferring  those  goods  or  providing  services.  The  Company  accounts  for  a  contract  when  it  has
approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance
and collectability of consideration is probable.

When determining whether the customer has obtained control of the goods or services, the Company considers the point at which the customer may benefit
from the goods or services. For sale of IP to, revenue is recognized upon grant or transfer of the IP, as the Company's IP is considered functional in nature.

Performance obligations

A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in ASC 606. A contract’s
transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. The
Company's contracts may contain multiple performance obligations if a promise to transfer goods or services is separately identifiable from other promises
in  a  contract  and,  therefore,  is  considered  distinct.  For  contracts  with  multiple  performance  obligations,  the  Company  determines  the  standalone  selling
price of each performance obligation and allocates the total transaction price using the relative selling price basis. The Company recognizes performance
obligations based on their nature.

Significant payment terms

The Company’s revenue arrangements include payments to the Company of one or more of the following: a non-refundable, upfront payment; milestone
payments and royalties on commercial sales of IP product candidates, if any. To date, the Company has received upfront payments and several milestone
payments but has not received any license or option fees or earned royalty revenue as a result of product sales.

Under ASC 606, the Company estimates the amount of consideration to which it will be entitled in exchange for satisfying performance obligations. Based
on the Company’s current contracts, variable consideration primarily exists in the following forms: development and regulatory milestones, royalties and
sales-based  milestones.  The  Company  utilizes  the  "most  likely  amount"  variable  consideration  method  for  estimating  development  and  regulatory
milestone consideration to include in the transaction price. The Company only includes an amount of variable consideration in the transaction price to the
extent  it  is  probable  that  a  significant  reversal  in  the  cumulative  revenue  recognized  will  not  occur  when  the  uncertainty  associated  with  the  variable
consideration is subsequently resolved. The Company refers to this as the variable consideration constraint.

Due to the uncertainty associated with the occurrence of the underlying events which would trigger development and regulatory milestone consideration
under  its  revenue  arrangements,  with  the  exception  of  certain  initial  conditions  precedent  milestones,  the  Company  has  concluded  the  variable
consideration associated with all development and regulatory milestones to be fully constrained as of the ASC 606 transition date and as of December 31,
2020,  and  therefore  has  not  included  such  consideration  in  the  transaction  price  for  any  of  its  revenue  arrangements.  The  Company  will  reassess  this
conclusion at each subsequent reporting period and will only include amounts associated with regulatory or development milestones in the transaction price
when, or if, the variable consideration is determined to be released from the constraint.

In accordance with ASC 606, the Company is required to adjust the transaction price for the effects of the time value of money if the timing of payments
agreed to by the parties to the contract, explicitly or implicitly, provides the Company or its customer with a significant benefit of financing the transfer of
goods or services. The Company concluded that its licensing and collaboration arrangements do not contain a significant financing component because the
payment structure of its agreements arise from reasons other than providing a significant benefit of financing.

Contract assets

The Company did not have a contract asset as of December 31, 2020 or 2019.

Contract liabilities

The Company did not have a contract liability as of December 31, 2020 or 2019.

Revenue arrangements

Elion

F-10

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

In May 2016, Fennec Pharmaceuticals Inc. (Fennec or the “Company”) sold Eniluracil to Elion Oncology, LLC (Elion). The agreement called for $40,000
in cash and 5% royalties to be paid to Fennec for any income derived from the sale of Eniluracil. The agreement was for the sale, not license of IP. In
addition, the agreement did not call for any additional good or service beyond the transfer of IP and related assets (e.g. “all information and know-how”,
documentation, etc.).

In August 2020, Elion entered into a license agreement with Processa Pharmaceuticals, Inc. (Processa). The license agreement called for equity and cash
upon satisfying the “Condition Precedent”, along with development and regulatory milestone payments, Sales Milestone Payments, and Product Royalties.
The grant of the license was conditioned upon the “Condition Precedent” which was defined as (i) Processa’s closing of a public offering by October 30,
2020 in which Processa raised at least $15M and (ii) Processa’s shares being listed on NASDAQ. Upon satisfying the “Condition Precedent” Elion was
entitled to receive $100,000 in cash and 825,000 in shares of Processa of which the Company is entitled to 5%. In January 2021, the Company received
$5,000 in cash and 41,250 restricted shares of Processa common shares.

The  agreement  between  Elion  and  Processa  entitles  Elion  to  the  payments  outlined  in  the  table  below.  Fennec  would  be  eligible  to  receive  5%  of  the
following based on future milestone events:

Milestone Event
1st Year Anniversary of Effective Date
2nd Year Anniversary of Effective Date
1st Patient in Dose Confirmation Study
NDA Submission
1st FDA Approval in US
2nd FDA Approval in US
1st Regulatory Approval Outside US
2nd Regulatory Approval Outside US

Milestone Payment ($)
100,000 Restricted Shares
100,000 Restricted Shares
100,000 Restricted Shares
300,000 Restricted Shares
$5,000,000
$3,000,000
$2,000,000
$2,000,000

The Company notes that the above payments are conditioned upon the “Condition Precedent” and thus even the restricted shares that are due only upon the
passage of time are in fact variable. However, once the “Condition Precedent” occurred only the passage of time occur in order for the 1st and 2nd  Year
Anniversary payments to become due and as such the Company must conclude as of the date the “Condition Precedent” is satisfied that the 1st and 2nd Year
Anniversary milestone payments are also probable of coming to fruition and thus should be included in the transaction price during the 4th quarter of 2020
along with the aforementioned “Condition Precedent” payments.

The arrangement with Elion contains consideration that is variable based on the customer’s achievement of certain development and regulatory milestones.
The next milestone payment the Company may be entitled to receive is 5,000 restricted shares for 1st patient in Dose Confirmation Study and then another
15,000 restricted shares for the NDA submission. These are considered variable consideration that is fully constrained due to the uncertainty associated
with the achievement of the development milestone. The considerations related to royalties (first and second FDA approval in US and first and second
regulatory  approval  outside  of  US)  are  also  variable  consideration  that  are  fully  constrained  in  accordance  with  the  royalty  recognition  constraint.  The
variable  consideration  related  to  royalties  will  be  recognized  in  the  period  the  products  are  sold  by  Processa  and  the  Company  has  a  present  right  to
payment.

The  Company  recognized  $0.2  million  in  revenue  associated  with  the  aforementioned  cash  and  shares  it  became  entitled  to  for  the  year  ended
December 31, 2020. Due to the one year lockup provision on the Processa shares, the Company deemed it reasonable to apply a liquidity discount of 20%
to the valuation of the shares associated with the achievement of the October 30, 2020 milestone. Shares associated with the one- and two-year anniversary
milestones had a 30 and 40% liquidity discount applied to their fair market valuations.

Subsequent changes to the fair value of the underlying securities are recognized as unrealized gains or losses on marketable equity securities within the
consolidated statement of operations and comprehensive loss.

Research and development costs and investment tax credits

Research  costs,  including  employee  compensation,  laboratory  fees,  lab  supplies,  and  research  and  testing  performed  under  contract  by  third  parties,  are
expensed as incurred. Development costs, including drug substance costs, clinical study expenses and regulatory expenses are expensed as incurred.

Investment tax credits, which are earned as a result of qualifying research and development expenditures, are recognized when the expenditures are made,
and their realization is reasonably assured. They are applied to reduce related capital costs and research and development expenses in the year recognized.

F-11

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

Income taxes

The Company accounts for income taxes using the asset and liability method to compute the differences between the tax basis of assets and liabilities and
the  related  financial  amounts,  using  currently  enacted  tax  rates.  The  Company  has  deferred  tax  assets,  which  are  subject  to  periodic  recoverability
assessments. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount that more likely than not will be realized.
As of December 31, 2020, we maintained a full valuation allowance against our deferred tax assets.

The provisions of the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 740-10, Uncertainty in Income Taxes,
address the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under
ASC 740-10, we may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on
examination by taxing authorities, based on the technical merits of the position.

Foreign currency translation

The U.S. dollar is the functional currency for the Company’s consolidated operations. All gains and losses from currency translations are included in results
of operations.

Loss per share

Basic  net  loss  per  share  is  computed  by  dividing  net  loss  by  the  weighted  average  number  of  common  shares  outstanding  during  the  year.  Diluted  net
earnings  per  share  is  computed  using  the  same  method,  except  the  weighted  average  number  of  common  shares  outstanding  includes  convertible
debentures, stock options and warrants, if dilutive, as determined using the if-converted method and treasury methods. Accordingly, warrants to purchase
0.04 million of our common shares and options to purchase 3.0 million of our common shares at December 31, 2020, were not included in earnings per
share. Such options would have an antidilutive effect. In 2019, options to purchase 3.1 million common shares were excluded from the computation of
earnings per share as their inclusion would have been antidilutive.

Recent accounting pronouncements

In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for
Fair Value Measurement. ASU 2018-13 removes certain disclosures, modifies certain disclosures and adds additional disclosures.  The Company adopted
this ASU on January 1, 2020. Certain disclosures in ASU 2018-13 would need to be applied on a retrospective basis and others on a prospective basis. We
concluded after evaluation that ASU 2018-13 has no significant effect on our consolidated financial statements.

In January 2021, the FASB issued ASU No. 2021-01, Reference Rate Reform (Topic 848). In this ASU, the FASB refines the scope of Topic 848 to clarify
that  certain  optional  expedients  and  exceptions  therein  for  contract  modifications  and  hedge  accounting  apply  to  contracts  that  are  affected  by  the
discounting transition. Specifically, modifications related to reference rate reform would not be considered an event that requires reassessment of previous
accounting  conclusions.  The  ASU  also  amends  the  expedients  and  exceptions  in  Topic  848  to  capture  the  incremental  consequences  of  the  scope
clarification and to tailor the existing guidance to derivative instruments affected by the discounting transition. The amendments in the ASU are effective
immediately  for  all  entities.  Entities  may  choose  to  apply  the  amendments  retrospectively  as  of  any  date  from  the  beginning  of  an  interim  period  that
includes or is subsequent to March 12, 2020, or prospectively to new modifications from any date within an interim period that includes or is subsequent to
January 7, 2021, up to the date that financial statements are available to be issued. The Company chose to apply amendments prospectively and concluded
after evaluation that ASU 2021-01 has no significant effect on our consolidated financial statements.

F-12

 
 
 
 
 
 
 
 
 
 
 
 
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

3.            Loss per Share

Loss per common share is presented under two formats: basic loss per common share and diluted loss per common share. Basic loss per common share is
computed  by  dividing  net  loss  attributable  to  common  shareholders  by  the  weighted  average  number  of  common  shares  outstanding  during  the  period.
Diluted loss per common share is computed by dividing net loss by the weighted average number of common shares outstanding during the period, plus the
potentially dilutive impact of common shares equivalents (e.g. stock options and warrants). Dilutive common share equivalents consist of the incremental
common shares issuable upon exercise of stock options and warrants. The following table sets forth the computation of basic and diluted net loss per share
(in thousands except per share data):

Numerator:
Net loss

Denominator:

Weighted-average common shares, basic

Dilutive effect of stock options
Dilutive effect of warrants

Incremental dilutive shares

Weighted-average common shares, diluted
Net loss per share, basic and diluted

  December 31, 2020

    December 31, 2019

Year Ended

  $

(18,109)   $

(12,775)

23,704     
–     
–     
–     
23,704     
(0.76)   $

19,896 
– 
– 
– 
19,896 
(0.64)

  $

The following outstanding options and warrants were excluded from the computation of basic and diluted net loss per share for the periods presented
because including them would have had an anti-dilutive effect (in thousands):

Options to purchase common shares
Warrants to purchase common shares

4.            Stock options

Year Ended
  December 31, 2020     December 31, 2019  
3,088 
39 

2,952     
39     

The Compensation Committee of the Board of Directors administers the Company’s stock option plan. The Compensation Committee designates eligible
participants to be included under the plan and approves the number of options to be granted from time to time under the plan. On June 24, 2010, at the
Company’s  annual  meeting,  shareholders  approved  an  amendment  to  the  Company’s  Stock  Option  Plan  (the  “Plan  Maximum  Amendment”).  The  Plan
Maximum  Amendment  relates  to  changing  the  maximum  number  of  common  shares  issuable  under  the  stock  option  plan  from  a  fixed  number  of  6.7
million to the number of shares that represents twenty-five percent (25%) of the total number of all issued and outstanding common shares. Based upon the
current shares outstanding, a maximum of 6.5 million of our common shares are authorized for issuance under the plan. The option exercise price for all
options issued under the plan is based on the fair value of the underlying shares on the date of grant. All options vest within three years or less and are
exercisable for a period of ten years from the date of grant. The stock option plan, as amended, allows the issuance of Canadian and U.S. dollar grants. A
summary of the stock option transactions, for both the Canadian and U.S. dollar grants, through the year ended December 31, 2020 is below.

Summary of $CAD Option Activity

Share Prices Reported in $CAD

Outstanding and exercisable at December 31, 2018
Outstanding and exercisable at December 31, 2019
Exercised
Outstanding and exercisable at December 31, 2020

Summary of $USD Option Activity

Outstanding and exercisable at December 31, 2018
Granted
Outstanding and exercisable at December 31, 2019
Granted
Exercised
Outstanding and exercisable at December 31, 2020

Number of
Options
    (in thousands)      
648    $
648    $
(648)   $
-     

Range

Weighted
Average

2.43    $
2.43    $
2.43    $
-     

2.43 
2.43 
2.43 
- 

Number of
Options
    (in thousands)      
1,850    $
590     
2,440    $
705     
(193)    
2,952    $

Range

Weighted
Average

0.45 – 12.59    $
4.26 – 5.91     
0.45 – 12.59    $
5.91 – 8.09     
1.05 – 5.10     
0.45 – 12.59    $

3.80 
4.83 
3.80 
6.84 
2.39 
4.82 

F-13

 
 
 
 
 
 
 
 
 
 
   
     
 
 
   
      
  
   
      
  
   
   
   
   
   
 
 
 
 
 
 
   
   
 
 
 
 
 
   
 
   
 
 
      
  
   
   
   
   
 
 
 
 
   
 
   
 
 
      
  
   
   
   
   
   
   
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

Summary of $USD Option Remaining Life

Price in US Dollars

Number Outstanding and Exercisable at December 31, 2020
(in thousands)

Remaining Life (years)

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$

0.45 
0.54 
0.60 
0.72 
0.96 
1.05 
1.13 
1.23 
1.50 
1.59 
2.11 
2.30 
2.31 
2.35 
2.40 
2.44 
2.45 
2.51 
2.55 
2.69 
2.79 
2.94 
3.10 
3.60 
3.67 
4.26 
4.74 
4.83 
5.10 
5.40 
5.91 
6.17 
6.72 
6.93 
7.40 
8.09 
8.38 
10.10 
10.93 
12.59 

   Total

11   
19   
17   
50   
10   
60   
50   
8   
7   
90   
36   
4   
275   
4   
8   
49   
225   
4   
4   
90   
15   
3   
10   
3   
35   
85   
175   
244   
240   
20   
50   
180   
21   
435   
40   
50   
210   
20   
85   
10   
                                                                                                         2,952   

1.63 
1.38 
1.26 
2.65 
2.60 
2.94 
4.95 
4.87 
0.88 
4.55 
6.00 
4.36 
3.32 
4.59 
2.26 
5.44 
6.98 
4.21 
3.86 
5.07 
5.18 
2.38 
6.26 
3.38 
6.38 
8.47 
8.74 
8.80 
6.76 
8.88 
9.00 
9.62 
6.63 
9.37 
9.42 
9.89 
7.11 
6.88 
7.44 
7.26 
7.04 

Stock compensation expense for the fiscal years ended December 31, 2020 and 2019 was $2.9 million and $3.1 million respectively. These amounts have
been included in the general and administrative expenses for the respective periods. The weighted average fair value per share of options granted and or
vested during the fiscal years ended December 31, 2020 and 2019 was $6.84 and $4.83, respectively. The intrinsic value (being the difference between the
share price at December 31, 2020 and exercise price) of stock options exercisable at December 31, 2020 was $12.0 million. The intrinsic value of options
exercised during the fiscal year ended December 31, 2020 was $2.8 million. The fair value of all options vested during the fiscal year ended December 31,
2020 was $2.4 million.

The fair values of options granted in fiscal years ended December 31, 2020 and 2019 were estimated on the date the options were granted based on the
Black-Scholes option-pricing model, using the following weighted average assumptions for all options with a ten-year expiration:

Expected dividend
Risk-free interest rate
Expected volatility
Expected life

Year Ended December 31,
2020

Year Ended December 31,
2019

0%   
0.63– 1.90%   
136 – 148%   
10.0 years 

0%
1.63– 2.70%
125 – 179%

4.3 – 10.0 years 

F-14

 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

The Company uses the historical volatility and adjusts for available relevant market information pertaining to the Company’s share price.

Modification of Existing US Dollar Denominated Options

In 2019, the Company modified the terms of all outstanding US denominated options extending the expiration date by a weighted average amount of 2.98
years. The Company recorded option modification expense of approximately $1.34 million in the year ended December 31, 2019, included in the $3.1
million of stock compensation in general and administrative expense, discussed above. Some of the option grants were not fully vested, as a result, the
Company will recognize $0.2 million in expense over the next nine quarters. The following table summarizes the effect of the June 18, 2019 transaction:

Exercise Price
$USD

Number of
Options

Expiration
Date

Risk Free 
Rate

Expected
Life
(Years)

Volatility

Expense
Recognized
$USD
6/18/19

Expense
Recognized
$USD 
After 
6/18/19

0.45     
0.54     
0.60     
0.72     
0.96     
1.05     
1.05     
1.13     
1.23     
1.50     
1.59     
2.11     
2.30     
2.31     
2.35     
2.40     
2.44     
2.45     
2.51     
2.55     
2.69     
2.79     
2.94     
3.10     
3.60     
3.67     
4.83     
5.10     
6.72     
8.38     
10.10     
10.93     
12.59     

11,111   
9,259   
8,333   
16,666   
3,063   
4,762   
83,333   
50,000   
4,062   
6,666   
132,954   
35,545   
4,346   
275,324   
4,254   
8,332   
49,180   
285,000   
3,984   
3,920   
114,000   
21,790   
3,400   
10,000   
2,778   
35,000   
260,000   
250,000   
21,150   
210,000   
20,000   
85,000   
10,000   

08/17/2022    
05/17/2022    
04/04/2022    
08/23/2023    
08/06/2023    
11/20/2022    
11/20/2022    
12/11/2025    
11/10/2025    
11/18/2021    
01/24/2024    
12/30/2026    
05/11/2025    
04/25/2024    
08/03/2025    
04/03/2023    
06/06/2026    
07/05/2026    
03/16/2025    
11/07/2024    
12/31/2024    
08/04/2024    
05/17/2023    
05/15/2024    
04/03/2027    
05/17/2027    
04/04/2028    
06/27/2027    
08/17/2027    
02/06/2028    
11/16/2027    
06/08/2028    
04/03/2028    

2.20%   
2.04%   
2.04%   
2.04%   
2.04%   
2.04%   
2.04%   
1.80%   
1.80%   
2.20%   
1.86%   
1.83%   
1.80%   
1.86%   
1.80%   
2.04%   
1.80%   
1.83%   
1.80%   
1.86%   
1.80%   
1.86%   
2.04%   
1.83%   
1.86%   
1.83%   
1.93%   
1.83%   
1.83%   
1.83%   
1.83%   
1.83%   
1.83%   

3.16     
2.91     
2.80     
4.18     
4.13     
3.43     
3.43     
6.48     
6.40     
2.42     
4.60     
7.53     
5.90     
4.85     
6.13     
3.79     
6.98     
7.05     
5.74     
5.39     
5.54     
5.13     
3.91     
7.79     
4.91     
7.91     
9.80     
8.02     
8.16     
8.64     
8.41     
8.97     
8.79     

71%   
67%   
68%   
125%   
126%   
73%   
73%   
130%   
131%   
66%   
122%   
133%   
127%   
123%   
133%   
130%   
136%   
136%   
127%   
124%   
125%   
125%   
129%   
132%   
123%   
133%   
153%   
132%   
131%   
146%   
137%   
149%   
147%   

475     
670     
732     
20,642     
6,126     
1,886     
18,566     
33,193     
5,988     
2,247     
139,829     
12,331     
5,475     
404,154     
5,346     
13,640     
19,729     
114,692     
5,401     
5,529     
164,445     
35,363     
6,633     
3,839     
5,609     
14,951     
5,099     
94,204     
10,298     
58,434     
12,193     
51,289     
6,366     

- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
- 
526 
- 
- 
- 
- 
- 
- 
- 
- 
59,074 
26,291 
- 
67,273 
- 
- 
- 

2,110,313   

  $

1,285,374    $

153,064 

F-15

 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
      
    
 
   
  
   
      
  
   
      
  
 
      
 
   
  
   
      
  
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

5.             Fair Value Measurements

The Company has adopted ASC 820 Fair Value Measurements and Disclosure Topic of the FASB. This Topic applies to certain assets and liabilities that are
being measured and reported on a fair value basis. The Fair Value Measurements Topic defines fair value, establishes a framework for measuring fair value
in accordance with US GAAP, and expands disclosure about fair value measurements. This Topic enables the reader of the financial statements to assess
the inputs used to develop those measurements by establishing a hierarchy for ranking the quality and reliability of the information used to determine fair
values. The Topic requires that financial assets and liabilities carried at fair value be classified and disclosed in one of the following three categories:

Level 1: Quoted market prices in active markets for identical assets or liabilities.

Level 2: Observable market-based inputs or unobservable inputs that are corroborated by market data.

Level 3: Unobservable inputs that are not corroborated by market data.

Assets/Liabilities Measured at Fair Value on a Recurring Basis

Fair Value Measurement at December 31, (in thousands)

Quoted Price in Active
Market for Identical
Instruments
Level 1

Significant Other
Observable Inputs
Level 2

Significant
Unobservable Inputs
Level 3

Total

2020

2019

2020

2019

2020

2019

2020

2019

Assets
Cash and cash equivalents
Processa common shares

678 (1)     
-     

347 (1)     
-     

29,666 

136(2)   

13,303     
-     

-     
-     

-     
-     

30,344     

13,650 
- 

(1) The Company held approximately, $678,000 in cash as of December 31, 2020, of which approximately, $45,000 was in Canadian funds (translated
into U.S. dollars). As of December 31, 2019, the Company held approximately $347,000, of which approximately 30,000 was in Canadian funds
(translated into U.S. dollars).

(2) The Company received 41,250 restricted common shares of Processa (PSCA). The share restriction will expire in three tranches: 50%, 25% and
25% at the 6, 9 and 12 month intervals, respectively from October 30, 2020. At October 30, 2020 PSCA shares were trading at $4.11 per share.
The Company applied a 20% liquidity discount to the shares and will mark to market at each balance sheet date.

6.             Stockholders’ Equity

Authorized capital stock

The Company’s authorized capital stock consists of an unlimited number of shares of no-par common shares.

Warrants to Purchase Common Shares

At December 31, 2020, the Company had 39,130 warrants outstanding to purchase common shares at an exercise price of $6.80. The following table
summarized our warrant activity.

Outstanding and exercisable at December 31, 2018
Granted
Outstanding and exercisable at December 31, 2019
Granted
Outstanding and exercisable at December 31, 2020

F-16

Number of
Warrants

(in thousands)    

Range

Weighted
Average

  $

  $

  $

-    $
39     
39    $
-     
39    $

-    $
6.80     
6.80    $
-     
6.80    $

- 
6.80 
6.80 
- 
6.80 

 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
 
   
 
   
 
 
 
 
   
   
   
 
 
 
   
   
 
 
   
   
   
   
 
 
    
    
  
 
    
    
    
    
  
   
   
   
      
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

7.             Commitments and Contingencies

Oregon Health & Science University Agreement

On February 20, 2013, Fennec entered into a new exclusive license agreement with OHSU for exclusive worldwide license rights to intellectual property
directed to thiol-based compounds, including PEDMARKTM and their use in oncology (the "OHSU Agreement"). OHSU will receive certain milestone
payments, royalty on net sales for licensed products and a royalty on any consideration received from sublicensing of the licensed technology.

On May 18, 2015, Fennec negotiated an amendment ("Amendment 1") to the OHSU Agreement, which expands Fennec’s exclusive license to include the
use of N-acetylcysteine as a standalone therapy and/or in combination with PEDMARKTM for the prevention of ototoxicity induced by chemotherapeutic
agents to treat cancers. Further, Amendment 1 adjusts select milestone payments entered in the OHSU Agreement including but not limited to the royalty
rate on net sales for licensed products, royalty rate from sublicensing of the licensed technology and the fee payable upon the regulatory approval of a
licensed product.

The term of the OHSU Agreement as amended by Amendment 1 expires on the date of the last to expire claim(s) covered in the patents licensed to Fennec
or 8 years, whichever is later. In the event a licensed product obtains regulatory approval and is covered by the Orphan Drug Designation, the parties will in
good faith amend the term of the agreement. Sodium thiosulfate is currently protected by methods of use patents that the Company exclusively licensed
from OHSU that expire in Europe in 2021 and that expire in the United States in 2038. The OHSU Agreement is terminable by either Fennec or OHSU in
the  event  of  a  material  breach  of  the  agreement  by  either  party  after  45  days  prior  written  notice.  Fennec  also  has  the  right  to  terminate  the  OHSU
Agreement at any time upon 60 days prior written notice and payment of all fees due to OHSU under the OHSU Agreement.

Securities Class Action Suit

Following the U.S. Food and Drug Administration’s (FDA’s) CRL regarding its NDA for PEDMARKTM as described in Note 1, a putative lawsuit was
filed against us purportedly on behalf of purchasers of the Company’s securities between December 20, 2018 and August 10, 2020. The lawsuit seeks to
recover damages for Fennec investors under federal securities laws. While we believe that the lawsuit is without merit and intend to vigorously defend
against it, the lawsuit is in its early stages and no assessment can be made as to its likely outcome or whether the outcome will be material to us. This
litigation,  and  any  other  securities  class  actions  that  may  be  brought  against  us,  could  result  in  substantial  costs  and  a  diversion  of  our  management’s
attention and resources.

Executive Severance

In the event of his termination with us other than for cause, we will be obligated to pay Mr. Raykov a one-time severance payment equal to twelve months
of salary (currently $430,000). In the event of his termination with us other than for cause, we will be obligated to pay Mr. Andrade a one-time severance
payment  equal  to  six  months  of  salary  (currently  $155,875).  In  the  event  of  her  termination  with  us  other  than  for  cause,  we  will  be  obligated  to  pay
Ms. Goel a one-time severance payment equal to three months of salary (currently $90,000).

8.             Subsequent Events

Management has evaluated subsequent events through March 29, 2021, the date the financial statements were available to be issued and has concluded
there are no additional events that would require adjustment to our disclosure in the statements.

9.             Income Taxes

The Company operates in both U.S. and Canadian tax jurisdictions. Its income is subject to varying rates of tax and losses incurred in one jurisdiction
cannot be used to offset income taxes payable in another. A reconciliation of the combined Canadian federal and provincial income tax rate with the
Company’s effective tax rate is as follows (in thousands except for percentage rates):

Domestic (loss)/gain
Foreign loss
Loss before income taxes

Expected statutory rate (recovery)
Expected provision for (recovery of) income tax
Permanent differences
Change in valuation allowance
Effect of foreign exchange rate differences
Effect of change in future enacted tax rates
Tax credits and other adjustments
Effect of tax rate changes and other
Provision for income taxes

F-17

Year Ended
December 31,
2020

Year Ended
December 31,
2019

  $

(8,784)   $
(9,283)    
(18,067)    

(9,004)
(3,734)
(12,738)

26.50%   
(4,788)    
752 
3,737 
- 
- 
- 
299 
- 

  $

26.50%
(3,376)
901 
2,193 
- 
- 
- 
282 
- 

  $

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
   
  
   
  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

The Canadian statutory come tax rate of 26.0 percent is comprised of federal income tax at approximately 15.0 percent and provincial income tax at
approximately 11.0 percent.

The primary temporary differences which gave rise to future income taxes (recovery) at December 31, 2020 and December 31, 2019:

Future tax assets:
SR&ED expenditures
Income tax loss carryforwards
Non-refundable investment tax credits
Share issue costs
Accrued expenses
Fixed and intangible assets
Reserves

Less: valuation allowance
Net future tax assets

F-18

December 31,
2020

December 31,
2019

  $

  $

2,086    $
26,770     
1,083     
139     
-     
1,083     
-     
31,161     
(31,147)    
14    $

2,086 
23,182 
1,121 
99 
- 
1,083 
- 
27,572 
(27,572)
- 

 
 
 
 
 
 
 
   
 
   
      
  
   
   
   
   
   
   
 
   
   
 
Fennec Pharmaceuticals Inc.
Notes to the Consolidated Financial Statements
(U.S. dollars and shares in thousands, except per share information)

Tax Cuts and Jobs Act

On  December  22,  2017,  the  then  President  of  the  United  States  signed  into  law  an  Act  to  provide  for  reconciliation  pursuant  to  titles  II  and  V  of  the
concurrent  resolution  on  the  budget  for  fiscal  year  2018  (commonly  known  as  “the  Tax  Cuts  and  Jobs  Act  or  the  “TCJA”),  which  introduced  a
comprehensive  set  of  tax  reforms.  The  Tax  Cuts  and  Jobs  Act  significantly  revises  U.S.  tax  law  by,  among  other  provisions,  lowering  the  Company’s
corporate tax rate from 34% to 21% and eliminating or reducing certain income tax deductions.

In December 2017, in accordance with the SEC Staff Accounting Bulletin (“SAB”) 118–Income Tax Accounting Implications of the TCJA, the Company
recorded tax effects on a provisional basis based on a reasonable estimate. The TCJA did not have a material impact on the Company's financial statements
because its deferred temporary differences are fully offset by a valuation allowance and the Company does not have any offshore earnings from which to
record  the  mandatory  transition  tax.  During  2018,  the  Company  completed  its  analysis  under  SAB  118  and  no  additional  tax  effects  due  to  rate-
remeasurement were required to be recorded.

On  March  27,  2020  the  US  government  enacted  the  Coronavirus  Aid,  Relief,  and  Economic  Security  Act  (CARES  Act)  which  includes  numerous
modifications  to  income  tax  provisions,  including  a  limitation  on  business  interest  expense  and  net  operating  loss  provisions  and  the  acceleration  of
alternative minimum tax credits. Given the Company’s history of losses, the CARES Act did not have a material impact on its tax provision.

There  are  no  current  income  taxes  owed,  nor  are  any  income  taxes  expected  to  be  owed  in  the  near  term.  At  December  31,  2020  the  Company  has
unclaimed Scientific Research and Experimental Development ("SR&ED") expenditures, income tax loss carry-forwards and non-refundable investment
tax credits. The unclaimed amounts and their expiry dates are as listed below:

SR&ED expenditures (no expiry)
Income tax loss carryforwards (expiry date):
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
No expiration
Investment tax credits (expiry date):
2020
2021
2022
2023
2024
2025
2026
2027

Federal

Province/
State

    $

7,872    $

- 

- 
- 
- 
- 
6,169 
2,716 
4,219 
4,164 
2,116 
670 
789 
651 
655 
617 
941 
1,013 
1,638 
- 
- 
- 
15,114 

26     
233     
1,588     
4,849     
6,143     
13,868     
8,136     
10,509     
8,185     
2,608     
3,378     
3,491     
1,789     
1,812     
1,804     
2,208     
4,641     
5,567     
5,848     
5,791     
15,114     

52     
521     
379     
169     
189     
82     
86     
47     

F-19

 
 
 
 
 
 
 
 
 
   
   
 
     
      
  
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
      
  
     
  
     
  
     
  
     
  
     
  
     
  
     
  
     
  
 
 
Exhibit 23.1

 CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We hereby consent to the incorporation by reference in the Registration Statements on Forms S-8 (file nos. 333-221091 and 333-232353) and S-3 (file nos.
333-219884 and 333-249775) of Fennec Pharmaceuticals Inc. (the “Company”) of our report dated March 30, 2021 relating to the consolidated financial
statements as of December 31, 2020, which appear in the Annual Report on Form 10-K for the year ended December 31, 2020.

Irvine, California
March 30, 2021

/s/ HASKELL & WHITE LLP
HASKELL & WHITE LLP  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 31.1

I, Rostislav Raykov, certify that:

FENNEC PHARMACEUTICALS INC
CERTIFICATION

1. I have reviewed this annual report on Form 10-K for the period ended December 31, 2020 of Fennec Pharmaceuticals Inc.;

2. Based on my knowledge, this Annual Report does not contain any untrue statement of a material fact or omit to state a material fact necessary to

make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered
by this Annual Report;

3. Based on my knowledge, the financial statements, and other financial information included in this Annual 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 Annual Report;

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-
15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to
ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those
entities, particularly during the period in which this Annual 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 provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for
external purposes in accordance with generally accepted accounting principles;

(c)

Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this Annual Report our conclusions about
the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this Annual Report based on such evaluation;
and

(d) Disclosed in this Annual Report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s
most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably
likely to materially affect, the registrant’s internal control over financial reporting.

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the

registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably

likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(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 financial reporting.

Date:  March 30, 2021

By: /s/ Rostislav Raykov
Rostislav Raykov
Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 31.2

I, Robert Andrade, certify that:

FENNEC PHARMACEUTICALS INC.
CERTIFICATION

1. I have reviewed this annual report on Form 10-K for the period ended December 31, 2020 of Fennec Pharmaceuticals Inc.;

2. Based on my knowledge, this Annual Report does not contain any untrue statement of a material fact or omit to state a material fact necessary to

make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered
by this Annual Report;

3. Based on my knowledge, the financial statements, and other financial information included in this Annual 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 Annual Report;

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-
15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to
ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those
entities, particularly during the period in which this Annual 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 provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for
external purposes in accordance with generally accepted accounting principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this Annual Report our conclusions about the
effectiveness of the disclosure controls and procedures, as of the end of the period covered by this Annual Report based on such evaluation; and

(d) Disclosed in this Annual Report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most

recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to
materially affect, the registrant’s internal control over financial reporting.

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the

registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably

likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(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 financial reporting.

Date:  March 30, 2021

By: /s/ Robert Andrade
Robert Andrade
Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CERTIFICATION PURSUANT TO
18 U.S.C. §1350
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

Exhibit 32.1

In connection with the Annual Report of Fennec Pharmaceuticals Inc. (the “Company”) on Form 10-K for the period ended December 31, 2020 (the
“Report”), each of the undersigned, Rostislav Raykov, Chief Executive Officer of the Company, and Robert Andrade, Chief Financial Officer of the
Company, hereby certifies pursuant to 18 U.S.C. §1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

1.

2.

The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the
Company.

Date:  March 30, 2021

Date:  March 30, 2021

By: /s/ Rostislav Raykov
Rostislav Raykov
Chief Executive Officer

By: /s/ Robert Andrade
Robert Andrade
Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 99.1

FENNEC ANNOUNCES FISCAL YEAR 2020 FINANCIAL RESULTS AND PROVIDES BUSINESS UPDATE

~ Fennec is Working Closely with its Third-Party Drug Product Manufacturer to Finalize the New Drug Application (NDA) Resubmission for
PEDMARK™ ~

~ Resubmission of the NDA for PEDMARKTM is Planned for the Second Quarter of 2021 ~

~ Company Has Approximately $30 Million in Cash and No Outstanding Debt ~

Research  Triangle  Park,  NC,  March  30,  2021  –  Fennec  Pharmaceuticals  Inc.  (NASDAQ:FENC;  TSX:  FRX),  a  specialty  pharmaceutical  company
focused on the development of PEDMARKTM (a unique formulation of sodium thiosulfate (STS)) for the prevention of platinum-induced ototoxicity in
pediatric patients, today reported its financial results for the fiscal year ended December 31, 2020 and provided a business update.

“We  have  made  meaningful  progress  working  with  the  FDA  and  our  third-party  drug  product  manufacturer  towards  fully  addressing  the  Complete
Response Letter (CRL) received in August 2020 for PEDMARKTM. We believe we are on track to finalize and resubmit the New Drug Application (NDA)
for PEDMARK to the FDA in the second quarter of 2021,” said Rosty Raykov, chief executive officer of Fennec Pharmaceuticals. “Importantly and as
previously announced, the CRL identified no clinical or safety issues and there are no requirements for additional clinical data. We remain committed to
making PEDMARK commercially available to help prevent life-long hearing loss for children receiving cisplatin chemotherapy.”

Financial Results for the Fourth Quarter and Fiscal Year Ended December 31, 2020

·

·

·

Cash Position – Cash and cash equivalents were $30.3 million as of December 31, 2020. The net increase in cash balance over the fiscal year is the
result of an equity financing of $32 million in net proceeds completed in May 2020, which was offset by cash used for operating activities including
regulatory expenses associated with the regulatory submissions of PEDMARKTM and expenses associated with commercial launch readiness.
Revenue – Fennec earned royalty revenue originating from the 2016 sales agreement of Eniluracil to Elion Oncology, LLC. The agreement entitles
Fennec to a five percent share of gross amounts earned by Elion with respect to Eniluracil. During 2020, the Company received common shares and
cash valued at approximately $0.17 million.
Research and Development (R&D) Expenses – R&D expenses  were  $1.2  and  $5.1  million,  respectively,  for  the  fourth  quarter  and  year  ended
December 31, 2020, compared to $1.2 million and $5.6 million for the same period in 2019.

· General and Administrative (G&A) Expenses – G&A expenses were $2.3 million and $13.0 million, respectively, for the fourth quarter and year
ended December 31, 2020, compared to $2.5 million and $7.4 million, respectively for the same periods in 2019.  The annual increase in G&A was
largely due to commercialization readiness expenses for PEDMARKTM during the first nine months of 2020.
Net Loss - Net losses for the fourth quarter and year ended December 31, 2020 of $3.2 million ($0.13 per share) and $18.1 million ($0.76 per share),
respectively, compared to $3.6 million ($0.18 per share) and $12.8 million ($0.64 per share), respectively, for the same periods in 2019.
Financial  Guidance  –  The  Company  believes  its  cash  and  cash  equivalents  on  hand  as  of  December  31,  2020  will  be  sufficient  to  fund  the
Company's planned activities for 2021 including NDA resubmission and commercial readiness activities.

·

·

 
 
 
 
 
 
 
 
 
 
 
 
Financial Update

The selected financial data presented below is derived from our audited condensed consolidated financial statements, which were prepared in accordance
with U.S. generally accepted accounting principles. The complete audited condensed consolidated financial statements for the period ended December 31,
2020 and management's discussion and analysis of financial condition and results of operations will be available via www.sec.gov and www.sedar.com. All
values are presented in thousands unless otherwise noted.

Audited Condensed Consolidated
Statement of Operations:
(U.S. Dollars in thousands except per share amounts)

Three Months Ended

Twelve Months Ended

  December 31,

    December 31,

    December 31,

    December 31,

2020

2019

2020

2019

Revenue

  $

170    $

-    $

170    $

- 

Operating expenses:

Research and development
General and administrative

Total operating expense
Loss from operations

Other (expense)/income
Amortization expense
Unrealized gain on securities
Other loss
Net interest income

Total other (expense)/income, net

Net income/(loss)

Basic net income/(loss) per common share

Diluted net income/(loss) per common share

1,223     
2,293     

3,516     
3,346     

-     
100     
(5)    
13     
108     

1,172     
2,481     

3,653     
3,653     

(18)    
-     
(8)    
69     
43     

5,105     
12,950     

18,055     
17,885     

(402)    
100     
(9)    
87     
224     

5,607 
7,402 

13,009 
13,009 

(64)
- 
(17)
315 
234 

  $

  $

  $

(3,238)   $

(3,610)   $

(18,109)   $

(12,775)

(0.13)   $

(0.18)   $

(0.76)   $

(0.13)   $

(0.18)   $

(0.76)   $

(0.64)

(0.64)

 
 
 
 
 
 
 
   
 
 
 
 
 
   
   
   
 
 
   
     
     
   
 
 
 
   
      
      
      
  
   
      
      
      
  
   
   
 
   
      
      
      
  
   
   
 
   
      
      
      
  
   
      
      
      
  
   
   
   
   
   
 
   
      
      
      
  
 
   
      
      
      
  
 
   
      
      
      
  
 
 
Fennec Pharmaceuticals Inc.
Balance Sheets
(U.S. Dollars in thousands)

  December 31, 2020     December 31, 2019  

  $

  $

  $

  $

30,344    $
1,073     
-     
31,417    $

2,347    $
29,070     
31,417    $

13,650 
234 
262 
14,146 

2,271 
11,875 
14,146 

Fiscal Year Ended
  December 31, 2020     December 31, 2019  

  $

  $

  $

30,344    $
1,073     
(2,347)    
29,070    $

189,967    $
(162,140)    
29,070     

13,650 
234 
(2,271)
11,613 

154,663 
(144,031)
11,875 

Assets
Cash and cash equivalents
Other current assets
Non-current assets, net
Total Assets

Liabilities and stockholders’ equity
Current liabilities
Total stockholders’ equity
Total liabilities and stockholders’ equity

Working Capital
Selected Asset and Liability Data:
(U.S. Dollars in thousands)
Cash and cash equivalents
Other current assets
Current liabilities excluding derivative liability
Working capital

Selected Equity:
Common stock & APIC
Accumulated deficit
Stockholders’ equity

About PEDMARK™ 

Cisplatin and other platinum compounds are essential chemotherapeutic agents for many pediatric malignancies.  Unfortunately, platinum-based therapies
cause ototoxicity, or hearing loss, which is permanent, irreversible and particularly harmful to the survivors of pediatric cancer.

In  the  U.S.  and  Europe,  it  is  estimated  that,  annually,  over  10,000  children  may  receive  platinum-based  chemotherapy.    The  incidence  of  ototoxicity
depends upon the dose and duration of chemotherapy, and many of these children require lifelong hearing aids. There is currently no established preventive
agent for this hearing loss and only expensive, technically difficult and sub-optimal cochlear (inner ear) implants have been shown to provide some benefit.
Infants and young children that suffer ototoxicity at critical stages of development lack speech language development and literacy, and older children and
adolescents lack social-emotional development and educational achievement.

PEDMARK has been studied by cooperative groups in two Phase 3 clinical studies of survival and reduction of ototoxicity, The Clinical Oncology Group
Protocol ACCL0431 and SIOPEL 6. Both studies have been completed. The COG ACCL0431 protocol enrolled childhood cancers typically treated with
intensive  cisplatin  therapy  for  localized  and  disseminated  disease,  including  newly  diagnosed  hepatoblastoma,  germ  cell  tumor,  osteosarcoma,
neuroblastoma, and medulloblastoma.  SIOPEL 6 enrolled only hepatoblastoma patients with localized tumors.

The  Marketing  Authorization  Application  (MAA)  for  sodium  thiosulfate  (tradename  PEDMARQSI)  is  currently  under  evaluation  by  the  European
Medicines Agency (EMA).  PEDMARK has received Breakthrough Therapy and Fast Track Designation by the FDA in March 2018. 

 
 
 
 
   
      
  
   
   
 
   
      
  
   
      
  
   
  
 
 
   
     
 
   
   
 
   
      
  
   
      
  
   
   
 
 
 
 
 
 
 
About Fennec Pharmaceuticals

Fennec Pharmaceuticals Inc. is a specialty pharmaceutical company focused on the development of PEDMARK™ for the prevention of platinum-induced
ototoxicity  in  pediatric  patients.      Further,  PEDMARK  has  received  Orphan  Drug  Designation  in  the  U.S.  for  this  potential  use.  Fennec  has  a  license
agreement  with  Oregon  Health  and  Science  University  (OHSU)  for  exclusive  worldwide  license  rights  to  intellectual  property  directed  to  sodium
thiosulfate and its use for chemoprotection, including the prevention of ototoxicity induced by platinum chemotherapy, in humans.  For more information,
please visit www.fennecpharma.com

Forward Looking Statements

Except for historical information described in this press release, all other statements are forward-looking. Words such as “believe,” “anticipate,” “plan,”
“expect,”  “estimate,”  “intend,”  “may,”  “will,”  or  the  negative  of  those  terms,  and  similar  expressions,  are  intended  to  identify  forward-looking
statements. These forward-looking statements include the Company’s expectations regarding its interactions and communications with the FDA, including
the Company’s expectations and goals respecting the resolution the issues raised in the CRL and the Company’s plans to address them, and the anticipated
timing  of  the  Company’s  finalization  and  filing  of  an  NDA  resubmission  for  PEDMARK.    Forward-looking  statements  are  subject  to  certain  risks  and
uncertainties inherent in the Company’s business that could cause actual results to vary, including such risks and uncertainties relating to the Company’s
reliance on third party manufacturing, the risk that unforeseen factors may delay the resubmission of the NDA, the risks of delays in or failure to obtain
FDA approval of PEDMARK, the risks relating to the Company’s and its manufacturer’s ability to adequately address the concerns identified in the CRL,
the  risk  that  the  resubmission  of  the  NDA  to  the  FDA  will  not  be  satisfactory,  that  regulatory  and  guideline  developments  may  change,  scientific  data
and/or manufacturing capabilities may not be sufficient to meet regulatory standards or receipt of required regulatory clearances or approvals, clinical
results  may  not  be  replicated  in  actual  patient  settings,  unforeseen  global  instability,  including  political  instability,  or  instability  from  an  outbreak  of
pandemic or contagious disease, such as the novel coronavirus (COVID-19), or surrounding the duration and severity of an outbreak, protection offered by
the Company’s patents and patent applications may be challenged, invalidated or circumvented by its competitors, the available market for the Company’s
products will not be as large as expected, the Company’s products will not be able to penetrate one or more targeted markets, revenues will not be sufficient
to fund further development and clinical studies, the Company may not meet its future capital requirements in different countries and municipalities, and
other risks detailed from time to time in the Company’s filings with the Securities and Exchange Commission including its Annual Report on Form 10-K for
the year ended December 31, 2020.  Fennec disclaims any obligation to update these forward-looking statements except as required by law.

For a more detailed discussion of related risk factors, please refer to our public filings available at www.sec.gov and www.sedar.com.
For further information, please contact:

Investors:
Robert Andrade
Chief Financial Officer
Fennec Pharmaceuticals Inc.
(919) 246-5299

Media:
Elixir Health Public Relations
Lindsay Rocco
(862) 596-1304
lrocco@elixirhealthpr.com