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Seres Therapeutics, Inc.

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FY2022 Annual Report · Seres Therapeutics, Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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, 2022  

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: 001-37465

le

Seres Therapeutics, Inc.

(Exact Name of Registrant as Specified in Its Charter)

Delaware
(State or Other Jurisdiction of
Incorporation or Organization)

200 Sidney Street – 4  Floor
Cambridge, Massachusetts
(Address of Principal Executive Offices)

th

27-4326290
(IRS Employer
Identification No.)

02139
(Zip Code)

(617) 945-9626

(Registrant’s Telephone Number, Including Area Code)
Securities registered pursuant to Section 12(b) of the Act:

Title of each class
Common stock, par value $0.001 per share

Trading Symbol(s)
MCRB

  Name of each exchange on which registered

The Nasdaq Global Select Market

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

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes  ☐    No  ☒ 

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.    Yes  ☐    No  ☒
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months 

(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 the "large accelerated filer," "accelerated filer," "smaller reporting company," and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer

Non-accelerated filer

Emerging growth company 

☐  

☐  

☐  

Accelerated filer

Smaller reporting company

☒

☐

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

standards provided pursuant to section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting under 

Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report.        ☒ 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes  ☐    No  ☒
The aggregate market value of the voting and non-voting common stock held by non-affiliates of the registrant based on the closing price of the registrant’s common stock as reported on 

the Nasdaq Global Select Market on June 30, 2022, was $239,918,450. Solely for purposes of this disclosure, shares of common stock held by executive officers, directors and certain 
stockholders of the registrant as of such date have been excluded because such holders may be deemed to be affiliates.

As of March 3, 2023 there were 126,076,391 shares of the registrant’s common stock, par value $0.001 per share, outstanding.

DOCUMENTS INCORPORATED BY REFERENCE

Portions of the registrant’s definitive Proxy Statement relating to its 2023 Annual Meeting of Stockholders to be filed with the SEC within 120 days after the end of the fiscal year ended 

December 31, 2022 are incorporated herein by reference in Part III.

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

PART II.
Item 5.

Item 6.
Item 7.
Item 7A.
Item 8.
Item 9.
Item 9A.
Item 9B.
Item 9C.

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

PART IV.
Item 15.
Item 16.

SIGNATURES

TABLE OF CONTENTS

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

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

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

   Exhibits and Financial Statement Schedules
  Form 10-K Summary

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FORWARD-LOOKING STATEMENTS

This Annual Report on Form 10-K contains forward-looking statements. We intend such forward-looking statements to be covered by the safe 

harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities 
Exchange Act of 1934, as amended. All statements other than statements of historical facts contained in this Annual Report on Form 10-K, including 
without limitation statements regarding our future results of operations and financial position, business strategy, prospective products, product approvals, 
research and development costs, timing and likelihood of success, including the anticipated PDUFA target action date and potential FDA approval of SER-
109, manufacturing activities and related timing, commercialization efforts and related timing, our ability to continue as a going concern, plans and 
objectives of management for future operations and future results of anticipated products, are forward-looking statements. These statements involve known 
and unknown risks, uncertainties and other important factors that may cause our actual results, performance or achievements to be materially different from 
any future results, performance or achievements expressed or implied by the forward-looking statements.

In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expect,” “plan,” “anticipate,” “could,” 
“intend,” “target,” “project,” “contemplate,” “believe,” “estimate,” “predict,” “potential” or “continue” or the negative of these terms or other similar 
expressions. The forward-looking statements in this Annual Report on Form 10-K are only predictions. We have based these forward-looking statements 
largely on our current expectations and projections about future events and financial trends that we believe may affect our business, financial condition and 
results of operations. These forward-looking statements speak only as of the date of this report and are subject to a number of important factors that could 
cause actual results to differ materially from those in the forward-looking statements, including the risks, uncertainties and assumptions described under the 
sections in this report titled “Summary Risk Factors,” “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of 
Operations” and elsewhere in this Annual Report on Form 10-K.

Moreover, we operate in an evolving environment. New risk factors and uncertainties may emerge from time to time, and it is not possible for 

management to predict all risk factors and uncertainties. 

You should read this Annual Report on Form 10-K and the documents that we reference in this Annual Report on Form 10-K completely and with 

the understanding that our actual future results may be materially different from what we expect. We qualify all of our forward-looking statements by these 
cautionary statements. Except as required by applicable law, we do not plan to publicly update or revise any forward-looking statements contained herein, 
whether as a result of any new information, future events, changed circumstances or otherwise.

TRADEMARKS, SERVICE MARKS AND TRADENAMES

We have proprietary rights to trademarks used in this Annual Report on Form 10-K, which are important to our business and many of which are 
registered under applicable intellectual property laws. Solely for convenience, the trademarks, service marks, logos and trade names referred to in this 
Annual Report on Form 10-K are without the ® and ™ symbols, but such references are not intended to indicate, in any way, that we will not assert, to the 
fullest extent under applicable law, our rights to these trademarks, service marks and trade names. This Annual Report on Form 10-K contains additional 
trademarks, service marks and trade names of others, which are the property of their respective owners. All trademarks, service marks and trade names 
appearing in this Annual Report on Form 10-K are, to our knowledge, the property of their respective owners. We do not intend our use or display of other 
companies’ trademarks, service marks, copyrights or trade names to imply a relationship with, or endorsement or sponsorship of us by, any other 
companies.

SUMMARY RISK FACTORS

Our business is subject to numerous risks and uncertainties, including those described in Part I, Item 1A. “Risk Factors” in this Annual Report on 
Form 10-K. You should carefully consider these risks and uncertainties when investing in our common stock. The principal risks and uncertainties affecting 
our business include the following:

• We are a development-stage company and have incurred significant losses since our inception. We expect to incur losses for the foreseeable 

future and may never achieve or maintain profitability.

• We have identified conditions and events that raise substantial doubt regarding our ability to continue as a going concern.

• We will need additional funding in order to complete development of our product candidates and commercialize our products, if approved. If we 

are unable to raise capital when needed, we could be forced to delay, reduce or eliminate our product development programs or 
commercialization efforts.

•

Our limited operating history may make it difficult to evaluate the success of our business to date and to assess our future viability.

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•

•

•

•

•

•

Other than SER-109, we are early in our development efforts and may not be successful in our efforts to use our reverse translational microbiome 
therapeutics platform to build a pipeline of product candidates and develop marketable drugs. 

Our product candidates are based on microbiome therapeutics, which is an unproven approach to therapeutic intervention.

Clinical drug development involves a risky, lengthy and expensive process, with an uncertain outcome. We may incur additional costs or 
experience delays in completing, or ultimately be unable to complete, the development and commercialization of our product candidates.

Delays or difficulties in the enrollment of patients in clinical trials, could result in our receipt of necessary regulatory approvals being delayed or 
prevented.

If we are not able to obtain, or if there are delays in obtaining, required regulatory approvals, we or our collaborators will not be able to 
commercialize our product candidates or will not be able to do so as soon as anticipated, and our ability to generate revenue will be materially 
impaired. Additionally, failure to obtain marketing approval in international jurisdictions would prevent our product candidates from being 
marketed abroad.

Our collaboration and license agreements with Société des Produits Nestlé S.A., successor in interest to Nestec Ltd., and NHSc Rx License 
GmbH, successor in interest to NHSc Pharma Partners (collectively, and together with their affiliates and subsidiaries, Nestlé) are important to 
our business. If we or Nestlé fail to adequately perform under these agreements, or if we or Nestlé terminate the agreements, the development 
and commercialization of our CDI and IBD product candidates, including SER-109, SER-287 and SER-301, could be delayed or terminated and 
our business would be adversely affected.

• We rely, and expect to continue to rely, on third parties to conduct our clinical trials, and those third parties may not perform satisfactorily, 

including failing to meet deadlines for the completion of such trials.

• We rely on third parties for certain aspects of the manufacture of our product candidates for preclinical and clinical testing and expect to continue 
to do so for the foreseeable future. This reliance on third parties increases the risk that we will not have sufficient quantities of our product 
candidates or that such quantities may not be available at an acceptable cost, which could delay, prevent or impair our development or 
commercialization efforts.

•

Even if any of our product candidates receive marketing approval, it may fail to achieve the degree of market acceptance by physicians, patients, 
hospitals, third-party payors and others in the medical community necessary for commercial success.

• We face substantial competition, which may result in others discovering, developing or commercializing competing products before or more 

successfully than we do.

•

•

If we are unable to adequately protect our proprietary technology or obtain and maintain issued patents that are sufficient to protect our product 
candidates, others could compete against us more directly, which would have a material adverse impact on our business, results of operations, 
financial condition and prospects.

Our future success depends on our ability to retain key executives and to attract, retain and motivate qualified personnel.

• We may expand our operational capabilities, and as a result, we may encounter difficulties in managing our growth, which could disrupt our 

operations.

• We will continue to incur costs as a result of being a public company, and our management will continue to devote substantial time to compliance 

initiatives and corporate governance practices.

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Item 1. Business

PART I

Overview

We are a microbiome therapeutics company developing a novel class of biological drugs, which are designed to treat disease by modulating the 

microbiome to restore health by repairing the function of a disrupted microbiome to a non-disease state. We have an advanced drug pipeline with clinical 
assets that are formulated for oral delivery and a differentiated microbiome therapeutics drug discovery and development platform including good 
manufacturing practices, or GMP, manufacturing capabilities for this novel drug modality.  

Our highest priority is preparing for potential commercialization of SER-109, an investigational oral microbiome therapeutic in development for 
recurrent Clostridioides difficile infection, or CDI. In October 2022, the U.S. Food and Drug Administration, or FDA, accepted for review our biologics 
license application, or BLA, for SER-109. The BLA has been granted Priority Review designation with a Prescription Drug User Fee Act, or PDUFA, 
target action date of April 26, 2023. If approved by the FDA, we plan to launch SER-109 with our collaborator, Nestlé Health Science, soon after approval.

We are also designing microbiome therapeutics to decolonize pathogens and modulate host function to reduce and prevent infections. We believe 

that the scientific and clinical data from our SER-109 program validate this novel approach, which we refer to as Infection Protection. We believe the 
Infection Protection approach may be replicable across different bacterial pathogens to develop microbiome therapeutics with the potential to protect a 
range of medically compromised patients from infections. We are evaluating SER-155 in a Phase 1b study in patients receiving allogeneic hematopoietic 
stem cell transplantation, or allo-HSCT, to reduce incidences of gastrointestinal infections, bloodstream infections and graft-versus-host disease, or GvHD. 
In December 2022, the study’s Data and Safety Monitoring Board reviewed available clinical data for cohort 1 and cleared advancement to cohort 2. In 
February 2023, we announced the initiation of enrollment in cohort 2. We plan to announce initial safety and pharmacological data, including drug bacterial 
species engraftment from cohort 1, in May 2023. We are also progressing additional preclinical stage programs to evaluate how microbiome therapeutics 
may reduce incidence of infections in indications such as cancer neutropenia, chronic liver disease, solid organ transplant, and antimicrobial resistant 
infections more broadly in settings of high-risk such as intensive care units, or ICUs.

We continue our research activities in ulcerative colitis, or UC, including evaluating the potential to utilize biomarker-based patient selection and 

stratification for future studies. In addition, we continue to leverage microbiome pharmacokinetic and pharmacodynamic data from across our clinical and 
preclinical portfolios, using our reverse translational microbiome therapeutic development platform to conduct research on various indications, including 
inflammatory and immune diseases, cancer, and metabolic diseases. 

We have built and deploy a reverse translational platform for the discovery and development of microbiome therapeutics. This platform incorporates 

high-resolution analysis of human clinical data to identify microbiome biomarkers associated with disease and non-disease states; preclinical screening 
using human cell-based assays and in vitro/ex vivo and in vivo disease models customized for microbiome therapeutics; and microbiological capabilities 
and a strain library that spans broad biological and functional breadth to both identify specific microbes and microbial metabolites that are associated with 
disease and to design consortia of bacteria with specific pharmacological properties.

We have assembled a world class group of scientists, clinicians, directors and investors, who have established our leadership in the field of 

microbiome therapeutics. We were co-founded by Drs. Noubar Afeyan, David Berry and Geoffrey von Maltzahn of Flagship Pioneering. Through Flagship 
Pioneering’s contribution of foundational scientific concepts and intellectual property, assembly of our management team and critical early-stage support, 
we launched as the first company focused on the ecological nature of the microbiome. Led by Eric Shaff, our President and Chief Executive Officer, our 
experienced management team possesses core capabilities and know-how in microbiome therapeutics, drug development, commercialization, chemistry, 
manufacturing and controls, or CMC, public company management and finance. 

Our Strategy

Our goal is to remain the leading biopharmaceutical company developing and commercializing microbiome therapeutics to address significant 

unmet medical needs. We intend to focus in the near term on gaining FDA approval for SER-109 for recurrent CDI and continuing development of our 
highest priority clinical programs. Additionally, we continue to advance our differentiated microbiome drug discovery, development and manufacturing 
platforms and capabilities.  

Advancing our Programs

•

Supporting the BLA submission for our lead product candidate, SER-109, for patients with recurrent CDI, and advancing preparations 
for potential commercialization. In October 2022, our BLA for SER-109 was accepted for Priority Review by the FDA. A PDUFA target 
action date has been set for April 26, 2023. We continue to execute pre-commercialization activities with our commercialization collaborator, 
Nestlé Health Science, including appropriate market education and data dissemination to the medical community. In addition, activities are 
ongoing to engage payers. 

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We launched a disease education campaign in the fourth quarter of 2021 with an increasingly robust media plan as we approach potential 
commercial launch. In the second quarter of 2022, we deployed an experienced Nestlé payer team to conduct preapproval information 
exchange activities. To date, this team has engaged payers covering more than 150 million lives. In order to complement the current 
gastroenterology sales force of Nestlé Health Science, in the fourth quarter of 2022, a hospital selling team of twenty employees were hired 
to profile the top volume hospitals across the U.S. during the remainder of our prelaunch phase. In addition, we have SER-109 drug supply 
ready in anticipation of product approval and continue to make progress expanding commercial-scale production of SER-109 to prepare for 
anticipated future market demand. Our Long-Term Manufacturing Agreement with BacThera AG, or Bacthera, a global leader in 
biopharmaceutical product manufacturing, is designed to increase longer-term SER-109 product supply and adds to existing manufacturing 
capabilities. 

•

•

Maximizing the opportunity in Infection Protection. We believe that the scientific and clinical data from our SER-109 program validate our 
Infection Protection approach of using microbiome therapeutics to decolonize pathogens and modulate host function to reduce and prevent 
infections. Infection Protection may be replicable across different bacterial pathogens to develop microbiome therapeutics with the potential 
to protect a range of medically compromised patients from infections. We are evaluating SER-155 in a Phase 1b study in patients receiving 
allo-HSCT to reduce incidences of gastrointestinal infections, bloodstream infections and GvHD. We are also progressing additional 
preclinical stage programs to evaluate how microbiome therapeutics may reduce incidence of infection in indications such as cancer 
neutropenia, chronic liver disease, solid organ transplant, and antimicrobial resistant infections more broadly in settings of high-risk such as 
ICUs. 

Continuing research to inform further development in UC and immune modulation. We previously announced clinical, microbiome and 
metabolomic data from our SER-287 Phase 2b study and the first cohort of our SER-301 Phase 1b study. Available data for these 
investigational microbiome therapeutics suggest that there may be an opportunity to utilize biomarker-based patient selection and 
stratification for future studies. Research activities remain ongoing to inform potential further development activities that include patient 
population and disease severity selection and dose optimization in these populations.  

Advancing Our Capabilities

•

•

Leveraging our leading reverse translational microbiome therapeutics platform to develop additional innovative and novel microbiome 
therapeutics across a range of serious medical conditions with high unmet need including infectious and inflammatory disease and 
disease associated with modulation of host immunity. We believe that the combination of experience, proprietary data and proprietary know-
how related to the microbiome, the functional properties of microbial species and strains, microbe-host interactions, the cultivation of 
microbial strains, and microbiome-specific functional screens and analytics provides us a competitive advantage in the design and 
development of microbiome therapeutics. Our platform enables us to build upon our existing and growing clinical experience to rationally 
design treatments for acute and complex chronic diseases. We intend to leverage this advantage to develop additional innovative microbiome 
therapeutics.

Developing manufacturing capabilities sufficient to support commercialization of any approved microbiome therapeutic candidates. 
Microbiome therapeutic manufacturing requires capabilities that are distinct from other biologic drugs. We have made strategic investments 
in manufacturing capabilities to help ensure that we maintain control of our know-how and also because we believe these capabilities will be 
necessary and highly advantageous for the development of future microbiome therapeutic candidates. Our bioprocess and manufacturing 
personnel are focused on creating a platform of manufacturing expertise that will set the stage for further advances in the emerging field of 
microbiome therapeutics.

Our Microbiome Therapeutics Platform 

We have developed the leading reverse translational microbiome therapeutics platform which we believe enables us to apply our capabilities to 
efficiently identify, manufacture and develop novel microbiome therapeutics for serious human diseases. We use a reverse translational discovery platform 
that incorporates analysis of microbiome biomarkers from human clinical data and preclinical assessments using human cell-based assays and in vitro/ex 
vivo and in vivo disease models. Specifically, we start with data sets from both healthy subjects and subjects with disease to delineate at high-resolution the 
composition of the microbiome and physiological state of subjects and to identify specific microbiome and host signatures that associate with disease or the 
onset of disease. These in-human insights on how different microbe species and strains and microbe-associated metabolites are associated with disease 
along with how these microbes and metabolites directly or indirectly modulate disease-relevant functional pathways in the host are leveraged in preclinical 
drug design and development. 

Our discovery process begins with human data derived from clinical trials and cohort studies, which we use as a basis for target identification and 

the design of our microbiome therapeutic candidates. We compare healthy, normal colonic microbiomes to those in an unhealthy disrupted or disease state, 
revealing the ecological, compositional and functional differences between various states of disease and during the transition from health to disease or vice 
versa. Specifically, we utilize clinical data sets combined with 

6

advanced data sciences and microbiome analytics to identify microbiome signatures of disease at the resolution of specific species and strains, metabolites, 
and even genes that are associated with disease states. These microbiome biomarkers are associated with host signatures and biomarkers of disease to 
identify drug targets for our microbiome therapeutics. Our clinical data from the SER-109, SER-262, SER-401, SER-287 and SER-301 programs, and 
microbiome data generated with external collaborators, serve to instruct us on how the introduction of certain keystone microbes have the potential to 
restructure the microbiome and modulate the metabolic state of the gut to shift it to a non-disease state. 

We have developed a proprietary functionally characterized strain library and a suite of assays and screens, bioinformatics and computational tools, 
and databases, which facilitate our insights into the human microbiome. We have established proprietary, curated, reference databases and algorithms that: 
(i) integrate high-resolution genomic, metagenomic, metabolomic, and transcriptomic data sets, and data from in vitro and human cell-based assays, and in 
vitro/ex vivo and in vivo disease models, and (ii) enable us to track changes in the microbiome at the level of microbial species and individual strains and 
associate these changes with changes in the metabolic state of the gut and host physiology. Our analytics can integrate gene profiling and metabolomics 
data (the small molecules made by the microbiome) with genomic data (the collection of microbes defined by sequencing) to delineate microbiome 
biomarkers (the specific species or strains and functional pathways) that contribute to the state of disease or health. Further, we have established de novo 
analytics for pharmacokinetic and pharmacodynamic assessments of microbiome therapeutics.  Additionally, leveraging all of these data we have curated 
and continue to build a database that links and associates: (i) functional properties of microbial species/strains, (ii) functional pathways in hosts that can be 
modulated by the microbiome, (iii) the association of functional pathways to disease, and (iv) the association of existing non-microbiome drugs to the 
functional pathways. This continually growing database can be mined to inform drug design and disease area and patient population prioritization.

Our proprietary strain library of bacterial isolates from healthy donors and patients enables us to translate microbiome biomarker insights into 
defined consortia of bacteria. The strain library contains bacterial species isolated from individuals that are either healthy or that have a disease. Seres has 
developed extensive isolation and cultivation know-how. The strain library contains a majority of the Human Microbiome Project’s “most wanted” and 
many novel species we do not believe are described in other databases or the scientific literature. The functional properties of strains are characterized 
using proprietary in vitro and ex vivo human cell-based assays as well as full-genome sequences and genome functional annotation. Functional 
characterization of target strains includes properties such as how the bacteria interact with human colonic epithelial cells and human immune cells. We also 
seek to understand how these microbes improve the health of barrier cells in the gut and how they may impact immune responses.

We select bacteria from our library with specific predicted properties using novel algorithms for in silico functional design and optimization and 
grow the compositions in the lab to be tested both in vitro/ex vivo models as delineated above and in in vivo animal models. Our animal models include 
conventional mice, germ-free mice, and “humanized avatar” mice that possess only bacteria derived from humans; these models were developed to 
minimize confounding variables presented by model organism microbes. Data from our in vitro/ex vivo and in vivo screens are analyzed and used to 
optimize compositional designs; introducing new bacterial strains and optimizing existing strains until we identify a lead composition suitable for clinical 
testing.

Finally, we manufacture the bacterial composition under current Good Manufacturing Practices, or cGMP, or similar foreign requirements, which 

are required by FDA and European regulators. We believe our unique manufacturing capacities position us to exploit the insights of our proprietary human 
data and the novel biology of species and strains that have not previously been used for therapeutics. We have optimized fermentation conditions to 
generate spores and enhance bacterial yields in anaerobic fermentation and have in-house capabilities to formulate both spores and live non-spore bacteria. 
Our manufacturing facility in Cambridge, Massachusetts was designed to be fit-for-purpose and is highly differentiated compared to the offerings of 
commercial contract research organizations. We have secured additional capacity, designed to our specifications, via contract manufacturing organizations, 
or CMOs, to ensure adequate supply for potential commercial products. We continue working to address quality control requirements for our microbiome 
therapeutic candidates using proprietary microbiological and sequence-based testing schemes, including high-throughput quantitative analytics to assess the 
identity, potency, and purity of the final product. We intend to continue to work with regulators to meet the requirements for product approval. 

Taken together, we believe our platform, spanning drug discovery, preclinical translation, and novel manufacturing and quality control approaches, 

has enabled a field leading pipeline across a range of therapeutics areas.

Disease Overview and Our Product Pipeline

We believe our microbiome therapeutic candidates represent a novel approach with potential application across a broad range of human diseases. 

Our lead product candidate, SER-109, is designed to reduce further recurrence of CDI, a debilitating infection of the colon, in patients who have received 
antibiotic therapy for recurrent CDI by restructuring the gastrointestinal microbiome and modulating the metabolic landscape to address CDI. If approved 
by the FDA, we believe SER-109 will be a first-in-field oral microbiome drug. Building upon SER-109, we are developing novel microbiome therapeutics, 
such as SER-155, to specifically target infections and antimicrobial resistance. SER-155, a microbiome therapeutic candidate consisting of a consortium of 
cultivated bacteria, is designed to reduce incidences of gastrointestinal infections, bloodstream infections and GvHD in patients receiving allo-HSCT. We 
are progressing additional preclinical stage programs to evaluate how microbiome therapeutics may reduce incidence of infection in indications such as 
cancer neutropenia, chronic liver disease, solid organ transplant, and antimicrobial resistant infections 

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more broadly in settings of high-risk such as ICUs. We are also continuing research activities in UC, including evaluating the potential to utilize biomarker-
based patient selection and stratification for future studies. In addition, we continue to leverage microbiome pharmacokinetic and pharmacodynamic data 
from across our clinical and preclinical portfolios, using our reverse translational microbiome therapeutic development platform to conduct research on 
various indications, including inflammatory and immune diseases, cancer, and metabolic diseases.

CDI Overview and SER-109

Clostridioides difficile Infection 

C. difficile is a Gram-positive, toxin-producing, spore forming bacterium that may cause debilitating diarrhea in infected individuals, but can also 

lead to more severe outcomes, such as inflammation of the colon, or colitis, toxic megacolon and death. C. difficile bacteria express toxins that disrupt the 
structural architecture of cells causing leakage of fluids through the gastrointestinal, or GI, epithelium. The cells disrupted by these toxins eventually 
undergo apoptosis and die, disrupting the epithelial barrier and exposing the immune system to inflammatory stimuli, severe and persistent diarrhea and, in 
the most serious cases, death.

CDI is most often associated with the prior use of antibiotics, although age and poor immune status are important risk factors as well. Antibiotics are 

thought to decrease colonization resistance to CDI by disrupting the microbiome. Since C. difficile spores are able to survive for long periods of time 
outside the body, and because healthcare settings are often sites of significant antibiotic use, CDI is a leading cause of healthcare-associated infections in 
the United States. CDI is also a cause of morbidity and mortality among hospitalized cancer patients and bone marrow transplant patients as their immune 
systems are suppressed by cytotoxic drugs, which inhibit or prevent the functioning of cells, and they may be heavily treated with antibiotics to prevent or 
treat infections. More recently, the rise of community-acquired CDI has been recognized as a growing problem.

The Centers for Disease Control and Prevention, or CDC, has identified C. difficile as one of the top three most urgent antibiotic-resistant bacterial 
threats in the United States. It is the most common cause of hospital acquired infection in the United States, having overtaken MRSA. CDI is responsible 
for the deaths of over 20,000 Americans each year. During 2023, it is estimated that there will be approximately 459,000 cases of primary CDI and 156,000 
incidences of recurrent CDI within the United States. CDI is also costly to the healthcare system. According to a study published in Clinical Infectious 
Diseases, the economic burden of CDI in 2008 in U.S. acute care facilities alone was estimated to be as much as $4.8 billion. In addition, the average 
recurrent CDI treatment cost in the U.S. is estimated to be $34 thousand per patient, comprising mostly (88%) hospital-related costs (Rodrigues Infect 
Control Hosp Epidemiol 2017). The national incidence of CDI remains high despite declining from 476,000 in 2011 to 462,000 in 2017 (Guh, New 
England Journal of Medicine 2020). Further, according to a 2014 article in the American Journal of Infection Control, from 2001 to 2010, incidence of CDI 
per 1,000 patients discharged increased from 4.5 to 8.2 with an average hospital stay of eight days. Due to suboptimal approaches to treatment, patients 
with primary CDI have an approximate 20% - 25% change of recurrent infection increasing to greater than 40% after the first recurrence (Gerding, CID 
2018; Lashner ACG 2020; Dubberke CID 2018). 

Current and developing treatment alternatives and their limitations

Antibiotics.  According to the Infectious Disease Society of America, or IDSA, guidelines, the current standard of care for primary CDI is to treat 

with antibiotics, such as fidaxomicin or vancomycin. Fidaxomicin is recommended to treat primary CDI, it does not have a label claim to reduce or prevent 
CDI recurrence. No antibiotic therapeutics are currently approved for treatment of recurrent CDI. 

Recurrent CDI, defined as the presence of diarrhea and a positive C. difficile stool assay within two to eight weeks following the initial episode, is 
not well addressed by any of the available antibiotics. The risk of recurrent CDI increases to greater than 40% after the first recurrence. In extreme cases, 
patients may be treated continuously for years with vancomycin.

Antibiotics have two major limitations: they have no effect on the spores that germinate in a disrupted microbiome and their use appears to 
exacerbate microbiome disruption, resulting in increased risk of future CDI. Research in animal models has shown that antibiotic use not only eliminates 
many healthy bacteria in the GI tract, but also leads to the release of nutrients that facilitate the growth of C. difficile. Antibiotics have also been shown to 
change the ratio of primary versus secondary bile acids in the colon by killing bacteria required to metabolize bile acids. This shift to a predominance of 
primary bile acids further facilitates the growth of C. difficile, as it requires primary bile acids for germination of its spores. As a result, antibiotic use may 
induce a lasting microbiome disruption that makes it possible for C. difficile to colonize a person and then cause, or further perpetuate, disease.

Fecal microbiota transplantation.  FMT, also known as a stool transplantation, is a procedure during which donated stool, including fecal microbes, 
is typically instilled via colonoscopy into a patient with recurrent CDI. FMT presents several challenges for effective treatment of the disease. FMT has the 
potential to transmit infectious or allergenic agents between hosts, involves the transmission of hundreds of unknown strains of bacteria, fungi, viruses and 
potentially parasites from donor to subject, and is difficult to perform on a mass scale. In November 2019 the FDA held a public hearing to obtain input on 
the use of FMT to treat Clostridioides difficile infection not responsive to standard therapies. Presentations were made by the academic community and 
development companies regarding the current and future use of FMT. In January, 2020, we submitted comments to the docket for the meeting that 
recommended: 1) increased scrutiny and regulation of unapproved, commercially available FMT that does not comply with IND requirements; 2) 
implementation of guidance for establishing safety of source materials for all microbiome products; and 3) safety and 

8

efficacy of all microbiome products to reduce recurrent CDI must be based on adequate and well controlled clinical trials including accurate assurance of 
diagnosis of the disease state – specifically toxin testing.

Fecal microbiota therapy.  In November 2022, the FDA approved Rebyota, the first fecal microbiota product approved by the FDA, for the 
prevention of recurrence of CDI in individuals 18 years of age and older following antibiotic treatment for recurrent CDI. Rebyota is administered rectally 
and is prepared from stool sourced from qualified donors. The stool is tested for a panel of transmissible pathogens. We believe our CMC process is 
differentiated by additional processes to inactivate and clear potential adventitious agents to help ensure product safety.  

Antibodies. Bezlotoxumab a fully human monoclonal antibody directed against C. difficile toxin B was approved in the United States in October 

2016 and in Europe in 2017 for the treatment of CDI. According to Phase 3 studies, the antibody demonstrated 10% absolute risk reduction in preventing 
recurrence of CDI. Antibodies bind toxins to alleviate the symptoms of CDI, but they do not address the underlying disruption of the microbiome, which 
we believe is the cause of recurrent CDI. Bezlotoxumab requires intravenous infusion. 

SER-109 

SER-109 is an oral microbiome therapeutic candidate consisting of a consortium of purified Firmicutes spores. The SER-109 manufacturing 
purification process is designed to remove unwanted microbes in an effort to reduce the risk of pathogen transmission beyond donor screening alone. SER-
109 is designed to reduce recurrent CDI in patients with a history of CDI by modulating the microbiome to a state that resists C. difficile germination and 
growth. SER-109, if approved, is intended to treat individuals with recurrent CDI, a patient population that is estimated to include approximately 156,000 
cases in the United States during 2023.

Phase 1b/2 clinical study 

The Phase 1b/2 clinical study was an open-label, single arm, descending-dose study that enrolled 30 patients with recurrent CDI. All enrolled 
patients received standard-of-care antibiotic treatment, followed by oral administration of SER-109. Of the 30 study patients, 26 (87%) achieved the 
primary endpoint of absence of CDI (defined in this study as more than three unformed bowel movements in a 24-hour period with laboratory confirmation 
of a positive C. difficile stool test) up to eight weeks following dosing. Three of the four patients who did not meet the primary endpoint were determined 
by their primary investigator to be recovering from CDI, and all symptoms resolved without further therapeutic intervention or antibiotics. In total, 29 of 30 
patients (97%) achieved the clinical cure rate, which we defined as the absence of CDI requiring antibiotic treatment during the eight-week period after 
SER-109 dosing. SER-109 was well tolerated in the study, with the most common adverse events being mild to moderate gastrointestinal symptoms. No 
drug related serious adverse events were observed.

Phase 2 clinical study 

The Phase 2 clinical study was a randomized, double-blinded, placebo-controlled, parallel-group two arm trial that enrolled a total of 89 patients 

with a history of multiply-recurrent CDI, defined as 3 or more CDI episodes within 9 months. SER-109 was administered orally following the completion 
of antibiotic treatment for CDI. The predefined study primary efficacy endpoint was the relative risk of CDI recurrence up to 8 weeks after treatment with 
SER-109 compared to treatment with placebo. CDI recurrence was defined as diarrhea for 2 or more consecutive days, a positive CDI test, and the 
requirement for antibiotic treatment. Based on 8-week data, CDI recurrence occurred in 44% of subjects (26 of 59) who received SER-109, compared to 
53% of subjects (16 of 30) who received placebo. The relative risk of CDI recurrence for the placebo population compared to the SER-109 population was 
not statistically significant. The most commonly reported AEs in both the SER-109 and placebo arms were in the GI category, and were diarrhea, 
abdominal pain, flatulence, and nausea. No drug-related SAEs were observed. 

Analysis of Phase 1b/2 and Phase 2 clinical study results

 In our Phase 2 clinical study, the study’s primary endpoint of reducing the relative risk of CDI recurrence at up to 8 weeks after treatment was not 

achieved. In order to understand the difference in outcome between Phase 1b/2 and Phase 2 clinical studies, we conducted an analysis of the available 
clinical, microbiome and CMC data. We identified key factors that potentially explain the Phase 2 clinical study results, including issues related to both the 
accurate diagnosis of C. difficile recurrent infection, and potential suboptimal dosing of subjects in the trial. 

The key factors include:

•

•

•

The diagnostic test for entry may not have differentiated subjects with active CDI disease from those with other disease but who had C. 
difficile carriage (e.g., irritable bowel syndrome);

The diagnostic test for CDI recurrence during the study (the primary endpoint) overestimated recurrences, as PCR was the most common test 
performed;

The safety profile of SER-109, which may include diarrhea in the first week following dosing, led to SER-109 subjects presenting for 
evaluation of recurrence at a time when they were likely to be colonized with C. difficile leading to mistaken diagnosis of recurrent CDI; and 

9

•

The dose and dosing regimen used in the study may not have been optimal in the Phase 2 clinical study based upon an assessment of the 
microbiome response using whole metagenomics shotgun sequencing.

From our reanalysis of the phase 1b/2 and 2 trials, we learned that there is a dose-dependent response governing early SER-109 pharmacokinetics, 

with increased engraftment associated with successful CDI resolution through 8 weeks. In the Phase 2 trial, SER-109 was dosed at 1 × 108 spores based on 
equivalent clinical outcomes and week 8 engraftment measures observed between the phase 1 dosing cohorts. However, our integrated analysis of both 
trials revealed that (1) engraftment kinetics at week 1 were of greater importance for reducing rCDI than later time points, (2) week 1 engraftment was 
highly variable in Phase 2 subjects, and (3) rapid engraftment was dependent on dose, which was clearly suboptimal in the Phase 2 trial (McGovern, 2020; 
Young, 2020). We hypothesized that rapid engraftment of a microbiome therapeutic may be critical to efficacy since CDI recurrence usually occurs within 
1–3 weeks of antibiotic discontinuation, the “window of vulnerability”; consistent with this hypothesis, in the Phase 2 trial, greater engraftment of SER-109 
species at week 1 was correlated with reduced CDI rates. This correlation was not previously appreciated due to the use of lower resolution 16S rRNA gene 
amplicon–based methods used in the Phase 1b/2 study for determining drug engraftment (Khanna, 2016).

Phase 3 clinical study design 

In the Phase 3 ECOSPOR III clinical study of SER-109, patients with multiply recurrent CDI were randomized 1:1 between SER-109 and placebo. 
Diagnosis of CDI for both study entry and for endpoint analysis utilized a C. difficile cytotoxin assay, compared to the Phase 2 clinical study, where most 
patients were diagnosed by PCR. Patients in the SER-109 arm received a total SER-109 dose, administered over three days, approximately 10-fold higher 
than the dose used in the Phase 2 clinical study to drive rapid engraftment of SER-109 bacteria in treated patients. The study evaluated patients for 24 
weeks and the primary endpoint was to compare the C. difficile recurrence rate in subjects who receive SER-109 verses placebo at up to eight weeks after 
dosing.  CDI recurrence is defined as diarrhea (>3 unformed bowel movements/day for 2 or more consecutive days), a positive CDI toxin test, and the 
decision by the primary investigator that antibiotic treatment is warranted. The study was conducted at approximately 100 sites in the United States and 
Canada.  

Phase 3 clinical study results

The study enrolled 182 patients with multiply recurrent CDI.  ECOSPOR III data demonstrated that the study achieved its primary endpoint where 

SER-109 was superior to placebo in reducing CDI recurrence at eight weeks, reflecting a recurrence-free rate of approximately 88% at eight weeks post-
treatment. SER-109 resulted in a 27% absolute reduction of recurrence of CDI compared to placebo at eight weeks post-treatment, which is a relative risk 
reduction of 68%. The number-needed-to treat was 3.6. The rate of recurrence at 12 weeks in the SER-109 arm was 18.0%, compared to a rate of 46.2% in 
the placebo arm, representing an absolute risk reduction of 28% (relative risk 0.40; 95% CI 0.24-0.65; p <0.001 and p< 0.002 for the test sequence), and 
thereby consistent with the results seen at eight weeks.  Results across stratifications of age and antibiotics remained similar. The study’s efficacy results 
related to the primary endpoint from all analyses exceeded the statistical threshold previously provided in consultation with the FDA that could allow this 
single clinical study to fulfill efficacy requirements for a BLA.  The efficacy results remained durable through 24 weeks of follow-up, as SER-109 was 
observed to significantly reduced recurrence rates compared to placebo over 24 weeks, 21.3% vs. 47.3%, respectively. These data were published in the 
New England Journal of Medicine in January 2022 and in the Journal of the American Medical Association in October 2022.

We believe the SER-109 safety results across completed studies have been favorable, with a well-tolerated adverse event profile. Overall incidence 

of patients who experienced treatment-emergent adverse events, or TEAEs, was 92.2% for SER-109 and 91.3% for placebo.  SER-109 had no serious 
treatment-related adverse events. The most commonly observed TEAEs were gastrointestinal disorders, the majority of which were mild to moderate in 
nature.

The study also examined the pharmacokinetics (i.e., drug bacterial species engraftment) and pharmacodynamics (i.e., metabolic changes) following 

SER-109 dosing. The data demonstrate that SER-109 administration resulted in the rapid and durable engraftment of SER-109-derived bacterial species 
into the gastrointestinal tract as soon as one week following dosing, and that this engraftment was maintained at subsequent timepoints evaluated, including 
at the eight-week timepoint corresponding to the study’s primary endpoint and the 24-week safety follow-up timepoint. The presence of SER-109 bacterial 
species was significantly greater (p<0.001) in SER-109 treated patients than in placebo patients at all timepoints evaluated. Significant differences were 
maintained in predefined subpopulation analyses of age and antibiotic use. Seres utilized advanced microbiome biomarker analytics and proprietary 
genomic reference datasets to identify, at a resolution of bacterial species, the gastrointestinal microbiome signatures associated with SER-109 engraftment.

SER-109 administration also resulted in modulation of the gastrointestinal metabolic landscape. Notably, data demonstrated a significant decrease in 

primary bile acids (p=0.038) and an increase in secondary bile acids (p<0.001) by one-week post-dosing; significant differences were maintained through 
week eight for secondary bile acids. Notably, SER-109 subjects had less variance across subjects in bile acid response than placebo subjects. Observations 
for both primary and secondary bile acids were maintained in predefined subpopulation analyses of age and antibiotic use. All microbiome analyses were 
conducted according to the treatment subjects actually received. Published research as well as preclinical studies have demonstrated that primary bile acids 
support 

10

germination of C. difficile spores that are the source of disease recurrence. In contrast, secondary bile acids have been reported to inhibit germination and 
the growth of C. difficile (Theriot and Young, Annu. Rev. Microbiol. 2015).

In November 2021, we initiated a SER-109 expanded access program across the United States. The program is designed to enable eligible adults 

with recurrent CDI to obtain access to SER-109 prior to a potential FDA product approval.

In June 2022, we announced confirmatory results from the ECOSPOR IV open-label study. The overall safety results observed in ECOSPOR IV 

through 24 weeks showed that SER-109 was well tolerated, consistent with the safety results observed in the prior completed Phase 3 study, ECOSPOR III. 
In ECOSPOR IV, subjects treated with SER-109 had a recurrence rate of 8.7% at eight weeks, which represented a 91.3% recurrence-free rate, consistent 
with the 88% rate observed in the ECOSPOR III study. Subjects with a first recurrence of CDI (29% of subjects in the ECOSPOR IV study) had a CDI 
recurrence rate of 6.5%, and subjects with ≥ two prior CDI episodes (ECOSPOR III inclusion criteria) had a CDI recurrence rate of 9.7% at eight weeks. At 
24 weeks, 13.7% of all subjects treated with SER-109 had a recurrence of CDI. In addition to data from the ECOSPOR III study, the ECOSPOR IV data 
was included as part of our BLA submission to the FDA.  

In October 2022, the FDA accepted for review our BLA for SER-109. The BLA has been granted Priority Review designation with a PDUFA target 

action date of April 26, 2023. If approved by the FDA, we plan to launch SER-109 with our collaborator, Nestlé Health Science, soon after approval. 

In addition, we plan on initiating a Phase 3 trial in the European Union, or EU, in order to expand access to the EU market upon potential approval.

Sales and Marketing

In July 2021, we entered into an agreement with NHSc Pharma Partners, succeeded by NHSc Rx License GmbH, or, together with Société des 

Produits Nestlé S.A, Nestlé, to jointly commercialize SER-109 in the United States and Canada. Under the terms of the agreement, Nestlé will assume the 
role of lead commercialization party. We received license payments of $175 million up front, and will receive an additional $125 million upon FDA 
approval of SER-109. The agreement also includes sales target milestones which, if achieved, could total up to $225 million. We will be responsible for 
development and pre-commercialization costs in the United States. Upon commercialization, we will be entitled to share equally in its commercial profits 
and losses.

This agreement represents a second strategic collaboration between the companies. Nestlé already has commercial rights to our investigational 
treatments for CDI and IBD outside of the United States and Canada, and with the July 2021 expansion, Nestlé became our global collaborator in SER-109. 

If SER-109 is approved in the United States and Canada, we believe it can be commercialized with a focused specialty sales force that will target 

gastrointestinal and infectious disease physicians, which are the two primary groups of physicians who treat recurrent CDI patients. We have initiated 
commercial readiness activities that include: C. difficile market assessments, publication and presentation planning, stakeholder and advocacy relationship 
mapping, brand name selection, and initiation of payer and reimbursement strategic planning. We launched a disease education campaign in the fourth 
quarter of 2021 with an increasingly robust media plan as we approach potential commercial launch. In the second quarter of 2022, we deployed an 
experienced Nestlé payer team to conduct preapproval information exchange activities. To date, this team has engaged payers covering more than 150 
million lives. In order to complement the current gastroenterology sales force of our commercialization collaborator, Nestlé Health Science, in the fourth 
quarter of 2022, a hospital selling team of twenty employees were hired to profile the top volume hospitals across the United States during the remainder of 
our prelaunch phase.

Infection Protection and SER-155 

We believe that the scientific and clinical data from our SER-109 program validate our novel approach of using microbiome therapeutics to 
decolonize pathogens, resulting in reduced rate of infections in medically compromised patients. Data from the SER-109 Phase 3 trial published in the New 
England Journal of Medicine and Journal of the American Medical Association show that microbiome therapeutics can restructure the gut microbiome and 
shift the gut metabolic landscape. Additional data show that SER-109 rapidly reduces the abundance of bacteria associated with common antibiotic 
resistance genes, or ARGs, and reduces ARG abundance in the gut. Collectively, these data demonstrate the potential for microbiome therapeutics to 
restore colonization resistance and ultimately to reduce infections and antimicrobial resistance. This Infection Protection approach may be replicable in 
protecting a range of medically compromised patients from infections seeded by the gut microbiome. It may also enable us to reduce antimicrobial resistant 
infections, which the World Health Organization declared as a top ten global public health threat facing humanity. 

We are evaluating SER-155 in a Phase 1b study in allo-HSCT recipients to reduce incidences of gastrointestinal infections, bloodstream infections 
and GvHD. We are also progressing additional preclinical stage programs to evaluate how microbiome therapeutics may reduce incidence of infection in 
indications such as cancer neutropenia, chronic liver disease, solid organ transplant, and antimicrobial resistant infections more broadly in settings of high-
risk such as ICUs.

SER-155, an oral microbiome therapeutic candidate consisting of a consortium of cultivated bacteria, is designed to decrease infection and 

translocation of antibiotic resistant bacteria in the gastrointestinal tract and modulate host immune responses to decrease GvHD. The rationale for this 
program is based in part on published clinical evidence from our collaborators at Memorial Sloan 

11

Kettering Cancer Center showing that allo-HSCT patients with decreased diversity of commensal microbes are significantly more likely to die due to 
infection and/or lethal GvHD. SER-155 was designed using our reverse translational microbiome therapeutics development platform to reduce incidences 
of gastrointestinal infections, bloodstream infections and GvHD in patients receiving allo-HSCT. The SER-155 Phase 1b study is designed to include 
approximately 70 patients in both an open-label and a randomized, double-blind, placebo-controlled cohort that will evaluate safety and tolerability before 
and after HSCT. Additionally, the engraftment of SER-155 bacteria (a measure of pharmacokinetics) and the efficacy of SER-155 in preventing infections 
and GvHD will be evaluated. In December 2022, the study’s Data and Safety Monitoring Board reviewed available clinical data for cohort 1 and cleared 
advancement to cohort 2. In February 2023, we announced the initiation of enrollment in cohort 2. We plan to announce initial safety and pharmacological 
data, including drug bacterial species engraftment from cohort 1, in May 2023. The study is being conducted at a number of leading cancer centers across 
the U.S.

Irritable Bowel Disease, Ulcerative Colitis, SER-287 and SER-301 

UC, a form of irritable bowel disease, or IBD, is a relapsing-remitting chronic inflammatory disorder affecting the mucosal surface of the colon, 
leading to episodes of bloody diarrhea, urgency and mucosal inflammation (Danese and Fiocchi, 2011), which generally begins in young adulthood and 
endures for life. The incidence of UC is rising worldwide, and the prevalence of the disease is highest in the United States, Canada, and Europe. In the 
United States alone, the prevalence of UC in adults is estimated to be 263 per 100,000, while in the pediatric population (age <20 years), prevalence of the 
disease is estimated to be 33.9 per 100,000. (Kappelman et al., 2013). The severity, extent, and duration of disease are also risk factors for developing colon 
cancer, which occurs at a rate as high as 0.5-1.0% per year, an important complication given the young age at which the disease strikes. Patients with UC 
also experience increased risk of CDI and primary sclerosing cholangitis, compared to the general population.

Currently, patients with UC require life-long therapy. Current medical therapies for the treatment of UC suppress the immune system rather than 
reduce the triggers of immune activation. We believe there remains an unmet need for safer agents with novel non-immunosuppressive mechanisms of 
action. Moreover, alternative therapy is needed for patients with UC who experience frequent flares or are intolerant to the aminosalicylate class of 
medication or where there are safety concerns relating to the use of immunomodulator or steroid therapy.

We continue our research activities in IBD, including evaluating the potential to utilize biomarker-based patient selection and stratification in future 

clinical studies in UC. UC patient populations are generally heterogeneous in their disease manifestation and we believe biomarker-based strategies may 
enable targeting more homogeneous patient populations in future studies. 

In July 2021, we announced topline results from the SER-287 Phase 2b study evaluating SER-287 in patients with mild-to-moderate UC, which did 

not meet its primary endpoint of improving clinical remission rates compared to placebo.  Following the data readout, in December 2021, we completed 
preliminary microbiome drug pharmacology analyses that demonstrated the engraftment of SER-287 bacterial species, however, unlike the Phase 1b study, 
anticipated changes in disease-relevant metabolites post-administration with SER-287 in the Phase 2b study were not observed to the same extent across 
the patients treated in the Phase 1b study.

In addition, we have completed preliminary analysis of data from the first cohort of the SER-301 Phase 1b study evaluating SER-301 in patients 

with mild-to-moderate UC, which included 15 subjects. Evaluation of the first cohort data by an independent Data Safety Monitoring Board indicated that 
it would be safe to proceed to the placebo-controlled second cohort. While efficacy was not a defined endpoint in the first cohort, evaluation of clinical 
outcome data collected as part of the study indicated that no subjects in the first cohort achieved clinical remission as defined by the FDA using the Three-
Component Modified Mayo Score after 10 weeks of treatment, though there were improvements in one or more individual components (endoscopic, stool 
frequency and rectal bleeding subscores) in some patients. SER-301 was optimized relative to SER-287 to incorporate bacterial strains that engrafted across 
the majority of patients in our previous trials, and strains that were associated with positive clinical outcomes and the modulation of key microbial-
associated metabolites. In the Phase 1b study, strains in SER-301 were observed to engraft in subjects across the trial period, and based on the assessment of 
metabolomic data, SER-301 demonstrated pharmacological properties consistent with its design and further led to baseline-dependent modulation of the 
metabolic landscape in the gastrointestinal tract of patients treated. In April 2022, we announced our decision not to proceed with the planned SER-301 
Phase 1b second study cohort.  In aggregate, our clinical and preclinical data suggest that there are IBD patient populations that may be more amenable to 
microbiome therapeutic intervention, and we continue to conduct analyses of data from our UC clinical stage programs and conduct preclinical studies to 
inform next steps for further development in UC and IBD more broadly.

Donor-derived product candidates

Manufacturing

SER-109 is a purified consortium of Firmicutes spores produced through a process of separation and purification from a natural human stool source, 
obtained from qualified, highly screened donors. The donor raw material is collected in a controlled setting, under a protocol that is designed to ensure that 
donors meet appropriate qualification criteria.

12

Donors are required to be in good health, and to possess a medical history that minimizes the risk of exposure to and transmission of an infectious 

disease. Donors are tested for infectious agents and screened for GI and other relevant health factors. Donors are monitored for health status changes on an 
ongoing basis throughout the donation period. At periodic intervals, and at the end of the donation period, the qualification assessment is repeated to help 
ensure the donor has maintained their health status. After successful completion of a periodic or exit screening, donations are released for use in 
manufacturing.

We initially process the donor material in our in-house Cambridge manufacturing facility, and then transfer the process intermediate to our partner 

CMO, GenIbet BioPharmaceuticals, SA, or GenIbet (acquired by Recipharm in February 2022), to further isolate and concentrate SER-109 for finishing to 
the oral capsule dosage form. The manufacturing process includes processes to inactivate and clear potential adventitious agents, to help ensure product 
safety. The purified drug substance is tested for identity, potency and purity, and subsequently formulated into drug product where it is again tested for 
identity, potency, purity, and pharmaceutical properties. The final drug product oral dosage form is four capsules daily for 3-days. Steps are specifically 
built into the process to remove and kill non-spore microbes. We have conducted validation studies demonstrating the ability of the process to inactivate 
and clear any potential extraneous pathogens of concern, and we believe we have sufficient data from these studies to support product registration. If 
approved, we anticipate that we will be able to produce a sufficient commercial supply of SER-109 to meet estimated demand in the United States using 
donations from a modest number of donors.

Commercial product supply for the initial phase of U.S. commercial launch is being produced at our Cambridge manufacturing facility and further 
processed at GenIbet. In November 2021, we entered into a collaboration with Bacthera to manufacture SER-109 to expand upon our existing capabilities 
for commercial product supply to meet anticipated demand in later years. Under the terms of the agreement, Bacthera is constructing a dedicated full-scale 
production suite for us at Bacthera’s Microbiome Center of Excellence in Visp, Switzerland, and is intended to provide manufacturing services for SER-
109. 

Cultivated product candidates

The production of live bacterial products is highly specialized. Owing to their hardiness and environmental persistence, production of aerobic and 

anaerobic vegetative bacteria, as well as spore-forming organisms, poses unique considerations for product, personnel, and facility design, operation, 
quality assurance and quality control. Manufacturing activities with spores are subject to specialized regulations. We expect that a typical commercial 
fermentation will yield on the order of hundreds or thousands of doses per liter depending on the product and its composition. Additionally, because a given 
total dose contains multiple strains, the per-strain requirements for production may be even lower. As a result, we believe the relatively high productivity of 
our manufacturing processes relative to the dose level will enable production scales for both clinical and commercial supply to be modest by traditional 
industry standards for biologics and vaccine manufacturing.

We have developed supply chains for producing and testing materials to ensure the availability of future clinical trial supplies. Our development 

processes are designed to ensure that the raw materials, process technologies and analytical tests we use are scalable and transferable to a cGMP 
manufacturing environment. These include the following core elements:

•

•

•

Fermentation. We are using microscale screening to optimize culture of the bacterial strains of interest in our current and foreseeable 
fermentation-based product candidates. These screens are designed to identify the fermentation platform that is best-suited for optimization 
and scale-up of the strains. Small-scale fermentation systems (0.1 L to 50 L) enable the optimization of a wide variety of culture conditions 
and have been demonstrated to be scalable to larger fermentation processes and enable technology transfer to clinical and final manufacturing 
sites. We employ platform fermentation processes as starting points for cGMP production processes and develop strain specific processes as 
required. To develop master cell banks, working cell banks, and bulk drug substance for commercial product, we are using bacterial strains 
that each originate from a unique research cell bank precursor, so we expect the research cell banks and final drug product should be 
genetically and physiologically similar.

Purification. Similar to fermentation, we believe small-scale purification operations are available for assessing large-scale cGMP 
manufacturing of live cells, and to quickly assess downstream process yield, quality and robustness. Our products in development are 
predominantly oral dosage forms containing live bacteria, hence purification is typically less complex than for parenteral biologics such as 
monoclonal antibodies that must separate highly similar components from the culturing process.  Separation of viable microbes from soluble 
fermentation broth components is typically much simpler by comparison.

Formulation. Our microbiome therapeutic candidates are combinations of bacteria and can be administered by a number of methods and by 
different routes. Where possible, our product formulation development is focused on oral delivery for patient convenience. The primary goal 
in developing a formulation is to deliver bacteria to the intended location in a condition where they are able to replicate and modulate the 
microbiome. Formulation development generally uses approved excipients and preservatives with pharmaceutical industry precedent, and 
will include screening of liquid, solid, and suspension formulations to maximize the opportunity for extended stability with minimal cold-
chain requirements.  Dosage forms for oral products may be liquid- or powder-filled capsules, tablets, sachets, or liquid containers. 

13

•

Analytical. We are addressing quality control requirements for our microbiome therapeutic candidates using proprietary microbiological, 
chemical, biochemical, and molecular sequence-based testing schemes. We have available and are further developing quality control, 
environmental monitoring and in-process analytical tools that can quantitatively measure the composition of spore, vegetative microbe and 
spore/vegetative combinations, which we believe enable a wide variety of drug products to be manufactured. Throughout the bioprocess and 
formulation development platform we use and will expand on quantitative analytics to assess the identity, potency and purity of the final 
product.

We currently have a 10,000 square foot cGMP manufacturing facility at our headquarters where we conduct cGMP manufacture of therapeutic 
candidates to support drug substance and drug product for early phase and small-scale clinical supplies and with the ability to perform both drug substance 
and drug product manufacturing for early and late-phase clinical development and at larger scales of operation. We may establish further manufacturing 
facilities that will serve late-phase clinical and commercial supply for our product candidates. We may do this by expanding our current facilities, or by 
purchasing or building additional facilities. We also use contract manufacturing and testing organizations to supplement our internal capacity. 

Collaboration and Manufacturing Agreements

Collaboration and License Agreement with Société des Produits Nestlé S.A. (Nestlé)

Material Agreements

In January 2016, we entered into the Collaboration and License Agreement, or the 2016 License Agreement, with Nestec, Ltd., as succeeded by 

Société des Produits Nestlé S.A., or, together with NHSc Pharma Partners, succeeded by NHSc Rx License GmbH, their affiliates, and their subsidiaries, 
Nestlé, for the development and commercialization of certain of our product candidates in development for the treatment and management of CDI and IBD, 
including UC and Crohn’s disease. The 2016 License Agreement will support the development of our portfolio of products for CDI and IBD in markets 
outside of the United States and Canada, or the 2016 Licensed Territory. 

License Agreement with NHSc Rx License GmbH (Nestlé)

In July 2021, we entered into a License Agreement, or the 2021 License Agreement, with NHSc Pharma Partners, succeeded by NHSc Rx License 

GmbH, or, together with Société des Produits Nestlé S.A., their affiliates and their subsidiaries, Nestlé. Pursuant to the 2021 License Agreement, we 
granted to Nestlé, under certain of our patent rights and know how, a co-exclusive, sublicensable (under certain circumstances) license to develop, 
commercialize and conduct medical affairs activities for (i) therapeutic products based on our microbiome technology (including our SER-109 product 
candidate) that are developed by us or on our behalf for the treatment of CDI and recurrent CDI, as well as any other indications pursued for the products 
upon mutual agreement of the parties, or the 2021 Field in the United States and Canada, or the 2021 Licensed Territory, and (ii) our SER-109 product 
candidate and any improvements and modifications thereto developed pursuant to the terms of the 2021 License Agreement, or the 2021 Collaboration 
Products, for any indications in the 2021 Licensed Territory. We are responsible for completing development of SER-109 in the 2021 Field in the United 
States until first regulatory approval for SER-109 is obtained. 

Long Term Manufacturing Agreement with Bacthera

In November 2021, we entered into a Long Term Manufacturing Agreement with BacThera AG, or Bacthera, a joint venture between Chr. Hansen 
and a Lonza Group affiliate, which was amended on December 14, 2022, or the Bacthera Agreement.  The Bacthera Agreement governs the general terms 
under which Bacthera, or one of its affiliates, will (i) construct a dedicated full-scale production suite for us at Bacthera’s Microbiome Center of Excellence 
in Visp, Switzerland, which is currently under construction; and (ii) provide manufacturing services to us for our SER-109 product and other products, as 
agreed to by both parties.

GenIbet Supply Agreement

In September 2015, we entered into a Supply Agreement, or the Supply Agreement, with GenIbet BioPharmaceuticals, SA (acquired by Recipharm 

in February 2022) to provide certain manufacturing and supply services to us for our product candidates for purposes of conducting clinical trials and 
supporting commercial supply. In March 2022, the term of the Supply Agreement was extended through June 30, 2023.

Indebtedness

Loan and Security Agreement with Hercules

In October 2019, we entered into a loan and security agreement with Hercules Capital, Inc., or Hercules, pursuant to which a term loan in an 
aggregate principal amount of up to $50.0 million, or the Original Credit Facility, was available to us in three tranches, subject to certain terms and 
conditions. We received the first tranche of $25.0 million upon signing the agreement on October 29, 2019, but did not borrow either of the second two 
tranches, which were available at different times upon Hercules’ approval until June 30, 2021.

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In April 2020, we entered into an amendment to the loan and security agreement with Hercules, or the First Amendment, permitting us to enter into 

a promissory note under the Paycheck Protection Program of the Coronavirus Aid, Relief and Economic Stability Act. 

In February 2022, we entered into a Second Amendment to the Original Credit Facility (as amended by the First Amendment), or the New Credit 

Facility, pursuant to which, term loans in an aggregate principal amount of up to $100.0 million have become available to us in five tranches subject to 
certain terms and conditions: (i) the first tranche in an aggregate principal amount of $25.0 million that was outstanding as of the February 24, 2022 
effective date, or the Effective Date, (ii) the second tranche in an aggregate principal amount of $12.5 million that has been advanced to us and was 
outstanding as of the Effective Date, (iii) the third tranche in an aggregate principal amount of $12.5 million that has been advanced to us and was 
outstanding as of the Effective Date, (iv) the fourth tranche in an aggregate principal amount of $25.0 million that is available upon satisfaction of certain 
conditions, including the approval by the FDA of a biologics license application in respect of SER-109, or the Regulatory Approval Milestone, by no later 
than December 15, 2023, and (v) the fifth tranche in an aggregate principal amount of up to $25.0 million that is available through the amortization date 
upon satisfaction of certain conditions, including the lenders’ investment committee approval. 

For a further description of our material agreements, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations 

– Liquidity and Capital Resources" in Part II, Item 7 of this Annual Report on Form 10-K.

Intellectual Property

We strive to protect the proprietary technology that is important to our business, including seeking and, if granted, maintaining patents intended to 

cover our product candidates and compositions, their methods of use and processes for their manufacture and any other aspects of inventions that are 
commercially important to the development of our business. We also utilize regulatory exclusivity as well as trade secrets to protect aspects of our business.

We plan to continue to expand our intellectual property estate by filing patent applications directed to compositions, methods of treatment, methods 

of manufacture and methods for patient selection created or identified from our ongoing development of our product candidates. Our success will depend 
on our ability to obtain and maintain patent and other proprietary protection for commercially important technology, inventions and know-how related to 
our business, defend and enforce any patents that we may obtain, preserve the confidentiality of our trade secrets and operate without infringing the valid 
and enforceable patents and proprietary rights of third parties. We also rely on know-how and continuing technological innovation to develop and maintain 
our proprietary position and, in the future, may rely on or leverage in-licensing opportunities. We seek to obtain domestic and international patent 
protection, and endeavor to promptly file patent applications for new commercially valuable inventions.

The patent positions of biopharmaceutical companies like us are generally uncertain and involve complex legal, scientific and factual questions. In 
addition, the coverage claimed in a patent may be challenged in courts after issuance. Moreover, many jurisdictions permit third parties to challenge issued 
patents in administrative proceedings, which may result in further narrowing or even cancellation of patent claims. We cannot predict whether the patent 
applications we are currently pursuing will issue as patents in any particular jurisdiction or at all, whether the claims of any patent applications, should they 
issue, will cover our product candidates, or whether the claims of any issued patents will provide sufficient protection from competitors or otherwise 
provide any competitive advantage.

Because patent applications in the United States and certain other jurisdictions are maintained in secrecy for 18 months or potentially even longer, 
and because publication of discoveries in the scientific or patent literature often lags behind actual discoveries and patent application filings, we cannot be 
certain of the priority of inventions covered by pending patent applications. Accordingly, we may not have been the first to invent the subject matter 
disclosed in some of our patent applications or the first to file patent applications covering such subject matter, and we may have to participate in 
interference proceedings or derivation proceedings declared by the United States Patent and Trademark Office, or USPTO, to determine priority of 
invention.

Our patent portfolio includes issued U.S. patents and patent applications in various stages of prosecution, including ex-U.S. international 

counterparts. We believe that issued claims will provide protection for our microbiome therapeutic candidates.

Patent Term

The base term of a U.S. patent is 20 years from the filing date of the earliest-filed non-provisional, patent application from which the patent claims 

priority. The term of a U.S. patent can be lengthened by patent term adjustment, which compensates the owner of the patent for administrative delays at the 
USPTO. In some cases, the term of a U.S. patent is shortened by terminal disclaimer that reduces its term to that of an earlier-expiring patent.

The term of a U.S. patent may be eligible for patent term extension under the Drug Price Competition and Patent Term Restoration Act of 1984, 

referred to as the Hatch-Waxman Act, to account for at least some of the time the drug is under development and regulatory review after the patent is 
granted. With regard to a drug for which FDA approval is the first permitted marketing of the active ingredient, the Hatch-Waxman Act allows for 
extension of the term of one U.S. patent that includes at least one claim covering the composition of matter of such an FDA-approved drug, an FDA- 
approved method of treatment using the drug and/or a method of manufacturing the FDA-approved drug. The extended patent term cannot exceed the 
shorter of five years beyond the non-extended 

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expiration of the patent or fourteen years from the date of the FDA approval of the drug, and a patent cannot be extended more than once or for more than a 
single product. During the period of extension, if granted, the scope of exclusivity is limited to the approved product for approved uses. Some foreign 
jurisdictions, including Europe and Japan, have analogous patent term extension provisions, which allow for extension of the term of a patent that covers a 
drug approved by the applicable foreign regulatory agency. In the future, if and when our product candidates receive FDA approval, we expect to apply, if 
appropriate, for patent term extension on patents covering those product candidates, their methods of use and/or methods of manufacture.

Trade Secrets

In addition to patents, we rely on trade secrets and know-how to develop and maintain our competitive position. We typically utilize trade secrets to 

protect aspects of our business. We protect trade secrets and know-how by establishing confidentiality agreements and invention assignment agreements 
with our employees, consultants, scientific advisors, contractors and collaborators. These agreements provide that all confidential information developed or 
made known during the course of an individual or entities’ relationship with us must be kept confidential during and after the relationship. These 
agreements also provide that all inventions resulting from work performed for us or relating to our business and conceived or completed during the period 
of employment or assignment, as applicable, shall be our exclusive property. In addition, we take other appropriate precautions, such as physical and 
technological security measures, to guard against misappropriation of our proprietary information by third parties.

Competition

The development and commercialization of new drug and biologic products is highly competitive and is characterized by rapid and substantial 

technological development and product innovations. We face competition with respect to our current product candidates and will face competition with 
respect to any product candidates that we may seek to develop or commercialize in the future from major pharmaceutical companies, specialty 
pharmaceutical companies and biotechnology companies worldwide. We are aware of a number of large pharmaceutical and biotechnology companies, as 
well as smaller, early-stage companies, that are pursuing the development of products, including microbiome therapeutics, and disease indications we are 
targeting. Potential competitors also include academic institutions, government agencies and other public and private research organizations that conduct 
research, seek patent protection and establish collaborative arrangements for research, development, manufacturing and commercialization.

Many of the companies against which we are competing or against which we may compete in the future have significantly greater financial 

resources, established presence in the market and expertise in research and development, manufacturing, preclinical testing, conducting clinical trials, 
obtaining regulatory approvals and marketing approved products than we do. Mergers and acquisitions in the pharmaceutical and biotechnology industries 
may result in even more resources being concentrated among a smaller number of our competitors.

These third parties compete with us in recruiting and retaining qualified scientific, clinical, manufacturing sales and marketing and management 

personnel, establishing clinical trial sites and patient registration for clinical trials, as well as in acquiring technologies complementary to, or necessary for, 
our programs.

The key competitive factors affecting the success of the product candidates that we develop, if approved, are likely to be their efficacy, safety, 

convenience, price, the level of competition and the availability of reimbursement from government and other third-party payors.

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

fewer or less severe side effects, are more convenient or are less expensive than any products that we may develop. Our competitors also may obtain FDA 
or other regulatory approval for their products more rapidly than we may obtain approval for ours, which could result in our competitors establishing a 
strong market position before we are able to enter the market, especially for any competitor developing a microbiome therapeutic which will likely share 
our same regulatory approval requirements. In addition, our ability to compete may be affected in many cases by insurers or other third-party payors 
seeking to encourage the use of lower cost products.

Government Regulation

The FDA and other regulatory authorities at federal, state and local levels, as well as in foreign countries, extensively regulate, among other things, 

the research, development, testing, manufacture, quality control, import, export, safety, effectiveness, labeling, packaging, storage, distribution, record 
keeping, approval, advertising, promotion, marketing, post-approval monitoring and post-approval reporting of drugs and biologics such as those we are 
developing. We, along with our contract manufacturers, will be required to navigate the various preclinical, clinical and commercial approval requirements 
of the governing regulatory authorities of the countries in which we wish to conduct studies or seek approval for our product candidates. The process of 
obtaining regulatory approvals and ensuring subsequent compliance with appropriate federal, state, local and foreign statutes and regulations requires the 
expenditure of substantial time and financial resources.

In the United States, the FDA regulates drug and biologic products under the Federal Food, Drug and Cosmetic Act, its implementing regulations 

and other laws, including, in the case of biologics, the Public Health Service Act. Our product candidates 

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are subject to regulation by the FDA as biologics. Biologics require the submission of a BLA and approval by the FDA before being marketed in the United 
States. 

The process required by the FDA before our biologic product candidates may be marketed in the United States generally involves the following:

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completion of preclinical laboratory tests and animal studies performed in accordance with the FDA’s good laboratory practice, or GLP, 
regulations;

submission to the FDA of an IND, which must become effective before clinical trials in the United States may begin;

approval by an institutional review board, or IRB, or ethics committee at each clinical site before a trial is commenced;

performance of adequate and well-controlled human clinical trials to establish the safety, purity and potency of the product candidate for each 
proposed indication, conducted in accordance with the FDA’s good clinical practice, or GCP, regulations;

preparation and submission to the FDA of a BLA after completion of all pivotal trials;

satisfactory completion of an FDA Advisory Committee review, if applicable;

determination by the FDA within 60 days of its receipt of a BLA to file the application for review; 

satisfactory completion of an FDA inspection of the manufacturing facility or facilities at which the product is produced to assess compliance 
with cGMP regulations, and to assure that the facilities, methods and controls are adequate to preserve the biological product’s continued 
safety, purity and potency, and of selected clinical investigation sites to assess compliance with GCPs; and

FDA review and approval of the BLA prior to any commercial marketing, sale or shipment of the product.

The testing and approval process requires substantial time, effort and financial resources, and we cannot be certain that any approvals for our 

product candidates will be granted on a timely basis, if at all.

Preclinical and Clinical Trials

Once a product candidate is identified for development, it enters the preclinical testing stage. Preclinical studies include laboratory evaluations of 

drug chemistry, formulation and stability, as well as studies to evaluate toxicity in animals, which must be conducted in accordance with GLP requirements. 
The results of the preclinical studies, together with manufacturing information and analytical data, are submitted to the FDA as part of an IND. An IND is a 
request for authorization from the FDA to administer an investigational new drug to humans. An IND must become effective before human clinical trials 
may begin. The IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA, within the 30-day time period, raises concerns or 
questions about the conduct of the clinical trial, including concerns that human research subjects will be exposed to unreasonable health risks. In such a 
case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical trial can begin. Submission of an IND may result in the FDA 
not allowing clinical trials to commence or not allowing clinical trials to commence on the terms originally specified in the IND. A separate submission to 
an existing IND must also be made for each successive clinical trial conducted during product development, and the FDA must grant permission, either 
explicitly or implicitly by not objecting, before each clinical trial can begin.

Clinical trials involve the administration of the product candidate to human subjects under the supervision of qualified investigators in accordance 

with GCPs, which include the requirement that all research subjects provide their informed consent for their participation in any clinical study. Clinical 
trials are conducted under protocols detailing, among other things, the objectives of the clinical trial and the parameters and criteria to be used in 
monitoring safety and evaluating effectiveness. Each protocol must be submitted to the FDA as part of the IND. While the IND is active, progress reports 
summarizing the results of the clinical trials and nonclinical studies performed since the last progress report, among other information, must be submitted at 
least annually to the FDA, and written IND safety reports must be submitted to the FDA and investigators for serious and unexpected suspected adverse 
events, findings from other studies suggesting a significant risk to humans exposed to the drug, findings from animal or in vitro testing suggesting a 
significant risk to humans exposed to the drug, and any clinically important increased rate of a serious suspected adverse reaction compared to that listed in 
the protocol or investigator brochure.

An independent institutional review board, or IRB, for each investigator site proposing to participate in a clinical trial must also review and approve 

the clinical trial before it can begin at that site, and the IRB must monitor the clinical trial until it is completed. Some studies also include oversight by an 
independent group of qualified experts organized by the clinical study sponsor, known as a data safety monitoring board, which provides authorization for 
whether or not a study may move forward at designated check points based on access to certain data from the study and may halt the clinical trial if it 
determines that there is an unacceptable safety risk for subjects or other grounds, such as no demonstration of efficacy. The FDA, the IRB, or the sponsor 
may suspend or discontinue a clinical trial at any time on various grounds, including a finding that the subjects are being exposed to an unacceptable health 
risk. There are also requirements governing the reporting of ongoing clinical studies and clinical study results to public registries.

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For purposes of BLA approval, clinical trials are typically conducted in three sequential phases, which may overlap or be combined.

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Phase 1 — The investigational product is initially introduced into healthy human subjects or patients with the target disease or condition. 
These studies are typically designed to test the safety, dosage tolerance, absorption, metabolism and distribution of the investigational 
product in humans, the side effects associated with increasing doses, and, if possible, to gain early evidence on effectiveness.

Phase 2 — The investigational product is typically administered to a limited patient population with a specified disease or condition to 
evaluate the preliminary efficacy, optimal dosages and dosing schedule and to identify possible adverse side effects and safety risks.

Phase 3 — The investigational product is administered to an expanded patient population to further evaluate dosage, to provide statistically 
significant evidence of clinical efficacy and to further test for safety, generally at multiple geographically dispersed clinical trial sites. These 
clinical trials are intended to establish the overall risk/benefit ratio of the investigational product and to provide an adequate basis for product 
approval.

In some cases, the FDA may condition approval of a BLA on the sponsor’s agreement to conduct additional clinical trials to further assess the 

biologic’s safety and effectiveness after BLA approval. Such post-approval clinical trials are typically referred to as Phase 4 clinical trials.

Concurrent with clinical trials, companies usually complete additional animal studies and must also develop additional information about the 

chemistry and physical characteristics of the biologic and finalize a process for manufacturing the biologic in commercial quantities in accordance with 
cGMP requirements. The manufacturing process must be capable of consistently producing quality batches of the product candidate and manufacturers 
must develop, among other things, methods for testing the identity, strength, quality and purity of the final biological product. Additionally, appropriate 
packaging must be selected and tested, and stability studies must be conducted to demonstrate that the product candidate does not undergo unacceptable 
deterioration over its shelf life.

BLA Submission and FDA Review

The results of preclinical studies and clinical trials, together with other detailed information, including extensive manufacturing information and 

information on the composition of the biologic, are submitted to the FDA in the form of a BLA requesting approval to market the biologic for one or more 
specified indications. The BLA must include all relevant data available from preclinical and clinical studies, including negative or ambiguous results as 
well as positive findings, together with detailed information relating to the product’s chemistry, manufacturing, controls, and proposed labeling, among 
other things. Data can come from company-sponsored clinical studies intended to test the safety and effectiveness of a use of the product, or from a number 
of alternative sources, including studies initiated by independent investigators. The submission of a BLA requires payment of a substantial user fee unless a 
waiver is granted or exemption applies.

Each BLA submitted to the FDA is reviewed for administrative completeness and reviewability within 60 days of the FDA’s receipt of the 
application. If the BLA is found to be complete, the FDA will file the BLA, triggering a full review of the application. The FDA may refuse to file any 
BLA that it deems incomplete or not properly reviewable at the time of submission. In this event, the BLA must be resubmitted with the additional 
information.

Once a BLA has been accepted for review, the FDA’s goal is to review standard applications within ten months after the filing date, or, if the 
application qualifies for Priority Review, six months after the FDA accepts the application for filing, but the overall timeframe is often extended by FDA 
requests for additional information or clarification. The FDA reviews a BLA to determine, among other things, whether the biological product is safe, pure 
and potent and whether the facility or facilities in which it is manufactured meet standards designed to assure the product’s continued safety, purity and 
potency. The FDA may also refer the application to an Advisory Committee for review, evaluation, and recommendation as to whether the application 
should be approved. The FDA is not bound by the recommendation of an advisory committee, but it generally follows such recommendations. 

Before approving a BLA, the FDA will inspect the facility or the facilities at which the biologic product is manufactured and will not approve the 
product unless it determines that the manufacturing processes and facilities are in compliance with cGMP and adequate to assure consistent production of 
the product within required specifications. Additionally, before approving a BLA, the FDA may inspect one or more clinical sites to assure that such trials 
were conducted in compliance with GCP. If the FDA determines that the application, manufacturing process or manufacturing facilities are not acceptable, 
it will outline the deficiencies in the submission and often will request additional testing or information. Notwithstanding the submission of any requested 
additional information, the FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.

After the FDA evaluates a BLA and conducts inspections of manufacturing facilities where the investigational product and/or its drug substance will 

be produced, the FDA may issue an approval letter or a Complete Response Letter, or CRL. An approval letter authorizes commercial marketing of the 
product with specific prescribing information for specific indications. A CRL will describe all of the deficiencies that the FDA has identified in the BLA, 
except that where the FDA determines that the data supporting the 

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application are inadequate to support approval, the FDA may issue the CRL without first conducting required inspections, testing submitted product lots, 
and/or reviewing proposed labeling. In issuing the CRL, the FDA may recommend actions that the applicant might take to place the BLA in condition for 
approval, including requests for additional information or clarification. The FDA may delay or refuse approval of a BLA if applicable regulatory criteria 
are not satisfied, require additional testing or information, and/or require post-marketing testing and surveillance to monitor safety or efficacy of a product.

If regulatory approval of a product is granted, such approval will be granted for particular indications and may entail limitations on the indicated 

uses for which such product may be marketed. For example, the FDA may approve the BLA with a Risk Evaluation and Mitigation Strategy, or REMS, to 
ensure the benefits of the product outweigh its risks. A REMS is a safety strategy implemented to manage a known or potential serious risk associated with 
a product and to enable patients to have continued access to such medicines by managing their safe use, and could include medication guides, physician 
communication plans, or elements to assure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. The FDA 
also may condition approval on, among other things, changes to proposed labeling or the development of adequate controls and specifications. Once 
approved, the FDA may withdraw the product approval if compliance with pre- and post-marketing requirements is not maintained or if problems occur 
after the product reaches the marketplace. The FDA may require one or more Phase 4 post-market studies and surveillance to further assess and monitor the 
product’s safety and effectiveness after commercialization and may limit further marketing of the product based on the results of these post-marketing 
studies.

Expedited Development and Review Programs

The FDA maintains several programs intended to facilitate and expedite development and review of new biologics designed to address unmet 
medical needs in the treatment of serious or life- threatening diseases or conditions. These programs include Fast Track designation, Breakthrough Therapy 
designation, Priority Review designation and Accelerated Approval, and the purpose of these programs is to expedite the development and review of 
qualifying product candidates. 

A biologic is eligible for Fast Track designation if it is intended to treat a serious or life- threatening disease or condition and demonstrates the 
potential to address unmet medical needs for such disease or condition. Fast Track designation provides increased opportunities for sponsor meetings with 
the FDA during preclinical and clinical development, in addition to the potential for rolling review, meaning that the agency may review portions of the 
marketing application before the sponsor submits the complete application, if the sponsor provides a schedule for the submission of the sections of the 
BLA, the FDA agrees to accept sections of the BLA and determines that the schedule is acceptable, and the sponsor pays any required user fees upon 
submission of the first section of the BLA. Product candidates receiving Fast Track status may also be eligible for Priority Review, if the relevant criteria 
are met.

In addition, a biologic product candidate may be eligible for Breakthrough Therapy designation if it is intended to treat a serious or life-threatening 

disease or condition and preliminary clinical evidence indicates that the product candidate may demonstrate substantial improvement over existing 
therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. Breakthrough 
Therapy designation provides all the features of Fast Track designation in addition to intensive guidance on an efficient development program beginning as 
early as Phase 1, and FDA organizational commitment to expedited development, including involvement of senior managers and experienced review staff 
in a cross-disciplinary review, where appropriate.

Any product candidate submitted to the FDA for approval, including a product candidate with Fast Track or Breakthrough Therapy designation, may 

also be eligible for additional FDA programs intended to expedite the review process, including Priority Review designation and accelerated approval. A 
BLA is eligible for Priority Review if the product candidate has the potential to provide a significant improvement in safety or effectiveness in the 
treatment, diagnosis or prevention of a serious disease or condition. Additionally, product candidates are eligible for accelerated approval if they can be 
shown to have an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit, or an effect on a clinical endpoint that can be measured 
earlier than an effect on irreversible morbidity or mortality which is reasonably likely to predict an effect on irreversible morbidity or mortality or other 
clinical benefit, taking into account the severity, rarity, or prevalence of the condition and the availability or lack of alternative treatments. Accelerated 
approval is usually contingent on a sponsor’s agreement to conduct confirmatory studies to verify and describe the product’s clinical benefit. Products 
receiving accelerated approval may be subject to expedited withdrawal procedures if the sponsor fails to conduct the required confirmatory studies in a 
timely manner or if such studies fail to verify the predicted clinical benefit. In addition, the FDA currently requires as a condition for accelerated approval 
pre-approval of promotional materials, which could adversely impact the timing of the commercial launch of the product. 

Fast Track designation, Breakthrough Therapy designation, Priority Review designation and Accelerated Approval do not change the standards for 

approval but may expedite the development or review process. 

Post-Approval Requirements

Approved biologics that are manufactured or distributed in the United States are subject to pervasive and continuing regulation by the FDA, 
including, among other things, requirements relating to recordkeeping, periodic reporting, product distribution, advertising and promotion and reporting of 
adverse experiences with the product. There also are continuing, annual user fee requirements for products marketed pursuant to approved applications.

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Any biologics manufactured or distributed pursuant to FDA approvals remain subject to continuing regulation by the FDA, including recordkeeping 

requirements and reporting of adverse experiences associated with the product. Manufacturers and their subcontractors are required to register their 
establishments with the FDA and certain state agencies and are subject to periodic unannounced inspections by the FDA and certain state agencies for 
compliance with ongoing regulatory requirements, including cGMP, which impose certain procedural and documentation requirements upon manufacturers 
and contract manufacturers. Changes to the manufacturing process are strictly regulated, and, depending on the significance of the change, may require 
prior FDA approval before being implemented. FDA regulations also require investigation and correction of any deviations from cGMP and impose 
reporting requirements. Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality control to 
maintain compliance with cGMP and other aspects of regulatory compliance.

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

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

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

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

refusal of the FDA to approve pending applications or supplements to approved applications, or suspension or revocation of product 
approvals;

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

consent decrees, corporate integrity agreements, debarment or exclusion from federal healthcare programs;

mandated modification of promotional materials and labeling and the issuance of corrective information;

the issuance of safety alerts, Dear Healthcare Provider letters, press releases and other communications containing warnings or other safety 
information about the product; or

injunctions or the imposition of civil or criminal penalties.

The FDA closely regulates the post-approval marketing and promotion of biologics, including standards and regulations for direct-to-consumer 
advertising, off-label promotion, industry-sponsored scientific and educational activities, and promotional activities involving the internet and social media. 
A company can make only those claims relating to safety and efficacy that are approved by the FDA. Physicians may prescribe legally available biologics 
for uses that are not described in the product’s labeling and that differ from those tested by us and approved by the FDA. The FDA does not regulate the 
behavior of physicians in their choice of treatments. The FDA does, however, impose stringent restrictions on manufacturers’ communications regarding 
off-label use. Failure to comply with these requirements can result in adverse publicity, warning letters, corrective advertising and potential civil and 
criminal penalties.

Biosimilars and Regulatory Exclusivity

The Affordable Care Act, signed into law in 2010, includes a subtitle called the Biologics Price Competition and Innovation Act, or BPCIA, which 

created an abbreviated approval pathway for biological products that are biosimilar to or interchangeable with an FDA-licensed reference biological 
product. Biosimilarity, which requires that there be no clinically meaningful differences between the biological product and the reference product in terms 
of safety, purity, and potency, can be shown through analytical studies, animal studies, and a clinical study or studies. Interchangeability requires that a 
product is biosimilar to the reference product and the product must demonstrate that it can be expected to produce the same clinical results as the reference 
product in any given patient and, for products that are administered multiple times to an individual, the biologic and the reference biologic may be 
alternated or switched after one has been previously administered without increasing safety risks or risks of diminished efficacy relative to exclusive use of 
the reference biologic. 

Under the BPCIA, an application for a biosimilar product may not be submitted to the FDA until four years following the date that the reference 

product was first licensed by the FDA. In addition, the approval of a biosimilar product may not be made effective by the FDA until 12 years from the date 
on which the reference product was first licensed. During this 12-year period of exclusivity, another company may still market a competing version of the 
reference product if the FDA approves a full BLA for the competing product containing that applicant’s own preclinical data and data from adequate and 
well-controlled clinical trials to demonstrate the safety, purity and potency of its product. The BPCIA also created certain exclusivity periods for 
biosimilars approved as interchangeable products. At this juncture, it is unclear whether products deemed “interchangeable” by the FDA will, in fact, be 
readily substituted by pharmacies, which are governed by state pharmacy law.

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A biological product can also obtain pediatric market exclusivity in the United States. Pediatric exclusivity, if granted, adds six months to existing 

exclusivity periods and patent terms. This six-month exclusivity, which runs from the end of other exclusivity protection or patent term, may be granted 
based on the voluntary completion of a pediatric study in accordance with an FDA-issued “Written Request” for such a study.

Orphan Drug Designation

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

disease or condition that affects fewer than 200,000 individuals in the United States, or if it affects more than 200,000 individuals in the United States, there 
is no reasonable expectation that the cost of developing and making the product available in the United States for the disease or condition will be recovered 
from sales of the product. Orphan designation must be requested before submitting a BLA. Orphan designation does not convey any advantage in or 
shorten the duration of the regulatory review and approval process, though companies developing orphan products are eligible for certain incentives, 
including tax credits for qualified clinical testing and waiver of application fees.

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

the product is entitled to a seven-year period of marketing exclusivity during which the FDA may not approve any other applications to market the same 
therapeutic agent for the same indication, except in limited circumstances, such as a subsequent product’s showing of clinical superiority over the product 
with orphan exclusivity or where the original applicant cannot produce sufficient quantities of product. Competitors, however, may receive approval of 
different therapeutic agents for the indication for which the orphan product has exclusivity or obtain approval for the same therapeutic agent for a different 
indication than that for which the orphan product has exclusivity. Further, if a designated orphan product receives marketing approval for an indication 
broader than the rare disease or condition for which it received orphan designation, it may not be entitled to orphan exclusivity.

Government Regulation Outside of the United States

To market any product outside of the United States, we would need to comply with numerous and varying regulatory requirements of other countries 
regarding safety and efficacy and governing, among other things, clinical trials, marketing authorization, manufacturing, commercial sales and distribution 
of our products. Because biologically sourced raw materials are subject to unique contamination risks, their use may be restricted in some countries. 
Whether or not we obtain FDA approval of a product, we must obtain the requisite approvals from regulatory authorities in foreign countries prior to the 
commencement of clinical studies or marketing of the product in those countries. The requirements and process governing the conduct of clinical studies, 
product licensing, pricing and reimbursement vary from country to country. Failure to comply with applicable foreign regulatory requirements, may be 
subject to, among other things, fines, suspension or withdrawal of regulatory approvals, product recalls, seizure of products, operating restrictions and 
criminal prosecution.

Non-clinical studies and clinical trials

Similar to the United States, the various phases of non-clinical and clinical research in the EU are subject to significant regulatory controls.

Non-clinical studies are performed to demonstrate the health or environmental safety of new biological substances. Non-clinical studies must be 

conducted in compliance with the principles of good laboratory practice, or GLP, as set forth in EU Directive 2004/10/EC. In particular, non-clinical 
studies, both in vitro and in vivo, must be planned, performed, monitored, recorded, reported and archived in accordance with the GLP principles, which 
define a set of rules and criteria for a quality system for the organizational process and the conditions for non-clinical studies. These GLP standards reflect 
the Organization for Economic Co-operation and Development requirements.

Clinical trials of medicinal products in the EU must be conducted in accordance with EU and national regulations and the International Conference 
on Harmonization, or ICH, guidelines on Good Clinical Practices, or GCP, as well as the applicable regulatory requirements and the ethical principles that 
have their origin in the Declaration of Helsinki.  Additional GCP guidelines from the European Commission, focusing in particular on traceability, apply to 
clinical trials of advanced therapy medicinal products, or ATMPs. If the sponsor of the clinical trial is not established within the EU, it must appoint an EU 
entity to act as its legal representative. The sponsor must take out a clinical trial insurance policy, and in most EU member states, the sponsor is liable to 
provide ‘no fault’ compensation to any study subject injured in the clinical trial.

The regulatory landscape related to clinical trials in the EU has been subject to recent changes. The EU Clinical Trials Regulation, or CTR, which 

was adopted in April 2014 and repeals the EU Clinical Trials Directive, became applicable on January 31, 2022. Unlike directives, the CTR is directly 
applicable in all EU member states without the need for member states to further implement it into national law. The CTR notably harmonizes the 
assessment and supervision processes for clinical trials throughout the EU via a Clinical Trials Information System, which contains a centralized EU portal 
and database. 

While the Clinical Trials Directive required a separate clinical trial application, or CTA, to be submitted in each member state, to both the competent 
national health authority and an independent ethics committee, much like the FDA and IRB respectively, the CTR introduces a centralized process and only 
requires the submission of a single application to all member states concerned. The 

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CTR allows sponsors to make a single submission to both the competent authority and an ethics committee in each member state, leading to a single 
decision per member state. The CTA must include, among other things, a copy of the trial protocol and an investigational medicinal product dossier 
containing information about the manufacture and quality of the medicinal product under investigation. The assessment procedure of the CTA has been 
harmonized as well, including a joint assessment by all member states concerned, and a separate assessment by each member state with respect to specific 
requirements related to its own territory, including ethics rules. Each member state’s decision is communicated to the sponsor via the centralized EU portal. 
Once the CTA is approved, clinical study development may proceed. 

The CTR foresees a three-year transition period. The extent to which ongoing and new clinical trials will be governed by the CTR varies. Clinical 

trials for which an application was submitted (i) prior to January 31, 2022 under the Clinical Trials Directive, or (ii) between January 31, 2022 and January 
31, 2023 and for which the sponsor has opted for the application of the Clinical Trials Directive remain governed by said Directive until January 31, 2025. 
After this date, all clinical trials (including those which are ongoing) will become subject to the provisions of the CTR.  

Medicines used in clinical trials must be manufactured in accordance with Good Manufacturing Practice, or GMP. Other national and EU-wide 

regulatory requirements may also apply.

During the development of a medicinal product, the EMA and national regulators provide the opportunity for dialogue and guidance on the 
development program. At the EMA level, this is usually done in the form of scientific advice, which is given by the Scientific Advice Working Party of the 
Committee for Medicinal Products for Human Use, or CHMP. A fee is incurred with each scientific advice procedure. Advice from the EMA is typically 
provided based on questions concerning, for example, quality (chemistry, manufacturing and controls testing), nonclinical testing and clinical trials, and 
pharmacovigilance plans and risk-management programs. Advice is not legally binding with regard to any future marketing authorization application of the 
product concerned. 

Marketing Authorizations 

In the EU, medicinal products can only be placed on the market after obtaining a marketing authorization, or MA. To obtain regulatory approval of 

an investigational biological product in the EU, we must submit a marketing authorization application, or MAA. The process for doing this depends, among 
other things, on the nature of the medicinal product.

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Centralized procedure—Under the centralized procedure, following the opining of the EMA’s CHMP the European Commission issues a single MA 
valid throughout the EU. The centralized procedure is compulsory for certain types of products, such as (i) medicinal products derived from biotechnology 
processes, such as genetic engineering, (ii) designated orphan medicinal products, (iii) advanced therapy medicinal products, or ATMPs, such as gene 
therapy, somatic cell therapy and tissue engineered products, and (iv) medicinal products that contain a new active substance indicated for the treatment of 
certain diseases, such as HIV/AIDS, cancer, neurodegenerative diseases, diabetes, autoimmune diseases and other immune dysfunctions, and viral diseases. 
The centralized procedure is optional for any products containing a new active substance not yet authorized in the EU, or for products that constitute a 
significant therapeutic, scientific or technical innovation or for which the granting of a MA would be in the interest of public health in the EU.

Under the centralized procedure the maximum timeframe for the evaluation of an MAA by the EMA's CHMP is 210 days, excluding clock stops, 

when additional written or oral information is to be provided by the applicant in response to questions asked by the CHMP. At the end of the review period, 
the CHMP provides an opinion to the European Commission. If this opinion is favorable, the Commission may then adopt a decision to grant an MA. In 
exceptional cases, the CHMP might perform an accelerated review of a MAA in no more than 150 days (excluding clock stops), when a medicinal product 
targets an unmet medical need and is expected to be of a major public health interest, particularly from the point of view of therapeutic innovation. The 
timeframe for the evaluation of an MAA under the accelerated assessment procedure is 150 days, excluding clock stops.  

Innovative products that target an unmet medical need and are expected to be of major public health interest may be eligible for a number of 
expedited development and review programs, such as the PRIME scheme, which provides incentives similar to the breakthrough therapy designation in the 
U.S. In March 2016, the EMA launched an initiative, the Priority Medicines, or PRIME, scheme, a voluntary scheme aimed at enhancing the EMA’s 
support for the development of medicines that target unmet medical needs. It is based on increased interaction and early dialogue with companies 
developing promising medicines, to optimize their product development plans and speed up their evaluation to help them reach patients earlier. Product 
developers that benefit from PRIME designation can expect to be eligible for accelerated assessment but this is not guaranteed. Many benefits accrue to 
sponsors of product candidates with PRIME designation, including but not limited to, early and proactive regulatory dialogue with the EMA, frequent 
discussions on clinical trial designs and other development program elements, and accelerated MAA assessment once a dossier has been submitted. 
Importantly, a dedicated contact and rapporteur from the CHMP is appointed early in the PRIME scheme facilitating increased understanding of the 
product at EMA’s committee level. An initial meeting initiates these relationships and includes a team of multidisciplinary experts at the EMA to provide 
guidance on the overall development and regulatory strategies.

National authorization procedures—There are also two other possible routes to authorize medicinal products in several member states, which are 

available for products that fall outside the scope of the centralized procedure:

•

•

Decentralized procedure. Using the decentralized procedure, an applicant may apply for simultaneous authorizations in more than one EU 
member states of medicinal products that have not yet been authorized in any EU member states and that do not fall within the mandatory 
scope of the centralized procedure. Under the decentralized procedure an identical dossier is submitted to the national competent authority of 
each of the member states in which the MA is sought, one of which is selected by the applicant as the reference member state. National MAs 
are issued by competent authorities of the EU member states for their respective territory.

Mutual recognition procedure. In the mutual recognition procedure, a medicine is first authorized in one EU member state, in accordance 
with the national procedures of that member state. Following this, further MAs can be sought from other EU member states in a procedure 
whereby the countries concerned recognize the validity of the original national MA.

MAs have an initial duration of five years. After these five years, the authorization may be renewed on the basis of a reevaluation of the risk-benefit 
balance. Once renewed, the MA is valid for an unlimited period unless the European Commission or the national competent authority decides, on justified 
grounds relating to pharmacovigilance, to proceed with one additional five-year renewal.

Data and Marketing Exclusivity

In the EU, upon receiving a MA, reference medicinal products generally receive eight years of data exclusivity and an additional two years of 

market exclusivity. If granted, data exclusivity period prevents generic or biosimilar applicants from relying on the preclinical and clinical trial data 
contained in the dossier of the reference product when applying for a generic or biosimilar MA in the EU during a period of eight years from the date on 
which the reference product was first authorized in the EU. During the additional two-year period of the market exclusivity period a generic or biosimilar 
MA can be submitted, and the innovator’s data may be referenced but no generic or biosimilar can be marketed in the EU until ten years have elapsed from 
the initial authorization of the reference product in the EU. The overall ten-year market exclusivity period can be extended to a maximum of eleven years 
if, during the first eight years of those ten years, the MA holder obtains an authorization for one or more new therapeutic indications which, during the 
scientific evaluation prior to their authorization, are held to bring a significant clinical benefit in comparison with existing therapies. However, there is no 
guarantee that a product will be considered by the EU’s regulatory authorities to be a new chemical entity, and products may not qualify for data 
exclusivity.

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There is a special regime for biosimilars, or biological medicinal products that are similar to a reference medicinal product but that do not meet the 
definition of a generic medicinal product, for example, because of differences in raw materials or manufacturing processes.  For such products, the results 
of appropriate preclinical or clinical trials must be provided, and guidelines from the EMA detail the type of quantity of supplementary data to be provided 
for different types of biological product. There are no such guidelines for complex biological products, such as gene or cell therapy medicinal products, and 
so it is unlikely that biosimilars of those products will currently be approved in the EU. However, guidance from the EMA states that they will be 
considered in the future in light of the scientific knowledge and regulatory experience gained at the time.

Orphan Medicinal Products

The criteria for designating an “orphan medicinal product” in the EU are similar in principle to those in the United States. A medicinal product may 

be designated as orphan if (1) it is intended for the diagnosis, prevention or treatment of a life-threatening or chronically debilitating condition; (2) either 
(a) such condition affects no more than five in 10,000 persons in the EU when the application is made, or (b) the product, without the benefits derived from 
orphan status, would not generate sufficient return in the EU to justify investment; and (3) there exists no satisfactory method of diagnosis, prevention or 
treatment of such condition authorized for marketing in the EU, or if such a method exists, the product will be of significant benefit to those affected by the 
condition. The application for orphan drug designation must be submitted before the MAA. Orphan medicinal products are eligible for financial incentives 
such as reduction of fees or fee waivers and are, upon grant of a MA, entitled to ten years of market exclusivity for the approved therapeutic indication. 
During this ten-year orphan market exclusivity period, the competent authorities cannot accept another MAA, or grant a MA, or accept an application to 
extend a MA for a similar product for the same indication. The period of market exclusivity is extended by two years for orphan medicinal products that 
have also complied with an agreed pediatric investigation plan, or PIP. No extension to any supplementary protection certificate can be granted on the basis 
of pediatric studies for orphan indications. Orphan drug designation does not convey any advantage in, or shorten the duration of, the regulatory review and 
approval process.

The ten-year market exclusivity may be reduced to six years if, at the end of the fifth year, it is established that the product no longer meets the 

criteria for orphan designation, for example, if the product is sufficiently profitable not to justify maintenance of market exclusivity. Additionally, a MA 
may be granted to a similar product for the same indication at any time if (i) the second applicant can establish that its product, although similar, is safer, 
more effective or otherwise clinically superior; (ii) the applicant consents to a second orphan medicinal product application; or (iii) the applicant cannot 
supply enough orphan medicinal product.

Pediatric Development

In the EU, MAAs for new medicinal products have to include the results of trials conducted in the pediatric population, in compliance with a 
pediatric investigation plan, or PIP, agreed with the EMA’s Pediatric Committee, or PDCO. The PIP sets out the timing and measures proposed to generate 
data to support a pediatric indication of the drug for which an MA is being sought. The PDCO can grant a deferral of the obligation to implement some or 
all of the measures of the PIP until there are sufficient data to demonstrate the efficacy and safety of the product in adults. Further, the obligation to provide 
pediatric clinical trial data can be waived by the PDCO when these data are not needed or appropriate because the product is likely to be ineffective or 
unsafe in children, the disease or condition for which the product is intended occurs only in adult populations, or when the product does not represent a 
significant therapeutic benefit over existing treatments for pediatric patients. Once the MA is obtained in all member states and study results are included in 
the product information, even when negative, the product is eligible for a six-months supplementary protection certificate extension (if any is in effect at 
the time of approval) or, in the case of orphan pharmaceutical products, a two year extension of the orphan market exclusivity is granted.

Post-Approval Requirements

Similar to the United States, both MA holders and manufacturers of medicinal products are subject to comprehensive regulatory oversight by the 

EMA, the European Commission and/or the competent regulatory authorities of the member states. The holder of a MA must establish and maintain a 
pharmacovigilance system and appoint an individual qualified person for pharmacovigilance who is responsible for oversight of that system. Key 
obligations include expedited reporting of suspected serious adverse reactions and submission of periodic safety update reports, or PSURs.

All new MAAs must include a risk management plan, or RMP, describing the risk management system that the company will put in place and 

documenting measures to prevent or minimize the risks associated with the product. The regulatory authorities may also impose specific obligations as a 
condition of the MA. Such risk-minimization measures or post-authorization obligations may include additional safety monitoring, more frequent 
submission of PSURs, or the conduct of additional clinical trials or post-authorization safety studies.  

The advertising and promotion of medicinal products is also subject to laws concerning promotion of medicinal products, interactions with 
physicians, misleading and comparative advertising and unfair commercial practices. All advertising and promotional activities for the product must be 
consistent with the approved summary of product characteristics, and therefore all off-label promotion is prohibited. Direct-to-consumer advertising of 
prescription medicines is also prohibited in the EU. Although general 

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requirements for advertising and promotion of medicinal products are established under EU directives, the details are governed by regulations in each 
member state and can differ from one country to another. 

Failure to comply with EU and member state laws that apply to the conduct of clinical trials, manufacturing approval, MA of medicinal products 

and marketing of such products, both before and after grant of the MA, manufacturing of pharmaceutical products, statutory health insurance, bribery and 
anti-corruption or with other applicable regulatory requirements may result in administrative, civil or criminal penalties. These penalties could include 
delays or refusal to authorize the conduct of clinical trials, or to grant MA, product withdrawals and recalls, product seizures, suspension, withdrawal or 
variation of the MA, total or partial suspension of production, distribution, manufacturing or clinical trials, operating restrictions, injunctions, suspension of 
licenses, fines and criminal penalties.

The aforementioned EU rules are generally applicable in the European Economic Area, or EEA (comprised of the 27 EU member states plus 

Iceland, Liechtenstein and Norway).

Brexit and the Regulatory Framework in the United Kingdom

Since the end of the Brexit transition period on January 1, 2021, Great Britain (England, Scotland and Wales) has not been directly subject to EU 

laws, however under the terms of the Ireland/Northern Ireland Protocol, EU laws generally apply to Northern Ireland. The EU laws that have been 
transposed into United Kingdom, or UK, law through secondary legislation remain applicable in Great Britain. However, under the Retained EU Law 
(Revocation and Reform) Bill 2022, which is currently before the UK parliament, any retained EU law not expressly preserved and “assimilated” into 
domestic law or extended by ministerial regulations (to no later than June 23, 2026) will automatically expire and be revoked by December 31, 2023. New 
legislation such as the EU CTR or in relation to orphan medicines will not be applicable in Great Britain. The UK government has passed a new Medicines 
and Medical Devices Act 2021, which introduces delegated powers in favor of the Secretary of State or an ‘appropriate authority’ to amend or supplement 
existing regulations in the area of medicinal products and medical devices. This allows new rules to be introduced in the future by way of secondary 
legislation, which aims to allow flexibility in addressing regulatory gaps and future changes in the fields of human medicines, clinical trials and medical 
devices.

As of January 1, 2021, the Medicines and Healthcare products Regulatory Agency, or MHRA, is the UK’s standalone medicines and medical 
devices regulator. Whilst Northern Ireland will continue to follow the EU regulatory regime, but its national competent authority will remain the MHRA. 

The MHRA has introduced changes to national licensing procedures, including procedures to prioritize access to new medicines that will benefit 

patients, including a 150-day assessment and a rolling review procedure. All existing EU MAs for centrally authorized products were automatically 
converted or grandfathered into UK MAs, effective in GB (only), free of charge on January 1, 2021, unless the MA holder chooses to opt-out. After Brexit, 
companies established in the UK cannot use the centralized procedure and instead must follow one of the UK national authorization procedures or one of 
the remaining post-Brexit international cooperation procedures to obtain an MA to commercialize products in the UK. The MHRA may rely on a decision 
taken by the European Commission on the approval of a new (centralized procedure) MA when determining an application for a GB authorization; or use 
the MHRA’s decentralized or mutual recognition procedures which enable MAs approved in EU member states (or Iceland, Liechtenstein, Norway) to be 
granted in GB.

Other Healthcare Laws

In addition to FDA restrictions on marketing of pharmaceutical and biological products, other healthcare regulatory laws restrict business practices 

in the biotechnology industry, which include, but are not limited to, anti-kickback, false claims, and transparency laws regarding drug pricing and payments 
and other transfers of value made to physicians and other healthcare providers. The federal Anti-Kickback Statute prohibits the offer, receipt, or payment of 
remuneration in exchange for or to induce the referral of patients or the use of products or services that would be paid for in whole or part by Medicare, 
Medicaid or other federal healthcare programs. Remuneration has been broadly interpreted to include anything of value, including cash, improper discounts 
and free or reduced-price items and services. Further, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it 
to have committed a violation. Many states have similar laws that apply to their state healthcare programs as well as private payors.

The False Claims Act, or FCA, imposes liability on persons who, among other things, knowingly present or cause to be presented, a false, fictitious 

or fraudulent claim for payment to, or approval by, the federal government, knowingly make, use, or cause to be made or used a false record or statement 
material to a false or fraudulent claim to the federal government, or knowingly make a false statement to avoid, decrease or conceal an obligation to pay 
money to the U.S. federal government. The FCA has been used to prosecute persons submitting claims for payment that are inaccurate or fraudulent, that 
are for services not provided as claimed, or for services that are not medically necessary. In addition, the government may assert that a claim including 
items or services resulting from a violation of the Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the False Claims Act. 
Actions under the FCA may be brought by the Attorney General or as a qui tam action by a private individual in the name of the government. The federal 
government is using the FCA, and the accompanying threat of significant liability, in its investigation and prosecution of pharmaceutical and biotechnology 
companies throughout the country, and has obtained multi-million and multi–billion-dollar settlements under the FCA in addition to individual criminal 
convictions under applicable criminal statutes. In addition, companies 

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have been forced to implement extensive corrective action plans and have often become subject to consent decrees or corporate integrity agreements, 
severely restricting the manner in which they conduct their business. Given the significant size of actual and potential settlements, it is expected that the 
government authorities will continue to devote substantial resources to investigating healthcare providers’ and manufacturers’ compliance with applicable 
fraud and abuse laws.

The federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, created additional federal criminal statutes that prohibit, among 

other actions, knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private third-
party payors, 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 a material fact or making any materially false, fictitious or fraudulent 
statement in connection with the delivery of or payment for healthcare benefits, items or services. Similar to the federal Anti-Kickback Statute, a person or 
entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation.

In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians and other healthcare providers. 

The ACA, among other things, imposed new reporting requirements through the Physician Payments Sunshine Act on certain manufacturers of drugs 
covered by a federal healthcare program for payments made by them to physicians (defined to include doctors, dentists, optometrists, podiatrists and 
chiropractors), certain non-physician practitioners (physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, 
anesthesiology assistants, and certified nurse midwives)  and teaching hospitals, as well as ownership and investment interests held by physicians and their 
immediate family members. Failure to submit required information may result in civil monetary penalties for all payments, transfers of value or ownership 
or investment interests that are not timely, accurately and completely reported in an annual submission. Manufacturers must submit reports by the 90th day 
of each calendar year. Certain states also mandate implementation of compliance programs, impose restrictions on drug manufacturer marketing practices 
and/or require the tracking and reporting of gifts, compensation and other remuneration to physicians, and pricing information and marketing expenditures.

To the extent that any of our product candidates, once approved, are sold in a foreign country, we may be subject to similar foreign laws and 
regulations, which may include, for instance, applicable post-marketing requirements, including safety surveillance, anti-fraud and abuse laws, and 
implementation of corporate compliance programs and reporting of payments or other transfers of value to healthcare professionals.

The shifting commercial compliance environment and the need to build and maintain robust systems to comply with different compliance and/or 

reporting requirements in multiple jurisdictions increase the possibility that a healthcare company may violate one or more of the requirements. Violations 
of any of such laws or any other governmental regulations that apply to drug manufacturers may result in significant penalties, including, without 
limitation, administrative, civil and criminal penalties, damages, fines, disgorgement, the curtailment or restructuring of operations, exclusion from 
participation in federal and state healthcare programs, reporting obligations and integrity oversight, and imprisonment.

Coverage and Reimbursement

Significant uncertainty exists as to the coverage and reimbursement status of any product candidates for which we obtain regulatory approval. In 

both domestic and foreign markets, sales and reimbursement of any approved products will depend, in part, on the extent to which third-party payors, such 
as government health programs, commercial insurance and managed healthcare organizations provide coverage, and establish adequate reimbursement 
levels for, such products. Third-party payors are increasingly challenging the prices charged for medical products and services and imposing controls to 
manage costs. Third-party payors may limit, or hinder, coverage to specific products on an approved list, also known as a formulary, which might not 
include all of the FDA-approved products for a particular indication. Additionally, we may need to conduct expensive pharmacoeconomic studies in order 
to demonstrate the cost-effectiveness of our products, as well as provide rebates and discounts which may impact the net selling price of our products. If 
third-party payors do not consider our products to be cost-effective compared to other therapies, the payors may not cover our products as a benefit under 
their plans or, if they do, the level of reimbursement may not be sufficient to allow us to sell our products on a profitable basis.

The containment of healthcare costs also has become a priority of federal and state governments and the prices of pharmaceutical and biological 

products have been a focus in this effort. Governments have shown significant interest in implementing cost-containment programs, including price 
controls, restrictions on reimbursement and requirements for substitution of generic products. Adoption of price controls and cost-containment measures, 
and adoption of more restrictive policies in jurisdictions with existing controls and measures, could further limit our net revenue and results.

Outside the United States, ensuring adequate coverage and payment for our products will face challenges. Pricing of prescription pharmaceuticals is 

subject to governmental control in many countries. Pricing negotiations with governmental authorities can extend well beyond the receipt of regulatory 
marketing approval for a product and may require us to conduct a clinical trial that compares the cost effectiveness of our product candidates or products to 
other available therapies. Conducting such a clinical trial could be expensive and result in delays in our commercialization efforts. Third-party payors are 
challenging the prices charged for medical products and services, and many third-party payors limit reimbursement for newly approved healthcare 
products. Recent budgetary pressures in many countries are also causing governments to consider or implement various cost-containment measures, 

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such as price freezes, increased price cuts and rebates. If budget pressures continue, governments may implement additional cost-containment measures. 
Cost-control initiatives could decrease the price we might establish for products that we may develop or sell, which would result in lower product revenues 
or royalties payable to us. There can be no assurance that any country that has price controls or reimbursement limitations for pharmaceutical products will 
allow favorable reimbursement and pricing arrangements for any of our products. The downward pressure on healthcare costs in general, particularly 
prescription products, has become very intense. As a result, increasingly high barriers are being erected to the entry of new products. In addition, in some 
countries, cross border imports from low priced markets exert a commercial pressure on pricing within a country.

Healthcare Reform

In the United States, there have been a number of federal and state proposals during the last few years regarding the pricing of pharmaceutical and 

biological products, government control and other changes to the healthcare system. It is uncertain what legislative proposals will be adopted or what 
actions federal, state or private payors for medical goods and services may take in response to any healthcare reform proposals or legislation. We cannot 
predict the effect medical or healthcare reforms may have on our business, and no assurance can be given that any such reforms will not have a material 
adverse effect.

By way of example, in March 2010, the ACA was signed into law, which, among other things, includes changes to the coverage and payment for 

pharmaceutical and biological products under government health care programs. Among other things, the ACA:

•

•

•

•

expanded manufacturers’ rebate liability under the Medicaid Drug Rebate Program by increasing the minimum rebate for both branded and 
generic drugs and revising the definition of ‘‘average manufacturer price,’’ or AMP, for calculating and reporting Medicaid drug rebates on 
outpatient prescription drug prices;

extended Medicaid drug rebates, previously due only on fee-for-service utilization, to Medicaid managed care utilization, and created an 
alternate rebate formula for new formulations of certain existing products that is intended to increase the amount of rebates due on those 
drugs;

expanded the types of entities eligible for the 340B drug discount program that mandates discounts to certain hospitals, community centers 
and other qualifying providers. With the exception of children’s hospitals, these newly eligible entities will not be eligible to receive 
discounted 340B pricing on orphan drugs. In addition, because 340B pricing is determined based on AMP and Medicaid drug rebate data, the 
revisions to the Medicaid rebate formula and AMP definition described above could cause the required 340B discounts to increase; and

established the Medicare Part D coverage gap discount program by requiring manufacturers to provide a 70% point-of-sale-discount off the 
negotiated price of applicable brand drugs to eligible beneficiaries during their coverage gap period as a condition for the manufacturers’ 
outpatient drugs to be covered under Medicare Part D.

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Since its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the ACA. On June 17, 2021, the U.S. 

Supreme Court dismissed the most recent judicial challenge to the ACA brought by several states without specifically ruling on the constitutionality of the 
ACA. Thus, the ACA will remain in effect in its current form. Further, prior to the U.S. Supreme Court ruling, President Biden issued an executive order to 
initiate a special enrollment period from February 15, 2021, through August 15, 2021, for purposes of obtaining health insurance coverage through the 
ACA marketplace. The executive order also instructed certain governmental agencies to review and reconsider their existing policies and rules that limit 
access to healthcare, including among others, reexamining Medicaid demonstration projects and waiver programs that include work requirements, and 
policies that create unnecessary barriers to obtaining access to health insurance coverage through Medicaid or the ACA. 

Other legislative changes have been proposed and adopted in the United States since the ACA was enacted. In For example, the Budget Control Act 

of 2011, enacted in August 2011, among other things, included reductions of Medicare payments to providers, which went into effect in April 2013 and, 
due to subsequent legislative amendments, will remain in effect through 2032, with the exception of a temporary suspension from May 1, 2020 through 
March 31, 2022, unless additional Congressional action is taken. In January 2013, the American Taxpayer Relief Act of 2012 was signed into law, which, 
among other things, further reduced Medicare payments to several types of providers, including hospitals, and increased the statute of limitations period for 
the government to recover overpayments to providers from three to five years. In addition, the American Rescue Plan Act of 2021 as signed into law, which 
eliminates the statutory Medicaid drug rebate cap, currently set at 100% of a drug’s AMP, beginning January 1, 2024.

More recently, there has been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, 

which have resulted in several Congressional inquiries and proposed and enacted legislation designed to, among other things, bring more transparency to 
product pricing, review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement 
methodologies for pharmaceutical and biological products. Most recently, on August 16, 2022 the Inflation Reduction Act of 2022 (“IRA”) was signed into 
law.  Among other things, the IRA requires manufacturers of certain drugs to engage in price negotiations with Medicare (beginning in 2026), with prices 
that can be negotiated subject to a cap; imposes rebates under Medicare Part B and Medicare Part D to penalize price increases that outpace inflation (first 
due in 2023); and replaces the Part D coverage gap discount program with a new discounting program (beginning in 2025).  The IRA permits the Secretary 
of the Department of Health and Human Services (HHS) to implement many of these provisions through guidance, as opposed to regulation, for the initial 
years.  For that and other reasons, it is currently unclear how the IRA will be effectuated, and the impact of the IRA on the pharmaceutical industry cannot 
yet be fully determined. Individual states in the United States have also become increasingly active in passing legislation and implementing regulations 
designed to control pharmaceutical product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product access 
and marketing cost disclosure and transparency measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing. 
Adoption of other new legislation at the federal, state, or foreign level could further limit reimbursement for pharmaceuticals, including our product 
candidates if approved.

Data Privacy and Security 

We may also be subject to U.S. federal, state and laws, regulations and standards governing the collection, use, access to, confidentiality, and 

security of health-related and other personal information, that could apply now or in the future to our operations or the operations of our partners. 
Numerous federal and state laws and regulations, including data breach notification laws, health information privacy and security laws and consumer 
protection laws and regulations, govern the collection, use, disclosure, and protection of health-related and other personal information.

In addition, certain foreign laws govern the privacy and security of personal data, including health-related data. Privacy and security laws, 
regulations, and other obligations are constantly evolving, may conflict with each other to complicate compliance efforts, and can result in investigations, 
proceedings, or actions that lead to significant civil and/or criminal penalties and restrictions on data processing.

Employees

Human Capital

As of December 31, 2022, we had 431 full-time permanent employees. Sixty-four employees work in administration, operations, and commercial 

and 367 work in research and development. None of our employees in the U.S. are represented by a labor union or covered by collective bargaining 
agreements, and we believe our relationship with our employees is good.  During 2022, we enhanced our capabilities by significantly expanding our 
employee base. The new employees were hired to support a variety of functions and key initiatives, including extending our research, clinical and pre-
clinical pipeline development, as well as our medical affairs, manufacturing and commercialization capabilities, with hires in commercial, clinical 
development and operations, research, medical affairs, manufacturing, and general and administrative functions. We expect to continue to add additional 
employees in 2023, with a focus on further enhancing our capabilities and increasing our capacities in these areas as we continue our focus on gaining FDA 
approval for SER-109 for recurrent CDI.

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Talent Acquisition and Development

We consider the intellectual capital, skills and experience of our employees to be an essential driver of our business and key to our future prospects. 
We face intense competition for qualified individuals from numerous pharmaceutical and biotechnology companies, universities, governmental entities and 
other research institutions, and we believe that our future success will depend in large part on our continued ability to attract and retain highly skilled 
employees. To attract qualified applicants to our company and retain our employees, we offer a total rewards package consisting of base salary and cash 
  to 75th percentile of the market based on geography, a comprehensive benefit package and equity compensation for every 
target bonus targeting the 50th
employee. Annual cash bonus opportunity and equity compensation increase as a percentage of total compensation based on level of responsibility. Any 
actual bonus payout is based on a combination of individual performance and corporate performance.

Diversity, Inclusion, and Belonging

As a microbiome therapeutics company developing a novel class of live biotherapeutic drugs, we believe that our long-term success and ability to 
deliver innovative, safe and effective medicines to patients requires a diverse and inclusive workforce. We value diversity at all levels of the organization 
and continue to focus on extending our diversity, equity and inclusion initiatives across our entire workforce, from: working with managers to develop 
strategies for building diverse, high performing teams; to ensuring that we attract, develop and retain diverse talent from all backgrounds; to increasing 
awareness within our company of unconscious biases, and supporting affinity groups comprised of individuals who are underrepresented in our company, 
industry or society, such as women, members of the LGBTQ community and people of color. In addition, we pride ourselves on an open culture that 
respects co-workers, values employees’ health and well-being and fosters professional development. We support employee growth and development in a 
variety of ways including with group training, individual mentoring and coaching, conference attendance and tuition reimbursement. Our management 
conducts annual employee engagement surveys and reports to our board of directors on human capital management topics, including corporate culture, 
diversity, equity and inclusion, employee development and retention, and compensation and benefits. Similarly, our board of directors regularly provides 
input on important decisions relating to these matters, including with respect to employee compensation and benefits, talent retention and development.

Our Corporate Information

We were incorporated in the State of Delaware in 2010 under the name Newco LS21, Inc. In October 2011, we changed our name to Seres Health, 

Inc., and in May 2015, we changed our name to Seres Therapeutics, Inc. Our principal executive offices are located at 200 Sidney Street, Cambridge, 
Massachusetts 02139 and our telephone number is (617) 945-9626. Our website address is www.serestherapeutics.com. The information contained in, or 
accessible through, our website does not constitute a part of this Annual Report on Form 10-K.

We are subject to the informational requirements of the Securities Exchange Act of 1934, as amended, or the Exchange Act, and, accordingly, file 

reports, proxy statements and other information with the Securities and Exchange Commission, or SEC. The SEC maintains a web site 
(http://www.sec.gov) that contains material regarding issuers that file electronically, such as ourselves, with the SEC.

We make available free of charge on our website our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-

K and amendments to those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Exchange Act, as soon as reasonably practicable after we 
electronically file such material with, or furnish it to, the SEC.

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Item 1A. Risk Factors

Our business faces significant risks and uncertainties. Accordingly, in evaluating our business, you should carefully consider the risk factors 
discussed below, as well as the other information included or incorporated by reference in this Annual Report on Form 10-K, including our consolidated 
financial statements and the related notes and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” The occurrence 
of any of the events or developments described below or elsewhere in this report could harm our business, financial condition, results of operations or 
growth prospects. 

Risks Related to Our Financial Position and Need for Additional Capital

We are a development-stage company and have incurred significant losses since our inception. We expect to incur losses for the foreseeable future and 
may never achieve or maintain profitability. 

Since inception, we have incurred significant operating losses. Our net loss was $250.2 million for the year ended December 31, 2022, $65.6 million 
for the year ended December 31, 2021, and $89.1 million for the year ended December 31, 2020. As of December 31, 2022, we had an accumulated deficit 
of $864.5 million. As noted elsewhere in this Annual Report on Form 10-K, we have identified conditions and events that raise substantial doubt about our 
ability to continue as a going concern. To date, we have financed our operations through the public offerings of our common stock, private placements of 
our common stock and preferred stock, payments under our collaboration agreements, and loan facility. We have devoted substantially all of our financial 
resources and efforts to developing our reverse translational microbiome therapeutics platform, identifying potential product candidates and conducting 
preclinical studies and clinical trials. We have not completed development of any of our product candidates, which we call microbiome therapeutic 
candidates, or other drugs or biologics. We expect to continue to incur significant expenses and operating losses for the foreseeable future.  We anticipate 
that our expenses may increase substantially as we: 

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complete the clinical development, seek regulatory approval, and prepare for potential commercialization of SER-109 for patients with 
recurrent CDI;

continue the clinical development of SER-155 to reduce incidences of gastrointestinal infections, bloodstream infections and GvHD in 
patients receiving allo-HSCT;

continue evaluating preclinical stage programs to reduce incidence of infection, in indications such as cancer neutropenia, chronic liver 
disease, solid organ transplant, and antimicrobial resistant infections more broadly; 

continue translational research activities, informed by the SER-287 Phase 2b and SER-301 Phase 1b study data, to evaluate the potential to 
utilize biomarker-based patient selection and stratification in future clinical development efforts;

make strategic investments in our research discovery and development platforms and capabilities to advance our priority programs;

make strategic investments in manufacturing capabilities;

maintain and augment our intellectual property portfolio and opportunistically acquire complementary intellectual property;

potentially establish a sales and distribution infrastructure and scale-up manufacturing capabilities to commercialize any products for which 
we may obtain regulatory approval;

perform our obligations under our agreements with our collaborators;

seek to obtain regulatory approvals for our product candidates; and

experience any delays or encounter any issues with any of the above, including but not limited to failed studies, complex results, safety issues 
or other regulatory challenges.

To become and remain profitable, we must succeed in developing and eventually commercializing products that generate significant revenue. This 

will require us to be successful in a range of challenging activities, including completing preclinical testing and clinical trials of our product candidates, 
discovering additional product candidates, obtaining regulatory approval for these product candidates and manufacturing, marketing and selling any 
products for which we may obtain regulatory approval. We are in the preliminary stages of many of these activities. We may never succeed in these 
activities and, even if we do, may never generate revenue that is significant enough to achieve profitability.

Because of the numerous risks and uncertainties associated with pharmaceutical product and biological development, we are unable to accurately 

predict the timing or amount of increased expenses or when, or if, we will be able to achieve profitability. 

Even if we do achieve profitability, we may not be able to sustain or increase profitability on a quarterly or annual basis. Our failure to become and 

remain profitable would depress our value and could impair our ability to raise capital, expand our business, maintain our research and development efforts, 
diversify our product offerings or even continue our operations.

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We have identified conditions and events that raise substantial doubt regarding our ability to continue as a going concern.

Based on our currently available cash resources and our current level of operations and cash flows for the 12-month period subsequent to the date of 

issuance of the consolidated financial statements included elsewhere in this Annual Report on Form 10-K, we believe it is reasonably likely that we will 
require additional funding in early 2024. There are certain contingent payments associated with the approval of our BLA for SER-109, which is currently 
under priority review by the FDA, including the potential to receive a $125.0 million milestone payment from Nestlé pursuant to the 2021 License 
Agreement, and a $25.0 million tranche under our New Credit Facility with Hercules, which becomes available upon the satisfaction of certain conditions, 
including FDA approval of SER-109. While we anticipate receiving these contingent payments in the first half of 2023, there is no assurance we will 
receive them. Because these contingent payments, and the ability to obtain sufficient additional equity or debt financing with terms favorable or acceptable 
to us, cannot be considered probable according to the applicable accounting standards because they are outside our control, there is substantial doubt about 
our ability to continue as a going concern for at least 12 months from the date that our consolidated financial statements for the year ended December 31, 
2022 were issued.

Substantial doubt about our ability to continue as a going concern may materially and adversely affect the price per share of our common stock, and 

it may be more difficult for us to obtain financing. If potential collaborators decline to do business with us or potential investors decline to participate in 
any future financings due to such concerns, our ability to increase our cash position may be limited. The perception that we may not be able to continue as a
going concern may cause others to choose not to deal with us due to concerns about our ability to meet our contractual obligations.

We have prepared our consolidated financial statements on a going concern basis, which contemplates the realization of assets and the satisfaction of 

liabilities and commitments in the normal course of business. Our audited consolidated financial statements included in this Annual Report on Form 10-K 
do not include any adjustments to reflect the possible inability of the Company to continue as a going concern within 12 months after the issuance of such 
financial statements.

We will need additional funding in order to complete development of our product candidates and commercialize our products, if approved. If we 

are unable to raise capital when needed, we could be forced to delay, reduce or eliminate our product development programs or commercialization 
efforts.

Our expenses may increase in connection with our ongoing activities, particularly as we complete clinical development, scale up manufacturing 

operations, seek regulatory approval, and prepare for commercialization of SER-109 if approved, continue the SER-155 Phase 1b study, continue research 
activities evaluating UC, and continue to research, develop and initiate clinical trials of our other product candidates. In addition, if we obtain regulatory 
approval for any of our product candidates, we expect to incur significant commercialization expenses related to product manufacturing, marketing, sales 
and distribution, and may not generate meaningful product revenues or collaboration profit in the near future.  Furthermore, we have incurred and expect to 
continue to incur additional costs associated with operating as a public company.  Accordingly, we will need to obtain substantial additional funding in 
connection with our continuing operations. If we are unable to raise capital when needed or on attractive terms, we could be forced to delay, reduce or 
eliminate our research and development programs or any future commercialization efforts.

As noted above, we have identified conditions and events that raise substantial doubt about our ability to continue as a going concern. Our future 

capital requirements will depend on many factors, including:

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the ongoing and long-term impact of the COVID-19 pandemic;

the impact of a continued increase in inflation rates or interest rates;

the progress and results of our clinical studies;

the cost of manufacturing our product candidates;

the scope, progress, results and costs of preclinical development, laboratory testing and clinical trials for our product candidates;

the revenue, if any, received from commercial sales of our product candidates for which we receive marketing approval;

the costs and timing of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and 
defending any intellectual property-related claims;

the effect of competing technological and market developments; and

the extent to which we acquire or invest in businesses, products and technologies, including entering into licensing or collaboration 
arrangements for product candidates.

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Any additional fundraising efforts may divert our management from their day-to-day activities, which may adversely affect our ability to develop 

and commercialize our product candidates. In addition, we cannot guarantee that future financing will be available in sufficient amounts or on terms 
acceptable to us, if at all. Additionally, market volatility resulting from current macroeconomic conditions, the COVID-19 pandemic, or other factors could 
also adversely impact our ability to access capital as and when needed.  Moreover, the terms of any financing may adversely affect the holdings or the 
rights of our stockholders and the issuance of additional securities, whether equity or debt, by us, or the possibility of such issuance, may cause the market 
price of our shares to decline. The sale of additional equity or convertible securities would dilute all of our stockholders and may decrease our stock price. 
The incurrence of indebtedness could result in increased fixed payment obligations and we may be required to agree to certain restrictive covenants, such as 
limitations on our ability to incur additional debt, limitations on our ability to acquire, sell, or license intellectual property rights and other operating 
restrictions that could adversely impact our ability to conduct our business. We could also be required to seek funds through arrangements with 
collaborators or others at an earlier stage than otherwise would be desirable and we may be required to relinquish rights to some of our technologies or 
product candidates or otherwise agree to terms unfavorable to us, any of which may have a material adverse effect on our business, operating results and 
prospects.

If we are unable to obtain funding on a timely basis, we may be required to significantly curtail, delay, or discontinue one or more of our research or 

development programs or the commercialization of any product candidates, or be unable to expand our operations or otherwise capitalize on our business 
opportunities, as desired, which could materially adversely affect our business, financial condition and results of operations.

Our limited operating history may make it difficult to evaluate the success of our business to date and to assess our future viability.

Since our inception in October 2010, we have devoted substantially all of our resources to developing our clinical and preclinical program, building 
our intellectual property portfolio, developing our supply chain, planning our business, raising capital and providing general and administrative support for 
these operations.  We have not yet demonstrated our ability to obtain regulatory approvals, manufacture a commercial-scale product, or arrange for a third 
party to do so on our behalf, or conduct sales and marketing activities necessary for successful product commercialization. Additionally, we expect our 
financial condition and operating results to continue to fluctuate significantly from quarter to quarter and year to year due to a variety of factors, many of 
which are beyond our control. Consequently, any predictions made about our future success or viability may not be as accurate as they could be if we had a 
longer operating history.

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

Other than SER-109, we are early in our development efforts and may not be successful in our efforts to use our reverse translational microbiome 
therapeutics platform to build a pipeline of product candidates and develop marketable drugs.

We are using our reverse translational microbiome therapeutics platform to develop microbiome therapeutic candidates. Other than SER-109, we are 

at an early stage of development and our platform has not yet, and may never, lead to approvable or marketable drugs. We are developing additional 
product candidates that we intend to be used to reduce infection and treat diseases where the microbiome is implicated.  We may have problems applying 
our technologies to these areas, and our product candidates may not be effective in reducing infection and disease. Our product candidates may not be 
suitable for clinical development, including as a result of their harmful side effects, limited efficacy or other characteristics that indicate that they are 
unlikely to be products that will receive marketing approval and achieve market acceptance. 

The success of our product candidates will depend on several factors, including the following:

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completion of preclinical studies and clinical trials with positive results;

receipt of marketing approvals from applicable regulatory authorities;

obtaining and maintaining patent and trade secret protection and regulatory exclusivity for our product candidates;

making arrangements with third-party manufacturers for, or establishing our own, commercial manufacturing capabilities;

launching commercial sales of our products, if and when approved, whether alone or in collaboration with others;

entering into new collaborations throughout the development process as appropriate, from preclinical studies through to commercialization;

acceptance of our products, if and when approved, by patients, the medical community and third-party payors;

effectively competing with other therapies;

obtaining and maintaining coverage and adequate reimbursement by third-party payors, including government payors, for our products, if 
approved;

protecting our rights in our intellectual property portfolio;

operating without infringing or violating the valid and enforceable patents or other intellectual property of third parties;

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maintaining a continued acceptable safety profile of our products following approval; and

maintaining and growing an organization of scientists and business people who can develop and commercialize our products and technology.

If we or our collaborators do not successfully develop and commercialize product candidates we will not be able to obtain product revenue in future 

periods, which likely would result in significant harm to our financial position and adversely affect our stock price.

Our product candidates are based on microbiome therapeutics, which is an unproven approach to therapeutic intervention.

All of our product candidates are based on microbiome therapeutics, a novel potential class of biological drugs, which are designed to treat disease 

by modulating the microbiome to restore health by repairing the function of a disrupted microbiome to a non-disease state. We have not, nor to our 
knowledge has any other company, received regulatory approval for, or manufactured on a commercial scale, a therapeutic based on this approach. We 
cannot be certain that our approach will lead to the development of approvable or marketable products or that we will be able to manufacture at commercial 
scale, if approved. In addition, our microbiome therapeutic candidates may have different effectiveness rates in various indications and in different 
geographical areas. Finally, the FDA or other regulatory authorities may lack experience in evaluating the safety and efficacy of products based on 
microbiome therapeutics, which could result in a longer than expected regulatory review process, increase our expected development costs and delay or 
prevent commercialization of our product candidates. 

Our reverse translational microbiome therapeutics platform relies on third parties for biological materials, including human stool. Some biological 
materials have not always met our expectations or requirements, and any disruption in the supply of these biological materials could materially adversely 
affect our business. For example, if any supplied biological materials are contaminated with disease organisms, we would not be able to use such biological 
materials. Although we have control processes and screening procedures, biological materials are susceptible to damage and contamination and may 
contain active pathogens. Improper storage of these materials, by us or any third-party suppliers, may require us to destroy some of our materials or 
products, which could delay the development or commercialization of our product candidates.

Clinical drug development involves a risky, lengthy and expensive process, with an uncertain outcome. We may incur additional costs or experience 
delays in completing, or ultimately be unable to complete, the development and commercialization of our product candidates.

It is difficult to predict when or if any of our product candidates will prove effective and safe in humans or will receive regulatory approval, and the 

risk of failure through the development process is high. Before obtaining marketing approval from regulatory authorities for the sale of any product 
candidate, we must complete preclinical development and then conduct extensive clinical trials to demonstrate the safety and efficacy of our product 
candidates in humans. Clinical testing is expensive, difficult to design and implement, can take many years to complete and is uncertain as to outcome. A 
failure of one or more clinical trials can occur at any stage of testing, and our clinical trials may not be successful. The outcome of preclinical testing and 
early clinical trials may not be predictive of the success of later clinical trials, and interim or preliminary results of a clinical trial, that we may from time to 
time announce, do not necessarily predict final results. A number of companies in the pharmaceutical and biotechnology industries have suffered 
significant setbacks in advanced clinical trials due to lack of efficacy or adverse safety profiles, notwithstanding promising results in earlier studies, and we 
cannot be certain that we will not face similar setbacks. 

In addition, we cannot be certain as to what type and how many clinical trials the FDA, or other regulatory authorities, will require us to conduct 

before we may successfully gain approval to market any of our other product candidates. Prior to approving a new therapeutic product, the FDA (or other 
regulatory authorities) generally requires that safety and efficacy be demonstrated in two adequate and well-controlled clinical trials. In some situations, 
evidence from a Phase 2 trial and a Phase 3 trial or from a single Phase 3 trial can be sufficient for FDA approval, such as in cases where the trial or trials 
provide highly reliable and statistically strong evidence of an important clinical benefit. 

We may experience numerous unforeseen events during, or as a result of, clinical trials that could delay or prevent our ability to receive marketing 

approval or commercialize our product candidates, including:

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inability to generate sufficient preclinical, toxicology, or other in vivo or in vitro data to support the initiation or continuation of clinical trials;

regulatory authorities or institutional review boards or ethics committees may not authorize us or our investigators to commence a clinical 
trial or conduct a clinical trial at a prospective trial site;

failures or delays in reaching agreement on acceptable clinical trial contracts or clinical trial protocols with prospective trial sites;

clinical trials of our product candidates may demonstrate undesirable side effects or produce negative or inconclusive results, and we may 
decide, or regulators may require us, to conduct additional clinical trials or abandon product development programs;

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the number of patients required for clinical trials of our product candidates may be larger than we anticipate, enrollment in these clinical trials 
may be slower than we anticipate or participants may drop out of these clinical trials at a higher rate than we anticipate;

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

we may have to suspend or terminate clinical trials of our product candidates for various reasons, including a finding that the participants are 
being exposed to unacceptable health risks;

regulatory authorities or institutional review boards or ethics committees may require that we or our investigators suspend or terminate 
clinical research for various reasons, including noncompliance with regulatory requirements or a finding that the participants are being 
exposed to unacceptable health risks;

the cost of clinical trials of our product candidates may be greater than we anticipate;

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

regulatory authorities may revise the requirements for approving our product candidates, or such requirements may not be as we anticipate; 
and

regarding trials managed by any current or future collaborators, our collaborators may face any of the above issues, and may conduct clinical 
trials in ways they view as advantageous to them but potentially suboptimal for us.

If we are required to conduct additional clinical trials or other testing of our product candidates beyond those that we currently contemplate, if we 

are unable to successfully complete clinical trials of our product candidates or other testing, if the results of these trials or tests are not positive or are only 
modestly positive or if there are safety concerns, we may:

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be delayed in obtaining marketing approval for our product candidates;

lose the support of current or any future collaborators, requiring us to bear more of the burden of development of certain compounds;

not obtain marketing approval at all;

obtain marketing approval in some countries and not in others;

obtain approval for indications or patient populations that are not as broad as we intend or desire;

obtain approval with labeling that includes significant use or distribution restrictions or safety warnings;

be subject to additional post-marketing testing requirements;

be subject to increased pricing pressure; or

have the product removed from the market after obtaining marketing approval.

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Additional clinical trials or changes in our development plans could cause us to incur significant development costs, delay or prevent the 
commercialization of SER-109 or otherwise adversely affect our business. In addition, prolonged disruptions caused by the COVID-19 pandemic could 
severely impact our preclinical studies and clinical trials, including by causing further difficulties or delays in initiating, enrolling, conducting, or 
completing our planned and ongoing clinical trials. See “—Risks Related to Our Operations—The COVID-19 pandemic has adversely impacted and could 
continue to adversely impact, our business, including our preclinical studies and clinical trials, results of operations and financial condition.”

Our product development costs will increase if we continue to experience delays in clinical testing or marketing approvals. We do not know whether 

any of our preclinical studies or clinical trials will begin as planned, will need to be restructured or will be completed on schedule, or at all. Significant 
preclinical or clinical trial delays also could shorten any periods during which we may have the exclusive right to commercialize our product candidates or 
allow our competitors to bring products to market before we do, potentially impairing our ability to successfully commercialize our product candidates and 
harming our business and results of operations.

In addition, the FDA’s and other regulatory authorities’ policies may change and additional government regulations may be enacted with respect to 

clinical trials.  For instance, the regulatory landscape related to clinical trials in the European Union, or EU, recently evolved. The EU Clinical Trials 
Regulation, or CTR, which was adopted in April 2014 and repeals the EU Clinical Trials Directive, became applicable on January 31, 2022. While the 
Clinical Trials Directive required a separate clinical trial application, or CTA, to be submitted in each member state, to both the competent national health 
authority and an independent ethics committee, the CTR introduces a centralized process and only requires the submission of a single application to all 
member states concerned. The CTR allows sponsors to make a single submission to both the competent authority and an ethics committee in each member 
state, leading to a single decision per member state. The assessment procedure of the CTA has been harmonized as well, including a joint assessment by all 
member states concerned, and a separate assessment by each member state with respect to specific requirements related to its own territory, including ethics 
rules. Each member state’s decision is communicated to the sponsor via the centralized EU portal. Once the CTA is approved, clinical study development 
may proceed. The CTR foresees a three-year transition period. The extent to which ongoing and new clinical trials will be governed by the CTR varies. 
Clinical trials for which an application was submitted (i) prior to January 31, 2022 under the Clinical Trials Directive, or (ii) between January 31, 2022 and 
January 31, 2023 and for which the sponsor has opted for the application of the Clinical Trials Directive remain governed by said Directive until January 
31, 2025. After this date, all clinical trials (including those which are ongoing) will become subject to the provisions of the CTR. Compliance with the CTR 
requirements by us and our third-party service providers, such as contract research organizations, or CROs, may impact our developments plans.  

The UK regulatory framework in relation to clinical trials is derived from existing EU legislation (as implemented into UK law, through secondary 

legislation). However, on January 17, 2022, the UK Medicines and Healthcare products Regulatory Agency, or MHRA, launched an eight-week 
consultation on reframing the UK legislation for clinical trials. The consultation closed on March 14, 2022 and aims to streamline clinical trials approvals, 
enable innovation, enhance clinical trials transparency, enable greater risk proportionality, and promote patient and public involvement in clinical trials. 
The Government has not yet published a response to the consultation but the outcome will be closely watched and will determine whether the UK chooses 
to align with the CTR or diverge from it to maintain regulatory flexibility. Under the terms of the Protocol on Ireland/Northern Ireland, provisions of the 
CTR which relate to the manufacture and import of investigational medicinal products and auxiliary medicinal products apply in Northern Ireland. A 
decision by the UK Government not to closely align its regulations with the new approach that has been adopted in the EU may have an effect on the cost 
of conducting clinical trials in the UK as opposed to other countries.   

If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies governing clinical trials, our 

business may be impacted. 

Delays or difficulties in the enrollment of patients in clinical trials, could result in our receipt of necessary regulatory approvals being delayed or 
prevented.

Successful and timely completion of clinical trials will require that we enroll a sufficient number of patient candidates. These trials and other trials 
we conduct may be subject to delays for a variety of reasons, including as a result of patient enrollment taking longer than anticipated, patient withdrawal 
or adverse events. These types of developments could cause us to delay the trial or halt further development. 

Our clinical trials will compete with other clinical trials that are in the same therapeutic areas as our product candidates, and this competition 

reduces the number and types of patients available to us, as some patients who might have opted to enroll in our trials may instead opt to enroll in a trial 
being conducted by one of our competitors. Because the number of qualified clinical investigators and clinical trial sites is limited, we expect to conduct 
some of our clinical trials at the same clinical trial sites that some of our competitors use, which will reduce the number of patients who are available for 
our clinical trials at such clinical trial sites. In addition, there may be limited patient pools from which to draw for clinical studies. In addition to the rarity 
of some diseases, the eligibility criteria of our clinical studies will further limit the pool of available study participants as we will require that patients have 
specific characteristics that we can measure or to assure their disease is either severe enough or not too advanced to include them in a study.

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Patient enrollment is also affected by other factors including:

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the severity of the disease under investigation;

the patient eligibility criteria for the study in question;

the perceived risks and benefits of the product candidate under study;

the availability of other treatments for the disease under investigation, including the use of fecal microbiota transplant, or FMT;

the existence of competing clinical trials;

the efforts to facilitate timely enrollment in clinical trials;

our payments for conducting clinical trials;

the patient referral practices of physicians;

the burden, or perceived burden, of the clinical study;

the ability to monitor patients adequately during and after treatment; and

the proximity and availability of clinical trial sites for prospective patients.

Our inability to enroll a sufficient number of patients for our clinical trials or a delayed rate of enrollment would result in significant delays and 

could require us to abandon one or more clinical trials altogether.  

Interim “top-line” and preliminary data from our clinical trials that we announce or publish from time to time may change as more patient data 
become available and are subject to audit and verification procedures that could result in material changes in the final data.

From time to time, we may publicly disclose interim, top-line or preliminary data from our preclinical studies and clinical trials, which is based on a 

preliminary analysis of then-available data, and the results and related findings and conclusions are subject to change following a more comprehensive 
review of the data related to the particular study or trial. We also make assumptions, estimations, calculations and conclusions as part of our analyses of 
data, and we may not have received or had the opportunity to fully and carefully evaluate all data. As a result, the top-line or preliminary results that we 
report may differ from future results of the same studies, or different conclusions or considerations may qualify such results, once additional data have been 
received and fully evaluated. Top-line or preliminary data also remain subject to audit and verification procedures that may result in the final data being 
materially different from the top-line or preliminary data we previously published. As a result, top-line and preliminary data should be viewed with caution 
until the final data are available. Adverse differences between interim data and final data could significantly harm our business prospects. Further, 
disclosure of interim data by us or by our competitors could result in volatility in the price of our common stock. 

Further, others, including regulatory authorities, may not accept or agree with our assumptions, estimates, calculations, conclusions or analyses or 
may interpret or weigh the importance of data differently, which could impact the value of the particular program, the approvability or commercialization 
of the particular product candidate or product and our company in general. In addition, the information we choose to publicly disclose regarding a 
particular study or clinical trial is based on what is typically extensive information, and you or others may not agree with what we determine is material or 
otherwise appropriate information to include in our disclosure. 

If the interim, top-line or preliminary data that we report differ from actual results, or if others, including regulatory authorities, disagree with the 

conclusions reached, our ability to obtain approval for, and commercialize, our product candidates may be harmed, which could harm our business, 
operating results, prospects or financial condition.

If we are not able to obtain, or if there are delays in obtaining, required regulatory approvals, we or our collaborators will not be able to commercialize 
our product candidates or will not be able to do so as soon as anticipated, and our ability to generate revenue will be materially impaired.

Our product candidates and the activities associated with their development and commercialization, including their design, testing, manufacture, 
safety, efficacy, recordkeeping, labeling, storage, approval, advertising, promotion, sale and distribution, are subject to comprehensive regulation by the 
FDA and other regulatory agencies in the United States and similar regulatory authorities outside the United States. Failure to obtain marketing approval 
for a product candidate in any jurisdiction will prevent us and our collaborators from commercializing the product candidate in that jurisdiction and may 
affect our plans for commercialization in other jurisdictions as well. We have not received approval to market any of our product candidates from 
regulatory authorities in any jurisdiction. We have only limited experience in filing and supporting the applications necessary to gain marketing approvals 
and expect to rely on third parties to assist us in this process. Securing marketing approval requires the submission of extensive preclinical and clinical data 
and supporting information to regulatory authorities for each therapeutic indication to establish the product 

36

candidate’s safety and efficacy. Securing marketing approval also requires the submission of information about the product manufacturing process to, and 
inspection of manufacturing facilities by, the regulatory authorities. Our product candidates may not be effective, may be only moderately effective or may 
prove to have undesirable or unintended side effects, toxicities or other characteristics that may preclude our obtaining marketing approval or prevent or 
limit commercial use.

The process of obtaining marketing approvals, both in the United States and abroad, is expensive, risky and may take many years. The scope and 

amount of clinical data required to obtain marketing approvals can vary substantially from jurisdiction to jurisdiction, and it may be difficult to predict 
whether a particular regulatory body will require additional or different studies than those conducted by a sponsor, especially for novel product candidates 
such as our microbiome therapeutic candidates. The FDA or foreign regulatory authorities may delay, limit, or deny approval to market our product 
candidates for many reasons, including: our inability to demonstrate that the clinical benefits of our product candidates outweigh any safety or other 
perceived risks; the regulatory authority’s disagreement with the interpretation of data from nonclinical or clinical studies; the regulatory authority’s 
requirement that we conduct additional preclinical studies and clinical trials; changes in marketing approval policies during the development period; 
changes in or the enactment of additional statutes or regulations, or changes in regulatory review process for each submitted product application; or the 
regulatory authority’s failure to approve the manufacturing processes or third-party manufacturers with which we contract. For instance, the EU 
pharmaceutical legislation is currently undergoing a complete review process, in the context of the Pharmaceutical Strategy for Europe initiative, launched 
by the European Commission in November 2020. A proposal for revision of several legislative instruments related to medicinal products (potentially 
revising the duration of regulatory exclusivity, eligibility for expedited pathways, etc.) is currently expected to be adopted by the European Commission in 
the first quarter of 2023. The proposed revisions, once they are agreed and adopted by the European Parliament and European Council (currently not 
expected before the end of 2024 or early 2025) may have a significant impact on the biopharmaceutical industry in the long term. 

There may also be interruptions or delays in the operations of the FDA or other foreign regulatory authorities due to the COVID-19 pandemic, 

which may impact approval timelines. The FDA has continued to monitor and implement changes to its inspectional activities to ensure the safety of its 
employees and those of the firms it regulates as it adapts to the evolving COVID-19 pandemic, and any resurgence of the virus or emergence of new 
variants may lead to further inspectional delays. Additionally, regulatory authorities have substantial discretion in the approval process and may refuse to 
accept a marketing application if deficient. In addition, varying interpretations of the data obtained from preclinical and clinical testing could delay, limit or 
prevent marketing approval of a product candidate. Any marketing approval we ultimately obtain may be limited or subject to restrictions or post-approval 
commitments that render the approved product not commercially viable. Of the large number of drugs in development, only a small percentage successfully 
complete the FDA or other regulatory approval processes and are commercialized.

Furthermore, our product candidates may not receive marketing approval even if they achieve their specified endpoints in clinical trials. Clinical 

data is often susceptible to varying interpretations and many companies that have believed that their products performed satisfactorily in clinical trials have 
nonetheless failed to obtain regulatory authority approval for their products. The FDA or foreign regulatory authorities may disagree with our trial design 
and our interpretation of data from nonclinical and clinical studies, or they may require additional confirmatory or safety evidence beyond our existing 
clinical studies. Upon the FDA’s review of data from any pivotal trial, it may request that the sponsor conduct additional analyses of the data or gather more 
data and, if it believes the data are not satisfactory, could advise the sponsor to delay filing a marketing application.

Even if we eventually complete clinical testing and receive approval of a biologics license application, or BLA, or foreign marketing authorization 

for one of our product candidates, the FDA or the applicable foreign regulatory authority may grant approval contingent on the performance of costly 
additional clinical trials, which may be required after approval. The FDA or the applicable foreign regulatory authority may also approve our product 
candidates for a more limited indication and/or a narrower patient population than we originally request, and the FDA, or applicable foreign regulatory 
authority, may not approve the labeling that we believe is necessary or desirable for the successful commercialization of our product candidates. Any delay 
in obtaining, or inability to obtain, applicable regulatory approval would delay or prevent commercialization of our product candidates and would 
materially adversely impact our business and prospects.

The development of therapeutic products targeting the underlying biology of the human microbiome is an emerging field, and it is possible that the 

FDA and other regulatory authorities could issue regulations or new policies in the future that could adversely affect our microbiome therapeutic 
candidates.

If we experience delays in obtaining approval or if we fail to obtain approval of our product candidates, the commercial prospects for our product 

candidates may be harmed and our ability to generate revenues will be materially impaired.

A Fast Track designation by the FDA may not actually lead to a faster development or regulatory review or approval process. 

We may seek Fast Track designation for some of our product candidates. If a drug or biologic is intended for the treatment of a serious or life-

threatening condition and nonclinical or clinical data demonstrate the potential to address unmet medical needs for this condition, the drug or biologic 
sponsor may apply for Fast Track designation. SER-287 received Fast Track designation from the FDA for the induction and maintenance of clinical 
remission in adults with mild-to-moderate UC. Fast Track designation provides increased opportunities for sponsor meetings with the FDA during 
preclinical and clinical development, in addition to the potential for rolling review of a BLA for such product candidate. The FDA has broad discretion 
whether or not to grant this designation, and even if we 

37

believe another particular product candidate is eligible for this designation, we cannot be certain that the FDA would decide to grant it. Even with Fast 
Track designation, we may not experience a faster development process, review or approval compared to conventional FDA procedures. Fast Track 
designation does not assure ultimate approval by the FDA. The FDA may withdraw Fast Track designation if it believes that the designation is no longer 
supported by data from our clinical development program.

A Breakthrough Therapy designation by the FDA for our product candidates may not lead to a faster development, regulatory review or approval 
process, and it does not increase the likelihood that our product candidates will receive marketing approval.

We have received Breakthrough Therapy designation for SER-109 for treatment of CDI, and we may seek a Breakthrough Therapy designation for 

our other product candidates. A Breakthrough Therapy is defined as a drug or biologic that is intended to treat a serious or life-threatening disease or 
condition, and preliminary clinical evidence indicates that the drug or biologic may demonstrate substantial improvement over existing therapies on one or 
more clinically significant endpoints, such as substantial treatment effects observed in early clinical development. For drugs or biologics that have been 
designated as breakthrough therapies, interaction and communication between the FDA and the sponsor can help to identify the most efficient path for 
clinical development. Drugs designated as breakthrough therapies by the FDA are also eligible for rolling review of the associated marketing application.

Designation as a Breakthrough Therapy is within the discretion of the FDA. Accordingly, even if we believe one of our product candidates meets the 

criteria for designation as a Breakthrough Therapy, the FDA may disagree and instead determine not to make such designation. The receipt of a 
Breakthrough Therapy designation for a product candidate may not result in a faster development process, review or approval compared to conventional 
FDA procedures and does not assure ultimate approval by the FDA. In addition, not all products designated as breakthrough therapies ultimately will be 
shown to have the substantial improvement over available therapies suggested by the preliminary clinical evidence at the time of designation. As a result, if 
the Breakthrough Therapy designation for SER-109 or any future designation we receive is no longer supported by subsequent data, the FDA may rescind 
the designation.

We may seek PRIME designation by EMA or other designations, schemes or tools in the EU for one or more of our product candidates, which we may 
not receive. Such designations may not lead to a faster development or regulatory review or approval process and do not increase the likelihood that 
our product candidates will receive marketing authorization.

We may seek EMA PRIME (Priority Medicines) designation or other designations, schemes or tools for one or more of our product candidates. In 

the EU, innovative products that target an unmet medical need and are expected to be of major public health interest may be eligible for a number of 
expedited development and review programs, such as the PRIME scheme, which provides incentives similar to the Breakthrough Therapy designation in 
the United States. PRIME is a voluntary scheme aimed at enhancing the European Medicines Agency’s, or EMA, support for the development of medicines 
that target unmet medical needs. It is based on increased interaction and early dialogue with companies developing promising medicines, to optimize their 
product development plans and speed up their evaluation to help them reach patients earlier. The benefits of a PRIME designation include the appointment 
of a rapporteur before submission of a marketing authorization application, early dialogue and scientific advice at key development milestones, and the 
potential to qualify products for accelerated review earlier in the application process.

Even if we believe one of our product candidates is eligible for PRIME, the EMA may disagree and instead determine not to make such designation. 

The EMA PRIME scheme or other schemes, designations, or tools, even if obtained or used for any of our product candidates may not lead to a faster 
development, regulatory review or approval process compared to therapies considered for approval under conventional procedures and do not assure 
ultimate approval. In addition, even if one or more of our product candidates is eligible to the PRIME scheme, the EMA may later decide that such product 
candidates no longer meet the conditions for qualification or decide that the time period for review or approval will not be shortened.

Product developers that benefit from PRIME designation may be eligible for accelerated assessment (in 150 days instead of 210 days), which may 

be granted for medicinal products of major interest from a public health perspective or that target an unmet medical need, but this is not guaranteed. 

The competent regulatory authorities in the EU have broad discretion whether to grant such an accelerated assessment, and, even if such assessment 

is granted, we may not experience a faster development process, review or authorization compared to conventional procedures. Moreover, the removal or 
threat of removal of such an accelerated assessment may create uncertainty or delay in the clinical development of our product candidates and threaten the 
commercialization prospects of our products and product candidates, if approved. Such an occurrence could materially impact our business, financial 
condition and results of operations. 

We may seek orphan drug designation for some of our product candidates but may not be able to obtain it. 

We have obtained orphan drug designation from the FDA for SER-109 for recurrent CDI and SER-287 for pediatric UC and may seek orphan drug 

designation and exclusivity for some of our future product candidates. Regulatory authorities in some jurisdictions, including the United States and Europe, 
may designate drugs and biologics for relatively small patient populations as orphan drugs. In the United States, the FDA may designate a drug or biologic 
as an orphan drug if it is intended to treat a rare disease or condition, which is defined as a disease or condition that affects fewer than 200,000 individuals 
in the United States, or a patient population greater than 200,000 in the United States where there is no reasonable expectation that the cost of developing 
the drug will be recovered from sales in the United States. Orphan drug designation must be requested before submitting a BLA. In the United 

38

States, orphan drug designation entitles a party to financial incentives such as opportunities for grant funding towards clinical trial costs, tax advantages 
and application fee waivers. After the FDA grants orphan drug designation, the generic identity of the drug and its potential orphan use are disclosed 
publicly by the FDA.

In addition, if a product with an orphan drug designation subsequently receives the first marketing approval for the disease or condition for which it 

has such designation, the product is entitled to a period of marketing exclusivity, which precludes the FDA or other regulatory authorities from approving 
another marketing application for the same drug or biologic for that time period, except in limited circumstances, such as a showing of clinical superiority 
over the product with orphan exclusivity or where the manufacturer is unable to assure sufficient product quantity for the orphan patient population. The 
applicable period is seven years in the United States and ten years in Europe. The European exclusivity period can be reduced to six years if, at the end of 
the fifth year, it is established that a product no longer meets the criteria for orphan drug designation or if the product is sufficiently profitable so that 
market exclusivity is no longer justified. Orphan drug exclusivity may be lost if the FDA or other regulatory authorities determine that the request for 
designation was materially defective or if the manufacturer is unable to assure a sufficient quantity of the drug or biologic to meet the needs of patients with 
the rare disease or condition. Exclusive marketing rights in the United States may also be unavailable if we or our collaborators seek approval for an 
indication broader than the orphan designated indication and may be lost if the FDA later determines that the request for designation was materially 
defective.

Even if we obtain orphan drug designation, we may not be the first to obtain marketing approval for any particular orphan indication due to the 

uncertainties associated with developing pharmaceutical products. Further, even if we obtain orphan drug exclusivity for a product candidate, that 
exclusivity for a product may not effectively protect the product from competition because different drugs and biologics can be approved for the same 
disease or condition. Even after an orphan drug or biologic is approved, the FDA or other regulatory authorities can subsequently approve the same drug or 
biologic for the same disease or condition if the FDA or other regulatory authorities conclude that the later drug is clinically superior in that it is shown to 
be safer, more effective or makes a major contribution to patient care. Orphan drug designation neither shortens the development time or regulatory review 
time nor gives the drug any advantage in the regulatory review or approval process.

Disruptions at the FDA and other government agencies caused by funding shortages or global health concerns could hinder their ability to hire, retain 
or deploy key leadership and other personnel, or otherwise prevent new or modified products from being developed, approved or commercialized in a 
timely manner or at all, which could negatively impact our business.

The ability of the FDA and other regulatory authorities to review and or approve new products can be affected by a variety of factors, including 

government budget and funding levels, statutory, regulatory, and policy changes, the FDA’s and other regulatory authorities' ability to hire and retain key 
personnel and accept the payment of user fees, and other events that may otherwise affect the FDA’s and other regulatory authorities' ability to perform 
routine functions. Average review times at the FDA have fluctuated in recent years as a result. In addition, government funding of other government 
agencies that fund research and development activities is subject to the political process, which is inherently fluid and unpredictable. Disruptions at the 
FDA and other regulatory authorities, such as the EMA, following its relocation to Amsterdam and resulting staff changes, may also slow the time 
necessary for new drugs and biologics to be reviewed and/or approved by necessary regulatory authorities, which would adversely affect our business.  For 
example, over the last several years, the U.S. government has shut down several times and certain regulatory authorities, such as the FDA, have had to 
furlough critical FDA employees and stop critical activities.  

Separately, in response to the COVID-19 pandemic, the FDA postponed most inspections of domestic and foreign manufacturing facilities at various 
points. Even though the FDA has since resumed standard inspection operations of domestic facilities where feasible, the FDA has continued to monitor and 
implement changes to its inspectional activities to ensure the safety of its employees and those of the firms it regulates as it adapts to the evolving COVID-
19 pandemic, and any resurgence of the virus or emergence of new variants may lead to further inspectional delays. Regulatory authorities outside the 
United States, including the EMA, have adopted similar restrictions or other policy measures in response to the COVID-19 pandemic. If a prolonged 
government shutdown occurs, or if global health concerns continue to prevent the FDA or other regulatory authorities from conducting their regular 
inspections, reviews, or other regulatory activities, it could significantly impact the ability of the FDA or other regulatory authorities to timely review and 
process our regulatory submissions, which could have a material adverse effect on our business.

Risks Related to our Dependence on Third Parties and Manufacturing

The collaboration and license agreements with Société des Produits Nestlé S.A. and NHSc Rx License GmbH (collectively, and together with their 
affiliates and subsidiaries, Nestlé) are important to our business. If we or Nestlé fail to adequately perform under these agreements, or if we or Nestlé 
terminate the agreements, the development and commercialization of our CDI and IBD product candidates, including SER-109, SER-287 and SER-
301, could be delayed or terminated and our business would be adversely affected.

In January 2016, we entered into a Collaboration and License Agreement with Nestlé, or the 2016 License Agreement. The 2016 License Agreement 

may be terminated:

•

by Nestlé in the event of serious safety issues related to SER-109, SER-287, SER-301 or other specific products added under the 2016 
License Agreement, or, collectively, the 2016 Collaboration Products;

39

•

•

by us if Nestlé challenges the validity or enforceability of any of our licensed patents; and 

by either Nestlé or us in the event of the other party’s uncured material breach or insolvency. 

Upon termination of the 2016 License Agreement, all licenses granted to Nestlé by us will terminate, and all rights in and to the 2016 Collaboration 

Products held by Nestlé will revert to us. If we commit a material breach of the 2016 License Agreement, Nestlé may elect not to terminate the 2016 
License Agreement but instead apply specified adjustments to its payment obligations and other terms and conditions of the 2016 License Agreement. If 
Nestlé were to make such adjustments, the funding from and benefits of the 2016 License Agreement could be diminished, which could adversely affect 
our financial condition. Unless the 2016 License Agreement is terminated by us for Nestlé’s uncured material breach, upon termination of the 2016 License 
Agreement, Nestlé will be eligible to receive post-termination royalties from us until Nestlé has recouped certain development costs related to the 2016 
Collaboration Products and specified percentages of any milestone payments paid to us under the 2016 License Agreement prior to termination, which 
could have a material adverse effect on our business.

In July 2021, we entered into a License Agreement with Nestlé, or the 2021 License Agreement. The 2021 License Agreement may be terminated:

•

•

•

•

•

by Nestlé with twelve months’ prior written notice, effective only on or after the third anniversary of first commercial sale of our SER-109 
product and any improvements and modifications thereto developed pursuant to the terms of the 2021 License Agreement, or the 2021 
Collaboration Products;

by Nestlé if first commercial sale of the first 2021 Collaboration Product has not occurred by the fifth anniversary of the effective date of the 
2021 License Agreement, with 180 days’ prior written notice, which must be provided during a specified period set forth in the 2021 License 
Agreement;

by Nestlé if regulatory approval for SER-109 is not granted after submission by us of a filing seeking first regulatory approval as set forth in 
the development and regulatory activity plan, and the parties fail to agree on further development of SER-109 in accordance with the terms of 
the 2021 License Agreement, with 180 days’ prior written notice, which must be provided within a specified period set forth in the 2021 
License Agreement;

by us if Nestlé challenges the validity or enforceability of any of our licensed patents; and 

by either Nestlé or us in the event of the other party’s uncured material breach or insolvency. 

Upon termination of the 2021 License Agreement, all licenses granted to Nestlé by us will terminate. If we commit a material breach of the 2021 

License Agreement, Nestlé may elect not to terminate the 2021 License Agreement but instead apply specified adjustments to the payment terms and other 
terms and conditions of the agreement. If Nestlé were to make such adjustments, the funding from and benefits of the 2021 License Agreement could be 
diminished, which could adversely affect our financial condition. In the event we materially breach the 2021 License Agreement or file for bankruptcy, the 
share of profits and milestones due to us will be reduced by a specified percentage until Nestlé has recouped twice the losses caused by our material breach 
or bankruptcy.  

Termination of these agreements could cause significant delays in our product development and commercialization efforts that could prevent us 
from commercializing our CDI and IBD product candidates without first expanding our internal capabilities or entering into another agreement with a third 
party. Any alternative collaboration or license could also be on less favorable terms to us. In addition, under the agreements, Nestlé agreed to provide 
funding for certain clinical development activities. If either of the agreements were terminated, we may need to refund those payments and seek additional 
financing to support the research and development of any terminated products or discontinue any terminated products, which could have a material adverse 
effect on our business.  

Under the collaboration and license agreements, we are dependent upon Nestlé to successfully commercialize any applicable collaboration products 

both outside and within the United States and Canada, as applicable. We cannot directly control Nestlé’s commercialization activities or the resources it 
allocates to our product candidates. Our interests and Nestlé’s interests may differ or conflict from time to time, or we may disagree with Nestlé’s level of 
effort or resource allocation. Nestlé may internally prioritize our product candidates differently than we do or it may not allocate sufficient resources to 
effectively or optimally commercialize them. If these events were to occur, our business would be adversely affected.

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

We expect to continue to rely on third parties, such as CROs, clinical data management organizations, medical institutions and clinical investigators, 

to conduct and manage our clinical trials.

Our reliance on these third parties for research and development activities will reduce our control over these activities but does not relieve us of our 
responsibilities. For example, we remain responsible for ensuring that each of our clinical trials is conducted in accordance with the general investigational 
plan and protocols for the trial. Moreover, the FDA requires us to comply with regulatory standards, commonly referred to as good clinical practices, or 
GCPs, for conducting, recording and reporting the results of clinical trials to assure that data and reported results are credible and accurate and that the 
rights, safety and welfare of trial participants are protected. Regulatory authorities enforce these GCPs through periodic inspections of trial sponsors, 
principal investigators and trial sites. If we or any of these third parties or our CROs 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. We cannot assure you that upon inspection by a given regulatory authority, such regulatory authority will 
determine that any of our clinical trials comply with GCP regulations. In addition, our clinical trials must be conducted with product produced under cGMP 
regulations or similar regulatory requirements outside the United States. Our failure to comply with these regulations may require us to repeat clinical 
trials, which would delay the regulatory approval process. Moreover, our business may be adversely affected if any of these third parties violates federal or 
state fraud and abuse or false claims laws and regulations or healthcare privacy and security laws. Other countries’ regulatory authorities also have 
requirements for clinical trials with which we must comply. We also are required to register ongoing clinical trials and post the results of completed clinical 
trials on a government-sponsored database, ClinicalTrials.gov, within specified timeframes. Failure to do so can result in fines, adverse publicity and civil 
and criminal sanctions.

Furthermore, these third parties may also have relationships with other entities, some of which may be our competitors. If these third parties do not 

successfully carry out their contractual duties, do not meet expected deadlines, experience work stoppages, terminate their agreements with us or need to be 
replaced, or do not conduct our clinical trials in accordance with regulatory requirements or our stated protocols, we may need to enter into new 
arrangements with alternative third parties, which could be difficult, costly or impossible, and our clinical trials may be extended, delayed, or terminated or 
may need to be repeated. If any of the foregoing occur, we may not be able to obtain, or may be delayed in obtaining, marketing approvals for our product 
candidates and may not be able to, or may be delayed in our efforts to, successfully commercialize our product candidates.

We also expect to rely on other third parties to store and distribute drug supplies for our clinical trials. Any performance failure on the part of our 

distributors could delay clinical development or marketing approval of our product candidates or commercialization of our products, producing additional 
losses and depriving us of potential product revenue.

We rely on third parties for certain aspects of the manufacture of our product candidates for preclinical and clinical testing and for potential 
commercial manufacture, and we expect to continue to do so for the foreseeable future. This reliance on third parties increases the risk that we will not 
have sufficient quantities of our product candidates or that such quantities may not be available at an acceptable cost, which could delay, prevent or 
impair our development or commercialization efforts. 

We rely, and expect to continue to rely, on third parties, including GenIbet and Bacthera, for certain aspects of materials supply for our product 
candidates in preclinical and clinical testing, as well as for commercial manufacture if any of our product candidates receive marketing approval. This 
reliance on third parties increases the risk that we will not have sufficient quantities of our product candidates on a timely basis or at all, or that such 
quantities will be available at an acceptable cost or quality, which could delay, prevent or impair our development or commercialization efforts.  For 
example, certain of our product candidates rely on human stool from third-party donors.  If we do not obtain an adequate supply of donor-derived material 
to meet clinical or commercial demand, our ability to manufacture our product candidates may be delayed or adversely impacted.

We rely on third-party manufacturers, which entails additional risks, including:

•

•

•

•

•

•

•

failure of third-party manufacturers to comply with regulatory requirements and maintain quality assurance;

failure of third-party manufacturers to perform the manufacturing process adequately;

breach of supply agreements by the third-party manufacturers;

failure to supply components, intermediates, services, or product according to our specifications;

failure to supply components, intermediates, services, or product according to our schedule or at all;

misappropriation or disclosure of our proprietary information, including our trade secrets and know-how; and

termination or nonrenewal of agreements by third-party manufacturers at times that are costly or inconvenient for us.

41

Third-party manufacturers may not be able to comply with current good manufacturing processes, or cGMP, regulations or similar regulatory 

requirements inside or outside the United States. Our failure, or the failure of our third-party manufacturers, to comply with applicable regulations could 
result in sanctions being imposed on us, including clinical holds, fines, injunctions, civil penalties, delays, suspension or withdrawal of approvals, license 
revocations, seizures or recalls of product candidates or products, operating restrictions and criminal prosecutions, any of which could significantly and 
adversely affect supplies of our products. Some of the contract manufacturers we rely on to produce our product candidates have never produced an FDA-
approved therapeutic. One of the contract manufacturers on which we rely will be constructing a building in which to manufacture our product candidates, 
which may not be completed on time or at all or, upon completion, may not be approved by the FDA. If our manufacturers are unable to comply with 
cGMP regulation or similar regulatory requirements outside the United States or if the FDA or other regulatory authorities do not approve their facility 
upon a pre-approval inspection, our therapeutic candidates may not be approved or may be delayed in obtaining approval. In addition, there are a limited 
number of manufacturers that operate under cGMP regulations and similar regulatory requirements outside the United States that might be capable of 
manufacturing our products. Therefore, our product candidates and any future products that we may develop may compete with other products for access to 
manufacturing facilities. Any failure to gain access to these limited manufacturing facilities could severely impact the clinical development, marketing 
approval and commercialization of our product candidates.

Any performance failure on the part of our existing or future manufacturers could delay clinical development or marketing approval. We do not 

currently have a second source for certain required materials used for the manufacture of finished product. If our current manufacturers cannot perform as 
agreed, we may be required to replace such manufacturers and we may be unable to replace them on a timely basis or at all. Our current and anticipated 
future dependence upon others for the manufacture of our product candidates or products could delay, prevent or impair our development and 
commercialization efforts.  Moreover, as a result of the COVID-19 pandemic, third-party manufacturers may be affected, which could disrupt their 
activities and as a result we could face difficulty sourcing key components necessary to produce supply of our product candidates, which may negatively 
affect our preclinical and clinical development activities.

We have no experience manufacturing our product candidates commercially, and we cannot assure you that we can manufacture our product 
candidates in compliance with regulations at a cost or in quantities necessary to make them commercially viable.

We have manufacturing facilities at our Cambridge, Massachusetts locations where we conduct process development, scale-up activities and a 
portion of the manufacture of microbiome therapeutics. The FDA and other comparable foreign regulatory authorities must, pursuant to inspections that are 
conducted after submitting a BLA or relevant foreign marketing submission, confirm that the manufacturing processes for the product meet cGMP or 
similar regulatory requirements outside the United States. We have not yet received the final results of any inspections of our manufacturing facilities.

We currently intend to rely in part on third-party manufacturers for the commercial manufacturing of SER-109 and may establish a manufacturing 

facility for SER-109 or any of our other product candidates for production at a commercial scale. We have no experience in manufacturing sufficient 
volume of our product candidates to meet potential market demands. We may not be able to develop commercial-scale manufacturing facilities that are 
adequate to produce materials for commercial use.

The equipment and facilities employed in the manufacture of pharmaceuticals are subject to stringent qualification requirements by regulatory 

agencies, including validation of facility, equipment, systems, processes and analytics. We may be subject to lengthy delays and expense in conducting 
validation studies, if we can meet the requirements at all.

In addition, some of our product candidates require donor material, of which we may not be able to collect sufficient quantities for commercial-scale 

or other manufacturing. 

Risks Related to Commercialization of Our Product Candidates and

Other Legal Matters

Even if any of our product candidates receive marketing approval, it may fail to achieve the degree of market acceptance by physicians, patients, 
hospitals, third-party payors and others in the medical community necessary for commercial success.

If any of our product candidates receives marketing approval, it may nonetheless fail to gain sufficient market acceptance by physicians, patients, 

third-party payors and others in the medical community. For example, current CDI treatment involves the use of antibiotics that are well established in the 
medical community or the use of FMT, and physicians may continue to rely on these treatments.  If our product candidates receive approval but do not 
achieve an adequate level of acceptance, we or our collaborators may not generate significant product revenue and we may not become profitable. The 
degree of market acceptance of our approved product candidates, if any, will depend on a number of factors, including:

•

•

•

•

their efficacy, safety and other potential advantages compared to alternative treatments;

the clinical indications for which our products are approved;

our ability to offer them for sale at competitive prices;

their convenience and ease of administration compared to alternative treatments;

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•

•

•

•

•

•

•

the willingness of the target patient population to try new therapies and of physicians to prescribe these therapies;

the strength of marketing and distribution support;

the availability of third-party coverage and adequate reimbursement for our product candidates;

the prevalence and severity of their side effects and their overall safety profiles;

any restrictions on the use of our products together with other medications;

interactions of our products with other medicines patients are taking; and

the ability of patients to take our products.

If we or our collaborators are unable to establish effective sales, marketing and distribution capabilities or enter into agreements with third parties with 
such capabilities, we or our collaborators may not be successful in commercializing our product candidates if and when they are approved.

We have employees with experience in sales and marketing, but we have limited sales or marketing infrastructure and, as a company, have no 

experience in the sale, marketing, or distribution of pharmaceutical products. To achieve commercial success for any product for which we obtain 
marketing approval, we will need to establish a sales and marketing organization or make arrangements with third parties to perform sales and marketing 
functions and we may not be successful in doing so.

In July 2021, we entered into the 2021 License Agreement with Nestlé, pursuant to which we granted Nestlé, under certain of our patent rights and 

know how, a co-exclusive, sublicensable (under certain conditions) license to develop, commercialize and conduct medical affairs activities for the 2021 
Collaboration Products in the United States and Canada. Under the 2021 License Agreement, Nestlé has the sole right to commercialize the 2021 
Collaboration Products in the 2021 Licensed Territory in accordance with a commercialization plan, subject to our right to elect to provide up to a specified 
percentage of all promotional details for a certain target audience. Each party will use commercially reasonable efforts to commercialize the 2021 
Collaboration Products in the 2021 Licensed Territory in accordance with the commercialization plan. Both parties will perform medical affairs activities 
for 2021 Collaboration Products in the 2021 Licensed Territory in accordance with a medical affairs plan. We will be responsible for commercialization and 
medical affairs activities costs incurred by the parties until first commercial sale of the first 2021 Collaboration Product in the 2021 Licensed Territory and 
in accordance with a pre-launch plan, up to a specified cap.

In the future, we expect to build a focused sales and marketing infrastructure, or certain components of such infrastructure, to market or co-promote 

our product candidates in the United States and potentially elsewhere, if and when they are approved. There are risks involved with establishing our own 
sales, marketing and distribution capabilities. For example, recruiting and training a sales force is expensive and time-consuming and could delay any 
product launch. If the commercial launch of a product candidate for which we recruit a sales force and establish marketing capabilities is delayed or does 
not occur for any reason, we would have prematurely or unnecessarily incurred these commercialization expenses. This may be costly, and our investment 
would be lost if we or our collaborators cannot retain or reposition sales and marketing personnel.

Factors that may inhibit efforts to commercialize our products include:

•

•

•

•

•

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

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

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

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

inability to obtain sufficient coverage and reimbursement from third-party payors and governmental agencies.

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

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

The development and commercialization of new drug and biologic products is highly competitive and is characterized by rapid and substantial 

technological development and product innovations. We and our collaborators face competition with respect to our 

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current product candidates and will face competition with respect to any product candidates that we may seek to develop or commercialize in the future, 
from major pharmaceutical companies, specialty pharmaceutical companies and biotechnology companies worldwide. We are aware of a number of large 
pharmaceutical and biotechnology companies, as well as smaller, early-stage companies, that are pursuing the development or commercialization of 
products, including microbiome therapeutics, for reducing CDI and other disease indications we are targeting. Some of these competitive products and 
therapies are based on scientific approaches that are the same as or similar to our approach, and others may be based on entirely different approaches. For 
example, FMT is a procedure that has resulted in reports of high success rates for recurrent CDI. Potential competitors also include academic institutions, 
government agencies, not-for-profits, and other public and private research organizations that conduct research, seek patent protection and establish 
collaborative arrangements for research, development, manufacturing and commercialization.

Many of the companies against which we are competing or against which we may compete in the future have significantly greater financial 

resources, established presence in the market and expertise in research and development, manufacturing, preclinical testing, conducting clinical trials, 
obtaining regulatory approvals and reimbursement and marketing approved products than we do. Mergers and acquisitions in the pharmaceutical and 
biotechnology industries may result in even more resources being concentrated among a smaller number of our competitors.

These third parties compete with us in recruiting and retaining qualified scientific, sales and marketing and management personnel, establishing 

clinical trial sites and patient registration for clinical trials, as well as in acquiring technologies complementary to, or necessary for, our programs.

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

fewer or less severe side effects, are more convenient or are less expensive than any products that we may develop. Our competitors also may obtain FDA 
or other regulatory approval for their products more rapidly than we may obtain approval for ours, which could result in our competitors establishing a 
strong market position before we are able to enter the market, especially for any competitor developing a microbiome therapeutic which will likely share 
our same regulatory approval requirements. In addition, our ability to compete may be affected in many cases by insurers or other third-party payors 
seeking to encourage the use of generic or biosimilar products.

Even if we are able to commercialize any product candidates, the products may become subject to unfavorable pricing regulations or third-party 
coverage and reimbursement policies, any of which would harm our business.

Our ability to commercialize any product candidates successfully will depend, in part, on the extent to which coverage and reimbursement for these 

products and related treatments will be available from government health administration authorities, private health insurers and other organizations. 
Government authorities and third-party payors, such as private health insurers and health maintenance organizations, decide which medications they will 
pay for and impact reimbursement levels.

Obtaining and maintaining adequate reimbursement for our products may be difficult. We cannot be certain if and when we will obtain an adequate 

level of reimbursement for our products by third-party payors. Even if we do obtain adequate levels of reimbursement, third-party payors, such as 
government or private healthcare insurers, carefully review, and increasingly question the coverage of, and challenge the prices charged for, drugs. 
Reimbursement rates from private health insurance companies vary depending on the company, the insurance plan and other factors. A primary trend in the 
U.S. healthcare industry and elsewhere is cost containment. Government authorities and third-party payors have attempted to control costs by limiting 
coverage and the amount of reimbursement for particular medications. 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. We may also be required to conduct expensive 
pharmacoeconomic studies to justify coverage and reimbursement or the level of reimbursement relative to other therapies. If coverage and reimbursement 
are not available or reimbursement is available only to limited levels, we may not be able to successfully commercialize any product candidate for which 
we obtain marketing approval, and the royalties resulting from the sales of those products may also be adversely impacted.

There may be significant delays in obtaining reimbursement for newly approved drugs, and coverage may be more limited than the purposes for 

which the drug is approved by the FDA or similar regulatory authorities outside the United States. Moreover, eligibility for reimbursement does not imply 
that a drug will be paid for in all cases or at a rate that covers our costs, including research, development, manufacture, sale and distribution. Interim 
reimbursement levels for new drugs, if applicable, may also not be sufficient to cover our costs and may not be made permanent. Reimbursement rates may 
vary according to the use of the drug and the clinical setting in which it is used, may be based on reimbursement levels already set for lower cost treatment 
approaches and may be incorporated into existing payments for other services. Net prices for drugs may be reduced by mandatory discounts or rebates 
required by government healthcare programs or private payors and by any future relaxation of laws that presently restrict imports of drugs from countries 
where they may be sold at lower prices than in the United States. Our inability to promptly obtain coverage and adequate reimbursement rates from both 
government-funded and private payors for any approved products that we develop could have a material adverse effect on our operating results, our ability 
to raise capital needed to commercialize products and our overall financial condition.

The regulations that govern marketing approvals, pricing, coverage and reimbursement for new drug products vary widely from country to country. 

Current and future legislation may significantly change the approval requirements in ways that could involve 

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additional costs and cause delays in obtaining approvals. Some countries require approval of the sale price of a drug before it can be reimbursed. In many 
countries, the pricing review period begins after marketing or product licensing approval is granted. In some foreign markets, prescription pharmaceutical 
pricing remains subject to continuing governmental control, including possible price reductions, even after initial approval is granted. As a result, we might 
obtain marketing approval for a product in a particular country, but then be subject to price regulations that delay our commercial launch of the product, 
possibly for lengthy time periods, and negatively impact the revenues we are able to generate from the sale of the product in that country. Adverse pricing 
limitations may hinder our ability to recoup our investment in one or more product candidates, even if our product candidates obtain marketing approval. 
There can be no assurance that our product candidates, if they are approved for sale in the United States or in other countries, will be considered medically 
necessary for a specific indication or cost-effective, or that coverage or an adequate level of reimbursement will be available.

Product liability lawsuits against us could cause us to incur substantial liabilities and limit commercialization of any products that we may develop.

We face an inherent risk of product liability exposure related to the testing of our product candidates in clinical trials and will face an even greater 
risk if we commercially sell any products that we may develop. If we cannot successfully defend ourselves against claims that our product candidates or 
products caused injuries, we will incur substantial liabilities. Regardless of merit or eventual outcome, liability claims may result in:

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regulatory investigations, product recalls or withdrawals, or labeling, marketing or promotional restrictions;

decreased demand for any product candidates or products that we may develop;

injury to our reputation and significant negative media attention;

withdrawal of clinical trial participants;

significant costs to defend the related litigation;

substantial monetary awards to trial participants or patients;

loss of revenue;

reduced resources of our management to pursue our business strategy; and

the inability to commercialize any products that we may develop.

We currently hold $5.0 million in product liability insurance coverage in the aggregate, with a per occurrence limit of $5.0 million, which may not 
be adequate to cover all liabilities that we may incur. We may need to increase our insurance coverage as we expand our clinical trials or if we commence 
commercialization of our product candidates. Insurance coverage is increasingly expensive. We may not be able to maintain insurance coverage at a 
reasonable cost or in an amount adequate to satisfy any liability that may arise.

We may face competition from biosimilars, which may have a material adverse impact on the future commercial prospects of our product candidates.

Even if we and our collaborators are successful in achieving regulatory approval to commercialize a product candidate faster than our competitors, 

we may face competition from biosimilars. In the United States, the Biologics Price Competition and Innovation Act, or BPCIA, enacted in 2010 as part of 
the Patient Protection and Affordable Care Act, created an abbreviated approval pathway for biological products that are demonstrated to be “highly 
similar,” or biosimilar, to or “interchangeable” with an FDA-approved biological product. Under the BPCIA, an application for a biosimilar product may 
not be submitted to the FDA until four years following the date that the reference product was first licensed by the FDA. In addition, the approval of a 
biosimilar product may not be made effective by the FDA until 12 years from the date on which the reference product was first licensed. During this 12-
year period of exclusivity, another company may still market a competing version of the reference product if the FDA approves a full BLA for the 
competing product containing the sponsor’s own preclinical data and data from adequate and well-controlled clinical trials to demonstrate the safety, purity 
and potency of their product. This pathway could allow competitors to reference data from innovative biological products 12 years after the time of 
approval of the innovative biological product. This data exclusivity does not prevent another company from developing a product that is highly similar to 
the innovative product, generating its own data and seeking approval. Data exclusivity only assures that another company cannot rely upon the data within 
the innovator’s application to support the biosimilar product’s approval.

We believe that any of our product candidates approved as a biological product under a BLA should qualify for the 12-year period of exclusivity. 
However, there is a risk that this exclusivity could be shortened due to congressional action or otherwise, or that the FDA will not consider our product 
candidates to be reference products for competing products, potentially creating the opportunity for generic competition sooner than anticipated. It is 
possible that Congress or the FDA may take these or other measures to reduce or eliminate periods of exclusivity. The BPCIA is complex and continues to 
be interpreted and implemented by the FDA, and such FDA implementation could have a material adverse effect on the future commercial prospects for 
our product candidates.

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In Europe, the European Commission has granted marketing authorizations for several biosimilars pursuant to a set of general and product class-
specific guidelines for biosimilar approvals issued over the past few years. In Europe, a competitor may reference data supporting approval of an innovative 
biological product but will not be able to get on the market until 10 years after the time of approval of the innovative product. This 10-year marketing 
exclusivity period can be extended to 11 years if, during the first eight of those 10 years, the marketing authorization holder obtains an approval for one or 
more new therapeutic indications that bring significant clinical benefits compared with existing therapies. In addition, companies may be developing 
biosimilars in other countries that could compete with our products. If competitors are able to obtain marketing approval for biosimilars referencing our 
products, our products may become subject to competition from such biosimilars, with the attendant competitive pressure and consequences.

Failure to obtain marketing approval in international jurisdictions would prevent our product candidates from being marketed abroad.

In order to market and sell our products in the European Union, or EU, and many other jurisdictions, we or our collaborators must obtain separate 

marketing approvals and comply with numerous and varying regulatory requirements. The approval procedure varies among countries and can involve 
additional testing. The time required to obtain approval in foreign countries may differ substantially from that required to obtain FDA approval. Clinical 
trials conducted in one country may not be accepted by regulatory authorities in other countries. The regulatory approval process outside the United States 
generally includes all of the risks associated with obtaining FDA approval. In addition, in many countries outside the United States, it is required that the 
product be approved for reimbursement before the product can be approved for sale in that country. We or our collaborators may not obtain approvals for 
our product candidates from regulatory authorities outside the United States on a timely basis, if at all. Approval by the FDA does not ensure approval by 
regulatory authorities in other countries or jurisdictions, and approval by one regulatory authority outside the United States does not ensure approval by 
regulatory authorities in other countries or jurisdictions or by the FDA. However, a failure or delay in obtaining regulatory approval in one country may 
have a negative effect on the regulatory process in others. We may not be able to file for marketing approvals and may not receive necessary approvals to 
commercialize our products in any market.

Any product candidate for which we obtain marketing approval will remain subject to significant post-marketing regulatory requirements and 
oversight.

Any product candidate for which we obtain marketing approval, along with the manufacturing processes, post-approval clinical data, labeling, 
advertising and promotional activities for such product, will be subject to the continual requirements of and review by the FDA and other regulatory 
authorities. These requirements include submissions of safety and other post-marketing information and reports, registration and listing requirements, 
cGMP and similar foreign requirements relating to manufacturing, quality control, quality assurance and corresponding maintenance of records and 
documents, requirements regarding the distribution of samples to physicians and recordkeeping. We and our contract manufacturers will also be subject to 
continual review and periodic inspections to assess compliance with cGMP and similar foreign requirements. Accordingly, we, and our collaborators and 
others with whom we work, must continue to expend time, money and effort in all areas of regulatory compliance, including manufacturing, production and 
quality control.

Even if marketing approval of a product candidate is granted, the approval may be subject to limitations on the indicated uses for which the product 
may be marketed or to specific conditions of approval, including a requirement to implement a risk evaluation and mitigation strategy, which could include 
requirements for a medication guide, communication plan, or restricted distribution system. If any of our product candidates receives marketing approval, 
the accompanying label may limit the approved use of our drug, which could limit sales of the product.

The FDA or other regulatory authorities may also impose requirements for costly post-marketing studies or clinical trials and surveillance to monitor

the safety or efficacy of our approved products. The FDA or other regulatory authorities closely regulates the post-approval marketing and promotion of 
drugs and biologics to ensure they are marketed only for the approved indications and in accordance with the provisions of the approved labeling. 
Violations of the FDA’s and other regulatory authorities’ restrictions relating to the promotion of prescription drugs by us or our collaborators may also lead 
to investigations alleging violations of federal and state health care fraud and abuse laws, as well as state consumer protection laws.

In addition, if a regulatory authority, we or our collaborators later discover previously unknown problems with our products, such as adverse events 

of unanticipated severity or frequency, problems with manufacturers or manufacturing processes, or failure to comply with regulatory requirements, the 
regulatory authority may impose restrictions on the products or us and our collaborators, including requiring withdrawal of the product from the market. 
Any failure by us or our collaborators to comply with applicable regulatory requirements may yield various results, including:

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litigation involving patients taking our products;

restrictions on such products, manufacturers or manufacturing processes;

restrictions on the labeling or marketing of a product;

restrictions on product distribution or use;

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requirements to conduct post-marketing studies or clinical trials;

warning letters;

withdrawal of products from the market;

suspension or termination of ongoing clinical trials;

refusal to approve pending applications or supplements to approved applications that we submit;

recall of products;

fines, restitution or disgorgement of profits or revenues;

suspension or withdrawal of marketing approvals;

damage to relationships with potential collaborators;

unfavorable press coverage and damage to our reputation;

refusal to permit the import or export of our products;

product seizure or detention;

injunctions; or

imposition of civil or criminal penalties.

Noncompliance with similar EU requirements regarding safety monitoring or pharmacovigilance can also result in significant financial penalties. 

Similarly, failure to comply with U.S. and foreign regulatory requirements regarding the development of products for pediatric populations and the 
protection of personal health information can also lead to significant penalties and sanctions.

Any government investigation of alleged violations of law could require us to expend significant time and resources in response and could generate 

negative publicity.

In addition, the FDA’s and other regulatory authorities’ policies may change and additional government regulations may be enacted that could 
prevent, limit or delay regulatory approval of our product candidates. We also 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.  It is difficult to predict whether or how any executive 
orders will be implemented, or whether they will be rescinded and replaced under future administrations. The policies and priorities of the new 
administrations are unknown and could materially impact the regulations governing our product candidates. 

If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to 

maintain regulatory compliance, we may be subject to enforcement action and we may not achieve or sustain profitability.

The FDA and other regulatory authorities actively enforce the laws and regulations prohibiting the promotion of off-label uses.

If any of our product candidates are approved and we or our collaborators are found to have improperly promoted off-label uses of those products, 
we may become subject to significant liability. The FDA and other regulatory authorities strictly regulate the promotional claims that may be made about 
prescription products, such as our product candidates, if approved. In particular, a product may not be promoted for uses that are not approved by the FDA 
or such other regulatory authorities as reflected in the product’s approved labeling. If we receive marketing approval for a product candidate, physicians 
may nevertheless prescribe it to their patients in a manner that is inconsistent with the approved label. If we or our collaborators are found to have 
promoted such off-label uses, we may become subject to significant liability. The U.S. federal government has levied large civil and criminal fines against 
companies for alleged improper promotion of off-label use and has enjoined several companies from engaging in off-label promotion. The FDA has also 
requested that companies enter into consent decrees or permanent injunctions under which specified promotional conduct is changed or curtailed. If we 
cannot successfully manage the promotion of our product candidates, if approved, we could become subject to significant liability, which would materially 
adversely affect our business and financial condition.

Our relationships and any collaborators' relationships with customers, physicians and third-party payors are and will be subject to applicable anti-
kickback, fraud and abuse and other healthcare laws and regulations, which could expose us or our collaborators to criminal sanctions, civil penalties, 
exclusion from governmental healthcare programs, contractual damages, reputational harm and diminished profits and future earnings.

Healthcare providers, physicians and third-party payors will play a primary role in the recommendation and prescription of any product candidates 

for which we obtain marketing approval. Our and our collaborators' current and future arrangements with third-party payors, physicians and customers 
expose us to broadly applicable fraud and abuse and other healthcare laws and regulations that may restrict the business or financial arrangements and 
relationships through which we market, sell and distribute any products for 

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which we obtain marketing approval. Restrictions under applicable federal and state healthcare laws and regulations include the following:

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the federal Anti-Kickback Statute prohibits, among other things, persons from knowingly and willfully soliciting, offering, receiving or 
providing remuneration, directly or indirectly, in cash or in kind, to induce or reward, or in return for, either the referral of an individual for, 
or the purchase, order or recommendation of, any good or service, for which payment may be made under a federal healthcare program, such 
as Medicare and Medicaid; a person or entity does not need to have actual knowledge of the statute or specific intent to violate it to have 
committed a violation; 

the False Claims Act, imposes, among other things, impose criminal and civil penalties, including through civil whistleblower or qui tam 
actions, against individuals or entities for knowingly presenting, or causing to be presented, to the federal government, claims for payment 
that are false or fraudulent, knowingly making, using or causing to be made or used, a false record or statement material to a false or 
fraudulent claim or from knowingly making a false statement to avoid, decrease or conceal an obligation to pay money to the federal 
government. In addition, 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 federal False Claims Act;

HIPAA, imposes criminal and civil liability for executing a scheme to defraud any healthcare benefit program or making false statements 
relating to healthcare matters; similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of these 
statutes or specific intent to violate them to have committed a violation;

the federal Physician Payment Sunshine Act requires applicable manufacturers of covered drugs to report payments and other transfers of 
value to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors), certain non-physician practitioners 
(physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, anesthesiology assistants, and 
certified nurse midwives), and teaching hospitals, and ownership and investment interests held by physicians and their immediate family 
members; manufacturers are required to submit reports to the government by the 90th day of each calendar year; and

analogous state and foreign laws and regulations, such as state anti-kickback and false claims laws, may apply to our business practices, 
including but not limited to, research, distribution, 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 foreign governments) and may require drug manufacturers to report information related to payments and other transfers of 
value to physicians and other healthcare providers, pricing information or marketing expenditures.

The risk of our or our collaborators being found in violation of these laws is increased by the fact that many of them have not been fully interpreted 

by the regulatory authorities or the courts, and their provisions are open to a variety of interpretations. Any action against us or our collaborators for 
violation of these laws, even if we successfully defend against it, could cause us to incur significant legal expenses and divert our management’s attention 
from the operation of our business. The shifting compliance environment and the need to build and maintain a robust system to comply with multiple 
jurisdictions with different compliance and reporting requirements increases the possibility that we may violate one or more of the requirements.

Efforts to ensure that our business arrangements with third parties will comply with applicable healthcare laws and regulations will involve 

substantial costs. It is possible that governmental authorities will conclude that our business practices may not comply with current or future statutes, 
regulations or case law involving applicable fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of any 
of these laws or any other governmental laws and regulations that may apply to us, we may be subject to significant civil, criminal and administrative 
penalties, damages, fines, imprisonment, exclusion from government funded healthcare programs, such as Medicare and Medicaid, reporting obligations 
and oversight if we become subject to a corporate integrity agreement or other agreement, and the curtailment or restructuring of our operations.

Recently enacted and future legislation may increase the difficulty and cost for us to obtain marketing approval of and commercialize our product 
candidates and affect the prices we may obtain.

In the United States and some foreign jurisdictions, there have been a number of legislative and regulatory changes and proposed changes regarding 

the healthcare system that could prevent or delay marketing approval of our product candidates, restrict or regulate post-approval activities and affect our 
ability to profitably sell any product candidates for which we obtain marketing approval.

In the United States, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation 
Act, or collectively the ACA, is a sweeping law intended to broaden access to health insurance, reduce or constrain the growth of healthcare spending, 
enhance remedies against fraud and abuse, add new transparency requirements for the healthcare and health insurance industries, impose new taxes and 
fees on the health industry and impose additional health policy reforms.

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Among the provisions of the ACA of importance to our potential product candidates are the following:

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establishment of a new pathway for approval of lower-cost biosimilars to compete with biologic products, such as those we are developing;

an annual, nondeductible fee payable by any entity that manufactures or imports specified branded prescription drugs and biologic agents;

an increase in the statutory minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program;

a new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer point-of-sale discounts off negotiated 
prices;

extension of manufacturers’ Medicaid rebate liability;

expansion of eligibility criteria for Medicaid programs;

expansion of the entities eligible for discounts under the Public Health Service pharmaceutical pricing program;

a new requirement to annually report drug samples that manufacturers and distributors provide to physicians; and

a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in and conduct comparative clinical effectiveness research, 
along with funding for such research.

Since its enactment, there have been judicial, executive and Congressional challenges to certain aspects of the ACA. On June 17, 2021, the U.S. 

Supreme Court dismissed the most recent judicial challenge to the ACA brought by several states without specifically ruling on the constitutionality of the 
ACA. Prior to the Supreme Court’s decision, President Biden issued an executive order initiating a special enrollment period from February 15, 2021 
through August 15, 2021 for purposes of obtaining health insurance coverage through the ACA marketplace.  The executive order also instructed certain 
governmental agencies to review and reconsider their existing policies and rules that limit access to healthcare. 

In addition, other legislative changes have been proposed and adopted since the ACA was enacted. For example, the Budget Control Act of 2011, 
enacted in August 2011, required sequestration that included aggregate reductions of Medicare payments to providers of 2% per fiscal year, which went 
into effect on April 1, 2013 and, due to subsequent legislative amendments, will remain in effect through 2030, unless additional Congressional action is 
taken. Under current legislation, the actual reduction in Medicare payments will increase in future years of the sequester. On January 2, 2013, the American 
Taxpayer Relief Act of 2012 was signed into law, which, among other things, reduced Medicare payments to several providers, including hospitals, and an 
increase in the statute of limitations period for the government to recover overpayments to providers from three to five years. 

Further, in March 2021, the American Rescue Plan Act of 2021 was signed into law, which, among other things, eliminated the statutory cap on drug 

manufacturers’ Medicaid Drug Rebate Program rebate liability, effective January 1, 2024. Under current law enacted as part of the ACA, drug 
manufacturers’ Medicaid Drug Rebate Program rebate liability is capped at 100% of the average manufacturer price for a covered outpatient drug.  We 
expect that other healthcare reform measures that may be adopted in the future may result in additional reductions in Medicare and other healthcare 
funding, more rigorous coverage criteria, new payment methodologies and in additional downward pressure on the price that we receive for any approved 
product. 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, attain profitability, or 
commercialize our product candidates, if approved.

Moreover, there has recently been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products. 

Individual states in the United States have become increasingly active in implementing regulations designed to contain pharmaceutical and biological 
product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and 
transparency measures. Most significantly, on August 16, 2022, President Biden signed the Inflation Reduction Act of 2022, or the IRA, into law. This 
statute marks the most significant action by Congress with respect to the pharmaceutical industry since adoption of the ACA in 2010. Among other things, 
the IRA requires manufacturers of certain drugs to engage in price negotiations with Medicare (beginning in 2026), with prices that can be negotiated 
subject to a cap; imposes rebates under Medicare Part B and Medicare Part D to penalize price increases that outpace inflation (first due in 2023); and 
replaces the Part D coverage gap discount program with a new discounting program (beginning in 2025). The IRA permits the Secretary of the Department 
of Health and Human Services to implement many of these provisions through guidance, as opposed to regulation, for the initial years. For that and other 
reasons, it is currently unclear how the IRA will be effectuated, and while the impact of the IRA on the pharmaceutical industry cannot yet be fully 
determined, it is likely to be significant. Legally mandated price controls on payment amounts by third-party payors or other restrictions could harm our 
business, results of operations, financial condition and prospects. In addition, regional healthcare authorities and individual hospitals are increasingly using 
bidding procedures to determine what pharmaceutical products and which suppliers will be included in their prescription drug and other healthcare 
programs. This could reduce the ultimate demand for our product candidates, if approved, or put pressure on our product pricing, which could negatively 
affect our business, results of operations, financial condition and prospects.

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

Governments outside the United States tend to impose strict price controls, which may adversely affect our revenues, if any.

In some countries, particularly the EU member states, the pricing of certain pharmaceuticals is subject to governmental control. In these countries, 

pricing negotiations with governmental authorities can take considerable time after the 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 coverage and 
reimbursement have been obtained. Reference pricing used by various EU member states and parallel distribution or arbitrage between low-priced and 
high-priced member states, can further reduce prices. To obtain reimbursement or pricing approval in some countries, we may be required to conduct a 
clinical trial that compares the cost-effectiveness of our product candidate to other available therapies. Other member states allow companies to fix their 
own prices for medicines but monitor and control company profits. Even if a pharmaceutical product obtains a marketing authorization in the EU, there can 
be no assurance that reimbursement for such product will be secured on a timely basis or at all. If coverage and reimbursement of our products are 
unavailable or limited in scope or amount, or if pricing is set at unsatisfactory levels, our business could be harmed, possibly materially.

Risks Related to Our Intellectual Property

If we are unable to adequately protect our proprietary technology or obtain and maintain issued patents that are sufficient to protect our product 
candidates, others could compete against us more directly, which would have a material adverse impact on our business, results of operations, financial 
condition and prospects.

Our success depends in large part on our ability to obtain and maintain patent and other intellectual property protection in the United States and 
other countries with respect to our proprietary technology and products. We seek to protect our proprietary position by filing patent applications in the 
United States and abroad related to our novel technologies and product candidates. We also rely on trade secrets to protect aspects of our business that are 
not amenable to, or that we do not consider appropriate for, patent protection.

The patent prosecution process is expensive and time-consuming, and we may not be able to file and prosecute all necessary or desirable patent 
applications at a reasonable cost, in a timely manner, or in all jurisdictions. Prosecution of our patent portfolio is at a very early stage. For some patent 
applications in our portfolio, we have filed national stage applications based on our Patent Cooperation Treaty, or PCT, applications, thereby limiting the 
jurisdictions in which we can pursue patent protection for the various inventions claimed in those applications. It is also possible that we will fail to identify 
patentable aspects of our research and development output before it is too late to obtain patent protection. It is possible that defects of form in the 
preparation or filing of our patents or patent applications may exist, or may arise in the future, such as, with respect to proper priority claims, inventorship, 
claim scope or patent term adjustments. If there are material defects in the form or preparation of our patents or patent applications, such patents or 
applications may be invalid and unenforceable. Moreover, our competitors may independently develop equivalent knowledge, methods and know-how. 
Any of these outcomes could impair our ability to prevent competition from third parties, which may have an adverse impact on our business, financial 
condition and operating results.

We have obtained licenses and options to obtain licenses from third parties and may obtain additional licenses and options in the future. In some 

circumstances, we may not have the right to control the preparation, filing and prosecution of patent applications, or to maintain the patents, covering 
technology that we license from third parties. We may also require the cooperation of our licensors to enforce any licensed patent rights, and such 
cooperation may not be provided. Therefore, these patents and applications may not be prosecuted and enforced in a manner consistent with the best 
interests of our business. Moreover, if we do obtain necessary licenses, we will likely have obligations under those licenses, and any failure to satisfy those 
obligations could give our licensor the right to terminate the license. Termination of a necessary license could have a material adverse impact on our 
business.

We have had in the past, and may have in the future, certain funding arrangements.  Such funding arrangements impose various obligations on us, 

including reporting obligations, and may subject certain of our intellectual property, such as intellectual property made using the applicable funding, to the 
rights of the U.S. government under the Bayh-Dole Act.  Any failure to comply with our obligations under a funding arrangement may have an adverse 
effect on our rights under the applicable agreement or our rights in the applicable intellectual property.  Compliance with our obligations or the exercise by 
the government or other funder of its rights, may limit certain opportunities or otherwise have an adverse effect on our business.

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Our patent portfolio currently includes 24 active patent application families (which includes an option to license certain IP from MD Anderson and 

exclusive licenses to certain IP from Memorial Sloan Kettering Cancer Center). Of these, 22 applications have been nationalized and two are pending at the 
PCT stage. While we have obtained 24 issued U.S. patents with one currently allowed, we cannot provide any assurances that any of our pending patent 
applications will mature into issued patents and, if they do, that such patents or our current patents will include claims with a scope sufficient to protect our 
product candidates or otherwise provide any competitive advantage. For example, we are pursuing claims to therapeutic, binary compositions of certain 
bacterial populations. Any claims that may issue may provide coverage for such binary compositions and/or their use. However, such claims would not 
prevent a third party from commercializing alternative compositions that do not include both of the bacterial populations claimed in pending applications, 
potential applications or patents that have or may issue. There can be no assurance that any such alternative composition will not be equally effective. 
Further, given that our SER-109 product candidate is a complex composition with some variation from lot-to-lot and that, likewise, third-party 
compositions may have similar complexity and variability, it is possible that a patent claim may provide coverage for some but not all lots of a product 
candidate or third-party product. These and other factors may provide opportunities for our competitors to design around our patents, should they issue.

Moreover, other parties have developed technologies that may be related or competitive to our approach and may have filed or may file patent 
applications and may have received or may receive patents that may overlap or conflict with our patent applications, either by claiming similar methods or 
by claiming subject matter that could dominate our patent position or cover one or more of our products. In addition, given the early stage of prosecution of 
our portfolio, it may be some time before we understand how patent offices react to our patent claims and whether they identify prior art of relevance that 
we have not already considered.

Publications of discoveries in the scientific literature often lag behind the actual discoveries, and patent applications in the United States and other 

jurisdictions are typically not published until 18 months after filing, or in some cases not at all. Therefore, we cannot know with certainty whether we were 
the first to make the inventions claimed in any owned patents or pending patent applications, or that we were the first to file for patent protection of such 
inventions, nor can we know whether those from whom we may license patents were the first to make the inventions claimed or were the first to file. For 
these and other reasons, the issuance, scope, validity, enforceability and commercial value of our patent rights are subject to a level of uncertainty. Our 
pending and future patent applications may not result in patents being issued which protect our technology or products, in whole or in part, or which 
effectively prevent others from commercializing competitive technologies and products. Changes in either the patent laws or interpretation of the patent 
laws in the United States and other countries may diminish the value of our patents or narrow the scope of our patent protection.

We may be subject to third-party preissuance submissions of prior art to the United States Patent and Trademark Office, or USPTO, or in a foreign 

jurisdiction in which our applications are filed, or become involved in opposition, derivation, reexamination, inter partes review, post-grant review or 
interference proceedings challenging our patent rights or the patent rights of others. For example, on April 25, 2017, we filed a notice of opposition in the 
European Patent Office challenging the validity of a patent issued to The University of Tokyo. See “—Third parties may initiate legal proceedings alleging 
that we are infringing their intellectual property rights, the outcome of which would be uncertain and could have a material adverse effect on the success of 
our business.”  The oral proceedings were held at the European Patent Office on February 18, 2019 and the Opposition Division required The University of 
Tokyo to narrow the scope of the claims of the patent.  The University of Tokyo appealed certain aspects of the Opposition Division’s decision, as did we 
and other opponents.  On November 18, 2022, The University of Tokyo requested termination of the appeal proceeding and revocation of its patent. On 
December 19, 2022, the Opposition Division officially terminated the appeal proceeding, and European Patent No. 2 575 835 B1 has been revoked in its 
entirety. 

An adverse determination in any such submission, proceeding or litigation could reduce the scope of, or invalidate, our patent rights, allow third 

parties to commercialize our technology or products and compete directly with us, without payment to us, or result in our inability to manufacture or 
commercialize products without infringing third-party patent rights. In addition, if the breadth or strength of protection provided by our patents and patent 
applications is threatened, it could dissuade companies from collaborating with us to license, develop or commercialize current or future product 
candidates. Furthermore, an adverse decision in an interference proceeding can result in a third party receiving the patent right sought by us, which in turn 
could affect our ability to develop, market or otherwise commercialize our product candidates. The issuance, scope, validity, enforceability and commercial 
value of our patents are subject to a level of uncertainty.

The patent position of biotechnology and pharmaceutical companies generally is highly uncertain, involves complex legal and factual questions and 

has in recent years been the subject of much litigation. Due to legal standards relating to patentability, validity, enforceability and claim scope of patents 
covering biotechnological and pharmaceutical inventions, our ability to obtain, maintain and enforce patents is uncertain and involves complex legal and 
factual questions. Even if issued, a patent’s validity, inventorship, ownership or enforceability is not conclusive. Accordingly, rights under any existing 
patent or any patents we might obtain or license may not cover our product candidates, or may not provide us with sufficient protection for our product 
candidates to afford a commercial advantage against competitive products or processes, including those from branded and generic pharmaceutical 
companies.

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The degree of future protection for our proprietary rights is uncertain, and we cannot ensure that:

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any of our pending patent applications, if issued, will include claims having a scope sufficient to protect our product candidates or any other 
products or product candidates;

any of our pending patent applications will issue as patents at all;

we will be able to successfully commercialize our product candidates, if approved, before our relevant patents expire;

we were the first to make the inventions covered by any existing patent and pending patent applications;

we were the first to file patent applications for these inventions;

others will not develop similar or alternative technologies that do not infringe or design around our patents;

others will not use pre-existing technology to effectively compete against us;

any of our patents, if issued, will be found to ultimately be valid and enforceable;

third parties will not compete with us in jurisdictions where we do not pursue and obtain patent protection;

we will be able to obtain and/or maintain necessary or useful licenses on reasonable terms or at all;

any patents issued to us will provide a basis for an exclusive market for our commercially viable products, will provide us with any 
competitive advantages or will not be challenged by third parties;

we will develop additional proprietary technologies or product candidates that are separately patentable; or

our commercial activities or products will not infringe upon the patents or proprietary rights of others.

Any litigation to enforce or defend our patent rights, even if we were to prevail, could be costly and time-consuming and would divert the attention 
of our management and key personnel from our business operations. We may not prevail in any lawsuits that we initiate and the damages or other remedies 
awarded if we were to prevail may not be commercially meaningful. Even if we are successful, domestic or foreign litigation, or USPTO or foreign patent 
office proceedings, may result in substantial costs and distraction to our management. We may not be able, alone or with our licensors or potential 
collaborators, to prevent misappropriation of our proprietary rights, particularly in countries where the laws may not protect such rights as fully as in the 
United States. Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation or other proceedings, 
there is a risk that some of our confidential information could be compromised by disclosure during this type of litigation or other proceedings. In addition, 
during the course of this kind of litigation or proceedings, there could be public announcements of the results of hearings, motions or other interim 
proceedings or developments or public access to related documents. If investors perceive these results to be negative, the market price for our common 
stock could be significantly harmed.

If we are unable to protect the confidentiality of our trade secrets and know-how, our business and competitive position may be harmed.

In addition to seeking patents for some of our technology and product candidates, we also utilize our trade secrets, including unpatented know-how, 

technology and other proprietary information, to maintain our competitive position. We seek to protect these trade secrets, in part, by entering into non- 
disclosure and confidentiality agreements with parties who have access to them, such as our employees, corporate collaborators, outside scientific 
collaborators, contract manufacturers, consultants, advisors and other third parties. We also seek to enter into confidentiality and invention or patent 
assignment agreements with our employees, advisors and consultants. Despite these efforts, any of these parties may breach the agreements and disclose 
our proprietary information, including our trade secrets, and we may not be able to obtain adequate remedies for such breaches. Our trade secrets may also 
be obtained by third parties by other means, such as breaches of our physical or computer security systems. Enforcing a claim that a party illegally 
disclosed or misappropriated a trade secret is difficult, expensive and time-consuming, and the outcome is unpredictable. In addition, some courts inside 
and outside the United States are less willing or unwilling to protect trade secrets. Moreover, if any of our trade secrets were to be lawfully obtained or 
independently developed by a competitor, we would have no right to prevent them, or those to whom they communicate it, from using that technology or 
information to compete with us. If any of our trade secrets were to be disclosed to or independently developed by a competitor, our competitive position 
would be harmed.

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Changes in U.S. patent law could diminish the value of patents in general, thereby impairing our ability to protect our products.

As is the case with other biotechnology companies, our success is heavily dependent on intellectual property, particularly patents. Obtaining and 
enforcing patents in the biotechnology industry involves both technological and legal complexity, and is therefore costly, time-consuming and inherently 
uncertain. In addition, patent reform legislation could further increase the uncertainties and costs surrounding the prosecution of our patent applications and 
the enforcement or defense of our issued patents. On September 16, 2011, the Leahy-Smith America Invents Act, or the Leahy-Smith Act, was signed into 
law. The Leahy-Smith Act includes a number of significant changes to U.S. patent law. These include provisions that affect the way patent applications are 
prosecuted and may also affect patent litigation. The USPTO developed new regulations and procedures to govern administration of the Leahy-Smith Act, 
and many of the substantive changes to patent law associated with the Leahy-Smith Act, in particular the first to file provisions, only became effective on 
March 16, 2013. A third party that files a patent application in the USPTO after that date but before us could therefore be awarded a patent covering an 
invention of ours even if 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. Thus, for our U.S. patent applications containing a priority claim after March 16, 2013, there is a greater 
level of uncertainty in the patent law. Moreover, some of the patent applications in our portfolio will be subject to examination under the pre-Leahy- Smith 
Act law and regulations, while other patent applications in our portfolio will be subject to examination under the law and regulations, as amended by the 
Leahy-Smith Act. This introduces additional complexities into the prosecution and management of our portfolio.

In addition, the Leahy-Smith Act limits where a patentee may file a patent infringement suit and provides opportunities for third parties to challenge 
any issued patent in the USPTO. These provisions apply to all of our U.S. patents, even those issued before March 16, 2013. Because of a lower evidentiary 
standard in USPTO proceedings compared to the evidentiary standard in U.S. 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 even though the same evidence would be insufficient 
to invalidate the claim if first presented in a federal court action. Accordingly, a third party may attempt to use the USPTO procedures to invalidate our 
patent claims because it may be easier for them to do so relative to challenging the patent in a federal court action. It is not clear what, if any, impact the 
Leahy-Smith Act will have on the operation of our business. However, the Leahy-Smith Act and its implementation could increase the uncertainties and 
costs surrounding the prosecution of our patent applications and the enforcement or defense of our issued patents, all of which could have a material 
adverse effect on our business and financial condition.

In addition, Supreme Court rulings have narrowed the scope of patent protection available in certain circumstances and weakened the rights of 
patent owners in certain situations. From time to time, the Supreme Court, other federal courts, Congress, or the USPTO, may change the standards of 
patentability and any such changes could have a negative impact on our business.

A number of cases decided by the Supreme Court have involved questions of when claims reciting abstract ideas, laws of nature, natural phenomena 

and/or natural products are eligible for a patent, regardless of whether the claimed subject matter is otherwise novel and inventive. These cases include 
Association for Molecular Pathology v. Myriad Genetics, Inc., 569 U.S. 12-398 (2013); Alice Corp. v. CLS Bank International, 573 U.S. 13-298 (2014); 
and Mayo Collaborative Services v. Prometheus Laboratories, Inc., 566 U.S. 10-1150 (2012). In response to these cases, the USPTO has issued guidance to 
the examining corps.

The USPTO first issued a memorandum reflecting the USPTO’s interpretation of the cases related to patent eligibility of natural products on March 

4, 2014, which it subsequently revised and expanded upon in several additional updates now incorporated into its Manual of Patent Examination Procedure. 
The USPTO’s interpretation of the case law and new guidelines for examination may influence, possibly adversely, prosecution and defense of certain types 
of claims in our portfolio.

In addition to increasing uncertainty with regard to our ability to obtain future patents, this combination of events has created uncertainty with 

respect to the value of patents, once obtained. Depending on these and other decisions by Congress, the federal courts and the USPTO, the laws and 
regulations governing patents could change or be interpreted in unpredictable ways that would weaken our ability to obtain new patents or to enforce any 
patents that may issue to us in the future. In addition, these events may adversely affect our ability to defend any patents that may issue in procedures in the 
USPTO or in courts.

Third parties may initiate legal proceedings alleging that we are infringing their intellectual property rights, the outcome of which would be uncertain 
and could have a material adverse effect on the success of our business.

Our commercial success depends upon our ability, and the ability of our collaborators, to develop, manufacture, market and sell our product 
candidates and use our proprietary technologies without infringing the proprietary rights of third parties. There is considerable intellectual property 
litigation in the biotechnology and pharmaceutical industries. While no such litigation has been brought against us and we have not been held by any court 
to have infringed a third party’s intellectual property rights, we cannot guarantee that our technology, products or use of our products do not infringe third-
party patents.

We are aware of numerous patents and pending applications owned by third parties in the fields in which we are developing product candidates, both 

in the United States and elsewhere. However, we may have failed to identify relevant third-party patents or applications. 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 patents 
issue. Moreover, it is difficult for industry participants, including us, to identify all third-party patent rights that may be relevant to our product candidates 
and technologies because patent searching is 

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imperfect due to differences in terminology among patents, incomplete databases and the difficulty in assessing the meaning of patent claims. We may fail 
to identify relevant patents or patent applications or may identify pending patent applications of potential interest but incorrectly predict the likelihood that 
such patent applications may issue with claims of relevance to our technology. In addition, we may be unaware of one or more issued patents that would be 
infringed by the manufacture, sale or use of a current or future product candidate, or we may incorrectly conclude that a third-party patent is invalid, 
unenforceable or not infringed by our activities. Additionally, pending patent applications that have been published can, subject to certain limitations, be 
later amended in a manner that could cover our technologies, our products or the use of our products. We are aware of several pending patent applications 
containing one or more claims that could be construed to cover some of our product candidates or technology, should those claims issue in their original 
form or in the form presently being pursued. In addition, we are aware of third-party patent families that include issued and allowed patents, including in 
the United States, including claims that, if valid and enforceable, could be construed to cover some of our product candidates or their methods of use. On 
April 25, 2017, we filed a notice of opposition in the European Patent Office challenging the validity of a patent issued to The University of Tokyo and 
requesting that it be revoked in its entirety for the reasons set forth in our opposition.  The oral proceedings were held at the European Patent Office on 
February 18, 2019 and the Opposition Division required The University of Tokyo to narrow the scope of the claims of the patent.  The University of Tokyo 
appealed certain aspects of the Oppositions Division’s decision, as did we and other opponents.  On November 18, 2022, The University of Tokyo 
requested termination of the appeal proceeding and revocation of its patent. On December 19, 2022, the Opposition Division officially terminated the 
appeal proceeding, and European Patent No. 2 575 835 B1 has been revoked in its entirety. 

The biotechnology and pharmaceutical industries are characterized by extensive litigation regarding patents and other intellectual property rights. 

Other parties may allege that our product candidates or the use of our technologies infringes patent claims or other intellectual property rights held by them 
or that we are employing their proprietary technology without authorization. We may become party to, or threatened with, future adversarial proceedings or 
litigation regarding intellectual property rights with respect to our products and technology, including interference or derivation proceedings before the 
USPTO and similar bodies in other countries. Third parties may assert infringement claims against us based on existing intellectual property rights and 
intellectual property rights that may be granted in the future. If we were to challenge the validity of an issued U.S. patent in court, such as an issued U.S. 
patent of potential relevance to some of our product candidates or methods of use, we would need to overcome a statutory presumption of validity that 
attaches to every U.S. patent. This means that in order to prevail, we would have to present clear and convincing evidence as to the invalidity of the patent’s 
claims. There is no assurance that a court would find in our favor on questions of infringement or validity.

Patent and other types of intellectual property litigation can involve complex factual and legal questions, and their outcome is uncertain. If we are 

found or believe there is a risk we may be found, to infringe a third party’s intellectual property rights, we could be required or may choose to obtain a 
license from such third party to continue developing and marketing our products and technology. However, we may not be able to obtain any such license 
on commercially reasonable terms or at all. Even if we were able to obtain a license, it could be non-exclusive, thereby giving our competitors access to the 
same technologies licensed to us. We could be forced, including by court order, to cease commercializing the infringing technology or product. In addition, 
we could be found liable for monetary damages, including treble damages and attorneys’ fees if we are found to have willfully infringed a patent. A finding 
of infringement could prevent us from commercializing our product candidates or force us to cease some of our business operations, which could materially 
harm our business. Claims that we have misappropriated the confidential information or trade secrets of third parties could have a similar negative impact 
on our business.

Even if we are successful in these proceedings, we may incur substantial costs and divert management time and attention in pursuing these 

proceedings, which could have a material adverse effect on us. If we are unable to avoid infringing the patent rights of others, we may be required to seek a 
license, defend an infringement action or challenge the validity of the patents in court, or redesign our products. Patent litigation is costly and time-
consuming. We may not have sufficient resources to bring these actions to a successful conclusion. In addition, intellectual property litigation or claims 
could force us to do one or more of the following:

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cease developing, selling or otherwise commercializing our product candidates;

pay substantial damages for past use of the asserted intellectual property;

obtain a license from the holder of the asserted intellectual property, which license may not be available on reasonable terms, if at all; and

in the case of trademark claims, redesign, or rename, some or all of our product candidates or other brands to avoid infringing the intellectual 
property rights of third parties, which may not be possible and, even if possible, could be costly and time-consuming.

Any of these risks coming to fruition could have a material adverse effect on our business, results of operations, financial condition and prospects.

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Issued patents covering our product candidates could be found invalid or unenforceable or could be interpreted narrowly if challenged in court.

Competitors may infringe our intellectual property, including our patents or the patents of our licensors. As a result, we may be required to file 

infringement claims to stop third-party infringement or unauthorized use. This can be expensive, particularly for a company of our size, and time-
consuming. If we initiated legal proceedings against a third party to enforce a patent, if and when issued, covering one of our product candidates, the 
defendant could counterclaim that the patent covering our product candidate is invalid and/or unenforceable. In patent litigation in the United States, 
defendant counterclaims alleging invalidity and/or unenforceability are commonplace. Grounds for a validity challenge include alleged failures to meet any 
of several statutory requirements, including lack of novelty, obviousness or non-enablement, or failure to claim patent eligible subject matter. Grounds for 
unenforceability assertions include allegations that someone connected with prosecution of the patent withheld relevant information from the USPTO, or 
made a misleading statement, during prosecution. Third parties may also raise similar claims before administrative bodies in the United States or abroad, 
even outside the context of litigation. Such mechanisms include re-examination, post grant review and equivalent proceedings in foreign jurisdictions, such 
as opposition proceedings. Such proceedings could result in revocation or amendment of our patents in such a way that they no longer cover our product 
candidates or competitive products. The outcome following legal assertions of invalidity and unenforceability is unpredictable. With respect to validity, for 
example, we cannot be certain that there is no invalidating prior art, of which we and the patent examiner were unaware during prosecution. If a defendant 
were to prevail on a legal assertion of invalidity and/or unenforceability, we would lose at least part, and perhaps all, of the patent protection on our product 
candidates. Moreover, even if not found invalid or unenforceable, the claims of our patents could be construed narrowly or in a manner that does not cover 
the allegedly infringing technology in question. Such a loss of patent protection would have a material adverse impact on our business.

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

Periodic maintenance fees on any issued patent are due to be paid to the USPTO and foreign patent agencies in several stages over the lifetime of the 

patent and, in some jurisdictions, during the pendency of a patent application. The USPTO and various foreign governmental patent agencies require 
compliance with a number of procedural, documentary, fee payment and other similar provisions during the patent application process. While an 
inadvertent lapse can in many cases be cured by payment of a late fee or by other means in accordance with the applicable rules, there are situations in 
which noncompliance can result in abandonment or lapse of the patent or patent application, resulting in partial or complete loss of patent rights in the 
relevant jurisdiction. Noncompliance events that could result in abandonment or lapse of a patent or patent application include, but are not limited to, 
failure to respond to official actions within prescribed time limits, non-payment of fees and failure to properly legalize and submit formal documents. In 
such an event, our competitors might be able to enter the market, which would have a material adverse effect on our business.

We may be subject to claims challenging the inventorship or ownership of our patents and other intellectual property.

It is our policy to enter into confidentiality and intellectual property assignment agreements with our employees, consultants, contractors and 
advisors. These agreements generally provide that inventions conceived by the party in the course of rendering services to us will be our exclusive property. 
However, these agreements may not be honored and may not effectively assign intellectual property rights to us. For example, even if we have a consulting 
agreement in place with an academic advisor pursuant to which such academic advisor is required to assign any inventions developed in connection with 
providing services to us, such academic advisor may not have the right to assign such inventions to us, as it may conflict with his or her obligations to 
assign all such intellectual property to his or her employing institution.

Litigation may be necessary to defend against these and other claims challenging inventorship or ownership. If we fail in defending any such claims, 

in addition to paying monetary damages, we may lose valuable intellectual property rights, such as exclusive ownership of, or right to use, valuable 
intellectual property. Such an outcome could have a material adverse effect on our business. Even if we are successful in defending against such claims, 
litigation could result in substantial costs and be a distraction to management and other employees.

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

Many of our employees were previously employed at universities or other biotechnology or pharmaceutical companies, including our competitors or 

potential competitors. We may also engage advisors and consultants who are concurrently employed at universities or other organizations or who perform 
services for other entities. Although we try to ensure that our employees, advisors and consultants do not use the proprietary information or know-how of 
others in their work for us, we may be subject to claims that we or our employees, advisors or consultants have used or disclosed intellectual property, 
including trade secrets or other proprietary information, of any such party’s former or current employer or in violation of an agreement with another party. 
Although we have no knowledge of any such claims being alleged to date, if such claims were to arise, litigation may be necessary to defend against any 
such claims.

In addition, while it is our policy to require our employees, consultants, advisors and contractors who may be involved in the development of 

intellectual property to execute agreements assigning such intellectual property to us, we may be unsuccessful in executing such an agreement with each 
party who in fact develops intellectual property that we regard as our own. Our and their assignment agreements may not be self-executing or may be 
breached, and we may be forced to bring claims against third parties, or defend claims they may bring against us, to determine the ownership of what we 
regard as our intellectual property. Similarly, we may be subject to claims that an employee, advisor or consultant performed work for us that conflicts with 
that person’s obligations to a third party, such as an employer, and thus, that the third party has an ownership interest in the intellectual property arising out 
of work performed for us. Litigation may be necessary to defend against these claims. Although we have no knowledge of any such claims being alleged to 
date, if such claims were to arise, litigation may be necessary to defend against any such claims.

If we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or 

personnel. Even if we are successful in prosecuting or defending against such claims, litigation could result in substantial costs and be a distraction to 
management.

If our trademarks and trade names are not adequately protected, then we may not be able to build name recognition in our markets of interest and our 
business may be adversely affected.

Our registered or unregistered trademarks or trade names may be challenged, infringed, circumvented or declared generic or determined to be 
infringing on other marks. We may not be able to protect our rights to these trademarks and trade names, which we need to build name recognition among 
potential collaborators or customers in our markets of interest. At times, competitors may adopt trade names or trademarks similar to ours, thereby 
impeding our ability to build brand identity and possibly leading to market confusion. In addition, there could be potential trade name or trademark 
infringement claims brought by owners of other registered trademarks or trademarks that incorporate variations of our registered or unregistered trademarks 
or trade names. Over the long term, if we are unable to establish name recognition based on our trademarks and trade names, then we may not be able to 
compete effectively and our business may be adversely affected. Our efforts to enforce or protect our proprietary rights related to trademarks, trade secrets, 
domain names, copyrights or other intellectual property may be ineffective and could result in substantial costs and diversion of resources and could 
adversely impact our financial condition or results of operations.

We will not seek to protect our intellectual property rights in all jurisdictions throughout the world and we may not be able to adequately enforce our 
intellectual property rights even in the jurisdictions where we seek protection.

Filing, prosecuting and defending patents on product candidates in all countries and jurisdictions throughout the world would be prohibitively 
expensive, and our intellectual property rights in some countries outside the United States could be less extensive than in the United States, assuming that 
rights are obtained in the United States and assuming that rights are pursued outside the United States. The statutory deadlines for pursuing patent 
protection in individual foreign jurisdictions are based on the priority date of each of our patent applications. For each of the patent families that we believe 
provide coverage for our product candidates, we decide whether and where to pursue protection outside the United States. In addition, the laws of some 
foreign countries do not protect intellectual property rights to the same extent as federal and state laws in the United States. Consequently, even if we do 
elect to pursue patent rights outside the United States, we may not be able to obtain relevant claims and/or 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.

Additionally, Europe's planned Unified Patent Court, or UPC, may present uncertainties for our ability to protect and enforce our patent rights 

against competitors in Europe. Although this new court is being implemented to provide more certainty and efficiency to patent enforcement throughout 
Europe, it will also provide our competitors with a new forum to use to centrally challenge our patents if opted into the UPC, rather than having to seek 
invalidity or non-infringement decisions on a country-by-country basis. Once the UPC is established, it will be several years before the scope of patent 
rights that will be recognized and the strength of patent remedies that will be provided is known.

Competitors may use our technologies in jurisdictions where we do not pursue and obtain patent protection to develop their own products and 
further, may export otherwise infringing products to territories where we have patent protection, but enforcement is not as strong as that in the United 
States. These products may compete with our products and our patents or other intellectual property 

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rights may not be effective or sufficient to prevent them from competing. Even if we pursue and obtain issued patents in particular jurisdictions, our patent 
claims or other intellectual property rights may not be effective or sufficient to prevent third parties from so competing.

The laws of some foreign countries do not protect intellectual property rights to the same extent as the laws of the United States. Many companies 
have encountered significant problems in protecting and defending intellectual property rights in certain foreign jurisdictions. The legal systems of some 
countries, particularly developing countries, do not favor the enforcement of patents and other intellectual property protection, especially those relating to 
biotechnology. This could make it difficult for us to stop the infringement of our patents, if obtained, or the misappropriation of our other intellectual 
property rights. For example, many foreign countries have compulsory licensing laws under which a patent owner must grant licenses to third parties. In 
addition, many countries limit the enforceability of patents against third parties, including government agencies or government contractors. In these 
countries, patents may provide limited or no benefit. Patent protection must ultimately be sought on a country-by-country basis, which is an expensive and 
time-consuming process with uncertain outcomes. Accordingly, we may choose not to seek patent protection in certain countries, and we will not have the 
benefit of patent protection in such countries.

If our ability to obtain and, if obtained, enforce our patents to stop infringing activities is inadequate, third parties may compete with our products, 

and our patents or other intellectual property rights may not be effective or sufficient to prevent them from competing. Accordingly, our intellectual 
property rights around the world may be inadequate to obtain a significant commercial advantage from the intellectual property we develop or license.

Risks Related to Our Operations

The COVID-19 pandemic has adversely impacted and could continue to adversely impact, our business, including our preclinical studies and clinical 
trials, results of operations and financial condition.

The COVID-19 pandemic and government measures taken in response have also had a significant impact, both direct and indirect, on businesses 

and commerce, as worker shortages have occurred, supply chains have been disrupted, and facilities and production have been suspended. We are 
continuing to monitor the impact of the COVID-19 pandemic on our operations and ongoing clinical development activity. Our mitigation activities to 
minimize COVID-19-related operation disruptions are ongoing, however, given the severity and evolving nature of the situation, the timing of clinical 
readouts is uncertain. As a result of the COVID-19 pandemic, including any resurgence or the emergence of new variants, we or our collaborators may 
experience further disruptions that could severely impact our business, preclinical studies and clinical trials, including:

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delays in receiving approval from local regulatory authorities to initiate our planned clinical trials;

delays or difficulties in enrolling patients in our clinical trials;

delays or difficulties in clinical site initiation, including difficulties in recruiting clinical site investigators and clinical site staff;

diversion of healthcare resources away from the conduct of clinical trials, including the diversion of hospitals serving as our clinical trial sites 
and hospital staff supporting the conduct of our clinical trials;

risk that participants enrolled in our clinical trials will contract COVID-19 while the clinical trial is ongoing, which could impact the results 
of the clinical trial, including by increasing the number of observed adverse events;

interruption of key clinical trial activities, such as clinical trial site data monitoring, due to limitations on travel imposed or recommended by 
federal or state governments, employers and others or interruption of clinical trial subject visits and study procedures (such as endoscopies 
that are deemed non-essential), which may impact the integrity of subject data and clinical study endpoints;

interruption or delays in the operations of the FDA or other regulatory authorities, which may impact approval timelines;

interruption of, or delays in receiving, supplies of our product candidates from our contract manufacturing organizations due to staffing 
shortages, production slowdowns, global shipping delays or stoppages and disruptions in delivery systems; 

limitations on employee resources that would otherwise be focused on the conduct of our preclinical studies and clinical trials, including 
because of sickness of employees or their families or the desire of employees to avoid contact with large groups of people.

refusal of the FDA or other regulatory authorities to accept data from clinical trials in affected geographies;

impacts from prolonged remote work arrangements, such as increased cybersecurity risks and strains on our business continuity plans; and

delays or difficulties with equity offerings due to disruptions and uncertainties in the securities market.

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In addition, the trading prices for our and other biopharmaceutical companies’ stock have been highly volatile as a result of the COVID-19 
pandemic and the continued increase in inflation rates and interest rates. As a result, we may face difficulties raising capital through sales of our common 
stock and any such sales may be on unfavorable terms. The COVID-19 pandemic continues to rapidly evolve. The extent to which the pandemic further 
impacts our business, including our preclinical studies and clinical trials, results of operations and financial condition will depend on future developments 
which are highly uncertain and cannot be predicted with confidence. Such factors include but are not limited to the duration and severity of the pandemic, 
the impact of variants, travel restrictions, quarantines, shelter-in-place orders and social distancing recommendations and regulations in the U.S. and other 
countries, business closures or business disruptions, the adoption and effectiveness of vaccines and vaccine distribution efforts, and the effectiveness of 
other actions taken in the U.S. and other countries to contain and treat the disease.

Our future success depends on our ability to retain key executives and to attract, retain and motivate qualified personnel.

We are highly dependent on Eric Shaff, our President and Chief Executive Officer, as well as the other principal members of our management, 

scientific and clinical team. Although we have entered into employment agreements with our executive officers, each of them may terminate their 
employment with us at any time. We do not maintain “key person” insurance for any of our executives or other employees.

Recruiting and retaining qualified scientific, clinical, manufacturing and sales and marketing personnel will also be critical to our success. The loss 

of the services of our executive officers or other key employees could impede the achievement of our research, development and commercialization 
objectives and seriously harm our ability to successfully implement our business strategy. Furthermore, replacing executive officers and key employees 
may be difficult and may take an extended period of time because of the limited number of individuals in our industry with the breadth of skills and 
experience required to successfully develop, gain regulatory approval of and commercialize products. Competition to hire from this limited pool is intense, 
and we may be unable to hire, train, retain or motivate these key personnel on acceptable terms given the competition among numerous pharmaceutical and 
biotechnology companies for similar personnel. We also experience competition for the hiring of scientific and clinical personnel from universities and 
research institutions. In addition, we rely on consultants and advisors, including scientific and clinical advisors, to assist us in formulating our research and 
development and commercialization strategy. Our consultants and advisors may be employed by employers other than us and may have commitments 
under consulting or advisory contracts with other entities that may limit their availability to us. If we are unable to continue to attract and retain high quality 
personnel, our ability to pursue our growth strategy will be limited. 

We may expand our operational capabilities, and as a result, we may encounter difficulties in managing our growth, which could disrupt our 
operations.

We may experience significant growth in the number of our employees and the scope of our operations, particularly in the areas of lead discovery 
and product development, regulatory affairs, clinical affairs and manufacturing and, if any of our product candidates receives marketing approval, sales, 
marketing and distribution. To manage potential future growth, we must continue to implement and improve our managerial, operational and financial 
systems, expand our facilities and continue to recruit and train additional qualified personnel. Due to our limited financial resources and the limited 
experience of our management team in managing a company with such potential growth, we may not be able to effectively manage the expansion of our 
operations or recruit and train additional qualified personnel. The expansion of our operations may lead to significant costs and may divert our management 
and business development resources. Any inability to manage growth could delay the execution of our business plans or disrupt our operations.

A variety of risks associated with operating internationally could materially adversely affect our business.

We currently have limited international operations, but our business strategy incorporates potentially expanding internationally if any of our product 
candidates receive regulatory approval. We have conducted clinical studies in Australia and New Zealand in the past, and may in the future conduct clinical 
studies in other countries as well. We currently plan to rely on collaborators, including Nestlé, to commercialize certain approved products outside of North 
America. Also, for certain manufacturing services for SER-109, we rely on GenIbet in Portugal, and Bacthera, which is constructing a dedicated full-scale 
production suite for us in Switzerland. Doing business internationally involves a number of risks, including but not limited to:

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multiple, conflicting and changing laws and regulations, such as privacy regulations, tax laws, export and import restrictions, employment 
laws, regulatory requirements and other governmental approvals, permits and licenses;

failure by us to obtain and maintain regulatory approvals for the use of our products in various countries;

additional potentially relevant third-party patent rights;

complexities and difficulties in obtaining protection and enforcing our intellectual property;

difficulties in staffing and managing foreign operations;

complexities associated with managing multiple payor reimbursement regimes, government payors or patient self-pay systems;

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limits in our ability to penetrate international markets;

global macroeconomic conditions, including a continued increase in inflation rates or interest rates, labor shortages, supply chain shortages, 
or other economic, political or legal uncertainties or adverse developments;

financial risks, such as longer payment cycles, difficulty collecting accounts receivable, the impact of local and regional financial crises on 
demand and payment for our products and exposure to foreign currency exchange rate fluctuations;

political unrest and wars, such as the current situation with Ukraine and Russia, which could delay or disrupt our business, and if such 
political unrest escalates or spills over to or otherwise impacts additional regions it could heighten many of the other risk factors included in 
this Item 1A;

natural disasters, political and economic instability, including terrorism and political unrest, outbreak of disease or epidemics such as the 
COVID-19 pandemic, boycotts, curtailment of trade and other business restrictions;

certain expenses including, among others, expenses for travel, translation and insurance; and

regulatory and compliance risks that relate to maintaining accurate information and control over sales and activities that may fall within the 
purview of the U.S. Foreign Corrupt Practices Act, its books and records provisions, or its anti-bribery provisions.

Any of these factors could significantly harm our future international expansion and operations and, consequently, our results of operations.

Our business and operations may suffer in the event of information technology system failures, cyberattacks or deficiencies in our cybersecurity.  

In the ordinary course of our business, we collect and store sensitive data, including personally identifiable information, intellectual property and 

proprietary business information owned or controlled by ourselves or our employees, customers and other parties. We manage and maintain our 
applications and data utilizing a combination of on-site systems and cloud-based data centers. We utilize external security and infrastructure vendors to 
manage parts of our data centers, and as a result a number of third-party vendors may or could have access to our confidential information. These 
applications and data encompass a wide variety of business-critical information, including research and development information, customer information, 
commercial information and business and financial information. We face a number of risks relative to protecting this critical information, including loss of 
access risk, inappropriate use or disclosure, unauthorized access, inappropriate modification and the risk of our being unable to adequately monitor and 
audit and modify our controls over our critical information. This risk extends to the third-party vendors and subcontractors we use to manage this sensitive 
data or otherwise process it on our behalf. The secure processing, storage, maintenance and transmission of this critical information are vital to our 
operations and business strategy, and we devote significant resources to protecting such information. Although we take reasonable measures to protect 
sensitive data from unauthorized access, use or disclosure, our information technology systems and those of our third-party service providers, strategic 
partners and other contractors or consultants are vulnerable to attack, damage and interruption from computer viruses and malware (e.g. ransomware), 
malicious code, natural disasters, terrorism, war, telecommunication and electrical failures, hacking, cyberattacks, phishing attacks and other social 
engineering schemes, employee theft or misuse, human error, fraud, denial or degradation of service attacks, sophisticated nation-state and nation-state-
supported actors or unauthorized access or use by persons inside our organization, or persons with access to systems inside our organization.  

We may also face increased cybersecurity risks due to our reliance on internet technology and the number of our employees who are working 
remotely, which may create additional opportunities for cybercriminals to exploit vulnerabilities. Furthermore, because the techniques used to obtain 
unauthorized access to, or to sabotage, systems change frequently and often are not recognized until launched against a target, we may be unable to 
anticipate these techniques or implement adequate preventative measures. We may also experience security breaches that may remain undetected for an 
extended period. Even if identified, we may be unable to adequately investigate or remediate incidents or breaches due to attackers increasingly using tools 
and techniques that are designed to circumvent controls, to avoid detection, and to remove or obfuscate forensic evidence. 

We and certain of our service providers are from time to time subject to cyberattacks and security incidents. If such an event were to occur and cause 

interruptions in our operations, it could result in a material disruption of our development programs and our business operations, whether due to a loss, 
corruption or unauthorized disclosure of our trade secrets, personal information or other proprietary or sensitive information or other similar disruptions. If 
we or our third-party vendors were to experience a significant cybersecurity breach of our or their information systems or data, the costs associated with the 
investigation and remediation could be material. Any such access, breach, or other loss of information could also result in legal claims or proceedings, and 
liability under federal or state laws that protect the privacy of personal information, and regulatory penalties. Notice of breaches may be required to 
affected individuals or other state, federal or foreign regulators, and for extensive breaches, notice may need to be made to the media or State Attorneys 
General. Such a notice could harm our reputation and our ability to compete. Although we have implemented security measures to prevent unauthorized 
access, such data is currently accessible through multiple channels, and there is no guarantee we can protect our data from breach.  

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Actual or perceived failures to comply with applicable data protection, privacy and security laws, regulations, standards and other requirements could 
adversely affect our business, results of operations, and financial condition.

The global data protection landscape is rapidly evolving, and we are or may become subject to numerous state, federal and foreign laws, 
requirements and regulations governing the collection, use, disclosure, retention, and security of personal information, such as information that we may 
collect in connection with clinical trials in the U.S. and abroad. Implementation standards and enforcement practices are likely to remain uncertain for the 
foreseeable future, and we cannot yet determine the impact future laws, regulations, standards, or perception of their requirements may have on our 
business. This evolution may create uncertainty in our business, affect our ability to operate in certain jurisdictions or to collect, store, transfer use and 
share personal information, necessitate the acceptance of more onerous obligations in our contracts, result in liability or impose additional costs on us. The 
cost of compliance with these laws, regulations and standards is high and is likely to increase in the future. Any failure or perceived failure by us to comply 
with federal, state or foreign laws or regulation, our internal policies and procedures or our contracts governing our processing of personal information 
could result in negative publicity, government investigations and enforcement actions, claims by third parties and damage to our reputation, any of which 
could have a material adverse effect on our results of operations, financial performance and business.

In the U.S., HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act, and their implementing regulations, 

or collectively HIPAA, imposes privacy, security and breach notification obligations on certain healthcare providers, health plans, and healthcare 
clearinghouses, known as covered entities, as well as their business associates that perform certain services that involve creating, receiving, maintaining or 
transmitting individually identifiable health information for or on behalf of such covered entities, and their covered subcontractors. Most healthcare 
providers, including research institutions from which we obtain clinical trial information, are subject to privacy and security regulations promulgated under 
HIPAA. We do not believe that we are currently acting as a covered entity or business associate under HIPAA and thus are not regulated under HIPAA. 
However, any person may be prosecuted under HIPAA’s criminal provisions either directly or under aiding-and-abetting or conspiracy principles. 
Consequently, depending on the facts and circumstances, we could face substantial criminal penalties if we knowingly receive individually identifiable 
health information from a HIPAA-covered healthcare provider or research institution that has not satisfied HIPAA’s requirements for disclosure of 
individually identifiable health information.

Certain states have also adopted comparable privacy and security laws and regulations, which govern the privacy, processing and protection of 

health-related and other personal information. Such laws and regulations will be subject to interpretation by various courts and other governmental 
authorities, thus creating potentially complex compliance issues for us and our future customers and strategic partners. For example, the California 
Consumer Privacy Act of 2018, or CCPA, went into effect on January 1, 2020. The CCPA creates individual privacy rights for California consumers and 
increases the privacy and security obligations of entities handling certain personal information. The CCPA provides for civil penalties for violations, as well 
as a private right of action for data breaches has increased the likelihood of, and risks associated with data breach litigation. Further, the California Privacy 
Rights Act, or CPRA, generally went into effect on January 1, 2023, and significantly amends the CCPA. It imposes additional data protection obligations 
on covered businesses, including additional consumer rights processes, limitations on data uses, new audit requirements for higher risk data, and opt outs 
for certain uses of sensitive data. It also creates a new California data protection agency authorized to issue substantive regulations and could result in 
increased privacy and information security enforcement. Additional compliance investment and potential business process changes may also be required. 
Similar laws have passed in Virginia, Colorado, Connecticut and Utah, and have been proposed in other states and at the federal level, reflecting a trend 
toward more stringent privacy legislation in the United States. The enactment of such laws could have potentially conflicting requirements that would make 
compliance challenging. In the event that we are subject to or affected by HIPAA, the CCPA, the CPRA or other domestic privacy and data protection laws, 
any liability from failure to comply with the requirements of these laws could adversely affect our financial condition. 

Our operations abroad may also be subject to increased scrutiny or attention from data protection authorities. For example, in Europe, European 

Union General Data Protection Regulation, or the GDPR, went into effect in May 2018 and imposes strict requirements for processing the personal data of 
individuals within the European Economic Area, or EEA. Companies that must comply with the GDPR face increased compliance obligations and risk, 
including more robust regulatory enforcement of data protection requirements and potential fines for noncompliance of up to €20 million or 4% of the 
annual global revenues of the noncompliant company, whichever is greater. Among other requirements, the GDPR regulates transfers of personal data 
subject to the GDPR to third countries that have not been found to provide adequate protection to such personal data, including the United States; in July 
2020, the Court of Justice of the EU, or CJEU, limited how organizations could lawfully transfer personal data from the EU/EEA to the United States by 
invalidating the Privacy Shield for purposes of international transfers and imposing further restrictions on the use of standard contractual clauses, or SCCs. 
In March 2022, the US and EU announced a new regulatory regime intended to replace the invalidated regulations; however, this new EU-US Data Privacy 
Framework has not been implemented beyond an executive order signed by President Biden on October 7, 2022 on Enhancing Safeguards for United States 
Signals Intelligence Activities. European court and regulatory decisions subsequent to the CJEU decision of July 16, 2020 have taken a restrictive approach 
to international data transfers. As supervisory authorities issue further guidance on personal data export mechanisms, including circumstances where the 
SCCs cannot be used, and/or start taking enforcement action, we could suffer additional costs, complaints and/or regulatory investigations or fines, and/or 
if we are otherwise unable to transfer personal data between and among countries and regions in which 

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we operate, it could affect the manner in which we provide our services, the geographical location or segregation of our relevant systems and operations, 
and could adversely affect our financial results.

Since the beginning of 2021, after the end of the transition period following the UK’s departure from the European Union, we are also subject to the 

UK data protection regime, which imposes separate but similar obligations to those under the GDPR and comparable penalties, including fines of up to 
£17.5 million or 4% of a noncompliant company’s global annual revenue for the preceding financial year, whichever is greater. Additionally, the EU 
adopted the EU Clinical Trials Regulation, which came into effect on January 31, 2022. This regulation imposes new obligations on the use of data 
generated from clinical trials and enables European patients to have the opportunity to access information about clinical trials. As we continue to expand 
into other foreign countries and jurisdictions, we may be subject to additional laws and regulations that may affect how we conduct business.

Although we work to comply with applicable laws, regulations and standards, our contractual obligations and other legal obligations, these 
requirements are evolving and may be modified, interpreted and applied in an inconsistent manner from one jurisdiction to another, and may conflict with 
one another or other legal obligations with which we must comply. Any failure or perceived failure by us or our employees, representatives, contractors, 
consultants, collaborators, or other third parties to comply with such requirements or adequately address privacy and security concerns, even if unfounded, 
could result in additional cost and liability to us, damage our reputation, and adversely affect our business and results of operations.

Acquisitions or joint ventures could disrupt our business, cause dilution to our stockholders and otherwise harm our business.

We may acquire other businesses, products or technologies as well as pursue strategic alliances, joint ventures, technology licenses or investments in 
complementary businesses. We have not made any acquisitions to date, and our ability to do so successfully is unproven. Any of these transactions could be 
material to our financial condition and operating results and expose us to many risks, including:

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disruption in our relationships with future customers or with current or future distributors or suppliers as a result of such a transaction;

unanticipated liabilities related to acquired companies;

additional exposure to cybersecurity risks and vulnerabilities from any newly acquired information technology infrastructure;

difficulties integrating acquired personnel, technologies and operations into our existing business;

diversion of management time and focus from operating our business to acquisition integration challenges;

increases in our expenses and reductions in our cash available for operations and other uses;

possible write-offs or impairment charges relating to acquired businesses; and

inability to develop a sales force for any additional product candidates.

Foreign acquisitions involve unique risks in addition to those mentioned above, including those related to integration of operations across different 

cultures and languages, currency risks and the particular economic, political and regulatory risks associated with specific countries.

Also, the anticipated benefit of any acquisition may not materialize. Future acquisitions or dispositions could result in potentially dilutive issuances 

of our equity securities, the incurrence of debt, contingent liabilities or amortization expenses or write-offs of goodwill, any of which could harm our 
financial condition. We cannot predict the number, timing or size of future joint ventures or acquisitions, or the effect that any such transactions might have 
on our operating results.

We have in the past been subject to securities class action litigation and may be subject to similar or other litigation in the future, which may harm our 
business.

Securities class action litigation has often been brought against a company following a decline in the market price of its securities. This risk is 
especially relevant for us because biopharmaceutical companies have experienced significant stock price volatility in recent years. On September 28, 2016, 
a purported stockholder filed a putative class action lawsuit in the U.S. District Court for the District of Massachusetts against us entitled Mariusz Mazurek 
v. Seres Therapeutics, Inc., et.al. alleging false and misleading statements and omissions about our clinical trials for our product candidate SER-109 in our 
public disclosures between June 25, 2015 and July 29, 2016. Although this lawsuit has been dismissed by the court, should we face similar or other 
litigation again, it could result in substantial costs and a diversion of management’s attention and resources, which could harm our business. In addition, the 
uncertainty of a pending lawsuit or potential filing of additional lawsuits could lead to more volatility and a reduction in our stock price.

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If we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incur costs that could 
harm our business.

We are subject to numerous environmental, health and safety laws and regulations, including those governing laboratory procedures and the 
handling, use, storage, treatment and disposal of hazardous materials and wastes. Our operations involve the use of hazardous and flammable materials, 
including chemicals and biological materials such as human stool. Our operations also produce hazardous waste products. We generally contract with third 
parties for the disposal of these materials and wastes. We cannot eliminate the risk of contamination or injury, including from the novel coronavirus SARS-
CoV-2, which causes the COVID-19 disease, from these materials. In the event of contamination or injury resulting from our use of hazardous materials, 
we could be held liable for any resulting damages, and any liability could exceed our resources. We also could incur significant costs associated with civil 
or criminal fines and penalties for failure to comply with such laws and regulations.

Although we maintain workers’ compensation insurance to cover us for costs and expenses we may incur due to injuries to our employees resulting 

from the use of hazardous materials, this insurance may not provide adequate coverage against potential liabilities. We do not maintain insurance for 
environmental liability or toxic tort claims that may be asserted against us in connection with our storage or disposal of biological, hazardous or radioactive 
materials.

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

Our ability to use our net operating loss carryforwards and research and development credits to offset future taxable income or income tax liabilities 
may be subject to certain limitations.

As of December 31, 2022, we had net operating loss carryforwards, or NOLs, of $501.8 million for federal income tax purposes and $481.9 million 

for state income tax purposes, which may be available to offset our future taxable income, if any. Our federal and state NOLs begin to expire in various 
amounts in 2035, provided that federal NOLs generated in taxable years after December 31, 2017 will not be subject to expiration. As of December 31, 
2022, we also had federal and state research and development and other tax credit carryforwards of approximately $42.1 million and $8.5 million, 
respectively, net of uncertain tax position reserves, available to reduce future income tax liabilities. Our federal and state tax credit carryforwards begin to 
expire in various amounts in 2031 and 2028, respectively. The federal research and development tax credit carryforwards include an orphan drug credit 
carryforward of $25.6 million. These NOLs and tax credit carryforwards could expire unused, to the extent subject to expiration, and be unavailable to 
offset future taxable income or income tax liabilities. In addition, in general, under Sections 382 and 383 of the U.S. Internal Revenue Code of 1986, as 
amended (the "Code"), a corporation that undergoes an “ownership change” is subject to limitations on its ability to use its pre-change NOLs and tax credit 
carryforwards to offset future taxable income and income taxes. For these purposes, an ownership change generally occurs where the aggregate change in 
stock ownership of one or more stockholders or groups of stockholders owning at least 5% of a corporation’s stock exceeds 50 percentage points over a 
three-year period.  We have experienced ownership changes in the past, per the Section 382 study performed through December 31, 2020, and may 
experience ownership changes in the future because of future transactions in our stock, some of which may be outside our control. We believe that none of 
the existing tax attributes will expire unused as a result of the calculated limitations. If we undergo future ownership changes, our ability to use our NOLs 
and tax credit carryforwards could be further limited.  For these reasons, we may not be able to use a material portion of our NOLs or tax credit 
carryforwards, even if we attain profitability. We have recorded a full valuation allowance related to our NOLs and other deferred tax assets due to the 
uncertainty of the ultimate realization of the future tax benefits of such assets. Federal NOLs arising in periods beginning after December 31, 2017 may 
generally only be used to offset 80% of taxable income in years beginning after December 31, 2020, which may require us to pay federal income taxes in 
future years despite generating federal NOLs in prior years.

The terms of our credit facility place restrictions on our operating and financial flexibility. If we raise additional capital through debt financing, the 
terms of any new debt could further restrict our ability to operate our business. 

In October 2019, we entered into a loan and security agreement with Hercules Capital, Inc., or Hercules, pursuant to which a term loan in an 
aggregate principal amount of up to $50.0 million, or the Original Credit Facility, was available to us in three tranches, subject to certain terms and 
conditions. We received the first tranche of $25.0 million upon signing the agreement on October 29, 2019, but did not borrow either of the second two 
tranches, which were available at different times upon Hercules’ approval until June 30, 2021.

In April 2020, we entered into an amendment to the loan and security agreement with Hercules, or the First Amendment, permitting us to enter into 

a promissory note under the Paycheck Protection Program of the Coronavirus Aid, Relief and Economic Stability Act. 

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In February 2022, we entered into a second amendment to the loan and security agreement with Hercules, or the Second Amendment, which 
amended the Original Credit Facility. Pursuant to the Second Amendment, term loans in an aggregate principal amount of up to $100.0 million, or the New 
Credit Facility, have become available to us in five tranches, subject to certain terms and conditions: (i) the first tranche in an aggregate principal amount of 
$25.0 million that was outstanding as of the February 24, 2022 effective date, or the Effective Date, (ii) the second tranche in an aggregate principal amount 
of $12.5 million that has been advanced to us and was outstanding as of the Effective Date, (iii) the third tranche in an aggregate principal amount of $12.5 
million that has been advanced to us and was outstanding as of the Effective Date, (iv) the fourth tranche in an aggregate principal amount of $25.0 million 
available upon satisfaction of certain conditions, including the approval by the FDA of a biologics license application in respect of SER-109 by no later 
than December 15, 2023, or the Regulatory Approval Milestone, and (v) the fifth tranche in an aggregate principal amount of up to $25.0 million that is 
available through the amortization date upon satisfaction of certain conditions, including the lenders’ investment committee approval. The New Credit 
Facility is secured by a lien on substantially all of our assets, other than intellectual property. We also agreed not to pledge or secure our intellectual 
property to others. 

The New Credit Facility includes affirmative and negative covenants and events of default applicable to us.  The affirmative covenants include, 

among others, covenants requiring us to maintain our legal existence and governmental approvals, deliver certain financial reports and maintain insurance 
coverage.  The negative covenants include, among others, restrictions on our transferring collateral, making changes to the nature of our business, incurring 
additional indebtedness, engaging in mergers or acquisitions, paying dividends or making other distributions, making investments, engaging in transactions 
with affiliates. The New Credit Facility also includes a conditional liquidity covenant commencing on June 15, 2023, which ceases to apply if certain 
conditions including the Regulatory Approval Milestone are satisfied. Events of default include, among other things and subject to customary exceptions: 
(i) insolvency, liquidation, bankruptcy or similar events; (ii) failure to pay any debts due under the loan and security agreement with Hercules or other loan 
documents on a timely basis; (iii) failure to observe certain covenants under the loan and security agreement with Hercules; (v) occurrence of a material 
adverse effect; (vi) material misrepresentation by us; (vii) occurrence of any default under any other agreement involving material indebtedness; and (viii) 
certain material money judgments. If we default under the loan and security agreement, Hercules may accelerate all of our repayment obligations and take 
control of our pledged assets, potentially requiring us to renegotiate our agreement on terms less favorable to us or to immediately cease operations. 
Further, if we are liquidated, the lenders’ right to repayment would be senior to the rights of the holders of our common stock to receive any proceeds from 
the liquidation.  Any declaration by Hercules of an event of default could significantly harm our business and prospects and could cause the price of our 
common stock to decline. If we raise any additional debt financing, the terms of such additional debt could further restrict our operating and financial 
flexibility.

Risks Related to Our Common Stock

Our executive officers, directors and principal stockholders, if they choose to act together, have the ability to control or significantly influence all 
matters submitted to stockholders for approval.

Our executive officers, directors and stockholders who owned more than 5% of our outstanding common stock and their respective affiliates, in the 
aggregate, hold shares representing approximately 68.5% of our outstanding voting stock as of December 31, 2022. As a result, if these stockholders were 
to choose to act together, they would be able to control or significantly influence all matters submitted to our stockholders for approval, as well as our 
management and affairs. For example, these persons, if they choose to act together, would control or significantly influence the election of directors and 
approval of any merger, consolidation or sale of all or substantially all of our assets. This concentration of ownership control may:

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delay, defer or prevent a change in control;

entrench our management and the board of directors; or

impede a merger, consolidation, takeover or other business combination involving us that other stockholders may desire.

A significant portion of our total outstanding shares are eligible to be sold into the market, which could cause the market price of our common stock to 
drop significantly, even if our business is doing well.

Sales of a substantial number of shares of our common stock in the public market, or the perception in the market that the holders of a large number 

of shares intend to sell shares, could reduce the market price of our common stock. We have also registered and intend to continue to register all shares of 
common stock that we may issue under our equity compensation plans. Once we register these shares, they can be freely sold in the public market upon 
issuance, subject to volume limitations applicable to affiliates.

Provisions in our restated certificate of incorporation and amended and restated bylaws and under Delaware law could make an acquisition of our 
company, which may be beneficial to our stockholders, more difficult and may prevent attempts by our stockholders to replace or remove our current 
management.

Provisions in our restated certificate of incorporation and our amended and restated bylaws may discourage, delay or prevent a merger, acquisition 
or other change in control of our company that stockholders may consider favorable, including transactions in which stockholders might otherwise receive 
a premium for their shares. These provisions could also limit the price that investors might be willing to pay in the future for shares of our common stock, 
thereby depressing the market price of our common stock. In 

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addition, because our board of directors is responsible for appointing the members of our management team, these provisions may frustrate or prevent any 
attempts by our stockholders to replace or remove our current management by making it more difficult for stockholders to replace members of our board of 
directors. Among other things, these provisions include those establishing:

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a classified board of directors with three-year staggered terms, which may delay the ability of stockholders to change the membership of a 
majority of our board of directors;

no cumulative voting in the election of directors, which limits the ability of minority stockholders to elect director candidates;

the exclusive right of our board of directors to elect a director to fill a vacancy created by the expansion of the board of directors or the 
resignation, death or removal of a director, which prevents stockholders from filling vacancies on our board of directors;

the ability of our board of directors to authorize the issuance of shares of preferred stock and to determine the terms of those shares, including 
preferences and voting rights, without stockholder approval, which could be used to significantly dilute the ownership of a hostile acquirer;

the ability of our board of directors to alter our bylaws without obtaining stockholder approval;

the required approval of the holders of at least two-thirds of the shares entitled to vote at an election of directors to adopt, amend or repeal 
our bylaws or repeal the provisions of our restated certificate of incorporation regarding the election and removal of directors;

a prohibition on stockholder action by written consent, which forces stockholder action to be taken at an annual or special meeting of our 
stockholders;

the requirement that a special meeting of stockholders may be called only by the chairman of the board of directors, the chief executive 
officer, the president or the board of directors, which may delay the ability of our stockholders to force consideration of a proposal or to take 
action, including the removal of directors; and

advance notice procedures that stockholders must comply with in order to nominate candidates to our board of directors or to propose matters 
to be acted upon at a stockholders’ meeting, which may discourage or deter a potential acquirer from conducting a solicitation of proxies to 
elect the acquirer’s own slate of directors or otherwise attempting to obtain control of us.

Moreover, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the General Corporation Law of the State 
of Delaware, which prohibits a person who owns in excess of 15% of our outstanding voting stock from merging or combining with us for a period of three 
years after the date of the transaction in which the person acquired in excess of 15% of our outstanding voting stock, unless the merger or combination is 
approved in a prescribed manner. 

Our certificate of incorporation designates the Court of Chancery of the State of Delaware, subject to certain exceptions, as the sole and exclusive 
forum for certain types of actions and proceedings that may be initiated by our stockholders and our bylaws designate the federal district courts of the 
United States as the exclusive forum for actions arising under the Securities Act of 1933, as amended, which could limit our stockholders’ ability to 
obtain a favorable judicial forum for disputes with us or our directors, officers or employees. 

Our restated certificate of incorporation specifies that, unless we consent in writing to the selection of an alternative forum, the Court of Chancery of 

the State of Delaware will be the sole and exclusive forum for most legal actions involving actions brought against us by stockholders. In addition, our 
bylaws provide that the federal district courts of the United States are the exclusive forum for any complaint raising a cause of action arising under the 
Securities Act. Any person or entity purchasing or otherwise acquiring any interest in shares of our capital stock shall be deemed to have notice of and to 
have consented to the provisions of our restated certificate of incorporation and bylaws described above.

We believe these choice of forum provisions benefit us by providing increased consistency in the application of Delaware law by chancellors 
particularly experienced in resolving corporate disputes and in the application of the Securities Act by federal judges, as applicable, efficient administration 
of cases on a more expedited schedule relative to other forums and protection against the burdens of multi-forum litigation. However, the provisions may 
have the effect of discouraging lawsuits against our directors and officers. The enforceability of similar choice of forum provisions in other companies’ 
certificates of incorporation has been challenged in legal proceedings, and it is possible that, in connection with any applicable action brought against us, a 
court could find the choice of forum provisions contained in our restated certificate of incorporation or bylaws to be inapplicable or unenforceable in such 
action. If a court were to find the choice of forum provisions contained in our restated certificate of incorporation or bylaws to be inapplicable or 
unenforceable in an action, we may incur additional costs associated with resolving such action in other jurisdictions, which could adversely affect our 
business, financial condition or results of operations.

64

Because we do not anticipate paying any cash dividends on our capital stock in the foreseeable future, capital appreciation, if any, will be the sole 
source of gain for our stockholders.

We have never declared or paid cash dividends on our capital stock. We currently intend to retain all of our future earnings, if any, to finance the 

growth and development of our business. In addition, our loan and security agreement with Hercules Capital currently prohibits us from paying dividends 
on our equity securities, and any future debt agreements may likewise preclude us from paying dividends. As a result, capital appreciation, if any, of our 
common stock will be our stockholders’ sole source of gain for the foreseeable future.

General Risk Factors

The price of our common stock may be volatile and fluctuate substantially, which could result in substantial losses for purchasers of our common 
stock.

Our stock price is likely to be volatile. Furthermore, the stock market in general and the market for smaller biopharmaceutical companies in 
particular have experienced extreme volatility that has often been unrelated to the operating performance of particular companies. As a result of this 
volatility, our stockholders may not be able to sell their common stock at or above the price they paid for their common stock. The market price for our 
common stock may be influenced by many factors, including:

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•

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•

•

•

•

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the success of competitive products or technologies;

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

results of clinical trials of our product candidates or those of our competitors;

developments related to any future collaborations;

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

development of new product candidates that may address our markets and may make our product candidates less attractive;

changes in physician, hospital or healthcare provider practices that may make our product candidates less useful;

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

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

the recruitment or departure of key personnel;

the level of expenses related to any of our product candidates or clinical development programs;

failure to meet or exceed financial estimates and projections of the investment community or that we provide to the public;

the results of our efforts to discover, develop, acquire or in-license additional product candidates or products;

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

variations in our financial results or those of companies that are perceived to be similar to us;

changes in the structure of healthcare payment systems;

market conditions in the pharmaceutical and biotechnology sectors;

general economic, industry and market conditions; and

the other factors described in this “Risk Factors” section.

If securities or industry analysts issue an adverse or misleading opinion regarding our business, our common stock price and trading volume could 
decline.

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

65

We will continue to incur costs as a result of being a public company, and our management will continue to devote substantial time to compliance 
initiatives and corporate governance practices.

As a public company, we have incurred and will continue to incur significant legal, accounting and other expenses. The Sarbanes-Oxley Act of 
2002, the Dodd-Frank Wall Street Reform and Consumer Protection Act, the listing requirements of The Nasdaq Global Select Market and other applicable 
securities rules and regulations impose various requirements on public companies, including establishment and maintenance of effective disclosure and 
financial controls and corporate governance practices. Our management and other personnel devote and will need to continue to devote a substantial 
amount of time to these compliance initiatives. Moreover, these rules and regulations have increased and will continue to increase our legal and financial 
compliance costs and make some activities more time-consuming and costly. For example, we expect that these rules and regulations will continue to make 
it more difficult and more expensive for us to maintain director and officer liability insurance, which in turn could make it more difficult for us to attract 
and retain qualified members of our board of directors.

These rules and regulations are often subject to varying interpretations, in many cases due to their lack of specificity, and, as a result, their 

application in practice may evolve over time as new guidance is provided by regulatory and governing bodies. This could result in future uncertainty 
regarding compliance matters and higher costs necessitated by ongoing revisions to disclosure and governance practices.

If we fail to maintain an effective system of internal control over financial reporting, we may not be able to accurately report our financial results or 
prevent fraud. As a result, stockholders could lose confidence in our financial and other public reporting, which would harm our business and the 
trading price of our common stock. 

Effective internal control over financial reporting is necessary for us to provide reliable financial reports and, together with adequate disclosure 
controls and procedures, is designed to prevent fraud. Any failure to implement required new or improved controls, or difficulties encountered in their 
implementation could cause us to fail to meet our reporting obligations. 

Pursuant to Section 404, we are required to furnish a report by our management on our internal control over financial reporting. Additionally, we are 

no longer a non-accelerated filer, so we are required to include an attestation report on internal control over financial reporting issued by our independent 
registered public accounting firm. If we are unable to maintain effective internal control over financial reporting, we may not have adequate, accurate or 
timely financial information, and we may be unable to meet our reporting obligations as a public company or comply with the requirements of the 
Securities and Exchange Commission or Section 404. This could result in a restatement of our financial statements, the imposition of sanctions, including 
the inability of registered broker dealers to make a market in our common stock, or investigation by regulatory authorities. Any such action or other 
negative results caused by our inability to meet our reporting requirements or comply with legal and regulatory requirements or by disclosure of an 
accounting, reporting or control issue could adversely affect the trading price of our securities and our business. Material weaknesses in our internal control 
over financial reporting could also reduce our ability to obtain financing or could increase the cost of any financing we obtain. This could result in an 
adverse reaction in the financial markets due to a loss of confidence in the reliability of our financial statements.

Failure to keep up with evolving trends and shareholder expectations relating to environmental, social and governance, or ESG, practices or 

reporting could adversely impact our reputation, share price and access to and cost of capital.

Certain institutional investors, investor advocacy groups, investment funds, creditors and other influential financial market participants have become 

increasingly focused on companies’ ESG practices in evaluating their investments and business relationships, including the impact of business on the 
environment. Certain organizations also provide ESG ratings, scores and benchmarking studies that assess companies’ ESG practices. Although there are 
no universal standards for such ratings, scores or benchmarking studies, they are used by some investors to inform their investment and voting decisions. It 
is possible that our future stockholders or organizations that report on, rate or score ESG practices will not be satisfied with our ESG strategy or 
performance. Unfavorable press about or ratings or assessments of our ESG strategies or practices, regardless of whether or not we comply with applicable 
legal requirements, may lead to negative investor sentiment toward us, which could have a negative impact on our share price and our access to and cost of 
capital.

Item 1B. Unresolved Staff Comments

None.

Item 2. Properties

Our corporate headquarters is located in Cambridge, Massachusetts, where we lease approximately 83,396 square feet of office, laboratory, and pilot 

manufacturing space under a lease that was originally set to expire in November 2023. In December 2022, we amended the lease to extend the expiration 
date with respect to 68,636 square feet of office, laboratory, and pilot manufacturing space to January 2030. 

Research and Offices

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Clinical Manufacturing

We currently conduct part of our manufacturing operations in our leased facilities in Cambridge, Massachusetts, which contain manufacturing 

facilities for clinical products. We believe our current laboratory facilities and contract relationships are sufficient to meet our current bioprocess 
development and manufacturing needs.  Product candidates may be brought into the facilities for economies of operation, or may remain external with 
contract manufacturing organizations, depending on business dynamics and development needs.

We plan to control the production of all products under current good manufacturing practices by making strategic investments in manufacturing, 
which may include collaborations with third parties, the design and renovation of existing facilities and the construction of additional new facilities for 
commercial supply.

Item 3. Legal Proceedings

Opposition Proceeding 

On October 19, 2016, the European Patent Office granted European Patent No. 2 575 835 B1 to The University of Tokyo. On April 25, 2017, we 

filed a notice of opposition to this patent in the European Patent Office, requesting that it be revoked in its entirety for the reasons set forth in our 
opposition.  The oral proceedings were held at the European Patent Office on February 18, 2019 and the Opposition Division required The University of 
Tokyo to narrow the scope of the claims of the patent.  The University of Tokyo appealed certain aspects of the Opposition Division’s decision, as did we 
and other opponents. On November 18, 2022, The University of Tokyo requested termination of the appeal proceeding and revocation of its patent. On 
December 19, 2022, the Opposition Division officially terminated the appeal proceeding, and European Patent No. 2 575 835 B1 has been revoked in its 
entirety. 

Item 4. Mine Safety Disclosures

Not applicable.

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PART II

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

Market Information

Our common stock has been publicly traded on the Nasdaq Global Select Market under the symbol “MCRB” since June 26, 2015. Prior to that time, 

there was no public market for our common stock. 

The graph set forth below compares the cumulative total stockholder return on our common stock between January 1, 2018 and December 31, 2022, 
with the cumulative total return of (a) the Nasdaq Biotechnology Index and (b) the Nasdaq Composite Index, over the same period. This graph assumes the 
investment of $100 on December 31, 2017 in each of our common stock, the Nasdaq Biotechnology Index and the Nasdaq Composite Index and assumes 
the reinvestment of dividends, if any. The comparisons reflected in the graph and table are not intended to forecast the future performance of our stock and 
may not be indicative of our future performance.

Stock Performance Graph

Holders

As of March 3, 2023, there were approximately nine holders of record of our common stock. The actual number of stockholders is greater than this 
number of record holders, and includes stockholders who are beneficial owners, but whose shares are held in street name by brokers and other nominees. 
The number of holders of record also does not include stockholders whose shares may be held in trust by other entities.

Dividends

We have not paid any cash dividends on our common stock since inception and do not anticipate paying cash dividends in the foreseeable future. In 
addition, our loan and security agreement with Hercules Capital currently prohibits us from paying dividends on our equity securities, and any future debt 
agreements may likewise preclude us from paying dividends.  See “Management’s Discussion and Analysis of Financial Condition and Results of 
Operations – Liquidity and Capital Resources.”

Recent Sales of Unregistered Securities

We did not make any sales of unregistered securities during the quarter ended December 31, 2022. 

There were no repurchases of shares of common stock made during the quarter ended December 31, 2022.

Purchases of Equity Securities by the Issuer or Affiliated Purchasers

Item 6. [Reserved]

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

You should read the following discussion and analysis of financial condition and results of operations together with our consolidated financial 
statements and related notes included elsewhere in this Annual Report on Form 10-K. This discussion and other parts of this Annual Report on Form 10-K 
contain forward-looking statements that involve risks and uncertainties, such as statements regarding our plans, objectives, expectations, intentions and 
projections. Our actual results could differ materially from those discussed in these forward-looking statements. Important factors that could cause or 
contribute to such differences include, but are not limited to, those discussed in “Summary Risk Factors” and Part I and Item 1A. “Risk Factors” of this 
Annual Report on Form 10-K.

A discussion regarding our financial condition and results of operations for the years ended December 31, 2022 and 2021, including a year-to-year 

comparison between 2022 and 2021, is presented below. For a discussion regarding our financial condition and results of operations for the year ended 
December 31, 2020, including a year-to-year comparison between 2021 and 2020, refer to Part II, Item 7. "Management’s Discussion and Analysis of 
Financial Condition and Results of Operations" in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021, filed with the SEC on 
March 1, 2022.

Overview

We are a microbiome therapeutics company developing a novel class of biological drugs, which are designed to treat disease by modulating the 

microbiome to restore health by repairing the function of a disrupted microbiome to a non-disease state. We have an advanced drug pipeline with clinical 
assets that are formulated for oral delivery and a differentiated microbiome therapeutics drug discovery and development platform including good 
manufacturing practices, or GMP, manufacturing capabilities for this novel drug modality. 

Our highest priority is preparing for potential commercialization of SER-109, an investigational oral microbiome therapeutic in development for 

recurrent Clostridioides difficile infection, or CDI. In October 2022, the FDA accepted for review our BLA for SER-109. The BLA has been granted 
Priority Review designation with a Prescription Drug User Fee Act, or PDUFA, target action date of April 26, 2023. If approved by the FDA, we plan to 
launch SER-109 with our collaborator, Nestlé Health Science, soon after approval. 

We are also designing microbiome therapeutics to decolonize pathogens and modulate host function to reduce and prevent infections. We believe 

that the scientific and clinical data from our SER-109 program validate this novel approach, which we refer to as Infection Protection. We believe the 
Infection Protection approach may be replicable across different bacterial pathogens to develop microbiome therapeutics with the potential to protect a 
range of medically compromised patients from infections. We are evaluating SER-155 in a Phase 1b study in patients receiving allogeneic hematopoietic 
stem cell transplantation, or allo-HSCT, to reduce incidences of gastrointestinal infections, bloodstream infections and graft-versus-host disease, or GvHD. 
In December 2022, the study’s Data and Safety Monitoring Board reviewed available clinical data for cohort 1 and cleared advancement to cohort 2. In 
February 2023, we announced the initiation of enrollment in cohort 2. We plan to announce initial safety and pharmacological data, including drug bacterial 
species engraftment from cohort 1, in May 2023. We are also progressing additional preclinical stage programs to evaluate how microbiome therapeutics 
may reduce incidence of infection in indications such as cancer neutropenia, chronic liver disease, solid organ transplant, and antimicrobial resistant 
infections more broadly in settings of high-risk such as intensive care units, or ICUs. 

We continue our research activities in ulcerative colitis, or UC, including evaluating the potential to utilize biomarker-based patient selection and 

stratification for future studies. In addition, we continue to leverage microbiome pharmacokinetic and pharmacodynamic data from across our clinical and 
preclinical portfolios, using our reverse translational microbiome therapeutics development platform to conduct research on various indications, including 
inflammatory and immune diseases, cancer, and metabolic diseases. 

We have built and deploy a reverse translational platform for the discovery and development of microbiome therapeutics. This platform incorporates 

high-resolution analysis of human clinical data to identify microbiome biomarkers associated with disease and non-disease states; preclinical screening 
using human cell-based assays and in vitro/ex vivo and in vivo disease models customized for microbiome therapeutics; and microbiological capabilities 
and a strain library that spans broad biological and functional breadth to both identify specific microbes and microbial metabolites that are associated with 
disease and to design consortia of bacteria with specific pharmacological properties.

Since our inception in October 2010, we have devoted substantially all of our resources to developing our programs, platforms, and technologies, 

building our intellectual property portfolio, developing our supply chain, business planning, raising capital and providing general and administrative 
support for these operations.

Many of our product candidates are still in preclinical development or early-stage discovery. Our ability to generate product revenue or collaboration 

profit sufficient to achieve profitability will depend heavily on the successful development and eventual commercialization of one or more of our product 
candidates. Since our inception, we have incurred significant operating losses. Our net loss was $250.2 million for the year ended December 31, 2022 and 
as of December 31, 2022, we had an accumulated deficit of $864.5 million.  

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While we plan to focus our investment on our highest priority clinical programs in the near-term, our expenses may increase substantially in 

connection with our ongoing and planned activities, particularly as we:

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complete the clinical development, seek regulatory approval, and prepare for commercialization of SER-109 for patients with recurrent CDI; 

continue the clinical development of SER-155 to reduce incidences of gastrointestinal infections, bloodstream infections and GvHD in 
patients receiving allo-HSCT;

continue evaluating preclinical stage programs to reduce incidence of infection, in indications such as cancer neutropenia, chronic liver 
disease, solid organ transplant, and antimicrobial resistant infections more broadly;

continue translational research activities, informed by the SER-287 Phase 2b and SER-301 Phase 1b study data, to evaluate the potential to 
utilize biomarker-based patient selection and stratification in future clinical development efforts;

make strategic investments in our research discovery and development platforms and capabilities, to advance our priority programs;

make strategic investments in manufacturing capabilities;

maintain and augment our intellectual property portfolio and opportunistically acquire complementary intellectual property;

potentially establish a sales and distribution infrastructure and scale-up manufacturing capabilities to commercialize any products for which 
we may obtain regulatory approval;

perform our obligations under our agreements with our collaborators;

seek to obtain regulatory approvals for our product candidates; and

experience any delays or encounter any issues with any of the above, including but not limited to failed studies, complex results, safety issues 
or other regulatory challenges.

In addition, if we obtain marketing approval for any of our product candidates, we expect to incur significant commercialization expenses related to 
product manufacturing, marketing, sales and distribution. Furthermore, we expect to continue to incur additional costs associated with operating as a public 
company.

As a result, we will need additional financing to support our continuing operations. Until such time as we can generate significant revenue from 

product sales, if ever, we expect to finance our operations through a combination of public or private equity or debt financings or other sources, which may 
include collaborations with third parties. Adequate additional financing may not be available to us on acceptable terms, or at all. For example, the trading 
prices for our and other biopharmaceutical companies’ stock have been highly volatile as a result of factors such as the impacts of the COVID-19 
pandemic, the continued increase in inflation, and rising interest rates. As a result, we may face difficulties raising capital through sales of our common 
stock and any such sales may be on unfavorable terms. Our inability to raise capital as and when needed would have a negative impact on our financial 
condition and our ability to pursue our business strategy.  We will need to generate significant revenue to achieve profitability, and we may never do so. 

As of December 31, 2022, we had cash, cash equivalents and short- and long-term investments totaling $181.3 million. Based on our currently 

available cash resources and our current level of operations and cash flows for the 12-month period subsequent to the date of issuance of the consolidated 
financial statements included elsewhere in this Annual Report on Form 10-K we will require additional funding in early 2024. In accordance with 
applicable accounting standards, we evaluated whether there are conditions and events, considered in the aggregate, that raise substantial doubt about our 
ability to continue as a going concern within 12 months after the date of the issuance of the consolidated financial statements included elsewhere in this 
Annual Report on Form 10-K. In performing this analysis, we excluded certain elements of our operating plan that cannot be considered probable of 
occurring. Under the applicable accounting standards, the receipt of potential funding from future equity or debt issuances, and certain contingent payments 
associated with the approval of our BLA for SER-109, which is currently under priority review by the FDA, cannot be considered probable, as these events 
are outside our control. These contingent payments include a $125.0 million milestone payment from Nestlé pursuant to the 2021 License Agreement, and 
a $25.0 million tranche under our New Credit Facility with Hercules, which becomes available upon the satisfaction of certain conditions, including FDA 
approval of SER-109. Accordingly, management has concluded that substantial doubt exists about the Company’s ability to continue as a going concern for 
12 months from the date the consolidated financial statements included elsewhere in this Annual Report on Form 10-K, are issued. See “Risk Factors— 
Risks Related to Our Financial Position and Need for Additional Capital —We have identified conditions and events that raise substantial doubt regarding 
our ability to continue as a going concern.”

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SER-109

SER-109 is an oral microbiome therapeutic candidate consisting of a consortium of purified Firmicutes spores. The SER-109 manufacturing 
purification process is designed to remove unwanted microbes in an effort to reduce the risk of pathogen transmission beyond donor screening alone.  SER-
109 is designed to reduce recurrent CDI in patients with a history of CDI by modulating the microbiome to a state that resists C. difficile germination and 
growth. SER-109, if approved, is intended to treat individuals with recurrent CDI, a patient population that is estimated to include approximately 156,000 
cases in the United States during 2023.

The Phase 3 ECOSPOR III study was a multicenter, randomized, placebo-controlled study that enrolled 182 patients with multiply recurrent CDI. 

All patients who entered ECOSPOR III must have tested positive for C. difficile toxin. This inclusion criterion was implemented in an effort to ensure 
enrollment of only patients with active infection rather than simple colonization. The study was designed to evaluate patients for 24 weeks, with the 
primary endpoint comparing the C. difficile recurrence rate in subjects who received SER-109 verses placebo at up to eight weeks after dosing.

ECOSPOR III data demonstrated that the study achieved its primary endpoint where SER-109 was superior to placebo in reducing CDI recurrence 

at eight weeks, reflecting a recurrence-free rate of approximately 88% at eight weeks post-treatment. SER-109 resulted in a 27% absolute reduction of 
recurrence of CDI compared to placebo at eight weeks post-treatment, which is a relative risk reduction of 68%. The number-needed-to treat was 3.6. The 
rate of recurrence at 12 weeks in the SER-109 arm was 18.0%, compared to a rate of 46.2% in the placebo arm, representing an absolute risk reduction of 
28% (relative risk 0.40; 95% CI 0.24-0.65; p <0.001 and p< 0.002 for the test sequence), and thereby consistent with the results seen at eight weeks.  
Results across stratifications of age and antibiotics remained similar. The study’s efficacy results related to the primary endpoint from all analyses exceeded 
the statistical threshold previously provided in consultation with the FDA that could allow this single clinical study to fulfill efficacy requirements for a 
BLA.  The efficacy results remained durable through 24 weeks of follow-up, as SER-109 was observed to significantly reduced recurrence rates compared 
to placebo over 24 weeks, 21.3% vs. 47.3%, respectively. These data were published in the New England Journal of Medicine in January 2022 and in the 
Journal of the American Medical Association in October 2022.

In November 2021, we initiated a SER-109 expanded access program across the United States. The program is designed to enable eligible adults 

with recurrent CDI to obtain access to SER-109 prior to a potential FDA product approval. 

In June 2022, we announced confirmatory results from the ECOSPOR IV open-label study. The overall safety profile observed in ECOSPOR IV 

through 24 weeks indicated that SER-109 was well tolerated, consistent with the safety profile observed in the prior completed Phase 3 study, ECOSPOR 
III. In ECOSPOR IV, subjects treated with SER-109 had a recurrence rate of 8.7% at eight weeks, which indicates a 91.3% recurrence-free rate, consistent 
with the 88% rate observed in the ECOSPOR III study. Subjects with a first recurrence of CDI (29% of subjects in the ECOSPOR IV study) had a CDI 
recurrence rate of 6.5%, and subjects with ≥ two prior CDI episodes (ECOSPOR III inclusion criteria) had a CDI recurrence rate of 9.7% at eight weeks. At 
24 weeks, 13.7% of all subjects treated with SER-109 had a recurrence of CDI. In addition to data from the ECOSPOR III study, the ECOSPOR IV data 
was included as part of the rolling submission of the BLA to the FDA.  

In October 2022, the FDA accepted for review our BLA for SER-109. The BLA has been granted Priority Review designation with a PDUFA target 

action date of April 26, 2023. If approved by the FDA, we plan to launch SER-109 with our collaborator, Nestlé Health Science, soon after approval. 

In addition, we plan on initiating a Phase 3 trial in the European Union, or EU, in order to expand access to the EU market upon potential approval.

SER-155

SER-155, an oral microbiome therapeutic candidate consisting of a consortium of cultivated bacteria, is designed to decrease infection and 

translocation of antibiotic resistant bacteria in the gastrointestinal tract and modulate host immune responses to decrease GvHD. The rationale for this 
program is based in part on published clinical evidence from our collaborators at Memorial Sloan Kettering Cancer Center showing that allo-HSCT patients 
with decreased diversity of commensal microbes are significantly more likely to die due to infection and/or lethal GvHD. SER-155 was designed using our 
reverse translational discovery platform to reduce incidences of gastrointestinal infections, bloodstream infections and GvHD in patients receiving allo-
HSCT.  The SER-155 Phase 1b study is designed to include approximately 70 patients in both an open-label and a randomized, double-blind, placebo-
controlled cohort that will evaluate safety and tolerability before and after HSCT.  Additionally, the engraftment of SER-155 bacteria (a measure of 
pharmacokinetics) and the efficacy of SER-155 in preventing infections and GvHD will be evaluated. In December 2022, the study’s Data and Safety 
Monitoring Board reviewed available clinical data for cohort 1 and cleared advancement to cohort 2. In February 2023, we announced the initiation of 
enrollment in cohort 2. We plan to announce initial safety and pharmacological data, including drug bacterial species engraftment from cohort 1, in May 
2023. The study is being conducted at a number of leading cancer centers across the U.S.

Irritable Bowel Disease, Ulcerative Colitis, SER-287 and SER-301 

We continue our research activities in irritable bowel disease, or IBD, including evaluating the potential to utilize biomarker-based patient selection 

and stratification in future clinical studies in UC. UC patient populations are generally heterogeneous in their 

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disease manifestation, and we believe biomarker-based strategies may enable targeting more homogeneous patient populations in future studies. 

In July 2021, we announced topline results from our SER-287 Phase 2b study in mild-to-moderate UC patients, which did not meet its primary 

endpoint of improving clinical remission rates compared to placebo.  Following the data readout, in December 2021, we completed preliminary 
microbiome drug pharmacology analyses that demonstrated the engraftment of SER-287 bacterial species, however, unlike the Phase 1b study, anticipated 
changes in disease-relevant metabolites post-administration with SER-287 in the Phase 2b study were not observed to the same extent across the patients 
treated in the Phase 1b study.

In addition, we have completed preliminary analysis of data from the first cohort of our SER-301 Phase 1b study in mild-to moderate UC patients, 
which included 15 subjects. Evaluation of the first cohort data by an independent Data Safety Monitoring Board indicated that it would be safe to proceed 
to the placebo-controlled second cohort. While efficacy was not a defined endpoint in the first cohort, evaluation of clinical outcome data collected as part 
of the study indicated that no subjects in the first cohort achieved clinical remission as defined by the FDA using the Three-Component Modified Mayo 
Score after 10 weeks of treatment, though there were improvements in one or more individual components (endoscopic, stool frequency and rectal bleeding 
subscores) in some patients. SER-301 was optimized relative to SER-287 to incorporate bacterial strains that engrafted across the majority of patients in 
our previous trials, and strains that were significantly associated with positive clinical outcomes and the modulation of key microbial-associated 
metabolites. In the Phase 1b study, strains in SER-301 were observed to engraft in subjects across the trial period, and based on the assessment of 
metabolomic data, SER-301 demonstrated pharmacological properties consistent with its design and further led to baseline-dependent modulation of the 
metabolic landscape in the gastrointestinal tract of patients treated. In April 2022, we announced our decision not to proceed with the planned SER-301 
Phase 1b second study cohort.  In aggregate, our clinical and preclinical data suggest that there are IBD patient populations that may be more amenable to 
microbiome therapeutic intervention, and we continue to conduct analyses of data from our UC clinical stage programs and conduct preclinical studies to 
inform next steps for further development in UC and IBD more broadly.

Patent Portfolio

Intellectual Property

We have an extensive patent portfolio directed to rationally designed ecologies of spores and microbes. The portfolio includes both company-owned 

patents and applications, and those that we have rights to as licensee. For example, our portfolio includes an option to license foundational intellectual 
property related to the use of bacteria in combination with checkpoint inhibitors from MD Anderson. The patents and applications included in our portfolio 
cover both composition of matter and methods (e.g., method of treating). Our intellectual property rights related to SER-109, SER-155, SER-287 and SER-
301 extend through 2034. We plan on continuing to broaden our patent portfolio. Currently, we have 24 active patent application families, which includes 
22 nationalized applications and two pending at the PCT stage. To date, we have obtained 24 issued U.S. patents and one U.S. patent application has been 
currently allowed. 

Regulatory Exclusivity

If we obtain marketing approval for any of our product candidates, we expect to receive marketing exclusivity against biosimilar products. For a 

new biological composition approved by the FDA, a 12-year period of exclusivity in the United States may be obtained. In Europe, the European 
Medicines Agency awards 10 years of exclusivity for new molecular entities.

Revenue 

Financial Operations Overview

To date we have not generated any revenues from the sale of products.  Our revenues have been derived primarily from our agreements with our 

collaborators. See “—Liquidity and Capital Resources.”

Operating Expenses

Our operating expenses since inception have consisted primarily of research and development activities and general and administrative costs.

Research and Development Expenses

Research and development expenses consist primarily of costs incurred for our research activities, including our discovery efforts and the 

development of our product candidates, which include:

•

•

expenses incurred under agreements with third parties, including contract research organizations, or CROs, that conduct research, preclinical 
activities and clinical trials on our behalf as well as contract manufacturing organizations that manufacture drug products for use in our 
preclinical and clinical trials;

salaries, benefits and other related costs, including stock-based compensation expense, for personnel in our research and development 
functions;

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•

•

•

•

costs of outside consultants, including their fees, stock-based compensation and related travel expenses;

the cost of laboratory supplies and acquiring, developing and manufacturing preclinical study and clinical trial materials;

costs related to compliance with regulatory requirements; and

facility-related expenses, which include direct depreciation costs and allocated expenses for rent and maintenance of facilities and other 
operating costs.

We expense research and development costs as incurred. We recognize external development costs based on an evaluation of the progress to 
completion of specific tasks using information provided to us by our vendors and our clinical investigative sites. Payments for these activities are based on 
the terms of the individual agreements, which may differ from the pattern of costs incurred, and are reflected in our financial statements as prepaid or 
accrued research and development expenses.

Our primary focus of research and development since inception has been on our reverse translational microbiome therapeutics platform and the 

subsequent development of our product candidates. Our direct research and development expenses are tracked on a program-by-program basis and consist 
primarily of external costs, such as fees paid to investigators, consultants, CROs in connection with our preclinical studies and clinical trials, lab supplies 
and consumables, and regulatory fees. We do not allocate employee-related costs and other indirect costs to specific research and development programs 
because these costs are deployed across multiple product programs under development.

Research and development activities are central to our business model. Product candidates in later stages of clinical development generally have 

higher development costs than those in earlier stages of clinical development, primarily due to the increased size and duration of later-stage clinical trials. 
We expect that our research and development expenses will continue to increase in the near future as we scale up manufacturing operations, support the 
BLA review process by the FDA, and prepare for commercialization of SER-109, however in the event of approval of our BLA for SER-109, we expect the 
potential decline in research and development expenses related to SER-109 as the majority of commercial manufacturing costs will be capitalized. We 
expect to continue to discover and develop additional product candidates, including SER-155, and pursue later stages of clinical development of our 
product candidates. We also expect to continue conducting analyses of data from our UC clinical stage programs to inform next steps for further 
development.

General and Administrative Expenses

General and administrative expenses consist primarily of salaries and other related costs, including stock-based compensation, for personnel in our 
executive, finance, commercial, business development and administrative functions. General and administrative expenses also include professional service 
fees for marketing and market access activities in preparation for the commercial launch of SER-109; legal fees relating to patent and corporate matters; 
professional fees for accounting, auditing, tax and consulting services; insurance costs; travel expenses; and facility-related expenses, which include direct 
depreciation costs and allocated expenses for rent and maintenance of facilities and other operating costs.

We expect that our general and administrative expenses will increase in the future as we increase our headcount and expand our infrastructure to 

support the potential growth in our research and development activities and the potential commercialization of our product candidates, and as we conduct 
pre-launch activities to prepare for commercialization of SER-109. We also may continue to incur increased expenses associated with being a public 
company, including increased costs of accounting, audit, legal, regulatory and tax-related services associated with maintaining compliance with exchange 
listing rules and the requirements of the Securities and Exchange Commission, director and officer insurance costs and investor and public relations costs.

Collaboration (Profit) Loss Sharing - related party

Collaboration (profit) loss sharing – related party includes 50% sharing of the profit or loss related to the pre-launch activities and 

commercialization activities associated with the 2021 License Agreement with Nestlé as discussed in Note 11 to our consolidated financial statements. 

Other (Expense) Income, Net

Interest Income, Net

Interest income consists of interest earned on our cash, cash equivalents and investments.

Interest Expense

Interest expense consists of interest incurred under our loan and security agreement with Hercules.

Other (Expense) Income 

Other (expense) income primarily consists of amortization of premiums on investments, amortization of debt issuance costs, and sublease income.

73

Income Taxes

Since our inception in 2010, we have not recorded any U.S. federal or state income tax benefits for the net losses we have incurred in each year or 
our earned research and development tax credits, due to our uncertainty of realizing a benefit from those items. As of December 31, 2022, we had federal 
and state net operating loss carryforwards of $501.8 million and $481.9 million, respectively, both of which begin to expire in 2035. As of December 31, 
2022, we also had federal and state research and development tax credit carryforwards of $42.1 million and $8.5 million, respectively, net of uncertain tax 
position reserves, which begin to expire in 2031 and 2028, respectively. The federal research and development tax credits include an orphan drug credit 
carryforward of $25.6 million.

Critical Accounting Policies and Significant Judgments and Estimates

Our consolidated financial statements are prepared in accordance with generally accepted accounting principles, or GAAP, in the United States. The 
preparation of our consolidated financial statements and related disclosures requires the application of appropriate technical accounting rules and guidance, 
as well as the use of estimates. The application of these policies necessarily involves judgments regarding future events. These estimates and judgments, in 
and of themselves, could materially impact the consolidated financial statements and disclosures based on varying assumptions. We believe that the 
estimates and assumptions involved in the accounting policies described below may have the greatest potential impact on our consolidated financial 
statements and, therefore, consider these to be our critical accounting policies. We evaluate our estimates and assumptions on an ongoing basis. Our actual 
results may differ from these estimates under different assumptions and conditions.

Revenue Recognition

We recognize revenue in accordance with the guidance under ASC 606, Revenue from Contracts with Customers. ASC 606 applies to all contracts 

with customers, except those contracts that are within the scope of other guidance, such as leases, insurance, and financial instruments. We enter into 
agreements that are within the scope of ASC 606, under which we license certain of our product candidates and perform research and development services 
in connection with such arrangements. The terms of these arrangements typically include payment of one or more of the following: nonrefundable up-front 
fees, reimbursement of research and development costs, development, clinical, regulatory and commercial sales milestone payments, and royalties on net 
sales of licensed products.  Under ASC 606, we recognize revenue when our customer obtains control of promised goods or services, in an amount that 
reflects the consideration which we expect to receive in exchange for those goods or services. When determining the timing and extent of revenue 
recognition for arrangements that we determine are within the scope of ASC 606, we perform the following five steps: 

(i)

(ii)

(iii)

(iv)

(v)

identify the contract(s) with a customer; 

identify the performance obligation(s) in the contract; 

determine the transaction price; 

allocate the transaction price to the performance obligation(s) in the contract; and 

recognize revenue when (or as) the entity satisfies a performance obligation. 

We only apply the five-step model to contracts when it is probable that we will collect the consideration to which we are entitled in exchange for the 

goods or services transferred to our customer. 

At contract inception, once the contract is determined to be within the scope of ASC 606, we assess the goods or services promised within the 

contract to determine whether each promised good or service is a performance obligation. The promised goods or services in our arrangements typically 
consist of a license to our intellectual property and/or research and development services. We may provide options to additional items in such 
arrangements, which are accounted for as separate contracts when our customer elects to exercise such options, unless the option provides a material right 
to our customer.  Performance obligations are promises in a contract to transfer a distinct good or service to our customer that (i) our customer can benefit 
from on its own or together with other readily available resources, and (ii) is separately identifiable from other promises in the contract. Goods or services 
that are not individually distinct performance obligations are combined with other promised goods or services until such combined group of promises meets 
the requirements of a performance obligation. 

We determine transaction price based on the amount of consideration we expect to receive for transferring the promised goods or services in the 
contract. Consideration may be fixed, variable, or a combination of both. At contract inception for arrangements that include variable consideration, we 
estimate the probability and extent of consideration we expect to receive under the contract utilizing either the most likely amount method or expected 
amount method, whichever best estimates the amount expected to be received. We then consider any constraints on the variable consideration and include 
in the transaction price variable consideration to the extent it is deemed probable that a significant reversal in the amount of cumulative revenue recognized 
will not occur when the uncertainty associated with the variable consideration is subsequently resolved.  

We then allocate the transaction price to each performance obligation based on the relative standalone selling price and recognize as revenue the 

amount of the transaction price that is allocated to the respective performance obligation when (or as) control is transferred to our customer and the 
performance obligation is satisfied. For performance obligations which consist of licenses and 

74

other promises, we utilize judgment to assess the nature of the combined performance obligation to determine whether the combined performance 
obligation is satisfied over time or at a point in time and, if over time, the appropriate method of measuring progress. We evaluate the measure of progress 
each reporting period and, if necessary, adjust the measure of performance and related revenue recognition.

We record amounts as accounts receivable when the right to consideration is deemed unconditional. When consideration is received, or such 

consideration is unconditionally due, from our customer prior to transferring goods or services to our customer under the terms of a contract, a contract 
liability is recorded for deferred revenue.

We do not assess whether a contract has a significant financing component if the expectation at contract inception is that the period between 

payment by our customer and the transfer of the promised goods or services to our customer will be one year or less. Incremental costs of obtaining a 
contract are expensed as and when incurred if the expected period over which we would have amortized the asset is one year or less, or the amount is 
immaterial.

Collaboration Revenue 

Arrangements with collaborators may include licenses to intellectual property, research and development services, manufacturing services for 
clinical and commercial supply, and participation on joint steering committees. We evaluate the promised goods or services to determine which promises, 
or group of promises, represent performance obligations. In contemplation of whether a promised good or service meets the criteria required of a 
performance obligation, we consider the stage of development of the underlying intellectual property, the capabilities and expertise of our customer relative 
to the underlying intellectual property, and whether the promised goods or services are integral to or dependent on other promises in the contract. When 
accounting for an arrangement that contains multiple performance obligations, we must develop judgmental assumptions, which may include market 
conditions, reimbursement rates for personnel costs, development timelines and probabilities of regulatory success to determine the stand-alone selling 
price for each performance obligation identified in the contract.  

When we conclude that a contract should be accounted for as a combined performance obligation and recognized over time, we must then determine 

the period over which revenue should be recognized and the method by which to measure revenue. We generally recognize revenue using a cost-based 
input method. 

Licenses of Intellectual Property

If a license to our intellectual property is determined to be distinct from the other performance obligations identified in the arrangement, we 
recognize revenue allocated to the license when the license is transferred to our customer and our customer is able to use and benefit from the license.  For 
licenses that are bundled with other promises, we utilize judgment to assess the nature of the combined performance obligation to determine whether the 
combined performance obligation is satisfied over time or at a point in time and, if over time, the appropriate method of measuring progress for purposes of 
recognizing revenue associated with the bundled performance obligation.  We evaluate the measure of progress each reporting period and, if necessary, 
adjust the measure of progress and related revenue recognition.

Milestone Payments

At the inception of each arrangement that includes developmental and regulatory milestone payments, we evaluate whether the achievement of each 
milestone specifically relates to our efforts to satisfy a performance obligation or transfer a distinct good or service within a performance obligation. If the 
achievement of a milestone is considered a direct result of our efforts to satisfy a performance obligation or transfer a distinct good or service and the 
receipt of the payment is based upon the achievement of the milestone, the associated milestone value is allocated to that distinct good or service, otherwise 
it will be allocated to all performance obligations of the arrangement based on the initial allocation. 

We evaluate each milestone to determine when and how much of the milestone to include in the transaction price.  We first estimate the amount of 
the milestone payment that we could receive using either the expected value or the most likely amount approach. We primarily use the most likely amount 
approach as that approach is generally most predictive for milestone payments with a binary outcome. Then, we consider whether any portion of that 
estimated amount is subject to the variable consideration constraint (that is, whether it is probable that a significant reversal of cumulative revenue would 
not occur upon resolution of the uncertainty). We update the estimate of variable consideration included in the transaction price at each reporting date 
which includes updating the assessment of the likely amount of consideration and the application of the constraint to reflect current facts and 
circumstances.

Royalties

For arrangements that include sales-based royalties, including milestone payments based on the level of sales, and the license is deemed to be the 

predominant item to which the royalties relate, we recognize revenue at the later of (i) when the related sales occur, or (ii) when the performance obligation 
to which some or all of the royalty has been allocated has been satisfied (or partially satisfied). To date, we have not recognized any revenue related to 
sales-based royalties or milestone payments based on the level of sales.

75

Manufacturing Supply Services

For arrangements that include a promise of supply of clinical or commercial product, we determine if the supply is a promise in the contract or a 

future obligation at our customer’s option. If determined to be a promise at inception of the contract, we evaluate the promise to determine whether it is a 
separate performance obligation or a component of a bundled performance obligation. If determined to be an option, we determine if the option provides a 
material right to our customer and if so, account for the option as a separate performance obligation. If determined to be an option but not a material right, 
we account for the option as a separate contract when our customer elects to exercise the option.

Application of the above guidance requires significant judgment and requires us to make determinations based on the facts and circumstances under 

each arrangement. 

Accrued Research and Development Expenses

As part of the process of preparing our consolidated financial statements, we are required to estimate our accrued research and development 

expenses. This process involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been 
performed on our behalf and estimating the level of service performed and the associated costs incurred for the services when we have not yet been 
invoiced or otherwise notified of the actual costs. The majority of our service providers invoice us in arrears for services performed, on a pre-determined 
schedule or when contractual milestones are met; however, some require advanced payments. We make estimates of our accrued expenses as of each 
balance sheet date in our financial statements based on facts and circumstances known to us at that time, which include information from our CROs and 
CMOs reported to us on a periodic basis. Examples of estimated accrued research and development expenses include fees paid to:

•

•

•

•

CROs in connection with performing research services on our behalf and clinical trials;

investigative sites or other providers in connection with clinical trials;

vendors in connection with preclinical and clinical development activities; and

vendors related to product manufacturing, development and distribution of preclinical and clinical supplies.

We base our expenses related to preclinical studies and clinical trials on our estimates of the services received and efforts expended pursuant to 
quotes and contracts with multiple CROs that conduct and manage clinical trials on our behalf. The financial terms of these agreements are subject to 
negotiation, vary from contract to contract and may result in uneven payment flows. There may be instances in which payments made to our vendors will 
exceed the level of services provided and result in a prepayment of the clinical expense. Payments under some of these contracts depend on factors such as 
the successful enrollment of patients and the completion of clinical trial milestones. In accruing service fees, we estimate the time period over which 
services will be performed, enrollment of patients, number of sites activated and the level of effort to be expended in each period.  If the actual timing of 
the performance of services or the level of effort varies from our estimate, we adjust the accrual or amount of prepaid expense accordingly. Although we do 
not expect our estimates to be materially different from amounts actually incurred, our understanding of the status and timing of services performed relative 
to the actual status and timing of services performed may vary and may result in us reporting amounts that are too high or too low in any particular period. 
To date, we have not made any material adjustments to our prior estimates of accrued research and development expenses.

76

Comparison of the Years Ended December 31, 2022 and 2021

The following table summarizes our results of operations for the years ended December 31, 2022 and 2021. 

Results of Operations

Revenue:

Collaboration revenue - related party
Grant revenue

Total revenue

Operating expenses:

Research and development
General and administrative
Collaboration (profit) loss sharing - related party

Total operating expenses

Loss from operations
Other (expense) income:

Interest income
Interest expense
Other (expense) income

Total other expense, net

Net loss

Revenue 

Year Ended
December 31,

2022

2021
(in thousands)

Change

  $

7,128     $
—    
7,128    

143,857     $
1,070      
144,927      

(136,729 )
(1,070 )
(137,799 )

172,920    
79,694    
1,004    
253,618    
(246,490 )  

3,058    
(6,020 )  
(705 )  
(3,667 )  
(250,157 )   $

141,891      
69,261      
(1,732 )    
209,420      
(64,493 )    

2,870      
(2,910 )    
(1,045 )    
(1,085 )    
(65,578 )   $

31,029  
10,433  
2,736  
44,198  
(181,997 )

188  
(3,110 )
340  
(2,582 )
(184,579 )

  $

Total revenue was $7.1 million and $144.9 million for the years ended December 31, 2022 and 2021, respectively.  The decrease in total revenue of 

$137.8 million was primarily due to the collaboration revenue that was recognized during the year ended December 31, 2021 upon on the transfer of 
control of the license by the Company to Nestlé, pursuant to the 2021 License Agreement. In addition, the decrease was partially driven by a $7.4 million 
decrease in collaboration revenue attributable to the services performed pursuant to the 2016 License Agreement, partially offset by an increase of $2.0 
million attributable to the services performed pursuant to the 2021 License Agreement. Revenue for the year ended December 31, 2021 also included $1.1 
million of grant revenue related to our CARB-X grant for SER-155, from which we will receive no additional funding.    

Research and Development Expenses

Microbiome therapeutics platform
SER-109
SER-287
Early stage programs
Total direct research and development expenses
Personnel-related (including stock-based compensation)

Total research and development expenses

Year Ended
 December 31,

2022

2021

(in thousands)

Change

36,142     $
48,649      
1,715      
6,828      
93,334      
79,586      
172,920     $

34,784     $
40,510      
9,881      
4,953      
90,128      
51,763      
141,891     $

1,358  
8,139  
(8,166 )
1,875  
3,206  
27,823  
31,029  

  $

  $

Research and development expenses were $172.9 million for the year ended December 31, 2022, compared to $141.9 million for the year ended 

December 31, 2021. The increase of $31.0 million was due primarily to the following:

•

•

an increase in personnel-related costs of $27.8 million primarily due to an increase of $24.5 million in salaries, bonus, payroll taxes and 
employee benefits expenses as well as a $3.3 million increase in stock-based compensation expense; 

an increase of $8.1 million in expenses related to our SER-109 program, due primarily to an increase of $8.7 million in lab supplies and 
consumables, and facility-related costs, primarily from the opening of both the new donor collection facility in Tempe and the quality control 
lab in Waltham, as we advance development and scale SER-109 manufacturing to prepare for commercialization. The total increase is also 
attributable to an increase of $1.2 million in other manufacturing 

77

 
 
 
   
 
 
 
 
   
   
 
 
 
 
 
     
     
   
   
 
   
 
 
     
     
   
   
 
   
 
   
 
   
 
   
 
 
     
     
   
   
 
   
 
   
 
   
 
 
 
 
 
   
 
 
 
 
   
   
 
 
 
 
   
   
   
   
   
 
costs, and an increase of $0.8 million in professional fees, partially offset by a decrease in clinical trial costs of $1.9 million, and analytical 
testing of $0.7 million; 

an increase of $1.9 million in expenses of our early stage programs primarily driven by an increase of $1.5 million in external consulting 
expenses, lab supplies and consumables of $0.3 million, and professional fees of $0.1 million;

an increase of $1.4 million in research expenses related to our reverse translational microbiome therapeutics platform due primarily to an 
increase of $1.6 million in lab supplies and consumables and $2.1 million in analytical testing, offset by a decrease of $1.6 million in 
professional fees and $0.7 million in clinical trials costs; partially offset by

a decrease of $8.2 million in expenses of our SER-287 program primarily driven by a decrease of $7.2 million in clinical trial costs and $1.2 
million in analytical testing, offset by an increase of $0.3 million in materials storage costs.

•

•

•

Research and development activities are central to our business model. Product candidates in later stages of clinical development generally have 

higher development costs than those in earlier stages of clinical development, primarily due to the increased size and duration of later-stage clinical trials. 
We expect that our research and development expenses will continue to increase in the near future as we scale up manufacturing operations, support the 
BLA review process by the FDA, and prepare for commercialization of SER-109, however in the event of approval of our BLA for SER-109, we expect the 
potential decline in research and development expenses related to SER-109 as the majority of commercial manufacturing costs will be capitalized. We 
expect to continue to discover and develop additional product candidates, including SER-155, and pursue later stages of clinical development of our 
product candidates. We also expect to continue conducting analyses of data from our UC clinical stage programs to inform next steps for further 
development.

General and Administrative Expenses

Personnel-related (including stock-based compensation)
Professional fees
Facility-related and other

Total general and administrative expenses

Year Ended
December 31,

2022

2021
(in thousands)

Change

  $

  $

31,277     $
32,260    
16,157    
79,694     $

23,933     $
33,754      
11,574      
69,261     $

7,344  
(1,494 )
4,583  
10,433  

General and administrative expenses were $79.7 million for the year ended December 31, 2022, compared to $69.3 million for the year ended 

December 31, 2021. The increase of $10.4 million was primarily due to the following:

•

•

•

an increase in personnel-related costs of $7.3 million, due to an increase of $5.3 million in salaries, bonus, payroll taxes and employee benefit 
expenses, and a $2.0 million increase in stock-based compensation expense; and

an increase in facility-related and other costs of $4.6 million due primarily to increases in licenses, computer expenses and office supplies of 
$5.4 million, offset by a decrease in information technology costs of $0.9 million; partially offset by

a decrease in professional fees of $1.5 million primarily due to a $2.0 million decrease in consulting and recruiting fees, offset by a $0.5 
million increase in legal expenses. 

Collaboration (Profit) Loss Sharing - related party

Collaboration (profit) loss sharing – related party was $1.0 million of expense for the year ended December 31, 2022, compared to $1.7 million of 

income for the year ended December 31, 2021. For the year ended December 31, 2022 we incurred $15.1 million of pre-launch expenses which we 
recorded within research and development expense or general and administrative expense based on the nature of the underlying expense, and our 
collaborative partner incurred $17.1 million of pre-launch expenses. Pre-launch expenses incurred by us and our collaborative partners increased from $5.6 
million and $2.1 million, respectively, for the year ended December 31, 2021, due to 2022 being the first full year of the agreement. The $1.0 million of 
expense and $1.7 million of income recorded for the years ended December 31, 2022 and 2021, respectively, represent the sharing of 50% of the pre-launch 
expenses. These amounts represent expense to us in 2022 because our collaborative partner performed more of the pre-launch activities than we, and 
income to us in 2021 because we performed more of the pre-launch activities than our collaborative partner. 

Other (Expense) Income, Net

Other (expense) income, net was $3.7 million of expense for the year ended December 31, 2022 compared to $1.1 million of expense for the year 
ended December 31, 2021. This increase was primarily driven by the increase in interest expense on the New Credit Facility, as a result of the increased 
outstanding balance and increasing interest rate throughout the year ended December 31, 2022.

78

 
 
 
   
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
Liquidity and Capital Resources

Since our inception, we have generated revenue only from collaborations and have incurred recurring net losses. We anticipate that we will 
continue to incur losses for at least the next several years. Our research and development and general and administrative expenses may continue to increase 
and, as a result, we will need additional capital to fund our operations, which we may obtain from additional financings, public offerings, research funding, 
additional collaborations, contract and grant revenue or other sources.

In November 2019, we entered into a common stock sales agreement, or the 2019 Sales Agreement, with Cowen to sell shares of our common stock 

with aggregate gross sales proceeds of up to $25.0 million, from time to time, through an "at the market" equity offering program, or ATM, under which 
Cowen acts as sales agent.  In March 2020, in connection with filing an updated registration statement on Form S-3 (File No. 333-237033), we entered into 
a new common stock sales agreement, or the 2020 Sales Agreement, with Cowen on substantially the same terms as the 2019 Sales Agreement and 
terminated the 2019 Sales Agreement. In May 2021, we entered into a new common stock sales agreement, or the 2021 Sales Agreement, with Cowen to 
sell shares of our common stock with aggregate gross sales proceeds of up to $150.0 million, from time to time, through an ATM under which Cowen acts 
as sales agent, and terminated the 2020 Sales Agreement.  During the year ended December 31, 2022, we sold approximately 655 thousand shares of 
common stock under the 2021 Sales Agreement, at an average price of approximately $7.26 per share, raising aggregate net proceeds of approximately $4.4 
million after deducting an aggregate commission of approximately 3%. During the year ended December 31, 2021, we did not sell any shares of common 
stock under the 2020 Sales Agreement or the 2021 Sales Agreement. During the year ended December 31, 2020, we sold approximately 5.8 million shares 
of common stock under the 2019 Sales Agreement and the 2020 Sales Agreement, as applicable, at an average price of approximately $4.40 per share, 
raising aggregate net proceeds of approximately $24.8 million after deducting an aggregate commission of approximately 3%. 

On June 29, 2022, we entered into securities purchase agreements with new and existing investors and certain directors and officers in a registered 

direct offering, or the Registered Direct Offering, of an aggregate of 31,746,030 shares of our common stock at a purchase price of $3.15 per share for total 
net proceeds of approximately $96.7 million, after deducting placement agent’s fees and other estimated offering expenses. Net proceeds included an 
aggregate of $27.5 million received from Flagship Pioneering Fund VII, L.P. and Nutritional Health LTP Fund, L.P., affiliates of Flagship Pioneering, or 
Flagship, one of our significant stockholders, in exchange for 8,738,243 shares. The closing date of the Registered Direct Offering was July 5, 2022.

As of December 31, 2022, we had cash, cash equivalents and short- and long-term investments totaling $181.3 million and an accumulated deficit of 

$864.5 million. For the year ended December 31, 2022, we incurred a net loss of $250.2 million, and used cash in operations of $228.8 million. We expect 
that our operating losses and negative cash flows will continue for the foreseeable future. We are eligible to receive contingent milestone payments under 
the 2021 License Agreement if certain development, regulatory approval or sales target milestones are achieved. In the event of the approval of our BLA 
for SER-109, which is currently under priority review by the FDA, we will receive an additional $125.0 million payment from Nestlé pursuant to the 2021 
License Agreement (see Note 11, Collaboration Revenue, to the consolidated financial statements included elsewhere in this Annual Report on Form 10-
K), and become eligible to receive a $25.0 million tranche under our New Credit Facility with Hercules, which becomes available upon the satisfaction of 
certain conditions, including FDA approval of SER-109. Additionally, following approval, we will be eligible to receive payments from Nestlé for the 
supply of SER-109. Following first commercial sale of SER-109, we will be entitled to share equally in its commercial profits and losses.

Under applicable accounting standards, we have the responsibility to evaluate whether conditions or events raise substantial doubt about our ability 
to meet our future financial obligations as they become due within 12 months after the date the consolidated financial statements are issued. The receipt of 
certain contingent payments associated with the FDA approval of our BLA for SER-109, which include the $125.0 million milestone payment from Nestlé 
and the $25.0 million tranche under our New Credit Facility with Hercules, cannot be considered probable, as these events are outside of our control. Based 
on its currently available cash resources, we believe it is reasonably likely that we will require additional funding in early 2024. Accordingly, management 
has concluded that these circumstances raise substantial doubt about our ability to continue as a going concern. Substantial doubt about our ability to 
continue as a going concern may materially and adversely affect the price per share of our common stock, and it may be more difficult for us to obtain 
financing. If potential collaborators decline to do business with us or potential investors decline to participate in any future financings due to such concerns, 
our ability to increase our cash position may be limited. We will need to generate significant revenues to achieve profitability, and we may never do so. 
Because of the numerous risks and uncertainties associated with the development of our current and any future product candidates, the development of our 
platform and technology and because the extent to which we may enter into collaborations with third parties for development of any of our product 
candidates is unknown, we are unable to estimate the amounts of increased capital outlays and operating expenses required for completing the research and 
development of our product candidates. 

Collaboration and Manufacturing Agreements

License Agreement with Société des Produits Nestlé S.A. (Nestlé)

In January 2016, we entered into the 2016 License Agreement with Nestec, Ltd., as succeeded by Société des Produits Nestlé S.A., or, together with 
NHSc Rx License GmbH, their affiliates, and their subsidiaries, Nestlé, for the development and commercialization of certain of our product candidates in 
development for the treatment and management of CDI and IBD, including 

79

UC and Crohn’s disease. In exchange for the license, Nestlé agreed to pay us an upfront cash payment of $120.0 million, which we received in February 
2016. Nestlé has also agreed to pay us tiered royalties, at percentages ranging from the high single digits to high teens, of net sales of certain products 
based on our microbiome technology that are being developed for the treatment of CDI and IBD, including SER-109, SER-262, SER-287 and SER-301, or 
collectively, the 2016 Collaboration Products, in markets outside of the United States and Canada, or the 2016 Licensed Territory. We are eligible to receive 
up to $285.0 million in development milestone payments, $375.0 million in regulatory payments and up to an aggregate of $1.1 billion for the achievement 
of certain commercial milestones related to the sales of 2016 Collaboration Products. The full potential value of the up-front payment and milestone 
payments payable by Nestlé is over $1.9 billion, assuming all products receive regulatory approval and are successfully commercialized. In September 
2016, we received a $10.0 million milestone payment associated with the initiation of the Phase 1b clinical study for SER-262 in CDI. In June 2017, we 
initiated a Phase 3 clinical study of SER-109 (ECOSPOR III) in patients with multiply recurrent CDI. In July 2017, we received $20.0 million based on the 
achievement of this milestone under the 2016 License Agreement. In November 2018, we executed a letter agreement with Nestlé, or the Letter Agreement, 
modifying certain terms of the 2016 License Agreement. Under the Letter Agreement, Nestlé agreed to pay us the $20.0 million Phase 3 milestone payment 
upon commencement of the Phase 2b study for SER-287. In December 2018, we received $40.0 million in milestone payments in connection with the 
commencement of the Phase 2b study for SER-287. In August 2020, we received $10.0 million from Nestlé in connection with the initiation of the Phase 
1b SER-301 study.  To date, we have received $80.0 million in development milestones under the 2016 License Agreement with Nestlé.

For the development of 2016 Collaboration Products for IBD under a global development plan, we agreed to pay the costs of clinical trials of such 

products up to and including Phase 2 clinical trials, and 67% of the costs for Phase 3 and other clinical trials of such products, with Nestlé bearing the 
remaining 33% of such costs. The Letter Agreement also provides scenarios under which Nestlé’s reimbursement to us for certain Phase 3 development 
costs would be reduced or delayed depending on the outcomes of the SER-287 Phase 2b study. For other clinical development of 2016 Collaboration 
Products for IBD, we agreed to pay the costs of such activities to support approval in the United States and Canada, and Nestlé agreed to bear the cost of 
such activities to support approval of 2016 Collaboration Products in the 2016 Licensed Territory.

With respect to development of 2016 Collaboration Products for CDI under a global development plan, we agreed to pay all costs of Phase 2 clinical 
trials for SER-109 and for Phase 3 clinical trials for SER-109. We agreed to bear all costs of conducting any Phase 1 or Phase 2 clinical trials under a global 
development plan for 2016 Collaboration Products other than SER-109 for CDI. We agreed to pay 67% and Nestlé agreed to pay 33% of other costs of 
Phase 3 clinical trials conducted for 2016 Collaboration Products other than SER-109 for CDI under a global development plan. For other clinical 
development of 2016 Collaboration Products for CDI, we agreed to pay costs of such development activities to support approval in the United States and 
Canada, and Nestlé agreed to bear the cost of such activities to support approval of 2016 Collaboration Products in the 2016 Licensed Territory.

The 2016 License Agreement continues in effect until terminated by either party on the following bases: (i) Nestlé may terminate the 2016 License 

Agreement in the event of serious safety issues related to any of the 2016 Collaboration Products; (ii) we may terminate the 2016 License Agreement if 
Nestlé challenges the validity or enforceability of any of our licensed patents; and (iii) either party may terminate the 2016 License Agreement in the event 
of the other party’s uncured material breach or insolvency. Upon termination of the 2016 License Agreement, all licenses granted to Nestlé by us will 
terminate, and all rights in and to the 2016 Collaboration Products in the 2016 Licensed Territory will revert to us. If we commit a material breach of the 
2016 License Agreement, Nestlé may elect not to terminate the 2016 License Agreement but instead apply specified adjustments to its payment obligations 
and other terms and conditions of the 2016 License Agreement. 

License Agreement with NHSc Rx License GmbH (Nestlé)

On July 1, 2021, we entered into a License Agreement, or the 2021 License Agreement, with NHSc Pharma Partners, succeeded by NHSc Rx 
License GmbH, or, together with Société des Produits Nestlé S.A., their affiliates, and their subsidiaries, Nestlé. Pursuant to the 2021 License Agreement, 
we granted to Nestlé, under certain of our patent rights and know how, a co-exclusive, sublicensable (under certain circumstances) license to develop, 
commercialize and conduct medical affairs activities for (i) therapeutic products based on our microbiome technology (including our SER-109 product 
candidate) that are developed by us or on our behalf for the treatment of CDI and recurrent CDI, as well as any other indications pursued for the products 
upon mutual agreement of the parties, or the 2021 Field, in the United States and Canada, or the 2021 Licensed Territory, and (ii) our SER-109 product 
candidate and any improvements and modifications thereto developed pursuant to the terms of the 2021 License Agreement, or the 2021 Collaboration 
Products, for any indications in the 2021 Licensed Territory.

The 2021 License Agreement sets forth the parties’ respective obligations for development, regulatory, commercialization, medical affairs, and 

manufacturing and supply activities for the 2021 Collaboration Products with respect to the 2021 Field and the 2021 Licensed Territory.  Pursuant to the 
2021 License Agreement, we are responsible for, and will use commercially reasonable efforts in, conducting development of SER-109 in the 2021 Field in 
the United States until first regulatory approval for SER-109 is obtained in the 2021 Field in the United States and in accordance with a development and 
regulatory activity plan, at our cost, subject to certain exceptions specified in the 2021 License Agreement.  We are also responsible for all regulatory 
affairs related to 2021 Collaboration Products in the 2021 Field in the 2021 Licensed Territory, at its cost, except that expenses incurred for regulatory 
activities approved by a joint steering committee pursuant to a life cycle management plan for 2021 Collaboration Products are shared 

80

equally between the parties.  We will be solely responsible for manufacturing and supplying 2021 Collaboration Products for development in the 2021 
Field in the 2021 Licensed Territory.

Nestlé has the sole right to commercialize the 2021 Collaboration Products in the 2021 Licensed Territory in accordance with a commercialization 

plan, subject to our right to elect to provide up to a specified percentage of all promotional details for a certain target audience.  Each party will use 
commercially reasonable efforts to commercialize the 2021 Collaboration Products in the 2021 Licensed Territory in accordance with the 
commercialization plan.  Both parties will perform medical affairs activities for 2021 Collaboration Products in the 2021 Licensed Territory in accordance 
with a medical affairs plan.  We will be solely responsible for the manufacturing and supply of 2021 Collaboration Products for commercialization under a 
supply agreement that will be entered into between the parties.  We are responsible for commercialization and medical affairs activities costs incurred by 
the parties until first commercial sale of the first 2021 Collaboration Product in the 2021 Licensed Territory and in accordance with a pre-launch plan, up to 
a specified cap.  Following first commercial sale of the first 2021 Collaboration Product, we will be entitled to share equally in its commercial profits and 
losses.

In exchange for the grant of the licenses under the 2021 License Agreement, Nestlé agreed to pay us a non-refundable, non-creditable and non-

cancelable upfront payment of $175.0 million, which was received in July 2021. Nestlé also agreed to pay us an additional $125.0 million due upon FDA 
approval of SER-109, $10.0 million upon Canadian regulatory approval of SER-109, and sales target milestones payments totaling up to $225.0 million.

The 2021 License Agreement continues in effect until all development and commercialization activities for all 2021 Collaboration Products in the 
2021 Licensed Territory have permanently ceased. The 2021 License Agreement may be terminated by either party upon sixty days’ written notice for the 
other party’s material breach that remains uncured during such sixty-day period, or immediately upon written notice for the other party’s insolvency. Nestlé 
may also terminate the 2021 License Agreement at-will (i) with twelve months’ prior written notice, effective only on or after the third anniversary of first 
commercial sale of the first 2021 Collaboration Product in the 2021 Licensed Territory, (ii) if first commercial sale of the first 2021 Collaboration Product 
in the 2021 Licensed Territory has not occurred by the fifth anniversary of the effective date of the 2021 License Agreement, with one hundred eighty days’ 
prior written notice, which must be provided during a specified period set forth in the 2021 License Agreement, or (iii) if regulatory approval for SER-109 
is not granted after submission by us of a filing seeking first regulatory approval as set forth in the development and regulatory activity plan, and the parties 
fail to agree on further development of SER-109 in accordance with the terms of the 2021 License Agreement, with one hundred eighty days’ prior written 
notice, which must be provided within a specified period set forth in the 2021 License Agreement. We may also terminate the 2021 License Agreement 
immediately upon written notice if Nestlé challenges any licensed patent in the 2021 Licensed Territory.

Upon termination of the 2021 License Agreement, all licenses granted to Nestlé by us will terminate. If we commit a material breach of the 2021 

License Agreement, Nestlé may elect not to terminate the 2021 License Agreement but instead apply specified adjustments to the payment terms and other 
terms and conditions of the 2021 License Agreement. The 2021 License Agreement contains customary representations and warranties by the parties, 
intellectual property provisions including ownership, patent prosecution, enforcement and defense, certain indemnification rights in favor of each party, and 
customary confidentiality provisions and limitations of liability.

Long Term Manufacturing Agreement with Bacthera

In November 2021, we entered into a Long Term Manufacturing Agreement with BacThera AG, or Bacthera, a joint venture between Chr.  Hansen 
and a Lonza Group affiliate, which was amended on December 14, 2022, or the Bacthera Agreement.  The Bacthera Agreement governs the general terms 
under which Bacthera, or one of its affiliates, will (i) construct a dedicated full-scale production suite for us at Bacthera’s Microbiome Center of Excellence 
in Visp, Switzerland, which is currently under construction; and (ii) provide manufacturing services to us for our SER-109 product and other products, as 
agreed to by the parties.

Under the terms of the Bacthera Agreement, we agreed to pay Bacthera a total of at least 256 million CHF (or approximately $277 million) for the 

initial term of the agreement, inclusive of the construction fees and annual operating fees. Bacthera is funding the majority of the construction costs and 
will own and control the manufacturing suite during construction. The construction fees that we are responsible for represent a small percentage of the 
overall construction costs and are payable upon the achievement of certain milestones related to the construction of the dedicated manufacturing suite.  The 
annual operating fee includes the cost of a baseline annual batch production volume.  We have also agreed to pay certain other ancillary fees and a per-
batch fee in excess of the baseline batches.  These fees are subject to adjustment during construction for certain items outside of Bacthera’s control and 
annually against an agreed index.  We will supply the active pharmaceutical ingredients to Bacthera to enable it to perform the services and pay for certain 
other raw materials and manufacturing components, which will be acquired by Bacthera.

The Bacthera Agreement has an initial term that continues until the tenth anniversary of the earlier of (a) successful completion of construction and 

demonstration of Bacthera’s readiness for commercial production or (b) the commencement of manufacturing. The initial term is subject to renewals, which 
could extend the term to 16 years, and additional three-year terms thereafter.  Each party has the ability to terminate the Bacthera Agreement upon the 
occurrence of certain customary conditions.  We may also terminate the Bacthera Agreement for convenience after a defined period.  In the event of a 
termination, we have certain financial obligations that would apply, and Bacthera has agreed to grant a license to Bacthera-developed manufacturing know 
how, if any, and provide technical 

81

assistance to us, so that we could transfer the manufacturing operations to ourselves or a third party.  The Bacthera Agreement also contains 
representations, warranties and indemnity obligations as well as limitations of liability that are customary for agreements of this type.

Indebtedness

Loan and Security Agreement with Hercules

In October 2019, we entered into a loan and security agreement with Hercules Capital, Inc., or Hercules, pursuant to which a term loan in an 
aggregate principal amount of up to $50.0 million, or the Original Credit Facility, was available to us in three tranches, subject to certain terms and 
conditions. We received the first tranche of $25.0 million upon signing the agreement on October 29, 2019, but did not borrow either of the second two 
tranches, which were available at different times upon Hercules’ approval until June 30, 2021. 

On April 16, 2020, we entered into an amendment to the Loan Agreement, or the First Amendment, permitting us to enter into a promissory note 
under the Paycheck Protection Program of the Coronavirus Aid, Relief and Economic Stability Act. On April 17, 2020 we issued a Promissory Note to 
Bank of America, NA, or the Loan, pursuant to which we received loan proceeds of $2.9 million, however, based on updated guidance related to this 
program, we decided to repay the full amount of the Loan, and repaid the Loan on May 4, 2020.

Effective as of February 24, 2022, or the Effective Date, we entered into a Second Amendment to the Original Credit Facility (as amended by the 

First Amendment), or the New Credit Facility, pursuant to which term loans in an aggregate principal amount of up to $100.0 million have become 
available to us in five tranches including the first tranche under the Original Credit Facility, subject to certain terms and conditions.

The first tranche in an aggregate principal amount of $25.0 million was outstanding as of the Effective Date, after taking into account reborrowing 

by us on the Effective Date of a previously-repaid principal amount of approximately $2.9 million. The second tranche in an aggregate principal amount of 
$12.5 million and the third tranche in an aggregate principal amount of $12.5 million have been advanced to us and were outstanding as of the Effective 
Date. The fourth tranche in an aggregate principal amount of $25.0 million is available upon satisfaction of certain conditions, including the approval by 
the FDA of a biologics license application in respect of SER-109, or the Regulatory Approval Milestone, by no later than December 15, 2023. The fifth 
tranche in an aggregate principal amount of up to $25.0 million is available through the Amortization Date (as defined below) upon satisfaction of certain 
conditions, including the Lenders’ investment committee approval. 

All advances outstanding under the New Credit Facility bear interest at a rate equal to the greater of either (i) the Prime Rate (as reported in The 

Wall Street Journal) plus 6.40%, and (ii) 9.65%.  For all advances outstanding under the New Credit Facility, we will make interest only payments through 
December 31, 2023, extendable to December 31, 2024 upon satisfaction of certain conditions, such applicable date, the Amortization Date. The principal 
balance and interest of the advances will be repaid in equal monthly installments after the Amortization Date and continuing through October 1, 2024, 
extendable to October 1, 2025, upon satisfaction of certain conditions, such applicable date, the Maturity Date. 

We may prepay advances under the New Credit Facility, in whole or in part, at any time subject to a prepayment charge equal to: (a) 2.0% of 
amounts so prepaid, if such prepayment occurs during the first year following the Effective Date; (b) 1.5% of the amount so prepaid, if such prepayment 
occurs during the second year following the Effective Date, and (c) 1.0% of the amount so prepaid, if such prepayment occurs during the third year 
following the Effective Date. 

We will pay an end of term charge of 4.85% of the aggregate amount of the advances made under the Old Credit Facility on the earliest date of (i) 
November 1, 2023; (ii) the date that we prepay all of the outstanding principal in full, or (iii) the date the loan payments are accelerated due to an event of 
default. We will pay an additional end of term charge of 1.75% of the aggregate amount of the advances under the New Credit Facility (including the first 
tranche of $25.0 million) on the earliest date of (i) the Maturity Date; (ii) the date that we prepay all of the outstanding principal in full, or (iii) the date the 
loan payments are accelerated due to an event of default.

Other terms of the New Credit Facility remain generally identical to those under the Old Credit Facility, with certain covenants amended by the 

Second Amendment to provide us with additional operational flexibility, including the ability for us to issue up to $350.0 million in convertible notes. The 
New Credit Facility includes a conditional liquidity covenant commencing on June 15, 2023, which ceases to apply if certain conditions including the 
Regulatory Approval Milestone are satisfied.

The New Credit Facility is secured by substantially all of our assets, other than our intellectual property.  We have agreed to not pledge or secure our 

intellectual property to others. 

As of December 31, 2022 and 2021, the outstanding principal under the New Credit Facility was $50.0 million and $24.1 million, respectively.  For 
a further description of the New Credit Facility, see Note 8 to our consolidated financial statements included elsewhere in this Annual Report on Form 10-
K.

82

Cash Flows

The following table summarizes our sources and uses of cash, cash equivalents and restricted cash for the years ended December 31, 2022 and 2021. 

Cash (used in) provided by operating activities
Cash provided by investing activities
Cash provided by financing activities

Net (decrease) increase in cash, cash equivalents and restricted cash

Operating Activities

Year Ended December 31,

2022

2021

(in thousands)

  $
  $
  $
  $

(228,816 )   $
  $
82,428  
129,602  
  $
(16,786 )   $

6,688  
64,088  
1,178  
71,954  

During the year ended December 31, 2022, net cash used in operating activities was $228.8 million, primarily due to net loss of $250.2 million and 
changes in our operating assets and liabilities of $18.4 million, partially offset by non-cash charges of $39.7 million. Non-cash charges consisted of $25.5 
million of stock-based compensation expense, $5.2 million related to the amortization of right-of-use assets, $6.6 million of depreciation, $1.4 million of 
net amortization of premiums related to our investments and amortization of debt issuance costs, and collaboration loss sharing of $1.0 million related to 
the 2021 License Agreement with Nestlé. Changes in our operating assets and liabilities during the year ended December 31, 2022 primarily consisted of a 
$12.6 million increase in prepaid expenses and other current and non-current assets, a $7.1 million decrease in deferred revenue and a $4.2 million decrease 
in operating lease liabilities, partially offset by a $3.3 million increase in accrued expenses and other liabilities and a $2.2 million increase in accounts 
payable. The increase in prepaid expenses and other current and non-current assets was primarily due to the remittance of the second milestone payment 
pursuant to the Bacthera Agreement. The decrease in deferred revenue is due to recognition of revenue during the year for services performed under both 
the 2021 License Agreement and the 2016 License Agreement. The decrease in operating lease liabilities was due to the cash payment of lease obligations. 

During the year ended December 31, 2021, net cash provided by operating activities was $6.7 million, primarily due to changes in our operating 
assets and liabilities of $41.5 million and non-cash charges of $30.7 million, partially offset by a net loss of $65.6 million. Non-cash charges consisted 
primarily of $20.2 million of stock-based compensation expense, $3.3 million related to the amortization of right-of-use assets, $5.9 million of 
depreciation, and $2.5 million of net amortization of premiums related to our investments, partially offset by collaboration profit sharing of $1.7 million 
related to the 2021 License Agreement with Nestlé. Changes in our operating assets and liabilities during the year ended December 31, 2021 primarily 
consisted of a $43.0 million increase in accrued expenses and other liabilities, a $9.4 million increase in accounts payable and a $9.4 million decrease in 
accounts receivable, partially offset by a $12.3 million increase in prepaid expenses and other current and non-current assets, a $4.4 million decrease in 
deferred revenue and a $3.6 million decrease in operating lease liabilities. The increase in accrued expenses and other current and long-term liabilities was 
primarily due to the liability established for pre-launch activities in conjunction with the 2021 License Agreement with Nestlé. The decrease in deferred 
revenue is due to recognition of revenue during the year, partially offset by an increase of $8.2 million, which represents the portion of the transaction price 
for the 2021 License Agreement allocated to the research and development services. The decrease in operating lease liabilities was due to the cash payment 
of lease obligations.

Investing Activities

During the year ended December 31, 2022, net cash provided by investing activities was $82.4 million, primarily due to maturities of investments of 

$140.5 million, partially offset by purchases of investments of $48.2 million and purchases of property and equipment of $9.8 million. 

During the year ended December 31, 2021, net cash provided by investing activities was $64.1 million, primarily due to maturities of investments of 

$169.6 million, partially offset by purchases of investments of $96.0 million and purchases of property and equipment of $9.6 million.

Financing Activities

During the year ended December 31, 2022, net cash provided by financing activities was $129.6 million, consisting of $96.7 million of net proceeds 

received from the Registered Direct Offering that we completed in July 2022, $27.6 million of proceeds received from the New Credit Facility, and $4.4 
million from the issuance of common stock via our at the market equity program, net of issuance costs. We also received $1.0 million from the issuance of 
common stock associated with the exercise of stock options and $1.8 million in connection with the issuance of common stock under our 2015 Employee 
Stock Purchase Plan, or ESPP. These cash inflows were partially offset by principal payments under the Original Credit Facility of $1.9 million.     

During the year ended December 31, 2021, net cash provided by financing activities was $1.2 million.  This was a result of $1.3 million from the 

exercise of stock options and $0.8 million from the issuance of common stock under the ESPP, partially offset by $0.9 million of principal payments 
relating to our term loan.  

83

 
 
 
 
 
 
   
 
 
 
 
 
Funding Requirements

Our expenses may increase substantially in connection with our ongoing clinical development activities and our research and development activities. 

In addition, we expect to continue to incur additional costs associated with operating as a public company. We anticipate that our expenses will increase 
substantially if and as we:

•

•

•

•

•

•

•

•

•

•

•

complete the clinical development, seek regulatory approval, and prepare for commercialization of SER-109 for patients with recurrent CDI;

continue the clinical development of SER-155 to reduce incidences of gastrointestinal infections, bloodstream infections and GvHD in 
patients receiving allo-HSCT;

continue evaluating preclinical stage programs to reduce incidence of infection, in indications such as cancer neutropenia, chronic liver 
disease, solid organ transplant, and antimicrobial resistant infections more broadly;

continue translational research activities, informed by the SER-287 Phase 2b and SER-301 Phase 1b study data, to evaluate the potential to 
utilize biomarker-based patient selection and stratification in future clinical development efforts;

make strategic investments in our research discovery and development platforms and capabilities to advance our priority programs;

make strategic investments in manufacturing capabilities;

maintain and augment our intellectual property portfolio and opportunistically acquire complementary intellectual property;

potentially establish a sales and distribution infrastructure and scale-up manufacturing capabilities to commercialize any products for which 
we may obtain regulatory approval;

perform our obligations under our agreements with our collaborators;

seek to obtain regulatory approvals for our product candidates; and

experience any delays or encounter any issues with any of the above, including but not limited to failed studies, complex results, safety issues 
or other regulatory challenges. 

Because of the numerous risks and uncertainties associated with the development of our product candidates, we are unable to estimate the amounts 
of increased capital outlays and operating expenses associated with completing the research and development of our product candidates. Our future capital 
requirements will depend on many factors, including:

•

•

•

•

•

•

•

•

•

•

the impact of the COVID-19 pandemic, including any resurgence or the emergence of new variants;

the impact of continued increase in inflation rates or interest rates;

the progress and results of our clinical studies and preclinical development;

the cost of manufacturing our product candidates;

the costs, timing and outcome of regulatory review of our product candidates and research activities;

the costs and timing of future commercialization activities, including manufacturing, marketing, sales and distribution, for any of our product 
candidates for which we receive marketing approval;

the revenue, if any, received from commercial sales of our product candidates for which we receive marketing approval;

the costs and timing of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and 
defending any intellectual property-related claims;

the effect of competing technological and market developments; and

the extent to which we acquire or invest in businesses, products and technologies, including entering into licensing or collaboration 
arrangements for product candidates.

Identifying potential product candidates and conducting preclinical testing and clinical trials is a time-consuming, expensive and uncertain process 
that takes years to complete, and we may never generate the necessary data or results required to obtain marketing approval and achieve product sales. In 
addition, our product candidates, if approved, may not achieve commercial success. Our commercial revenues, if any, will be derived from sales of 
products that we do not expect to be commercially available for many years, if ever. Accordingly, we will need to obtain substantial additional funds to 
achieve our business objectives.

Adequate additional funds may not be available to us on acceptable terms, or at all. Additionally, market volatility resulting from macroeconomic 

conditions, the COVID-19 pandemic, or other factors could also adversely impact our ability to access capital as 

84

and when needed.  To the extent that we raise additional capital through the sale of equity or convertible debt securities, our shareholders’ ownership 
interest will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect our shareholders’ rights as 
common stockholders. Our loan and security agreement with Hercules currently includes, and any additional debt financing and preferred equity financing, 
if available, may involve agreements that include, covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, 
making capital expenditures or declaring dividends. Additional debt or preferred equity financing may also require the issuance of warrants, which could 
potentially dilute our shareholders’ ownership interest.

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

As noted above, the magnitude and duration of the COVID-19 pandemic and its impact on our liquidity and future funding requirements is uncertain 

as of the filing date of this Annual Report on Form 10-K as this continues to evolve globally. See “Risk Factors—Risks Related to Our Operations—The 
COVID-19 pandemic has adversely impacted and could continue to adversely impact, our business, including our preclinical studies and clinical trials, 
results of operations and financial condition” in Part I, Item 1A of this Annual Report on Form 10-K for a further discussion of the possible impact of the 
COVID-19 pandemic on our business.

As discussed in Note 1 of the consolidated financial statements included elsewhere in this Annual Report on Form 10-K, we have the responsibility 

to evaluate whether conditions or events raise substantial doubt about our ability to meet our future financial obligations as they become due within 12 
months after the date the consolidated financial statements are issued. The receipt of potential funding from future equity or debt issuances and certain 
contingent payments associated with the FDA approval of our BLA for SER-109, which is currently under priority review by the FDA, which include the 
potential to receive a $125.0 million milestone payment from Nestlé pursuant to the 2021 License Agreement, and a $25.0 million tranche under our New 
Credit Facility with Hercules, cannot be considered probable, as these events are outside of our control. Based on our currently available cash resources and 
our current level of operations and cash flow analysis for the 12-month period subsequent to the date of issuance of the consolidated financial statements, 
we believe it is reasonably likely that it will require additional funding in early 2024. Accordingly, management has concluded that these circumstances 
raise substantial doubt about our ability to continue as a going concern.  

We have entered into arrangements that contractually obligate us to make payments that will affect our liquidity and cash flows in future periods. 

Such arrangements include those related to our lease commitments, long-term debt, and long-term manufacturing agreements.

Contractual Obligations and Commitments

Lease Commitments

Our lease commitments reflect payments due under our operating lease agreements for our corporate headquarters, office and laboratory space, and 

donor collection facilities, that expire between May 2028 and April 2033. As of December 31, 2022, our contractual commitments for our leases were 
$187.2 million, of which $16.8 million is expected to be paid within one year, and $170.5 million will be paid over the remaining term of such leases. Our 
lease commitments also include $5.5 million for leases that had not yet commenced as of December 31, 2022.  For additional information on our leases and 
timing of future payments, please read Note 7, Leases, to the consolidated financial statements included in this Form 10-K.

Loan Agreement

Our commitments due for our term loan under our arrangement with Hercules total $7.0 million in interest-only payments through January 1, 2024, 

and a backend fee of $1.2 million due in November 2023. Our remaining commitments are due through October 2024, and include principal and interest 
payments of $53.3 million, and an additional fee upon maturity of the loan of $0.9 million. The interest rate in effect at December 31, 2022 was 13.40%. 
See Note 8, Notes Payable, to the consolidated financial statements for further discussion of the Hercules term loan.

Bacthera Long Term Manufacturing Agreement  

Our commitments due under our long-term manufacturing agreement with Bacthera, inclusive of construction fees and annual operating fees, total 

$263.1 million, of which $65.5 million in construction fees are expected to be paid within one year, and the remaining $197.6 million in operating fees will 
be paid over the remaining 10 years, beginning in 2024 upon completion of the construction of the facility.

Other Obligations

85

We enter into contracts in the normal course of business with CROs for clinical trials, preclinical research studies and testing, manufacturing and 
other services and products for operating purposes. These contracts generally provide for termination upon notice, and therefore we believe that our non-
cancelable obligations under these agreements are not material.

For a discussion of recent accounting standards see Note 2, Summary of Significant Accounting Policies, to our consolidated financial statements 

Recently Issued and Adopted Accounting Pronouncements

included in this report.

Item 7A. Quantitative and Qualitative Disclosures about Market Risk

We are exposed to market risk related to changes in interest rates. 

Interest Rate Fluctuation Risk

As of December 31, 2022, our cash and cash equivalents consisted of cash and money market accounts. Our interest income is sensitive to changes 

in the general level of U.S. interest rates. However, because of the short-term nature of the instruments in our portfolio, an immediate 10% change in 
market interest rates would not have a material impact on the fair market value of our investment portfolio or on our financial position or results of 
operations.

As of December 31, 2022, we had outstanding borrowings under the New Credit Facility.  We accrue interest at a rate equal to the greater of either 

(i) the Prime Rate (as reported in The Wall Street Journal) plus 6.40%, and (ii) 9.65%. An immediate 10% change in the Prime Rate would not have a 
material impact on our debt‑related obligations, financial position or results of operations

Item 8. Financial Statements and Supplementary Data

The financial statements required to be filed pursuant to this Item 8 are appended to this report. An index of those financial statements is found in 

Item 15.

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

None.

Item 9A. Controls and Procedures

Limitations on Effectiveness of Controls and Procedures

In designing and evaluating our disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well 

designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and 
procedures must reflect the fact that there are resource constraints and that management is required to apply judgment in evaluating the benefits of possible 
controls and procedures relative to their costs.

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our principal executive officer and our principal financial officer, has evaluated the effectiveness of 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), as of the end of 
the period covered by this Annual Report on Form 10-K. Based on such evaluation, our principal executive officer and principal financial officer has 
concluded that as of December 31, 2022, our disclosure controls and procedures were effective at the reasonable assurance level.

Management’s Annual Report on Internal Control Over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over our financial reporting, as such term is defined in 

Rule 13a-15(f) and 15d-15(f) under the Securities Exchange Act of 1934, as amended.

Our management conducted an assessment of the effectiveness of our internal control over financial reporting based on the criteria set forth in 

“Internal Control – Integrated Framework (2013)” issued by the Committee of Sponsoring Organizations of the Treadway Commission.

Based on this assessment, our management concluded that, as of December 31, 2022, our internal control over financial reporting was effective.

The effectiveness of our internal control over financial reporting as of December 31, 2022, has been audited by PricewaterhouseCoopers LLP, an 

independent registered public accounting firm, as stated in their report included in this Annual Report on Form 10-K on page F-1. 

86

There were no changes in our internal control over financial reporting during our most recent fiscal quarter that have materially affected, or are 

reasonably likely to materially affect, our internal control over financial reporting.

Changes in Internal Control Over Financial Reporting

Item 9B. Other Information

None.

Item 9C. Disclosure Regarding Foreign Jurisdictions That Prevent Inspections

Not applicable.

87

Item 10. Directors, Executive Officers and Corporate Governance

PART III

Director Biographical Information

Name

Age

   Position

Dennis A. Ausiello, M.D. (3)(4)

Grégory Behar (3)

Stephen Berenson (3)
Paul R. Biondi (2)

Willard H. Dere, M.D. (4)
Claire M. Fraser, Ph.D. (1)(4)

Kurt C. Graves (2)

Richard N. Kender (1)(2)

Eric D. Shaff

Meryl S. Zausner (1)(2)

77

53

62
53

69
67

55

67

47

66

  Director

  Director

  Chairman of the Board of Directors
  Director

  Director
  Director

  Director

  Director

  President, Chief Executive Officer and Director

  Director

(1)

(2)

(3)

(4)

Member of the audit committee.

Member of the compensation and talent committee.

Member of the nominating and corporate governance committee.

Member of the science and clinical development committee.

Dennis A. Ausiello, M.D. has served as a member of our board of directors since April 2015. Dr. Ausiello has served as the Jackson Distinguished Professor 
of Clinical Medicine at Harvard Medical School and Director, Emeritus of Harvard Medical School’s M.D./Ph.D. Program since 1996, Chair of Medicine, 
Emeritus, and Director of the Center for Assessment Technology and Continuous Health (CATCH) at Massachusetts General Hospital, which he co-
founded, since 2012, and Physician-in-Chief Emeritus at Massachusetts General Hospital since 2013. From 1996 to April 2013, Dr. Ausiello served as the 
Chief of Medicine at Massachusetts General Hospital. Dr. Ausiello is a member of the Institute of Medicine of the National Academy of Sciences and a 
fellow of the American Academy of Arts and Sciences. Dr. Ausiello has served on the board of directors of Alnylam Pharmaceuticals since April 2012 and 
previously served on the board of directors of Pfizer Inc. from 2006 to 2020, where he currently serves on the advisory board since 2019. Dr. Ausiello also 
serves on the boards of directors of numerous privately held companies. Dr. Ausiello received a B.A. in Biochemistry from Harvard College and an M.D. 
from the University of Pennsylvania. We believe that Dr. Ausiello is qualified to serve on our board of directors because of his extensive experience as a 
physician and as a director of pharmaceutical companies.

Grégory Behar has served as a member of our board of directors since December 2014. Mr. Behar has served as Chief Executive Officer of Nestlé Health 
Science, a business unit of Société des Produits Nestlé S.A., a health sciences company, since July 2014. From August 2011 to May 2014, Mr. Behar was 
President and Chief Executive Officer of Boehringer Ingelheim Pharmaceuticals Inc. (USA), a pharmaceutical company. From 2010 to July 2011, Mr. 
Behar was Corporate Vice President Region NECAR (North European Union, Canada and Australasia) for Boehringer-Ingelheim GmbH, a pharmaceutical 
company. Mr. Behar has served on the boards of directors of Nestlé Health Science since July 2014, Axcella Health, Inc. since February 2016 and Sonova 
AG since April 2021 and previously served on the board of directors of Aimmune Therapeutics, Inc. from November 2016 until its acquisition in October 
2020. Mr. Behar received his B.S. in Mechanical Engineering from the University of California, Los Angeles, an M.S. in Mechanical Engineering and 
Manufacturing from EPFL in Switzerland and an M.B.A. from INSEAD in France. We believe that Mr. Behar is qualified to serve on our board of directors 
because of his extensive business experience in the health sciences and pharmaceutical industries.

Stephen Berenson has served as Chairman of our board of directors since December 2019 and as a member of our board of directors since August 2019. 
Mr. Berenson has been a Managing Partner at Flagship Pioneering, a life sciences innovation firm which conceives, creates, resources and develops first-in-
category life sciences companies, since June 2017. Prior to Flagship, Mr. Berenson spent 33 years in various roles as an investment banker at J.P. Morgan, 
most recently serving in the role of Vice Chairman of Investment Banking from 2005 to April 2017, where he focused on providing high-touch strategic 
advice and complex transaction execution to leading companies across all industries globally. He was co-founder of J.P. Morgan’s Global Strategic 
Advisory Council and co-founder of the firm’s Board Initiative. Mr. Berenson has served as chairman of the board of directors of Cellarity, a privately held 
company, since July 2021, and has served on the boards of directors of Moderna, Inc. since October 2017 and Repertoire Immune Medicines, a privately 
held company, since May 2021. Mr. Berenson received an S.B. in Mathematics from the Massachusetts Institute of Technology. We believe that Mr. 
Berenson is qualified to serve on our board of directors because of his extensive experience working with rapidly-growing companies across various 
industries.

Paul R. Biondi has served as a member of our board of directors since March 2020. Mr. Biondi is an Executive Partner and President of Pioneering 
Medicines at Flagship Pioneering, roles he has held since November 2019. Mr. Biondi joined Flagship Pioneering 

88

 
  
  
 
  
 
  
 
 
  
 
 
  
 
  
 
  
 
  
 
following a seventeen-year tenure at Bristol-Myers Squibb, or BMS, a pharmaceutical company, where he was most recently the Senior Vice President of 
Strategy and Business Development from October 2015 to November 2019. Prior to serving in the role of Senior Vice President of Strategy, from 2002 to 
2015, Mr. Biondi held a series of other leadership roles within BMS’ Research and Development organization overseeing strategy, portfolio, and project 
management, as well as clinical and business operations. Mr. Biondi holds a bachelor’s degree from Dartmouth College and an M.B.A. from the J.L. 
Kellogg School of Management at Northwestern University. We believe that Mr. Biondi is qualified to serve on our board of directors because of his 
extensive experience in biopharmaceutical strategy and corporate development.

Willard H. Dere, M.D. has served as a member our board of directors since July 2017. Dr. Dere has been Professor Emeritus, Department of Internal 
Medicine, at the University of Utah School of Medicine since July 2022. Prior to retirement, and beginning in November 2014, Dr. Dere held multiple roles 
at the University of Utah Health Sciences Center, including Associate Vice President for Research, Co-Director of the Utah Clinical and Translational 
Science Institute, and Co-Director of the Center for Genomic Medicine. Prior to his professorship, from 2003 until 2014, Dr. Dere worked at Amgen, where 
he was Senior Vice President and head of Global Development, and led development programs in multiple therapeutic areas. From 1989 to 2014, he 
worked at Eli Lilly and led multiple development programs, and also worked in clinical pharmacology, regulatory affairs and safety.  Dr. Dere has served 
on the boards of directors of BioMarin Pharmaceutical, Inc. since 2016 and Mersana Therapeutics, Inc. since 2018, and previously served on the boards of 
directors of Ocera Therapeutics and Radius Health. Dr. Dere received his B.A. in History and Zoology and M.D. from the University of California, Davis, 
completed his internal medicine residency training at the University of Utah, and his postdoctoral training in endocrinology and metabolism at the 
University of California, San Francisco. We believe Dr. Dere is qualified to serve on our board of directors due to his extensive academic experience and 
his knowledge of the biotechnology industry.

Claire M. Fraser, Ph.D. has served as a member of our board of directors since January 2023. Since 2007, Dr. Fraser has been the director of the Institute 
for Genome Sciences and a Professor of Medicine and Microbiology and Immunology at the University of Maryland School of Medicine in Baltimore, 
Maryland. From 1998 to 2007, she served as president and director of The Institute for Genomic Research, a not-for-profit research organization engaged in 
human and microbial genomics studies. Dr. Fraser has served on the board of directors of Becton, Dickinson, and Company since 2006, and previously 
served as the Chair of the Board and a director of the American Association for the Advancement of Science. Dr. Fraser received her bachelor’s degree in 
Biology from Rensselaer Polytechnic Institute and her Ph.D. in Pharmacology from State University of New York-Buffalo. We believe Dr. Fraser is 
qualified to serve on our board of directors due to her extensive academic experience and her knowledge of the microbiome industry.

Kurt C. Graves has served as a member of our board of directors since November 2015. Mr. Graves has served as the Executive Chairman of i20 
Therapeutics, Inc., a biotechnology company, since August 2021. Mr. Graves was previously the Chairman, President and Chief Executive Officer of 
Intarcia Therapeutics, Inc., a biotechnology company, from September 2010 to December 2020 and on its board of directors from August 2010 to 
December 2020. Previously, he served as Executive Vice President, Chief Commercial Officer and Head of Strategic Development at Vertex 
Pharmaceuticals Inc., or Vertex, from July 2007 to October 2009. Prior to joining Vertex, Mr. Graves held various leadership positions at Novartis 
Pharmaceuticals Corporation, or Novartis Corp., from 1999 to June 2007, including the Global General Medicines Business Unit Head and Chief 
Marketing Officer for the pharmaceuticals division of Novartis Corp. from September 2003 to June 2007. He served on the boards directors of Radius 
Health, Inc. from May 2011 to March 2020, and Achillion Pharmaceuticals, Inc. from June 2012 to January 2020. Mr. Graves received a B.S. in Biology 
from Hillsdale College. We believe Mr. Graves is qualified to serve as a member of our board of directors because of his extensive experience in the life 
sciences industry, membership on various boards of directors and his leadership and management experience.

Richard N. Kender has served as a member of our board of directors since October 2014. From October 1978 to September 2013, Mr. Kender held 
positions in a variety of corporate areas at Merck & Co., Inc., or Merck, a pharmaceutical company, most recently serving as Senior Vice President of 
Business Development and Corporate Licensing. Mr. Kender has served on the boards of directors of Poxel S.A. since March 2015 and Bicycle 
Therapeutics PLC since July 2019.  He previously served on the boards of directors of INC Research Holdings, Inc. between December 2014 and August 
2017, Abide Therapeutics, Inc., a privately held company, between December 2015 and May 2019, and ReViral Ltd., a privately held company, from 
November 2019 to June 2022.  Mr. Kender received a B.S. in Accounting from Villanova University and an M.B.A. from Fairleigh Dickinson University. 
We believe Mr. Kender is qualified to serve on our board of directors because of his finance experience and knowledge of the biotechnology industry.

Eric D. Shaff has served as our President and Chief Executive Officer and a member of our board of directors since January 2019. Previously, he served as 
our Chief Operating and Financial Officer and Executive Vice President from January 2018 until January 2019 and as our Chief Financial Officer from 
November 2014 until January 2019. From January 2012 to November 2014, Mr. Shaff was Vice President of Corporate Finance for Momenta 
Pharmaceuticals, or Momenta, a biotechnology company, where he helped manage Momenta’s accounting, finance, planning, and procurement functions, 
as well as contributing to Momenta’s investor relations efforts. Prior to Momenta, Mr. Shaff held a number of corporate development and finance positions 
with Genzyme Corporation, a biotechnology company, most recently as Vice President of Finance/Controller for the Personalized Genetic Health division. 
Mr. Shaff has served on the board of directors of Sigilon Therapeutics, Inc. since November 2017. Mr. Shaff received his B.A. from the University of 
Pennsylvania and his M.B.A. from Cornell University. We believe Mr. Shaff is qualified to serve on our board of directors because of his extensive 
business and finance experience and his knowledge of the biotechnology industry.

89

Meryl Zausner has served as a member of our board of directors since August 2018. Ms. Zausner worked for Novartis Pharmaceuticals, Inc., or Novartis, a 
pharmaceutical company, from 1988 until her retirement in 2017, most recently serving as Chief Financial and Administrative Officer and a member of the 
Pharmaceutical Executive Committee and Global Finance Leadership Team of Novartis in the United States. At Novartis, she helped launch the Oncology 
Business Unit, as well as the company’s shared services organization. Prior to serving as Chief Financial and Administrative Officer, Ms. Zausner was a 
member of the Novartis Global Oncology leadership team, where she contributed to the development and commercialization of therapies, including 
Gleevec® (imatinib). Ms. Zausner previously served on the boards of directors of Goldfinch Bio, Inc., a privately held company, from February 2021 to 
December 2022, the Multiple Myeloma Research Foundation from September 2009 to June 2021, and Neon Therapeutics, Inc. from December 2017 to 
May 2020. Ms. Zausner received a B.S. in Accounting and Economics from the University at Albany, SUNY. We believe Ms. Zausner is qualified to serve 
on our board of directors because of her finance and leadership experience and knowledge of the pharmaceutical industry.

Name

Eric D. Shaff

David Arkowitz
Paula A. Cloghessy

Thomas J. DesRosier
David S. Ege, Ph.D.

Matthew Henn, Ph.D.
Lisa von Moltke, M.D.
Teresa L. Young, Ph.D.

Information about our Executive Officers

Age

  Position

47

61
52

68
48

48
64
56

  President, Chief Executive Officer and Director
Executive Vice President, Chief Financial Officer and Head of Business 
Development

  Executive Vice President and Chief People Officer

  Executive Vice President and Chief Legal Officer
  Executive Vice President and Chief Technology Officer

  Executive Vice President and Chief Scientific Officer
  Executive Vice President and Chief Medical Officer
  Executive Vice President, Chief Commercial and Strategy Officer

Information concerning Eric D. Shaff, our President and Chief Executive Officer, may be found above in the section entitled “Director Biographical 
Information.”

David Arkowitz has served as our Executive Vice President, Chief Financial Officer and Head of Business Development since June 2021. Previously, he 
served as the Chief Financial Officer of Flexion Therapeutics, Inc., a biotechnology company, from May 2018 to May 2021. From September 2013 to May 
2018, Mr. Arkowitz served as Chief Operating Officer and Chief Financial Officer at Visterra, Inc., a biotechnology company that was acquired by Otsuka 
Pharmaceutical Co. He also previously served as Chief Financial Officer at each of Mascoma Corporation, AMAG Pharmaceuticals Inc., and Idenix 
Pharmaceuticals LLC and held additional leadership positions within each company. Preceding his tenure at Idenix, Mr. Arkowitz spent more than 13 years 
at Merck & Co., Inc. where he held roles of increasing responsibility, including Vice President and Controller of the U.S. operations, Controller of the 
global research and development division, and the Chief Financial Officer of Merck’s Canadian subsidiary. Mr. Arkowitz has served on the boards of 
directors of F-star Therapeutics, Inc. since November 2020 and Kineta, Inc. since December 2022, and previously served on the boards of directors of 
Yumanity Therapeutics, Inc., Spring Bank Pharmaceuticals, Inc. and Proteostasis Therapeutics, Inc. He obtained his B.A. in mathematics at Brandeis 
University and his M.B.A. in finance at Columbia University Business School.

Paula A. Cloghessy has served as our Executive Vice President and Chief People Officer since February 2022. Previously, Ms. Cloghessy served in roles of 
increasing seniority at Translate Bio, Inc., or Translate Bio, a biotechnology company acquired by Sanofi S.A., or Sanofi, a global biopharmaceutical 
company, from 2016 to December 2021, culminating in her role as Chief People Officer.  In these roles, Ms. Cloghessy was responsible for leading human 
resources and organizational development and performance. Prior to Translate Bio, Ms. Cloghessy held senior roles at Joule Unlimited Technologies, Inc. 
and Interleukin Genetics, Inc. Ms. Cloghessy received her B.A. in Psychology from University of Massachusetts, Boston.

Thomas J. DesRosier has served as our Chief Legal Officer, Executive Vice President, and Secretary since May 2016. Previously, he served as Executive 
Vice President, Chief Legal and Administrative Officer and Secretary of ARIAD Pharmaceuticals, Inc., a biopharmaceutical company, from 2015 to 2016, 
Executive Vice President, Chief Legal and Administrative Officer and Secretary of Cubist Pharmaceuticals, Inc., or Cubist, a biopharmaceutical company, 
from 2014 to 2015 and Senior Vice President, Chief Legal Officer and Secretary of Cubist from 2013 to 2014. Before that, Mr. DesRosier served as Senior 
Vice President, General Counsel North America of Sanofi from 2011 to 2013. From 1999 to 2011, Mr. DesRosier held leadership roles of increasing 
seniority within the legal group of Genzyme Corporation, a biotechnology company, culminating in his role as Senior Vice President, Chief Legal Officer. 
Mr. DesRosier has served as a member of the board of directors of Avanir Pharmaceuticals, a privately held company and wholly-owned subsidiary of 
Otsuka Pharmaceutical Company, Ltd., since June 2017. Mr. DesRosier earned a B.A. in Chemistry from the University of Vermont and a J.D. from Wake 
Forest University School of Law.

David S. Ege, Ph.D. has served as our Executive Vice President and Chief Technology Officer since October 2020. Previously, Dr. Ege served in a variety 
of technical and leadership roles in R&D and manufacturing at Merck from November 2003 to October 2020, most recently as global lead for digital 
strategy in Merck’s Manufacturing Division from June 2019 to October 2020. From April 2015 to June 2019, Dr. Ege served as Executive Director of 
Vaccines & Biologics Manufacturing at Merck’s plant in Elkton, Virginia, 

90

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
where he led bulk manufacturing operations for Gardasil®, Gardasil9® and Cancidas®. He has contributed to the successful first-in-class licensure and 
launch of cervical cancer vaccines, Gardasil® (2006) and Gardasil9® (2014), and a breakthrough cancer immunotherapy, Keytruda® (2014). He graduated 
summa cum laude from Princeton with a B.S.E. in chemical engineering and earned his Ph.D. in chemical engineering from the University of 
Pennsylvania.

Matthew Henn, Ph.D. has served as our Executive Vice President and Chief Scientific Officer since February 2019. Since joining our company at its launch 
in June 2012, he has held positions of increasing seniority, most recently as Executive Vice President, Head of Discovery and Microbiome R&D from 
January 2018 to February 2019, and previously as Senior Vice President, Head of Discovery and Bioinformatics from June 2012 to January 2018. Prior to 
joining our company, he was the Director of Viral Genomics and Assistant Director of the Genome Sequencing Center for Infectious Diseases at the Broad 
Institute of the Massachusetts Institute of Technology and Harvard. He currently serves on the scientific advisory boards of the Forsyth Institute and 
Growcentia, Inc., an agricultural microbiome company. Dr. Henn earned his B.S. in Ecology and Evolutionary Sciences from the University of New 
Hampshire and his Ph.D. in Ecosystem Sciences from the University of California at Berkeley, where he was a NASA Earth Systems Sciences Fellow, and 
trained as a NSF Postdoctoral Fellow in Microbiology at Duke University.

Lisa von Moltke, M.D. has served as our Executive Vice President and Chief Medical Officer since March 2020. Previously, Dr. von Moltke worked for 
Alkermes, Inc., a pharmaceutical company, from June 2015 to December 2019, where she served in roles of increasing seniority, culminating as Senior 
Vice President and Head of Clinical Development. Beginning in June 2015, Dr. Moltke served as VP Clinical Pharmacology, DMPK and Bioanalytics, was 
promoted to Head of Clinical Development in November 2015, and became SVP in June 2018. Prior to joining Alkermes, Dr. von Moltke served as Vice 
President Clinical Pharmacology at Sanofi/Genzyme Corporation, a biotechnology company, from 2009 to 2015 and was US Head Clinical & Exploratory 
Pharmacology Sciences (CEP) and Early Development. Starting in 2014 she was Head CEP for Japan and China regions. From 2006 to 2009, Dr. von 
Moltke was Head, Translational Medicine for the Takeda Oncology Company, a biopharmaceutical company, in Cambridge, MA. Dr. von Moltke has 
served on the board of directors of Cara Therapeutics, Inc. since November 2022. She has served as President of the American College of Clinical 
Pharmacology, and as the Editor-in-Chief of The Journal of Clinical Pharmacology. Dr. von Moltke earned a B.A. degree at Wellesley College and her 
M.D. from Michigan State University, College of Human Medicine.

Teresa L. Young, Ph.D. has served as our Executive Vice President, Chief Commercial and Strategy Officer since June 2020. Previously, Dr. Young served 
as Vice President, Global Commercial Strategy at Sage Therapeutics from March 2018 to June 2020, where she led development of Sage’s global 
commercial capabilities, including global marketing, insights and analytics and new product planning. Prior to that, she held commercial leadership roles of 
increasing responsibility at Bristol-Myers Squibb from November 2010 to March 2018, culminating in her role as Vice President and General Manager, 
Cardiovascular, in which she led the global ELIQUIS® business to become the company’s largest product by revenue. Earlier in her career, Dr. Young held 
marketing and sales roles at GlaxoSmithKline from June 1993 to November 2010, where she catalyzed growth for the company’s Urology, Diabetes and 
NeuroHealth organizations. Dr. Young is a member of the Women in Bio and Healthcare Businesswomen’s Association and served on the Advisory Board 
of the Healthcare Businesswomen’s Association. Dr. Young received her B.S. in pharmacy and her Ph.D. in healthcare marketing from the University of 
South Carolina.

Code of Ethics

Our board of directors has adopted a Code of Business Conduct and Ethics applicable to all officers, directors and employees, which is available on 

our website at www.serestherapeutics.com in the “Investors and News” section under “Corporate Governance.” We intend to satisfy the disclosure 
requirement under Item 5.05 of Form 8-K regarding amendment to, or waiver from, a provision of our Code of Business Conduct and Ethics, as well as 
Nasdaq’s requirement to disclose waivers with respect to directors and executive officers, by posting such information on our website at the address and 
location specified in the preceding sentence. The information contained on our website is not incorporated by reference into this Annual Report on Form 
10-K.

The remainder of the information required to be disclosed by this item will be contained in the Proxy Statement for our Annual Meeting of 

Stockholders to be held in 2023 and is incorporated herein by reference.

Other

91

Item 11. Executive Compensation

The information required to be disclosed by this item will be contained in the Proxy Statement for our Annual Meeting of Stockholders to be held in 

2023 and is incorporated herein by reference.

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

The information required to be disclosed by this item will be contained in the Proxy Statement for our Annual Meeting of Stockholders to be held in 

2023 and is incorporated herein by reference.

Item 13. Certain Relationships and Related Transactions and Director Independence

The information required to be disclosed by this item will be contained in the Proxy Statement for our Annual Meeting of Stockholders to be held in 

2023 and is incorporated herein by reference.

Item 14. Principal Accountant Fees and Services

The information required to be disclosed by this item will be contained in the Proxy Statement for our Annual Meeting of Stockholders to be held in 

2023 and is incorporated herein by reference.

92

Item 15. Exhibits and Financial Statements Schedules

(a)(1) Financial Statements.

PART IV

See the “Index to Consolidated Financial Statements” on page F-1 below for the list of financial statements filed as part of this report.

(a)(2) Financial Statement Schedules.

All schedules have been omitted because they are not required or because the required information is given in the Consolidated Financial Statements 

or Notes thereto set forth below beginning on page F-1.

(a)(3) Exhibits.

The following is a list of all exhibits filed as a part of this Annual Report on Form 10-K.

Filed/
Furnished
Herewith

*

*

*

Exhibit
Number

  3.1

  3.2

  4.1

  4.2

10.1#

10.2#

10.3#

10.4#

10.5#

10.6

10.7

10.8

10.9#

10.10#

10.11#

10.12#

10.13#

Exhibit Description

Form  

File No.

  Exhibit

Incorporated by Reference

Restated Certificate of Incorporation

Amended and Restated Bylaws

8-K

8-K

001-37465

001-37465

Specimen Stock Certificate evidencing the shares of common 
stock

S-1/A

333-204484

  Description of Capital Stock

  10-K

001-37465

2015 Incentive Award Plan, as amended and forms of award 
agreements thereunder

3.1

3.2

4.2

4.2

Filing
Date

7/1/15

12/7/20

6/16/15

3/2/21

  2015 Employee Stock Purchase Plan

  S-1/A  

333-204484

2012 Stock Incentive Plan, as amended and form of option 
agreement thereunder

S-1

333-204484

10.3

10.1

6/16/15

5/27/15

2022 Employment Inducement Award Plan and forms of award 
agreements thereunder

  Non-Employee Director Compensation Program

Lease Agreement, dated April 1, 2015, by and between the 
Registrant and ARE-MA Region No. 38, LLC

S-1

333-204484

10.13

5/27/15

Lease, dated November 11, 2015, by and between the Registrant 
and BMR-Sidney Research Campus, LLC

10-K

001-37465

10.13

3/14/16

First Amendment to Lease, dated December 9, 2022, by and 
between Registrant and BMR-Sidney Research Campus, LLC 
(f/k/a BMR 200-Sidney Street LLC)

Second Amended and Restated Employment Agreement, dated 
January 29, 2021, by and between the Registrant and Eric D. 
Shaff

Amended and Restated Employment Agreement, dated January 
29, 2021 by and between the Registrant and Thomas J. 
DesRosier

Second Amended and Restated Employment Agreement, dated 
January 29, 2021, by and between the Registrant and Matthew 
R. Henn, Ph.D.

Amended and Restated Employment Agreement, dated January 
29, 2021, by and between the Registrant and David S. Ege, 
Ph.D.

8-K

001-37465

10.1

12/14/22

8-K

001-37465

10.1

2/1/21

8-K

001-37465

10.2

2/1/21

8-K

001-37465

10.3

2/1/21

10-Q

001-37465

10.2

8/3/21

Letter Agreement, dated November 4, 2021, by and between the 
Registrant and David S. Ege, Ph.D. 

10-Q

001-37465

10.2

11/10/21

93

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
10.14#

10.15#

Amended and Restated Employment Agreement, dated January 
29, 2021, by and between the Registrant and Teresa L. Young 

  Amended and Restated Employment Agreement, dated January 
29, 2021, by and between the Registrant and Lisa von Moltke, 
M.D.

10-K

001-37465

10.13

3/2/21

  10-K

001-37465

10.14  

3/2/21

10.16#

  Employment Agreement, dated May 10, 2021 by and between 

  8-K

001-37465

10.1

5/20/21

the Registrant and David Arkowitz 

10.17#

  Employment Agreement, dated January 5, 2022, by and 

  10-K

001-37465

10.16  

3/1/22

between the Registrant and Paula Cloghessy

10.18

10.19

10.20

10.21^

10.22

10.23^

10.24

Loan and Security Agreement, dated October 29, 2019, between 
the Registrant and Hercules Capital, Inc. 

8-K

001-37465

10.1

11/4/19

First Amendment to Loan and Security Agreement by and 
between the Registrant and Hercules Capital, Inc., dated April 
16, 2020

Second Amendment to Loan and Security Agreement, dated 
February 24, 2022 by and between the Registrant and Hercules 
Capital, Inc.

Collaboration and License Agreement, dated January 9, 2016, 
by and between the Registrant and Société des Produits Nestlé 
S.A.

Amendment No. 1 to the Collaboration and License Agreement, 
dated August 10, 2016, by and between the Registrant and 
Nestec Ltd.

Letter Agreement dated October 30, 2018, by and between the 
Registrant and Nestec Ltd. 

10-Q

001-37465

10.2

7/28/20

10-K

001-37465

10.19

3/1/22

10-Q

001-37465

10.1

5/16/16

10-K

001-37465

10.22

3/6/19

10-K

001-37465

10.23

3/6/19

  Securities Purchase Agreement, dated August 12, 2020 by and 
between the Company and Société des Produits Nestlé S.A.

  8-K

001-37465

10.1

8/14/20

10.25†

  License Agreement, dated July 1, 2021, by and between the 

  10-Q

001-37465

10.1

11/10/21    

Registrant and NHSc Pharma Partners

10.26†

  Amendment No. 1 to License Agreement, dated March 24, 

  10-Q

001-37465

10.3

5/4/222

2022, by and between the Registrant and NHSc Pharma Partners

10.27†

  Long Term Manufacturing Agreement, dated November 8, 
2021, by and between the Registrant and BacThera AG

  10-K

001-37465

10.25  

3/1/22

10.28†

  Amendment to Long Term Manufacturing Agreement, dated 

December 14, 2022, by and between the Registrant and 
BacThera AG

10.29

10.30

10.31

10.32†

21.1

23.1

  Form of Non-Affiliate Purchase Agreement

  Form of Affiliate Purchase Agreement

Placement Agency Agreement, dated June 29, 2022, by and 
between Registrant and J.P. Morgan Securities LLC

Supply Agreement, dated September 15, 2015, by and between 
Registrant and GenIbet BioPharmaceuticals, SA, as amended

  8-K

  8-K

8-K

001-37465

001-37465

001-37465

10.1

10.2

10.3

6/30/22

6/30/22

6/30/22

10-Q

001-37465

10.1

11/2/22

  Subsidiaries of Seres Therapeutics, Inc.

  10-K

001-37465

21.1

3/2/20

Consent of PricewaterhouseCoopers LLP, Independent 
Registered Public Accounting Firm

94

*

*

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
31.1

31.2

32.1

32.2 

101.INS

Rule 13a-14(a)/15d-14(a) Certification of Chief Executive 
Officer

Rule 13a-14(a)/15d-14(a) Certification of Chief Financial 
Officer

  Section 1350 Certification of Chief Executive Officer

  Section 1350 Certification of Chief Financial Officer

Inline XBRL Instance Document- the Instance Document does 
not appear in the interactive data file because its XBRL tags are 
embedded within the Inline XBRL document

101.SCH

  Inline XBRL Taxonomy Extension Schema Document

101.CAL

Inline XBRL Taxonomy Extension Calculation Linkbase 
Document

101.LAB

  Inline XBRL Taxonomy Extension Label Linkbase Document

101.PRE

101.DEF

104

Inline XBRL Taxonomy Extension Presentation Linkbase 
Document

Inline XBRL Taxonomy Extension Definition Linkbase 
Document

Cover Page Interactive Data File (formatted as Inline XBRL and 
contained in Exhibit 101)

*

*

**

**

*

*

*

*

*

*

*

* Filed herewith.
** Furnished herewith.
# Indicates management contract or compensatory plan. 
^ Confidential treatment has been granted with respect to redacted portions of this exhibit. Redacted portions of this exhibit have been filed separately with 
the SEC.
† Portions of this exhibit (indicated by asterisks) have been omitted pursuant to Regulation S-K, Item 601(b)(10)(iv). Such omitted information is both (i) 
not material and (ii) the type that the Registrant treats as private or confidential.

Item 16. Form 10-K Summary

None.

95

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

its behalf by the undersigned, thereunto duly authorized.

SIGNATURES

Date: March 7, 2023

  SERES THERAPEUTICS, INC.

  By:

  /s/ Eric D. Shaff
  Eric D. Shaff
  President, Chief Executive Officer and Director

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

registrant and in the capacities and on the dates indicated.

/s/ Eric D. Shaff

Signature

Eric D. Shaff

/s/ David Arkowitz

Title

Date

  President, Chief Executive Officer
  and Director
  (Principal Executive Officer)
  Executive Vice President, Chief Financial Officer, 

and Head of Business Development

David Arkowitz

  (Principal Financial and Accounting Officer)

/s/ Stephen Berenson

  Chairman of the Board

Stephen Berenson

/s/ Dennis A. Ausiello

Dennis A. Ausiello, M.D.

/s/ Grégory Behar

/s/ Paul R. Biondi

Grégory Behar

Paul R. Biondi

/s/ Willard H. Dere

Willard H. Dere, M.D.

/s/ Claire M. Fraser

Claire M. Fraser, Ph.D.

/s/ Kurt C. Graves

Kurt C. Graves

/s/ Richard N. Kender

Richard N. Kender

/s/ Meryl S. Zausner

Meryl S. Zausner

  Director

  Director

  Director

  Director

  Director

  Director

  Director

  Director

96

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

March 7, 2023

  
 
 
   
   
 
   
 
   
 
 
 
 
 
 
 
 
 
 
   
 
   
 
   
 
 
 
 
 
 
   
   
 
 
 
 
 
 
   
   
 
 
 
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
   
   
 
   
   
 
   
   
 
INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

Report of Independent Registered Public Accounting Firm (PCAOB ID 238)
Consolidated Balance Sheets as of December 31, 2022 and 2021
Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 2022, 2021 and 2020
Consolidated Statements of Stockholders’ Equity (Deficit) as of December 31, 2022, 2021 and 2020
Consolidated Statements of Cash Flows for the years ended December 31, 2022, 2021 and 2020
Notes to Consolidated Financial Statements

Page

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

F-1

 
 
 
Report of Independent Registered Public Accounting Firm

To the Board of Directors and Stockholders of Seres Therapeutics, Inc.

Opinions on the Financial Statements and Internal Control over Financial Reporting

We have audited the accompanying consolidated balance sheets of Seres Therapeutics, Inc. and its subsidiaries (the “Company”) as of December 31, 2022 
and 2021, and the related consolidated statements of operations and comprehensive loss, of stockholders' equity (deficit) and of cash flows for each of the 
three years in the period ended December 31, 2022, including the related notes (collectively referred to as the “consolidated financial statements”). We also 
have audited the Company's internal control over financial reporting as of December 31, 2022, based on criteria established in Internal Control - Integrated 
Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of 
December 31, 2022 and 2021, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2022 in 
conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material 
respects, effective internal control over financial reporting as of December 31, 2022, based on criteria established in Internal Control - Integrated 
Framework (2013) issued by the COSO.

Substantial Doubt About the Company’s Ability to Continue as a Going Concern

The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going concern.  As discussed in 
Note 1 to the consolidated financial statements, the Company has incurred losses and negative cash flows from operations since its inception and needs to 
raise additional capital to fund future operations, which raises substantial doubt about its ability to continue as a going concern.  Management’s plans in 
regard to these matters are also described in Note 1.  The consolidated financial statements do not include any adjustments that might result from the 
outcome of this uncertainty.

Basis for Opinions

The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, 
and for its assessment of the effectiveness of internal control over financial reporting, included in Management’s Annual Report on Internal Control Over 
Financial Reporting appearing under Item 9A. Our responsibility is to express opinions on the Company’s consolidated financial statements and on the 
Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting 
Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities 
laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable 
assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective 
internal control over financial reporting was maintained in all material respects.

Our audits of the consolidated financial statements 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. Our audit of internal 
control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness 
exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing 
such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.

Definition and Limitations of Internal Control over Financial Reporting

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting 
and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control 
over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly 
reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit 
preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are 
being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding 

F-2

  
prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial 
statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of 
effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of 
compliance with the policies or procedures may deteriorate.

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 (i) relates to accounts or disclosures that are material to the consolidated 
financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not 
alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, 
providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.

Revenue Recognition – Collaboration and License Agreement with Société des Produits Nestlé S.A. (Nestlé) Recognized Under an Input Method

As described in Notes 2 and 11 to the consolidated financial statements, the Company recognizes revenue arising from a collaboration and license 
agreement with Nestlé, which totaled $3.0 million for the year ended December 31, 2022. The promised goods and services represent one combined 
performance obligation and the entire transaction price was allocated to that single combined performance obligation. When management concludes that a 
contract should be accounted for as a combined performance obligation and recognized over-time, management must then determine the period over which 
revenue should be recognized and the method by which to measure revenue. Management generally recognizes revenue using a cost-based input method, 
which measures the extent of progress towards completion based on the ratio of actual costs incurred to the total estimated costs expected upon satisfying 
the performance obligation. 

The principal considerations for our determination that performing procedures relating to revenue recognition for the collaboration and license agreement 
with Nestlé recognized under an input method is a critical audit matter are the significant judgment by management when determining the total estimated 
costs expected upon satisfying the performance obligation, which in turn led to significant auditor judgment, subjectivity and effort in performing 
procedures to evaluate the total estimated costs expected upon satisfying the performance obligation.

Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated 
financial statements. These procedures included testing the effectiveness of controls relating to the revenue arising from the collaboration and license 
agreement with Nestlé, including controls over the total estimated costs expected upon satisfying the performance obligation. These procedures also 
included, among others, evaluating and testing management’s process for determining the total estimated costs expected upon satisfying the performance 
obligation, which included testing actual costs incurred and evaluating the reasonableness of estimated costs to satisfy the performance obligation. 
Evaluating the reasonableness of estimated costs to satisfy the performance obligation involved assessing management’s ability to reasonably estimate 
costs to satisfy the performance obligation by (i) evaluating the appropriateness of changes to management’s estimates of total costs to satisfy the 
performance obligation; (ii) performing a comparison of management’s prior period cost estimates to actual costs incurred; and (iii) evaluating whether the 
cost estimates used by management were reasonable considering consistency with industry and company-specific data.

/s/ PricewaterhouseCoopers LLP 
Boston, Massachusetts
March 7, 2023

We have served as the Company’s auditor since 2014.

F-3

  
SERES THERAPEUTICS, INC.
CONSOLIDATED BALANCE SHEETS
(In thousands, except share and per share data)

Assets
Current assets:

Cash and cash equivalents
Short term investments
Prepaid expenses and other current assets

Total current assets
Property and equipment, net
Operating lease assets
Restricted cash
Restricted investments
Long term investments
Other non-current assets

Total assets

Liabilities and Stockholder's Equity
Current liabilities:

Accounts payable
Accrued expenses and other current liabilities (1)
Operating lease liabilities
Short term portion of note payable, net of discount
Deferred revenue - related party

Total current liabilities

Long term portion of note payable, net of discount
Operating lease liabilities, net of current portion
Deferred revenue, net of current portion - related party
Other long-term liabilities (2)

Total liabilities

Commitments and contingencies (Note 13)
Stockholders’ equity:

Preferred stock, $0.001 par value; 10,000,000 shares authorized at December 31, 2022 and 2021; 
no shares issued and outstanding at December 31, 2022 and 2021, respectively
Common stock, $0.001 par value; 200,000,000 shares authorized at December 31, 2022 and 2021; 
125,222,273 and 91,889,418 shares issued and outstanding at December 31, 2022 and 2021, 
respectively
Additional paid-in capital
Accumulated other comprehensive loss
Accumulated deficit

Total stockholders’ equity

Total liabilities and stockholders’ equity

December 31,

2022

2021

163,030     $
18,311    
13,423    
194,764    
22,985    
110,984    
8,185    
1,401    
—    
10,465    
348,784     $

17,440     $
59,840    
3,601    
456    
4,259    
85,596    
50,591    
107,942    
92,430    
1,442    
338,001    

180,002  
110,704  
12,922  
303,628  
17,938  
18,208  
8,000  
1,401  
495  
5,189  
354,859  

13,735  
45,094  
6,610  
—  
16,819  
82,258  
24,643  
17,958  
86,998  
11,495  
223,352  

—    

—  

125    
875,181    
(12 )  
(864,511 )  
10,783    
348,784     $

92  
745,829  
(60 )
(614,354 )
131,507  
354,859  

  $

  $

  $

  $

[1] Includes related party amounts of $34,770 and $21,098 at December 31, 2022 and December 31, 2021, respectively (see Note 11)
[2] Includes related party amounts of $0 and $10,585 at December 31, 2022 and December 31, 2021, respectively (see Note 11)

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

F-4

 
 
 
 
 
 
   
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
(In thousands, except share and per share data)

Revenue:

Collaboration revenue - related party
Grant revenue
Collaboration revenue

Total revenue

Operating expenses:

Research and development expenses
General and administrative expenses
Collaboration (profit) loss sharing - related party

Total operating expenses

Loss from operations
Other (expense) income:

Interest income
Interest expense
Other (expense) income

Total other (expense) income, net

Net loss

Net loss per share attributable to common stockholders, basic and diluted

Weighted average common shares outstanding, basic and diluted
Other comprehensive loss:

Unrealized gain (loss) on investments, net of tax of $0
Currency translation adjustment

Total other comprehensive income (loss)

Comprehensive loss

2022

Year Ended December 31,
2021

2020

  $

  $

  $
  $

7,128     $
—  
—  
7,128    

172,920     $
79,694    
1,004    
253,618    
(246,490 )  

3,058    
(6,020 )  
(705 )  
(3,667 )  
(250,157 )   $
(2.31 )   $

143,857     $
1,070  
—  

144,927    

141,891     $
69,261    
(1,732 )  
209,420    
(64,493 )  

2,870    
(2,910 )  
(1,045 )  
(1,085 )  
(65,578 )   $
(0.72 )   $

11,897  
4,157  
17,161  
33,215  

90,570  
30,775  
—  
121,345  
(88,130 )

946  
(2,924 )
981  
(997 )
(89,127 )
(1.12 )

108,077,043    

91,702,866    

79,789,220  

49    
(1 )  
48    

  $

(250,109 )   $

(12 )  
(1 )  
(13 )  
(65,591 )   $

(47 )
—  
(47 )
(89,174 )

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

F-5

 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
   
   
 
 
   
   
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)
(In thousands, except share data)

Common Stock

  Additional

Total

  Stockholders

Shares
70,143,252     $

Par
Value

Paid-in
Capital

70     $

411,255     $

  Accumulated  
Deficit
(459,649 )   $

-     $

Equity
(Deficit)

(48,324 )

  Accumulated  
Other
Comprehensiv
e
Loss

12,075,000    

12    

243,736      

—      

—      

243,748  

19,899      

—    

19,900  

959,002    

5,787,681    

2,214,011    

125,000    
155,293  
—  
—  
—  
91,459,239  

329,112  
100,417  

650  
—  
—  
—  
91,889,418  

326,864  

282,401  
322,560  

31,746,030  

1    

6    

2    

—    
—  
—  
—  
—  
91    

1    
—  

—  
—  
—  
—  
92    

—  

—  
—  

32  

24,767      

14,419      

120      
462  
8,824  
—  
—  
723,482  

1,298  
827  

—  
20,222  
—  
—  
745,829  

966  

—  
1,769  

96,689  

—      

—      

—      
—  
—  
(47 )    
—  
(47 )    

—      
—  

—  
—  
(13 )    
—  
(60 )    

—  

—  
—  

—  

—  
—  
48  
—  
(12 )   $

—      

24,773  

—      

14,421  

—      
—  
—  
—  
(89,127 )    
(548,776 )    

—  
—  

—  
—  
—  
(65,578 )    
(614,354 )    

—  

—  
—  

—  

—  
—  
—  

(250,157 )    
(864,511 )   $

120  
462  
8,824  
(47 )
(89,127 )
174,750  

1,299  
827  

—  
20,222  
(13 )
(65,578 )
131,507  

966  

—  
1,769  

96,721  

4,447  
25,482  
48  
(250,157 )
10,783  

655,000  
—  
—  
—  
    125,222,273  

  $

1  
—  
—  
—  
125     $

4,446  
25,482  
—  
—  
875,181  

  $

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

F-6

Balance at December 31, 2019

Issuance of common stock from public
   offering, net of commissions, underwriting
   discounts and offering costs of $288
Issuance of common stock from Securities Purchase 
Agreement, net of offering costs - related party of 
$100
Issuance of common stock from at the market equity 
offering, net of issuance costs of $673
Issuance of common stock upon exercise of stock 
options
Issuance of common stock upon vesting of RSUs, net
   of tax withholdings
Issuance of common stock under ESPP plan
Stock-based compensation expense
Other comprehensive loss
Net loss

 Balance at December 31, 2020

Issuance of common stock upon exercise of stock 
options
Issuance of common stock under ESPP plan
Issuance of common stock upon vesting of RSUs, net
   of tax withholdings
Stock-based compensation expense
Other comprehensive loss
Net loss

 Balance at December 31, 2021

Issuance of common stock upon exercise of stock 
options
Issuance of common stock upon vesting of RSUs and 
PSUs, 
   net of tax withholdings
Issuance of common stock under ESPP
Issuance of common stock net of issuance costs of 
$3,279
Issuance of common stock from at the market equity 
offering,
   net of issuance costs of $310
Stock-based compensation expense
Other comprehensive loss
Net loss

Balance at December 31, 2022

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
   
 
 
       
   
 
 
   
 
 
   
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
   
   
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
SERES THERAPEUTICS, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)

Cash flows from operating activities:

Net loss
Adjustments to reconcile net loss to net cash provided by (used in) operating 
activities:

Stock-based compensation expense
Depreciation and amortization expense
Non-cash operating lease cost
Amortization of premiums on investments
Amortization of debt issuance costs
Collaboration (profit) loss sharing - related party
Changes in operating assets and liabilities:
Prepaid expenses and other current and non-current assets
Accounts receivable
Deferred revenue - related party
Accounts payable
Operating lease liabilities
Accrued expenses and other current and long-term liabilities (3)

Net cash (used in) provided by operating activities

Cash flows from investing activities:
Purchases of property and equipment
Purchases of investments
Sales and maturities of investments

Net cash provided by (used in) investing activities

Cash flows from financing activities:

Proceeds from issuance of common stock, net of issuance costs
Proceeds from Securities Purchase Agreement, net of issuance costs -
   related party
Proceeds from issuance of note payable
Proceeds from at the market equity offering, net of issuance costs
Proceeds from exercise of stock options
Proceeds from issuance of common stock and restricted common stock
Issuance of common stock under ESPP
Repayment of notes payable

Net cash provided by financing activities

Net (decrease) increase in cash, cash equivalents and restricted cash
Effect of exchange rate changes on cash, cash equivalents and restricted cash
Cash, cash equivalents and restricted cash at beginning of year

Cash, cash equivalents and restricted cash at end of year
Supplemental disclosure of cash flow information:

Cash paid for interest

Supplemental disclosure of non-cash investing and financing
   activities:

Property and equipment purchases included in accounts payable and
   accrued expenses
Lease liability arising from obtaining right-of-use assets
Prepaid rent reclassified to right-of-use assets

Year Ended December 31,
2021  

2022  

2020  

  $

(250,157 )   $

(65,578 )   $

(89,127 )

25,482    
6,629    
5,224    
688    
705    
1,004    

(12,599 )  
—    
(7,128 )  
2,203    
(4,203 )  
3,336    
(228,816 )  

(9,821 )  
(48,221 )  
140,470    
82,428    

20,222    
5,947    
3,275    
498    
2,526    
(1,732 )

(12,337 )
9,387  
(4,357 )
9,362  
(3,550 )
43,025  
6,688    

(9,566 )  
(95,971 )  
169,625    
64,088    

8,824  
6,578  
2,315  
446  
551  
-  

(2,186 )
(7,602 )
(11,565 )
(1,159 )
(4,456 )
3,771  
(93,610 )

(591 )
(218,284 )
59,984  
(158,891 )

96,721    

—    

243,748  

—    
27,606    
4,447    
966    
—    
1,769    
(1,907 )  
129,602    
(16,786 )  
(1 )  
188,002    
171,215     $

—    
—    
—    
1,299    
—    
827    
(948 )  
1,178    
71,954    
(1 )  
116,049    
188,002     $

19,900  
—  
24,773  
14,421  
120  
462  
—  
303,424  
50,923  
—  
65,126  
116,049  

4,926     $

2,446     $

2,453  

2,276     $
91,412     $
6,822     $

874     $
12,442     $
—     $

451  
—  
—  

  $

  $

  $
  $
  $

[3] Includes related party amounts of $3,087 and $31,683 at December 31, 2022 and 2021 respectively (see Note 11)

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

F-7

 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
   
 
 
 
 
   
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
     
   
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
     
     
   
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

1.

Nature of the Business and Basis of Presentation

Seres Therapeutics, Inc. (the “Company”) was incorporated under the laws of the State of Delaware in October 2010 under the name Newco LS21, 
Inc. In October 2011, the Company changed its name to Seres Health, Inc., and in May 2015, the Company changed its name to Seres Therapeutics, Inc. 
The Company is a microbiome therapeutics company developing a novel class of biological drugs, which are designed to treat disease by modulating the 
microbiome to restore health by repairing the function of a disrupted microbiome to a non-disease state.  The Company’s lead product candidate, SER-109, 
is designed to reduce further recurrences of Clostridioides difficile infection (“CDI”), a debilitating infection of the colon, in patients who have received 
antibiotic  therapy  for  recurrent  CDI  by  restructuring  the  colonic  microbiome  and  changing  its  function.    If  approved  by  the  U.S.  Food  and  Drug 
Administration  (“FDA”),  the  Company  believes  SER-109  will  be  a  first-in-field  oral  microbiome  drug.  Building  upon  SER-109,  the  Company  is 
developing  therapeutic  candidates,  such  as  SER-155,  to  specifically  target  infections  and  antimicrobial  resistance.  SER-155,  a  microbiome  therapeutic 
candidate consisting of a consortium of cultivated bacteria, is designed to reduce incidences of gastrointestinal infections, bloodstream infections and graft 
versus  host  disease  ("GvHD”)  in  patients  receiving  allogeneic  hematopoietic  stem  cell  transplantation  (“allo-HSCT”).  The  Company  is  progressing 
additional  preclinical  stage  programs  to  evaluate  how  microbiome  therapeutics  may  reduce  incidence  of  infection,  which  the  Company  refers  to  as 
Infection  Protection,  in  indications  such  as  cancer  neutropenia,  chronic  liver  disease,  solid  organ  transplant,  and  antimicrobial  resistant  infections  more 
broadly in settings of high-risk such as intensive care units. The Company is also continuing its research activities in ulcerative colitis ("UC"), including 
evaluating the potential to utilize biomarker-based patient selection and stratification for future studies.  In addition, the Company continues to leverage 
microbiome  pharmacokinetic  and  pharmacodynamic  data  from  across  its  clinical  and  preclinical  portfolios,  using  its  reverse  translational  microbiome 
therapeutic development platform to conduct research on various indications, including inflammatory and immune diseases, cancer, and metabolic diseases. 
The  Company  has  built  and  deploys  a  reverse  translational  platform  for  the  discovery  and  development  of  microbiome  therapeutics.  This  platform 
incorporates high-resolution analysis of human clinical data to identify microbiome biomarkers associated with disease and non-disease states; preclinical 
screening  using  human  cell-based  assays  and  in  vitro/ex  vivo  and  in  vivo  disease  models  customized  for  microbiome  therapeutics;  and  microbiological 
capabilities  and  a  strain  library  that  spans  broad  biological  and  functional  breadth  to  both  identify  specific  microbes  and  microbial  metabolites  that  are 
associated with disease and to design consortia of bacteria with specific pharmacological properties.    

The accompanying consolidated financial statements have been prepared on a basis that assumes that the Company will continue as a going concern 
and that contemplates the realization of assets and satisfaction of liabilities and commitments in the normal course of business. As of December 31, 2022, 
the Company had an accumulated deficit of $864,511 and cash, cash equivalents and short- and long-term investments of $181,341. 

The Company is subject to risks common to companies in the biotechnology industry including, but not limited to, new technological innovations, 
protection of proprietary technology, dependence on key personnel, compliance with government regulations and the need to obtain additional financing. 
Product candidates currently under development will require significant additional research and development efforts, including extensive preclinical and 
clinical  testing  and  regulatory  approval,  prior  to  commercialization.  The  Company  operates  in  an  environment  of  rapid  change  in  technology  and 
substantial competition from pharmaceutical and biotechnology companies. In addition, the Company is dependent upon the services of its employees and 
consultants. 

The  Company’s  product  candidates  are  in  development.  There  can  be  no  assurance  that  the  Company's  research  and  development  will  be 
successfully  completed,  that  adequate  protection  for  the  Company’s  intellectual  property  will  be  obtained,  or  maintained,  that  any  product  candidate 
developed will obtain necessary government regulatory approval or that any approved product will be commercially viable. Even if the Company’s product 
development efforts are successful, it is uncertain when, if ever, the Company will generate significant revenue from product sales. 

The Company's primary focus in recent months has been and will continue to be supporting the Biologics License Application ("BLA") submission 
for  our  lead  product  candidate,  SER-109,  and  continuing  to  prepare  for  potential  commercialization,  including  the  manufacture  of  SER-109,  until  and 
continuing  after  the  Prescription  Drug  User  Fee  Act  ("PDUFA")  target  action  date  set  by  the  FDA  of  April  26,  2023.  The  Company  has  commenced 
manufacture  of  SER-109  in  consideration  of  potential  commercialization,  which  requires  capital  and  resources.  Successful  execution  of  the  pre-
commercialization activities required by our collaboration agreement with Société des Produits Nestlé S.A., successor in interest to Nestec Ltd., and NHSc 
Rx  License  GmbH,  a  significant  stockholder  of  the  Company  and  successor  in  interest  to  NHSc  Pharma  Partners  (collectively,  and  together  with  their 
affiliates  and  subsidiaries,  “Nestlé”),  requires  continued  investment  in  readying  for  launch.  Still,  there  can  be  no  assurance  that  the  BLA  for  SER-109, 
which is currently under priority review by the FDA, will be approved, that the FDA will complete its review of the BLA in the anticipated timeline, or 
that, in the event of approval, the demand for SER-109 will be sufficient to meet the Company's forecasted cash needs without raising significant additional 
capital.

The  Company  also  has  a  credit  facility  (the  "New  Credit  Facility")  pursuant  to  a  Loan  and  Security  Agreement  (the  “Loan  Agreement”)  with 

Hercules Capital, Inc. ("Hercules," see Note 8, Notes Payable), which is collateralized by substantially all of the 

F-8

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Company’s assets excluding intellectual property. The Company is currently in compliance with the financial covenants in the New Credit Facility. The 
New  Credit  Facility  includes  a  conditional  liquidity  covenant  commencing  on  June  15,  2023,  which  ceases  to  apply  if  certain  conditions  are  satisfied. 
Violation of any covenant under the New Credit Facility provides Hercules with the option to accelerate repayment of amounts borrowed and terminate its 
commitment to extend further credit, among other remedies as defined in the New Credit Facility. 

Primarily as a result of the increased and costly efforts to prepare for potential commercialization of SER-109, in conjunction with the Company's 
research and development efforts for other preclinical and product candidates, for the year ended December 31, 2022, the Company incurred a net loss of 
$250,157, and had net operating cash outflows of $228,816. The Company expects that its operating losses and negative cash flows will continue for the 
foreseeable future. The Company is eligible to receive contingent milestone payments under its license agreement with Nestlé executed in July 2021 (see 
Note  11,  Collaboration  Revenue)  if  certain  development,  regulatory  approval  or  sales  target  milestones  are  achieved.  Upon  approval  of  the  BLA,  the 
Company is entitled to receive an additional $125,000 payment from Nestlé, and a $25,000 tranche under the New Credit Facility, which becomes available 
upon the satisfaction of certain conditions, including FDA approval of SER-109. Additionally, following FDA approval, the Company will be eligible to 
receive payments from Nestlé for the supply of SER-109. In the event of commercial sale of SER-109, the Company will be entitled to share equally in its 
commercial profits and losses. The payments under the 2021 License Agreement and the additional tranche under the New Credit Facility are uncertain and 
there is no assurance that the Company will receive any of them, because they are contingent upon approval of the Company's BLA, which is currently 
under priority review by the FDA. Based on the Company's currently available cash resources, current and forecasted level of operations, and forecasted 
cash flows for the 12 month period subsequent to the date of issuance of these consolidated financial statements, in the absence of approval of SER-109 by 
the FDA, and therefore, without the receipt of the approval milestone and other payments to which it is entitled to receive as a result thereof, the Company 
believes it is reasonably likely that it will require additional funding in early 2024. These factors raise substantial doubt about the Company’s ability to 
continue as a going concern.

Management's  plans  to  mitigate  the  conditions  that  raise  substantial  doubt  about  the  Company’s  ability  to  continue  as  a  going  concern  include 
continuing to seek regulatory approval of the BLA for SER-109 and therefore earning the $125,000 milestone payment from Nestlé and becoming eligible 
for the $25,000 tranche under the New Credit Facility, as well as the ability to commercialize SER-109 and receive payments from Nestlé for the supply of 
SER-109, and share equally in commercial profits and losses with Nestlé pursuant to the 2021 License Agreement. Management may also seek to raise 
additional  capital  through  financing  or  other  transactions,  including  the  Company's  at  the  market  equity  offering.  Because  certain  elements  of  the 
Company’s operating plan are outside of the Company’s control, primarily the approval of its BLA for SER-109, which has not occurred as of the issuance 
of  these  consolidated  financial  statements,  and  the  ability  to  raise  capital  through  an  equity  or  other  financing,  those  elements  cannot  be  considered 
probable  according  to  Accounting  Standards  Codification  (“ASC”)  205-40,  Going Concern  ("ASC  205-40"),  and  therefore  cannot  be  considered  in  the 
evaluation of mitigating factors. As a result, management has concluded that substantial doubt exists about the Company’s ability to continue as a going 
concern for 12 months from the date these consolidated financial statements are issued.

The  accompanying  financial  statements  have  been  prepared  in  conformity  with  accounting  principles  generally  accepted  in  the  United  States  of 
America  (“GAAP”)  and  include  the  accounts  of  the  Company  and  its  wholly  owned  subsidiaries  after  elimination  of  all  intercompany  accounts  and 
transactions.

2.

Summary of Significant Accounting Policies

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported 
amounts  of  assets  and  liabilities,  the  disclosure  of  contingent  assets  and  liabilities  at  the  date  of  the  consolidated  financial  statements  and  the  reported 
amounts of revenue and expenses during the reporting periods. In these consolidated financial statements, the Company uses estimates and assumptions 
related  to  revenue  recognition  and  the  accrual  of  research  and  development  expenses.  Estimates  are  periodically  reviewed  in  light  of  changes  in 
circumstances, facts and experience. Actual results could differ from the Company’s estimates.

Cash Equivalents

The  Company  considers  all  short-term,  highly  liquid  investments  with  original  maturities  of  90  days  or  less  at  acquisition  date  to  be  cash 
equivalents. Cash equivalents, which consist of money market accounts, commercial paper and corporate bonds purchased with original maturities of less 
than 90 days from the date of purchase, are stated at fair value.

F-9

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Investments

The  Company  classifies  all  of  its  marketable  debt  securities  as  available-for-sale  securities.  Accordingly,  these  marketable  debt  securities  are 
recorded  at  fair  value  and  unrealized  gains  and  losses  are  reported  as  a  separate  component  of  accumulated  other  comprehensive  loss  in  stockholders’ 
equity (deficit), unless the Company has determined that the security has experienced a credit loss, or the Company expects to sell the security prior to the 
recovery of its unrealized losses. In such cases a security is considered impaired, and adjusted through a charge to the consolidated statement of operations 
and  comprehensive  loss.  The  cost  of  securities  sold  is  determined  on  a  specific  identification  basis,  and  realized  gains  and  losses  are  included  in  other 
income  (expense)  within  the  consolidated  statement  of  operations  and  comprehensive  loss.  No  credit  losses  were  recorded  during  the  years  ended 
December 31, 2022, 2021, and 2020.

The Company classifies its available-for-sale marketable debt securities as current assets on the consolidated balance sheet if they mature within one 
year from the balance sheet date.  Any available-for-sale marketable debt securities with maturities greater than one year from the balance sheet date are 
classified as long-term assets on the consolidated balance sheet. 

Restricted Investments

The Company held investments of $1,401 as of December 31, 2022 and 2021, in a separate restricted bank account as a security deposit for the lease 
of  the  Company’s  headquarters  in  Cambridge,  Massachusetts.  The  Company  has  classified  these  deposits  as  long-term  restricted  investments  on  its 
consolidated balance sheet.

Restricted Cash

The Company held restricted cash of $8,185 and $8,000 as of December 31, 2022 and 2021, respectively, which represents cash held for the benefit 
of  the  landlord  for  the  Company's  other  leases.  The  Company  has  classified  the  restricted  cash  as  long-term  on  its  consolidated  balance  sheet  as  the 
underlying leases are greater than 1 year.

Cash, cash equivalents and restricted cash were comprised of the following (in thousands):

Cash and cash equivalents
Restricted cash, non-current

Total cash, cash equivalents and restricted cash

Concentration of Credit Risk

December 31,

2022

2021

  $

  $

163,030  
8,185  
171,215  

  $

  $

180,002  
8,000  
188,002  

Financial  instruments  that  potentially  expose  the  Company  to  concentrations  of  credit  risk  consist  primarily  of  cash,  cash  equivalents  and 
investments. The Company has all cash, cash equivalents and investments balances at accredited financial institutions, in amounts that exceed federally 
insured limits. The Company does not believe that it is subject to unusual credit risk beyond the normal credit risk associated with commercial banking 
relationships.

Fair Value Measurements

Certain assets and liabilities are carried at fair value in accordance with GAAP. Fair value is defined as the exchange price that would be received 
for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction 
between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and 
minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three 
levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable:

•

•

•

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

Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted 
prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by 
observable market data.

Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to determining the fair value of the 
assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques.

F-10

 
 
 
 
 
 
 
 
 
 
 
 
   
   
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

The Company’s cash equivalents and investments are carried at fair value, determined according to the fair value hierarchy described above. The 
Company’s  investments  in  certificates  of  deposit  are  carried  at  amortized  cost,  which  approximates  fair  value.  The  carrying  values  of  the  Company’s 
prepaid expenses and other current and non-current assets, accounts payable and accrued expenses approximate their respective fair values due to the short-
term nature of these assets and liabilities. The carrying value of the Company’s long-term debt approximates its fair value (a level 2 measurement) at each 
balance sheet date due to its variable interest rate, which approximates a market interest rate.

Property and Equipment

Property and equipment are stated at cost less accumulated depreciation. Depreciation expense is recognized using the straight-line method over the

useful life of the asset, which are as follows:

Laboratory equipment
Computer equipment, furniture and office equipment

Leasehold improvements

Estimated Useful Life (In 
Years)
5
3
Lesser of useful life
or lease term

Expenditures for repairs and maintenance of assets are charged to expense as incurred. Upon retirement or sale, the cost and related accumulated 

depreciation of assets disposed of are removed from the accounts and any resulting gain or loss is included in loss from operations.

Impairment of Long-Lived Assets

Long-lived assets consist of property and equipment and right-of-use assets associated with our lease agreements. All of the Company's long-lived 
assets are to be held and used and have definitive lives and accordingly are tested for recoverability whenever events or changes in business circumstances 
indicate  that  the  carrying  amount  of  the  assets  may  not  be  fully  recoverable.  Factors  that  the  Company  considers  in  deciding  when  to  perform  an 
impairment review include significant underperformance of the business in relation to expectations, significant negative industry or economic trends and 
significant changes or planned changes in the use of the assets. If an impairment review is performed to evaluate a long-lived asset for recoverability, the 
Company compares forecasts of undiscounted cash flows expected to result from the use and eventual disposition of the long-lived asset to its carrying 
value. An impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of an asset are less than its 
carrying amount. The impairment loss would be based on the excess of the carrying value of the impaired asset over its fair value, determined based on 
discounted cash flows. To date, the Company has not recorded any impairment losses on long-lived assets.

Research and Development Costs

Research  and  development  costs  are  expensed  as  incurred.  Research  and  development  expenses  include  salaries,  stock-based  compensation  and 
benefits of employees, third-party license fees and other operational costs related to the Company’s research and development activities, including allocated 
facility-related expenses and external costs of outside vendors engaged to conduct both preclinical studies and clinical trials.

Research Contract Costs and Accruals

The Company has entered into various research and development contracts with research institutions and other companies. These agreements are 
generally cancelable, and related payments are recorded as research and development expenses as incurred. The Company records accruals for estimated 
ongoing  research  costs.  When  evaluating  the  adequacy  of  the  accrued  liabilities,  the  Company  analyzes  progress  of  the  studies,  including  the  phase  or 
completion  of  events,  invoices  received  and  contracted  costs.  Significant  judgments  and  estimates  are  made  in  determining  the  accrued  and  prepaid 
balances at the end of any reporting period. Actual results could differ from the Company’s estimates. The Company’s historical accrual estimates have not 
been materially different from the actual costs.

Patent Costs

All patent-related costs incurred in connection with filing and prosecuting patent applications are expensed as incurred due to the uncertainty about 

the recovery of the expenditure. Amounts incurred are classified as general and administrative expenses.

F-11

 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Accounting for Stock-Based Compensation

The Company measures all stock options and other stock-based awards granted to employees, non-employees, and directors based on the fair value 
on the date of the grant and recognizes compensation expense of those awards over the requisite service period, which is generally the vesting period of the 
respective award. Generally, the Company issues stock options, restricted stock units and restricted stock awards with only service-based vesting conditions 
and records the expense for these awards using the straight-line method. For stock options or restricted stock units issued with performance-based vesting 
conditions, the stock compensation expense related to these awards is recognized based on the grant date fair value when achievement of the performance 
condition is deemed probable.

The Company classifies stock-based compensation expense in its consolidated statement of operations and comprehensive loss in the same manner 

in which the award recipient’s payroll costs are classified or in which the award recipients’ service payments are classified.

The  Company  accounts  for  forfeitures  of  stock-based  awards  as  they  occur  rather  than  applying  an  estimated  forfeiture  rate  to  stock-based 

compensation expense. 

The fair value of each stock option grant is estimated on the date of grant using the Black- Scholes option-pricing model. The Company estimates its 
expected  common  stock  volatility  based  on  its  historical  common  stock  volatility  for  the  same  time  period.  The  Company  uses  the  simplified  method 
prescribed by Securities and Exchange Commission Staff Accounting Bulletin No. 107, Share-Based Payment, to calculate the expected term of options 
granted to employees, non-employees and directors. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the 
time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the 
Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future. 

Revenue Recognition

The Company recognizes revenue in accordance with the guidance under ASC 606, Revenue from Contracts with Customers ("ASC 606"). ASC 606 
applies  to  all  contracts  with  customers,  except  those  contracts  that  are  within  the  scope  of  other  guidance,  such  as  leases,  insurance,  and  financial 
instruments.  The  Company  enters  into  agreements  that  are  within  the  scope  of  ASC  606,  under  which  the  Company  licenses  certain  of  the  Company’s 
product  candidates  and  performs  research  and  development  services  in  connection  with  such  arrangements.  The  terms  of  these  arrangements  typically 
include payment of one or more of the following: nonrefundable up-front fees, reimbursement of research and development costs, development, clinical, 
regulatory and commercial sales milestone payments, and royalties on net sales of licensed products.  Under ASC 606, an entity recognizes revenue when 
its customer obtains control of promised goods or services, in an amount that reflects the consideration which the entity expects to receive in exchange for 
those goods or services. When  determining  the  timing  and  extent  of  revenue  recognition  for  arrangements  that  the  Company  determines  are  within  the 
scope of ASC 606, the Company performs the following five steps: 

a.

b.

c.

d.

e.

identify the contract(s) with a customer; 

identify the performance obligations in the contract; 

determine the transaction price; 

allocate the transaction price to the performance obligations in the contract; and 

recognize revenue when (or as) the entity satisfies a performance obligation. 

The Company only applies the five-step model to contracts when it is probable that the entity will collect the consideration to which it is entitled in 

exchange for the goods or services transferred to the customer. 

F-12

 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

At contract inception, once the contract is determined to be within the scope of ASC 606, the Company assesses the goods or services promised 
within the contract to determine whether each promised good or service is a performance obligation. The promised goods or services in the Company’s 
arrangements typically consist of a license to the Company’s intellectual property and/or research and development services. The Company may provide 
options to additional items in such arrangements, which are accounted for as separate contracts when the customer elects to exercise such options, unless 
the  option  provides  a  material  right  to  the  customer.    Performance  obligations  are  promises  in  a  contract  to  transfer  a  distinct  good  or  service  to  the 
customer that (i) the customer can benefit from on its own or together with other readily available resources, and (ii) is separately identifiable from other 
promises in the contract. Goods or services that are not individually distinct performance obligations are combined with other promised goods or services 
until such combined group of promises meet the requirements of a performance obligation. 

The Company determines the transaction price based on the amount of consideration the Company expects to receive for transferring the promised 
goods  or  services  in  the  contract.  Consideration  may  be  fixed,  variable,  or  a  combination  of  both.  At  contract  inception  for  arrangements  that  include 
variable consideration, the Company estimates the probability and extent of consideration it expects to receive under the contract utilizing either the most 
likely  amount  method  or  expected  amount  method,  whichever  best  estimates  the  amount  expected  to  be  received.  The  Company  then  considers  any 
constraints on the variable consideration and includes in the transaction price variable consideration to the extent it is deemed probable that a significant 
reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently 
resolved.  

The Company then allocates the transaction price to each performance obligation based on the relative standalone selling price and recognizes as 
revenue the amount of the transaction price that is allocated to the respective performance obligation when (or as) control is transferred to the customer and 
the performance obligation is satisfied. For performance obligations which consist of licenses and other promises, the Company utilizes judgment to assess 
the nature of the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time 
and, if over time, the appropriate method of measuring progress. The Company evaluates the measure of progress each reporting period and, if necessary, 
adjusts the measure of performance and related revenue recognition.

The Company records amounts as accounts receivable when the right to consideration is deemed unconditional. When consideration is received, or 
such consideration is unconditionally due, from a customer prior to transferring goods or services to the customer under the terms of a contract, a contract 
liability is recorded for deferred revenue.  

The Company does not assess whether a contract has a significant financing component if the expectation at contract inception is that the period 
between payment by the customer and the transfer of the promised goods or services to the customer will be one year or less. Incremental costs of obtaining 
a contract are expensed as and when incurred if the expected period over which the Company would have amortized the asset is one year or less, or the 
amount is immaterial.

Collaboration Revenue

Arrangements  with  collaborators  may  include  licenses  to  intellectual  property,  research  and  development  services,  manufacturing  services  for 
clinical and commercial supply, and participation on joint steering committees. The Company evaluates the promised goods or services to determine which 
promises, or group of promises, represent performance obligations. In contemplation of whether a promised good or service meets the criteria required of a 
performance  obligation,  the  Company  considers  the  stage  of  development  of  the  underlying  intellectual  property,  the  capabilities  and  expertise  of  the 
customer relative to the underlying intellectual property, and whether the promised goods or services are integral to or dependent on other promises in the 
contract. When accounting for an arrangement that contains multiple performance obligations, the Company must develop judgmental assumptions, which 
may include market conditions, reimbursement rates for personnel costs, development timelines and probabilities of regulatory success to determine the 
stand-alone selling price for each performance obligation identified in the contract.  

When  the  Company  concludes  that  a  contract  should  be  accounted  for  as  a  combined  performance  obligation  and  recognized  over  time,  the 
Company must then determine the period over which revenue should be recognized and the method by which to measure revenue. The Company generally 
recognizes revenue using a cost-based input method.

Licenses of intellectual property

If a license to the Company’s intellectual property is determined to be distinct from the other performance obligations identified in the arrangement, 
the Company recognizes revenue allocated to the license when the license is transferred to the customer and the customer is able to use and benefit from the 
license.  For licenses that are bundled with other promises, the Company utilizes judgment 

F-13

 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

to assess the nature of the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point
in  time  and,  if  over  time,  the  appropriate  method  of  measuring  progress  for  purposes  of  recognizing  revenue  associated  with  the  bundled  performance 
obligation.  The Company evaluates the measure of progress each reporting period and, if necessary, adjusts the measure of progress and related revenue 
recognition.

Milestone Payments

At  the  inception  of  each  arrangement  that  includes  developmental  and  regulatory  milestone  payments,  the  Company  evaluates  whether  the 
achievement of each milestone specifically relates to the Company’s efforts to satisfy a performance obligation or transfer a distinct good or service within 
a performance obligation. If the achievement of a milestone is considered a direct result of the Company’s efforts to satisfy a performance obligation or 
transfer a distinct good or service and the receipt of the payment is based upon the achievement of the milestone, the associated milestone value is allocated 
to that distinct good or service, otherwise it will be allocated to all performance obligations of the arrangement based on the initial allocation. 

The Company evaluates each milestone to determine when and how much of the milestone to include in the transaction price.  The Company first 
estimates the amount of the milestone payment that the Company could receive using either the expected value or the most likely amount approach. The 
Company primarily uses the most likely amount approach as that approach is generally most predictive for milestone payments with a binary outcome. 
Then, the Company considers whether any portion of that estimated amount is subject to the variable consideration constraint (that is, whether it is probable 
that  a  significant  reversal  of  cumulative  revenue  would  not  occur  upon  resolution  of  the  uncertainty).  The  Company  updates  the  estimate  of  variable 
consideration included in the transaction price at each reporting date which includes updating the assessment of the likely amount of consideration and the 
application of the constraint to reflect current facts and circumstances. 

Royalties

For arrangements that include sales-based royalties, including milestone payments based on the level of sales, and the license is deemed to be the 
predominant  item  to  which  the  royalties  relate,  the  Company  will  recognize  revenue  at  the  later  of  (i)  when  the  related  sales  occur,  or  (ii)  when  the 
performance  obligation  to  which  some  or  all  of  the  royalty  has  been  allocated  has  been  satisfied  (or  partially  satisfied).  To  date,  the  Company  has  not 
recognized any revenue related to sales-based royalties or milestone payments based on the level of sales.

Manufacturing supply services

For  arrangements  that  include  a  promise  of  supply  of  clinical  or  commercial  product,  the  Company  determines  if  the  supply  is  a  promise  in  the 
contract or a future obligation at the customer’s option. If determined to be a promise at inception of the contract, the Company evaluates the promise to 
determine whether it is a separate performance obligation or a component of a bundled performance obligation. If determined to be an option, the Company 
determines if the option provides a material right to the customer and if so, accounts for the option as a separate performance obligation. If determined to be 
an option but not a material right, the Company accounts for the option as a separate contract when the customer elects to exercise the option.

Grant Revenue

The  Company  generates  revenue  from  government  contracts  that  reimburse  the  Company  for  certain  allowable  costs  for  funded  projects.  For 
contracts with government agencies, when the Company has concluded that it is the principal in conducting the research and development expenses, and 
where  the  funding  arrangement  is  considered  central  to  the  Company’s  ongoing  operations,  the  Company  classifies  the  recognized  funding  received  as 
revenue. 

The Company has concluded to recognize funding received as revenue, rather than as a reduction of research and development expenses, because 
the Company is the principal in conducting the research and development activities and these contracts are central to its ongoing operations. Revenue is 
recognized as the qualifying expenses related to the contracts are incurred. Revenue recognized upon incurring qualifying expenses in advance of receipt of 
funding  is  recorded  in  the  Company’s  consolidated  balance  sheet  as  accounts  receivable.  The  related  costs  incurred  by  the  Company  are  included  in 
research and development expense in the Company’s consolidated statements of operations and comprehensive loss. 

F-14

 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Collaboration Profit and Loss

We  analyze  our  collaboration  arrangements  to  assess  whether  they  are  within  the  scope  of  ASC  808,  Collaborative  Arrangements  ("ASC  808"), 
which  includes  determining  whether  such  arrangements  involve  joint  operating  activities  performed  by  parties  that  are  both  active  participants  in  the 
activities and exposed to significant risks and rewards dependent on the commercial success of such activities. This assessment is performed throughout the 
life of the arrangement based on changes in the responsibilities of all parties in the arrangement. For collaboration arrangements within the scope of ASC 
808 that contain multiple elements, we first determine which elements of the collaboration are deemed to be within the scope of ASC 808 and those that are 
more reflective of a vendor-customer relationship and therefore within the scope of ASC 606. For those elements of the arrangement that are accounted for 
pursuant  to  ASC  606,  we  apply  the  five-step  model  prescribed  in  ASC  606,  as  described  above.  For  elements  of  collaboration  arrangements  that  are 
accounted  for  pursuant  to  ASC  808,  an  appropriate  recognition  method  is  determined  and  applied  consistently,  generally  by  analogy  to  ASC  606.  In 
arrangements where we do not deem our collaborator to be our customer, up-front payments from our collaborator are presented in the consolidated balance 
sheets as liabilities, and adjusted as we perform activities pursuant to the collaboration arrangement. As the Company and its collaborator perform activities 
pursuant to the arrangement, amounts due to or from the Company or the collaborator, based on the relative contributions of activities of each party, are 
recognized in the consolidated statements of operations and comprehensive loss as an increase or reduction in operating expenses based on the nature of the 
payments.

Income Taxes

The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets and liabilities for 
the expected future tax consequences of events that have been recognized in the consolidated financial statements or in the Company’s tax returns. Deferred 
taxes are determined based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect in the 
years in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The 
Company assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the 
weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is 
established through a charge to income tax expense.

The Company applies ASC 740-10, Accounting for Uncertain Tax Positions. The Company accounts for uncertainty in income taxes recognized in 
the financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to 
determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more-likely-than-not to 
be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the financial statements. The amount of the benefit that 
may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes
includes  the  effects  of  any  resulting  tax  reserves,  or  unrecognized  tax  benefits,  that  are  considered  appropriate  as  well  as  the  related  net  interest  and 
penalties.

Segment Data

The  Company  manages  its  operations  as  a  single  segment  for  the  purposes  of  assessing  performance  and  making  operating  decisions.  The 
Company’s  singular  focus  is  on  developing  microbiome  therapeutics  to  treat  the  modulation  of  the  colonic  microbiome.  Revenue  to  date  has  been 
generated solely through the Company's agreements with its collaborators, all of which has been earned in the United States. All tangible assets are held in 
the United States.

Comprehensive Loss

Comprehensive loss includes net loss as well as other changes in stockholders’ equity (deficit) that result from transactions and economic events 
other than those with stockholders. For the years ended December 31, 2022, 2021 and 2020, other comprehensive income (loss) consisted of changes in 
unrealized gains (losses) from available-for-sale investments and a currency translation adjustment.

Net Loss per Share

Basic net loss per share is computed using the weighted average number of common shares outstanding during the period. Diluted net loss per share 
is computed using the sum of the weighted average number of common shares outstanding during the period and, if dilutive, the weighted average number 
of potential shares of common stock, including the assumed exercise of stock options and unvested restricted stock. The Company applies the two-class 
method to calculate its basic and diluted net loss per share attributable to common stockholders. The two-class method is an earnings allocation formula 
that treats a participating security as having rights to 

F-15

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

earnings  that  otherwise  would  have  been  available  to  common  stockholders.  However,  the  two-class  method  does  not  impact  the  net  loss  per  share  of 
common stock as the Company was in a net loss position for each of the periods presented.

The  Company’s  convertible  preferred  stock  contractually  entitle  the  holders  of  such  shares  to  participate  in  dividends  but  do  not  contractually 
require the holders of such shares to participate in losses of the Company. Similarly, restricted stock awards entitle the holder of such awards to dividends 
declared or paid by the board of directors, regardless of whether such awards are unvested, as if such shares were outstanding common shares at the time of 
the dividend. However, the unvested restricted stock awards are not entitled to share in the residual net assets (deficit) of the Company. Accordingly, in 
periods in which the Company reports a net loss attributable to common stockholders, diluted net loss per share attributable to common stockholders is the 
same as basic net loss per share attributable to common stockholders, since dilutive common shares are not assumed to have been issued if their effect is 
anti-dilutive.

Leases

In accordance with ASC 842, Leases, the Company determines if an arrangement is or contains a lease at inception. A contract is or contains a lease 
if the contract conveys the right to control the use of an identified asset for a period of time in exchange for consideration. The Company classifies leases at 
the lease commencement date as operating or finance leases and records a right-of-use asset and a lease liability on the consolidated balance sheet for all 
leases  with  an  initial  lease  term  of  greater  than  12  months.  Leases  with  an  initial  term  of  12  months  or  less  are  not  recorded  on  the  balance  sheet,  but 
payments are recognized as expense on a straight-line basis over the lease term. The Company has elected not to record a right-of-use asset or lease liability 
for leases with terms of 12 months or less. 

A lease qualifies as a finance lease if any of the following criteria are met at the inception of the lease: (i) there is a transfer of ownership of the leased asset 
to the Company by the end of the lease term, (ii) the Company holds an option to purchase the leased asset that it is reasonably certain to exercise, (iii) the 
lease term is for a major part of the remaining economic life of the leased asset, (iv) the present value of the sum of lease payments equals or exceeds 
substantially all of the fair value of the leased asset, or (v) the nature of the leased asset is specialized to the point that it is expected to provide the lessor no 
alternative use at the end of the lease term. 

The Company enters into contracts that contain both lease and non-lease components. Non-lease components may include maintenance, utilities, and other 
operating costs. The Company combines the lease and non-lease components of fixed costs in its lease arrangements as a single lease component. Variable 
costs, such as utilities or maintenance costs, are not included in the measurement of right-of-use assets and lease liabilities, but rather are expensed when 
the event determining the amount of variable consideration to be paid occurs.

Finance and operating lease assets and liabilities are recognized at the lease commencement date based on the present value of the lease payments over the 
lease term using the discount rate implicit in the lease. If the rate implicit is not readily determinable, the Company utilizes an estimate of its incremental 
borrowing rate based upon the available information at the lease commencement date. Operating lease assets are further adjusted for prepaid or accrued 
lease payments. Operating lease payments are expensed using the straight-line method as an operating expense over the lease term. The Company’s lease 
terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Finance lease assets are 
amortized  to  depreciation  expense  using  the  straight-line  method  over  the  shorter  of  the  useful  life  of  the  related  asset  or  the  lease  term.  Finance  lease 
payments are bifurcated into (i) a portion that is recorded as imputed interest expense and (ii) a portion that reduces the finance liability associated with the 
lease. 

Right-of-use assets and lease liabilities are reassessed and remeasured when amendments to the terms of the lease agreement require reassessment 
and  remeasurement  of  the  lease  payments  and  other  inputs  to  the  calculation  of  right-of-use  assets  and  lease  liabilities.  The  Company  accounts  for 
remeasurements and modifications to lease liabilities using the present value of remaining lease payments and estimated incremental borrowing rate at the 
date of remeasurement. The adjustment to the lease liability is recognized as a gain or loss in operating expenses, or as an adjustment to the right-of-use 
asset, as appropriate, based on the terms and conditions within the lease that are amended.  

Recently Adopted Accounting Pronouncements

In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial 

Instruments (‘‘ASU 2016-13’’), which requires the measurement and recognition of expected credit losses for 

F-16

 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

financial assets held at amortized cost. ASU 2016-13 replaces the existing incurred loss impairment model with an expected loss model. It also eliminates 
the concept of other-than-temporary impairment and requires credit losses related to available-for-sale debt securities to be recorded through an allowance 
for credit losses rather than as a reduction in the amortized cost basis of the securities. These changes may result in earlier recognition of credit losses. In 
November 2018, the FASB issued ASU No. 2018-19, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, which narrowed the 
scope  and  changed  the  effective  date  for  non-public  entities  for  ASU  2016-13.  The  FASB  subsequently  issued  supplemental  guidance  within  ASU  No. 
2019-05, Financial Instruments—Credit Losses (Topic 326): Targeted Transition Relief (‘‘ASU 2019-05’’). ASU 2019-05 provides an option to irrevocably 
elect  the  fair  value  option  for  certain  financial  assets  previously  measured  at  amortized  cost  basis.  For  public  entities  that  are  Securities  and  Exchange 
Commission  ("SEC")  filers,  excluding  entities  eligible  to  be  smaller  reporting  companies,  ASU  2016-13  is  effective  for  annual  periods  beginning  after 
December 15, 2019, including interim periods within those fiscal years.  For all other entities, ASU 2016-13 is effective for annual periods beginning after 
December  15,  2022,  including  interim  periods  within  those  fiscal  years.  Early  adoption  is  permitted.  The  Company  adopted  the  new  standard  using  a 
modified  retrospective  approach  as  of  January  1,  2022.    The  adoption  of  this  standard  did  not  have  a  material  impact  on  the  Company's  consolidated 
financial statements. 

Recently Issued Accounting Pronouncements

The Company has considered all recent accounting pronouncements issued. The Company’s management believes that these recent pronouncements 

will not have a material effect on the Company’s financial statements.

3.

Fair Value of Financial Assets and Liabilities

The following tables present the Company’s fair value hierarchy for its assets and liabilities that are measured at fair value on a recurring basis (in 

thousands):

Cash Equivalents:

Money market funds
Commercial paper
Government securities

Investments:

Commercial paper
Corporate bonds
Government securities

Cash Equivalents:

Money market funds
Commercial paper

Investments:

Commercial paper
Corporate bonds
Government securities

Fair Value Measurements as of December 31, 2022 Using:

Level 1

Level 2

Level 3

Total

  $

  $

  $

  $

  $

  $

47,863     $
—      
—      

—     $
—      
—      
  $

47,863  

—     $
11,691      
4,966      

2,465     $
2,957      
12,889      
34,968     $

—     $
—      
—      

—     $
—      
—      
—     $

47,863  
11,691  
4,966  

2,465  
2,957  
12,889  
82,831  

Fair Value Measurements as of December 31, 2021 Using:

Level 1

Level 2

Level 3

Total

70,322     $
—    

—     $
—    
—    

70,322  

  $

—     $
3,999      

6,250     $
40,095      
64,854      
  $
115,198  

—     $
—      

—     $
—      
—      
  $
—  

70,322  
3,999  

6,250  
40,095  
64,854  
185,520  

Money  market  funds  are  valued  by  the  Company  based  on  quoted  market  prices,  which  represent  a  Level  1  measurement  within  the  fair  value 
hierarchy.  Commercial  paper,  corporate  bonds,  and  government  securities  are  valued  by  the  Company  using  quoted  prices  in  active  markets  for  similar 
securities, which represent a Level 2 measurement within the fair value hierarchy. There were no transfers between Level 1 or Level 2 during the years 
ended December 31, 2022 and 2021.

F-17

 
 
 
 
 
 
 
 
 
   
   
 
 
     
     
       
 
   
   
 
     
     
     
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
       
 
   
 
 
     
     
     
   
   
 
   
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

As of December 31, 2022 and 2021 the Company held a restricted investment of $1,401, which represents a certificate of deposit that is classified as 

Level 2 in the fair value hierarchy.

4.

Investments

Investments by security type consisted of the following at December 31, 2022 and 2021 (in thousands):

Investments:

Commercial paper
Corporate bonds
Government securities

Investments:

Commercial paper
Corporate bonds
Government securities

Amortized
Cost

Gross
Unrealized Gain

Gross
Unrealized Loss

Fair
Value

December 31, 2022

  $

  $

2,465     $
2,958    
12,898    
18,321     $

—     $
—    
3    
3     $

—     $
(1 )  
(12 )  
(13 )   $

2,465  
2,957  
12,889  
18,311  

Amortized
Cost

Gross
Unrealized Gain

Gross
Unrealized Loss

Fair
Value

December 31, 2021

  $

  $

6,250     $
40,123      
64,885      
111,258     $

—     $
—      
—      
—     $

—     $
(28 )    
(31 )    
(59 )   $

6,250  
40,095  
64,854  
111,199  

Investments with original maturities of less than 90 days are included in cash and cash equivalents on the consolidated balance sheets and are not 
included in the table above. Investments with maturities of less than twelve months are considered current assets and those investments with maturities 
greater than twelve months are considered non-current assets.

Excluded from the tables above at December 31, 2022 and 2021 are restricted investments of $1,401, as the cost approximates current fair value. 

The amortized cost and fair value of investments in commercial paper, corporate bonds, and government securities by contractual maturity, as of 

December 31, 2022  and were as follows (in thousands):

Due in 1-year or less
Due after 1-year through 5-years

Available-for-Sale

Cost

Fair Value

  $

  $

18,321     $
—    
18,321     $

18,311  
—  
18,311  

The amortized cost and fair value of investments in commercial paper, corporate bonds, and government securities by contractual maturity, as of 

December 31, 2021 were as follows (in thousands):

Due in 1-year or less
Due after 1-year through 5-years

Available-for-Sale

Cost

Fair Value

  $

  $

110,762     $
496    
111,258     $

110,704  
495  
111,199  

F-18

 
  
 
 
 
 
 
   
   
   
 
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
     
     
     
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

5.

Property and Equipment, Net

Property and equipment, net consisted of the following:

Laboratory equipment
Computer equipment
Furniture and office equipment
Leasehold improvements
Construction in progress

Less: Accumulated depreciation and amortization

December 31,

2022

2021

24,533     $
3,557      
3,491      
32,474      
3,970      
68,025      
(45,040 )    
22,985     $

19,137  
3,255  
1,219  
32,925  
1,670  
58,206  
(40,268 )
17,938  

  $

  $

Depreciation and amortization expense was $6,629, $5,947 and $6,578 for the years ended December 31, 2022, 2021 and 2020, respectively. During 

the year ended December 31, 2022, the Company disposed of certain fully-depreciated assets with a cost basis of $1,857.

6.

Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following:

Development and manufacturing costs
Payroll and payroll-related costs
Liability related to 2021 License Agreement (Note 11)
Facility and other

December 31,

2022

2021

  $

  $

6,717     $
14,709      
34,770      
3,644      
59,840     $

11,147  
9,216  
21,098  
3,633  
45,094  

7.

Leases 

The Company leases real estate, primarily laboratory, office and manufacturing space. The Company’s leases have remaining terms ranging from 
approximately two to ten years. Certain leases include one or more options to renew, exercisable at the Company’s sole discretion, with renewal terms that 
can extend the lease from approximately one year to five years. The Company evaluated the renewal options in its leases to determine if it was reasonably 
certain that the renewal option would be exercised, given the Company’s current business structure, uncertainty of future growth, and the associated impact 
to real estate, the Company concluded that it is not reasonably certain that any renewal options would be exercised. Therefore, the operating lease assets 
and operating lease liabilities only contemplate the initial lease terms. All the Company’s leases qualify as operating leases.

In  July  2021,  the  Company  entered  into  a  lease  agreement  for  a  donor  collection  facility  in  Tempe,  Arizona  with  a  lease  term  of  ten  years, 
commencing in March 2022, subject to certain renewal options, which are not deemed reasonably certain. Minimum lease payments total $4,052, net of 
tenant  improvement  allowance  of  $770,  through  the  lease  term.  At  lease  commencement,  the  Company  recorded  a  right-of-use  asset  of  $5,900,  which 
consists of the lease liability of $2,327 and $3,573 of leasehold improvements that revert back to the lessor at the termination of the lease.

In August 2021, the Company entered into a lease for additional office and laboratory space in Waltham, Massachusetts with a lease term of ten 
years, commencing in two phases in October 2021 and March 2022, respectively, with a third and final phase for laboratory space, not yet commenced at 
December  31,  2022.  Minimum  lease  payments  for  the  two  phases  that  commenced  in  2022  total  $12,125  and  $2,449,  respectively,  net  of  tenant 
improvement allowance of $767 for the laboratory space, through the lease term. At each lease commencement, the Company recorded right-of-use assets 
of $7,602  and  $2,662,  respectively,  which  consist  of  the  lease  liability  of  $7,602  for  the  office  space,  and  the  lease  liability  of  $1,273  and  $1,389  of 
leasehold improvements that revert back to the lessor at the termination of the lease for the laboratory space. The lease is subject to certain renewal options, 
which are not deemed reasonably certain at commencement of the first two phases.

In September 2021, the Company entered into a lease for additional laboratory and office space in Cambridge, Massachusetts with a lease term of 

ten years and a renewal option for an additional seven-year term. The lease commenced in December 2022, and the 

F-19

 
 
 
 
 
 
 
   
 
   
   
   
   
 
   
   
 
 
 
 
 
 
 
 
 
 
   
 
   
   
   
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

renewal  option  was  not  deemed  reasonably  certain  of  exercise.  Minimum  lease  payments  total  $101,548  throughout  the  lease  term.  At  lease 
commencement,  the  Company  recorded  a  right-of-use  asset  of  $56,065,  which  consists  of  the  lease  liability  of  $54,206  and  $1,859  of  leasehold 
improvements that revert back to the lessor at the termination of the lease.

In April 2022, the Company entered into a lease for additional laboratory and office space in Spring House, Pennsylvania, with a lease term of ten 
years and a renewal option, subject to certain conditions, for an additional five-year term. The undiscounted minimum lease payments are $2,980, net of a 
tenant improvement allowance of $1,223, over the original ten-year term. As of December 31, 2022, the lease has not yet commenced, and accordingly the 
Company has not recorded a right-of-use asset or a lease liability with respect thereto.

In  December  2022,  the  Company  amended  its  lease  of  its  corporate  headquarters  in  Cambridge,  Massachusetts  (the  "Lease  Amendment").  The 
Lease Amendment reduced the office space subject to the lease while maintaining the laboratory and manufacturing space and extended the term to begin 
in November 2023, when the term of the original lease concludes, and continue through January 2030. The Company accounted for the Lease Amendment 
as a modification to the existing lease and not a new contract separate from the existing contract, and accordingly increased the associated lease liability 
and  right-of-use  asset  by  $32,837.  Minimum  lease  payments  total  $60,022  throughout  the  term  of  the  Lease  Amendment,  net  of  a  tenant  improvement 
allowance of $1,000.  

The Company has committed to restore the leased space subject to the Lease Amendment to the condition specified in the original lease, and the 
Company updated its estimate of the costs required to fulfill this obligation in accordance with ASC 410, Asset Retirement Obligations, at the effective date 
of the modification. Based on current estimates, the Company recorded an additional asset retirement obligation of $452 in December 2022. 

The following table summarizes the presentation in the Company’s consolidated balance sheets of its operating leases:

Assets:
Operating lease assets

Liabilities:
Operating lease liabilities
Operating lease liabilities, net of current portion

Total operating lease liabilities

December 31,

2022

2021

  $

110,984  

  $

18,208  

  $

  $

3,601  
107,942  
111,543  

  $

  $

6,610  
17,958  
24,568  

The following table summarizes the effect of lease costs in the Company’s consolidated statement of operations and comprehensive loss:

Operating lease costs

Short-term lease costs

Variable lease costs

Sublease income

Total lease costs

2022

Year Ended December 31,
2021

2020

  $

  $

8,830     $
1,375    
4,547    
—    
14,752     $

5,170     $
1,452    
3,300    
(1,575 )  
8,347     $

4,163  

1,457  

2,890  
(1,813 )
6,697  

 During the years ended December 31, 2022, 2021, and 2020, the Company made cash payments for operating leases of $7,809, $6,821 and $6,302, 

respectively.

F-20

 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
   
 
 
   
 
   
 
   
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

As of December 31, 2022, future payments of operating lease liabilities are as follows (in thousands):

2023
2024
2025
2026
2027 and thereafter
Total future payments of operating lease liabilities

Less: imputed interest

Present value of operating lease liabilities

As of December 31, 2022  
16,815  
19,055  
21,164  
21,755  
108,383  
187,172  
(75,629 )
111,543  

  $

  $

  $

As of December 31, 2022, the weighted average remaining lease term was 8.92 years and the weighted average incremental borrowing rate used to 
determine the operating lease liability was 13%.  As of December 31, 2021, the weighted average remaining lease term was 6.12 years and the weighted 
average incremental borrowing rate used to determine the operating lease liability was 10%.  

8.

Notes Payable

On  October  29,  2019  (the  “Closing  Date”),  the  Company  entered  into  the  Loan  Agreement  with  Hercules  pursuant  to  which  a  term  loan  in  an 
aggregate principal amount of up to $50,000 (the “Original Credit Facility”) was available to the Company in three tranches, subject to certain terms and 
conditions. The first tranche of $25,000 was advanced to the Company on the Closing Date. The Company did not meet the milestone requirements for the 
second tranche under the Original Credit Facility, and as such, the additional amount of up to $12,500 was not available for the Company to borrow. The 
Company  elected  not  to  borrow  the  third  tranche  of  $12,500,  which  was  available  upon  Hercules’  approval  until  June  30,  2021.  Advances  under  the 
Original Credit Facility will bear interest at a rate equal to the greater of either (i) the Prime Rate (as reported in The Wall Street Journal) plus 4.40%, and 
(ii) 9.65%. Following an interest-only period of 24 months, principal payments are due in 24 equal monthly installments commencing December 1, 2021 
and ending November 1, 2023.

Effective  as  of  February  24,  2022  (the  “Effective  Date”),  the  Company  entered  into  an  Amendment  to  the  Loan  and  Security  Agreement  (the 
“Amendment”),  with  the  lenders  party  thereto  (the  “Lenders”),  and  Hercules  in  its  capacity  as  the  administrative  agent  and  the  collateral  agent  for  the 
Lenders,  which  amended  the  Original  Credit  Facility.  Pursuant  to  the  Amendment,  term  loans  in  an  aggregate  principal  amount  of  up  to  $100,000 (the 
“New Credit Facility”) became available to the Company in five tranches, subject to certain terms and conditions.

The first tranche in an aggregate principal amount of $25,000 was outstanding as of the Effective Date, after taking into account reborrowing by the 
Company on the Effective Date of a previously-repaid principal amount of approximately $2,900. The second tranche in an aggregate principal amount of 
$12,500 and the third tranche in an aggregate principal amount of $12,500 have been advanced to the Company and were outstanding as of the Effective 
Date. The fourth tranche in an aggregate principal amount of $25,000 is available upon satisfaction of certain conditions, including the approval by the 
FDA of a biologics license application in respect of SER-109 (the "Regulatory Approval Milestone") by no later than December 15, 2023. The fifth tranche 
in an aggregate principal amount of up to $25,000 is available through the Amortization Date (as defined below) upon satisfaction of certain conditions, 
including the Lenders’ investment committee approval.

All advances outstanding under the New Credit Facility will bear interest at a rate equal to the greater of either (i) the Prime Rate (as reported in The 
Wall  Street  Journal)  plus  6.40%,  and  (ii)  9.65%.  For  all  advances  outstanding  under  the  New  Credit  Facility,  the  Company  will  make  interest  only 
payments through December 31, 2023, extendable to December 31, 2024 upon satisfaction of certain conditions (such applicable date, the “Amortization 
Date”). The principal balance and interest of the advances will be repaid in equal monthly installments after the Amortization Date and continuing through 
October 1, 2024, extendable to October 1, 2025, upon satisfaction of certain conditions (such applicable date, the “Maturity Date”).  

The Company may prepay advances under the New Credit Facility, in whole or in part, at any time subject to a prepayment charge equal to: (a) 2.0% 
of amounts so prepaid, if such prepayment occurs during the first year following the Effective Date; (b) 1.5% of the amount so prepaid, if such prepayment 
occurs  during  the  second  year  following  the  Effective  Date,  and  (c)  1.0%  of  the  amount  so  prepaid,  if  such  prepayment  occurs  during  the  third  year 
following the Effective Date.  

The Company will pay an end of term charge of 4.85% of the aggregate amount of the advances made under the Original Credit Facility on the 
earliest date of (i) November 1, 2023; (ii) the date that the Company prepays all of the outstanding principal in full, or (iii) the date the loan payments are 
accelerated due to an event of default. The Company will pay an additional end of term charge of 1.75% of the aggregate amount of the advances under the 
New Credit Facility (including the first tranche of $25,000) on the earliest 

F-21

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

date  of  (i)  the  Maturity  Date;  (ii)  the  date  that  the  Company  prepays  all  of  the  outstanding  principal  in  full,  or  (iii)  the  date  the  loan  payments  are 
accelerated due to an event of default. 

Other terms of the New Credit Facility remain generally identical to those under the Original Credit Facility, with certain covenants amended by the 
Amendment to provide the Company with additional operational flexibility, including the ability for the Company to issue up to $350,000 in convertible 
notes. The New Credit Facility includes a conditional liquidity covenant commencing on June 15, 2023, which ceases to apply if certain conditions are 
satisfied.  

The New Credit Facility is secured by substantially all of the Company’s assets, other than the Company’s intellectual property. The Company has 

agreed to not pledge or secure its intellectual property to others. 

The Company accounted for the New Credit Facility as a modification in accordance with the guidance in ASC 470-50, Debt. Amounts paid to the 
lenders were recorded as debt discount and a new effective interest rate was established. Upon issuance, the New Credit Facility was recorded as a liability 
with an initial carrying value of $50,586, net of debt issuance costs. The initial carrying value will be accreted to the repayment amount, which includes the 
outstanding principal plus the end of term charge, through interest expense using the effective interest rate method over the term of the Loan Agreement. 
As of December 31, 2022, the carrying value of the New Credit Facility is $51,047 and the effective interest rate in effect is 15.01%.  As of December 31, 
2021, the carrying value of the New Credit Facility was $24,643, and the effective interest rate in effect was 11.47%. The New Credit Facility is classified 
as a long-term liability on the consolidated balance sheet.

The future principal payments due under the New Credit Facility, excluding interest and the end of term charge, are as follows:

Year Ending December 31,
2023
2024

Total

Principal

—  
50,000  
50,000  

  $
  $

During  the  years  ended  December  31,  2022  and  2021,  the  Company  recognized  $6,020  and  $2,910  of  interest  expense  related  to  the  Loan 

Agreement, respectively, which is reflected in interest expense on the consolidated statement of operations and comprehensive loss.

9.

Convertible Preferred Stock

On July 1, 2015, in connection with the closing of the initial public offering of the Company’s common stock (“IPO”), the Company effected its 

Restated Certificate of Incorporation, which authorizes the Company to issue 10,000,000 shares of preferred stock, $0.001 par value per share.

10.

Common Stock and Stock-Based Awards

On July 1, 2015, in connection with the closing of the IPO, the Company effected its Restated Certificate of Incorporation, which authorizes the 

Company to issue 200,000,000 shares of common stock, $0.001 par value per share.

In  November  2019,  the  Company  entered  into  a  common  stock  sales  agreement,  or  the  2019  Sales  Agreement,  with  Cowen  to  sell  shares  of  the 
Company's common stock with aggregate gross sales proceeds of up to $25,000, from time to time, through an "at the market" equity offering program, or 
ATM, under which Cowen acts as sales agent.  In March 2020, in connection with filing an updated registration statement on Form S-3 (File No. 333-
237033), the Company entered into a new common stock sales agreement, or the 2020 Sales Agreement, with Cowen on substantially the same terms as the 
2019 Sales Agreement and terminated the 2019 Sales Agreement. In May 2021, the Company entered into a new common stock sales agreement, or the 
2021 Sales Agreement, with Cowen to sell shares of its common stock with aggregate gross sales proceeds of up to $150,000, from time to time, through 
an ATM under which Cowen acts as sales agent, and terminated the 2020 Sales Agreement.  During the year ended December 31, 2022, the Company sold 
approximately 655,000 shares of common stock under the 2021 Sales Agreement, at an average price of approximately $7.26 per share, raising aggregate 
net  proceeds  of  approximately  $4,447  after  deducting  an  aggregate  commission  of  approximately  3%  and  other  issuance  costs.  During  the  year  ended 
December 31, 2021, the Company did not sell any shares of common stock under the 2020 Sales Agreement or the 2021 Sales Agreement. During the year 
ended  December  31,  2020,  the  Company  sold  approximately  5,788,000  shares  of  common  stock  under  the  2019  Sales  Agreement  and  the  2020  Sales 
Agreement, as applicable, at an average price of approximately 

F-22

 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

$4.40 per share, raising aggregate net proceeds of approximately $24,773 after deducting an aggregate commission of approximately 3% and other issuance 
costs.  

On August 12, 2020, the Company entered into an underwriting agreement (the “Underwriting Agreement”) with Cowen and Company, LLC and 
Piper Sandler & Co., as representatives of the several underwriters named therein (collectively, the “Underwriters”), in connection with the issuance and 
sale  by  the  Company  in  a  public  offering  of  10,500,000  shares  of  the  Company’s  common  stock  at  a  public  offering  price  of  $21.50  per  share,  less 
underwriting discounts and commissions, pursuant to an effective shelf registration statement on Form S-3 (Registration No. 333-244401) and a related 
prospectus supplement filed with the SEC (such public offering, the “offering”). Under the terms of the Underwriting Agreement, the Company granted the 
Underwriters  an  option  exercisable  for  30  days  to  purchase  up  to  an  additional  1,575,000  shares  of  its  common  stock  at  the  public  offering  price,  less 
underwriting discounts and commissions, which the underwriters exercised in full.  The Company received aggregate net proceeds from the offering of 
approximately $243,748 after deducting underwriting discounts and commissions and offering expenses payable by the Company.

Additionally on August 12, 2020, the Company entered into a Securities Purchase Agreement (the “Securities Agreement”) with Nestlé for the sale 
by the Company of 959,002 shares of the Company’s common stock at a purchase price of $20.855 per share (the “concurrent placement”). The Company 
received aggregate net proceeds from the concurrent placement of approximately $19,900 after deducting offering expenses payable by the Company.  The 
consummation of the concurrent placement was contingent upon the closing of the offering and the satisfaction of certain other customary conditions. The 
shares  were  offered  and  sold  to  Nestlé  pursuant  to  an  effective  registration  statement  on  Form  S-3  (File  No.  333-237033)  and  a  related  prospectus 
supplement filed with the SEC.

On June 29, 2022, the Company entered into securities purchase agreements with new and existing investors and certain directors and officers in a 
registered direct offering, or the Registered Direct Offering, of an aggregate of 31,746,030 shares of its common stock at a purchase price of $3.15 per 
share for total net proceeds of approximately $96,721, after deducting placement agent’s fees and other estimated offering expenses. Net proceeds included 
an aggregate of $27,525  received  from  Flagship  Pioneering  Fund  VII,  L.P.  and  Nutritional  Health  LTP  Fund,  L.P.,  affiliates  of  Flagship  Pioneering,  or 
Flagship, one of its significant stockholders, in exchange for 8,738,243 shares. The closing date of the Registered Direct Offering was July 5, 2022.

2012 Stock Incentive Plan

The Company’s 2012 Stock Incentive Plan, as amended, (the “2012 Plan”) provided for the Company to sell or issue common stock or restricted 
common stock, or to grant incentive stock options or nonqualified stock options for the purchase of common stock, to employees, members of the board of 
directors  and  consultants  of  the  Company.  The  2012  Plan  is  administered  by  the  board  of  directors,  or  at  the  discretion  of  the  board  of  directors,  by  a 
committee of the board of directors. The exercise prices, vesting and other restrictions are determined at the discretion of the board of directors, or their 
committee if so delegated, except that the exercise price per share of stock options may not be less than 100%  of  the  fair  market  value  of  the  share  of 
common stock on the date of grant and the term of stock option may not be greater than ten years. The Company generally granted stock-based awards with 
service conditions only (“service-based” awards).

Stock options granted under the 2012 Plan generally vest over four years and expire after ten years, although options have been granted with vesting 

terms less than four years. As of December 31, 2022, there were no shares available for future grant under the 2012 Plan.

2015 Incentive Award Plan

On June 16, 2015, the Company’s stockholders approved the 2015 Incentive Award Plan (the “2015 Plan”), which became effective on June 25, 
2015. The 2015 Plan was subsequently amended on December 14, 2022, and provides for the grant of incentive stock options, nonqualified stock options, 
stock appreciation rights, restricted stock awards, restricted stock units and other stock-based awards. The number of shares initially reserved for issuance 
under the 2015 Plan was the sum of (i) 2,200,000 shares of common stock and (ii) the number of shares subject to awards outstanding under the 2012 Plan 
that expire, terminate or are otherwise surrendered, canceled, forfeited or repurchased by the Company on or after the effective date of the 2015 Plan. In 
addition,  the  number  of  shares  of  common  stock  that  may  be  issued  under  the  2015  Plan  is  subject  to  increase  on  the  first  day  of  each  calendar  year, 
beginning in 2016 and ending in 2025, equal to the lesser of (i) 4% of the number of shares of the Company’s common stock outstanding on the last day of 
the preceding applicable calendar year and (ii) an amount determined by the Company’s board of directors.  

Stock awards granted under the 2015 Plan generally vest over four years and expire after ten years, although options have been granted with vesting 

terms less than four years. As of December 31, 2022, there were 967,206 shares available for future grant under the 2015 Plan.

F-23

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

2015 Employee Stock Purchase Plan

On June 16, 2015, the Company’s stockholders approved the 2015 Employee Stock Purchase Plan (the “ESPP”), which became effective on June 
25, 2015. A total of 365,000 shares of common stock were reserved for issuance under the ESPP. In addition, the number of shares of common stock that 
may be issued under the ESPP automatically increase on the first day of each calendar year, beginning in 2016 and ending in 2025, by an amount equal to 
the lesser of (i) 400,000 shares, (ii) 1% of the number of shares of the Company’s common stock outstanding on the last day of the applicable preceding 
calendar year and (iii) an amount determined by the Company’s board of directors. Offering periods under the ESPP will commence when determined by 
the  plan  administrator.  During  the  year  ended  and  as  of  December  31,  2022,  there  were  322,560 shares issued and 2,469,204  shares  were  reserved  and 
available for issuance under the ESPP, respectively.

The ESPP provides that eligible employees may contribute up to 15% of their eligible earnings toward the semi-annual purchase of the Company's 
common stock. The ESPP is qualified under Section 423 of the Internal Revenue Code. The employee's purchase price is derived from a formula based on 
the closing price of the common stock on the first day of the offering period versus the closing price on the date of purchase (or, if not a trading day, on the 
immediately preceding trading day).  The offering period under the ESPP has a duration of six months, and the purchase price with respect to each offering 
period beginning on or after such date is, until otherwise amended, equal to 85% of the lesser of (i) the fair market value of the Company's common stock 
at the commencement of the applicable six-month offering period or (ii) the fair market value of the Company's common stock on the purchase date. 

2022 Employment Inducement Award Plan

On  December  14,  2022,  the  Company’s  board  of  directors  approved  the  2022  Employment  Inducement  Award  Plan  (the  "2022  Plan"),  which 
became effective on such date without stockholder approval pursuant to Rule 5635(c)(4) of The Nasdaq Stock Market LLC listing rules (“Rule 5635(c)
(4)”). The 2022 Plan provides for the grant of nonqualified stock options, stock appreciation rights, restricted stock awards, restricted stock units and other 
stock- or cash-based awards. In accordance with Rule 5635(c)(4), awards under the 2022 Plan may only be made to a newly hired employee who has not 
previously  been  a  member  of  our  board  of  directors,  or  an  employee  who  is  being  rehired  following  a  bona  fide  period  of  non-employment  by  us  as  a 
material inducement to the employee’s entering into employment with us. A total of 2,500,000 shares of common stock were reserved for issuance under 
the  2022  Plan.  Any  shares  subject  to  awards  previously  granted  under  the  2022  Plan  that  expire,  terminate  or  are  otherwise  surrendered,  canceled,  or 
forfeited in any case, in a manner that results in the Company acquiring the shares covered by the award at a price not greater than the price (as adjusted to 
reflect any equity restructuring) paid by the Participant for such shares or not issuing any shares covered by the award, the unused shares covered by the 
award will again be available for award grants under the 2022 Plan.   

As of December 31, 2022, there were no awards outstanding and 2,500,000 shares available for future grant under the 2022 Plan.

Stock Options

The following table summarizes the Company’s stock option activity for the year ended December 31, 2022:

Outstanding as of December 31, 2021

Granted
Exercised
Forfeited

Outstanding as of December 31, 2022

Options exercisable as of December 31, 2022

Number of
Shares

Weighted
Average
Exercise
Price

Weighted
Average
Remaining
Contractua
l
Term

    (in years)

Aggregate
Intrinsic
Value

11,517,189    $
4,527,897     
(326,864 )   
(778,188 )   
14,940,034    $
7,441,253    $

11.10     
6.89    
2.96    
10.62    

10.03     

10.38     

7.42    $

28,007  

7.25    $

5.88    $

11,608  

8,115  

The weighted average grant-date fair value of stock options granted during the years ended December 31, 2022, 2021 and 2020 was $5.53, $15.33, 
and $5.08 per share, respectively. The total intrinsic value of stock options exercised during the years ended December 31, 2022, 2021, and 2020 was $981, 
$4,727, and $37,255, respectively.

F-24

 
 
 
 
   
   
   
 
 
 
 
   
 
   
 
 
  
  
     
   
  
     
   
  
     
   
  
  
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the 

Company’s common stock for those stock options that had exercise prices lower than the fair value of the Company’s common stock.

During the year ended December 31, 2021, the Company granted performance-based stock options to employees for the purchase of an aggregate of 
562  thousand  shares  of  common  stock  with  a  grant  date  fair  value  of  $5.53  per  share.  These  stock  options  are  exercisable  only  upon  achievement  of 
specified performance targets. As of December 31, 2022, none of these options were exercisable because none of the specified performance targets had 
been achieved. Because achievement of the specified performance targets was not deemed probable as of December 31, 2022, the Company did not record 
any expense for these stock options from the dates of issuance through December 31, 2022.

Restricted Stock Units

The  Company  has  granted  restricted  stock  units  ("RSUs")  with  service-based  vesting  conditions.  RSUs  represent  the  right  to  receive  shares  of 
common stock upon meeting specified vesting requirements. Restricted stock units may not be sold or transferred by the holder and vest according to the 
vesting conditions of each award. The table below summarizes the Company’s RSU activity for the year ended December 31, 2022: 

Unvested restricted stock units as of December 31, 2021

Granted
Forfeited
Vested

Unvested restricted stock units as of December 31, 2022

Number
of Shares

Weighted
Average Grant
Date Fair Value

734,755     $
1,302,844     $
(205,658 )   $
(282,401 )   $
1,549,540     $

17.68  
6.95  
11.82  
18.06  

9.37  

During  the  years  ended  December  31,  2022,  2021  and  2020,  the  Company  granted  1,302,844,  768,998  and  6,500  RSUs,  respectively.  RSUs 
generally vest over four years, with 25% vesting after one year, and the remaining 75% vesting quarterly over the next 3 years, subject to continued service 
to the Company through the applicable vesting date.

The aggregate intrinsic value of restricted stock units that vested during the years ended December 31, 2022, 2021 and 2020 was $1,809, $16, and 

$532, respectively. 

During the year ended December 31, 2021, the Company granted performance-based restricted stock awards to two employees for the purchase of 
an aggregate of 85,000 shares of common stock with a grant date fair value of $9.59 per share and 40,000 shares with a grant date fair value of $20.35 per 
share. These restricted stock awards vest only upon achievement of specified performance targets. As of December 31, 2021, these awards were not vested 
because  the  specified  performance  targets  had  not  been  achieved.  In  addition,  the  performance  targets  were  not  deemed  probable  of  achievement. 
Accordingly, the Company did not record any expense for these awards from the dates of issuance through December 31, 2021. In October 2022, 42,500 of 
the awards with a grant date fair value of $9.59, and 20,000 of the awards with a grant date fair value of $20.35, vested fully, as the associated performance 
targets were achieved. Accordingly, the Company recorded $815 in compensation expense during the year ended December 31, 2022, with respect to these 
awards. As of December 31, 2022, the remaining performance-based restricted stock awards in these grants were not vested because the associated  targets 
had  not  been  achieved.  In  addition,  the  performance  targets  were  not  deemed  probable  of  achievement.  Accordingly,  the  Company  did  not  record  any 
expense for these remaining awards from the dates of issuance through December 31, 2022. 

F-25

 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Stock-based Compensation Valuation

The  assumptions  that  the  Company  used  to  determine  the  fair  value  of  the  stock  options  granted  to  employees  and  directors  were  as  follows, 

presented on a weighted average basis:

Risk-free interest rate
Expected term (in years)
Expected volatility
Expected dividend yield

2022

Year Ended December 31,
2021

2020

1.67 %   
6.0      
104.0 %   
0 %   

0.73 %   
5.4      
106.5 %   
0 %   

1.26 %
6.0  
73.3 %
0 %

The Company estimates the fair value of rights to acquire common stock under the ESPP using a Black-Scholes valuation model on the date of grant 
and the straight-line attribution approach to recognize the expense. The assumptions that the Company used to determine the fair value of rights to acquire 
common stock under the ESPP were as follows, presented on a weighted average basis:

Risk-free interest rate
Expected term (in years)
Expected volatility
Expected dividend yield

Stock-based Compensation

2022

Year Ended December 31,
2021

2020

2.11 %   
0.5      
99.0 %   
0 %   

0.97 %   
0.5      
123.8 %   
0 %   

1.20 %
0.5  
74.9 %
0 %

The Company recorded stock-based compensation expense related to stock options and restricted stock units in the following expense categories of 

its consolidated statements of operations and comprehensive loss:

Research and development expenses
General and administrative expenses

2022

Year Ended December 31,
2021

2020

  $

  $

13,429     $
12,053      
25,482     $

10,146     $
10,076      
20,222     $

4,760  
4,064  
8,824  

As  of  December  31,  2022,  the  Company  had  an  aggregate  of  $57,005  of  unrecognized  stock-based  compensation  cost,  which  is  expected  to  be 

recognized over a weighted average period of 1.8 years.

11.

Collaboration Revenue

License Agreement with NHSc Rx License GmbH (Nestlé)

Summary of Agreement

In July 2021, the Company entered into the 2021 License Agreement with NHSc Pharma Partners, succeeded by NHSc Rx License GmbH (together 
with Société des Produits Nestlé S.A., their affiliates, and their subsidiaries, "Nestlé"). Under the terms of the Agreement, the Company granted Nestlé a 
co-exclusive,  sublicensable  (under  certain  circumstances)  license  to  develop,  commercialize  and  conduct  medical  affairs  activities  for  (i)  therapeutic 
products based on the Company's microbiome technology (including the Company's SER-109 product candidate) that are developed by the Company or on
the Company's behalf for the treatment of CDI and recurrent CDI, as well as any other indications pursued for the products upon mutual agreement of the 
parties (the “2021 Field”) in the United States and Canada (the “2021 Licensed Territory”), and (ii) the Company's SER-109 product candidate and any 
improvements  and  modifications  thereto  developed  pursuant  to  the  terms  of  the  2021  License  Agreement  (the  "2021  Collaboration  Products")  for  any 
indications in the 2021 Licensed Territory. The Company is responsible for completing development of SER-109 in the 2021 Field in the United States 
until first regulatory approval for SER-109 is obtained.  

Nestlé has the sole right to commercialize the 2021 Collaboration Products in the 2021 Licensed Territory in accordance with a commercialization 
plan. Both parties will perform medical affairs activities in the 2021 Licensed Territory in accordance with a medical affairs plan. The Company will be 
responsible for the manufacturing and supply for commercialization under a supply agreement that will be entered into between the parties. Both parties 
will perform pre-launch activities of 2021 Collaboration Products prior to the first 

F-26

 
 
 
 
 
 
 
   
   
 
   
   
   
   
 
 
 
 
 
 
 
   
   
 
   
   
   
   
 
 
 
 
 
 
   
   
 
   
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

commercial sale in the United States. The Company is responsible for funding the pre-launch activities until first commercial sale of 2021 Collaboration 
Products in the 2021 Licensed Territory and in accordance with a pre-launch plan, up to a specified cap. Following first commercial sale of the first 2021 
Collaboration Product, the Company will be entitled to share equally in its commercial profits and losses. 

In  connection  with  the  2021  License  Agreement,  the  Company  received  an  upfront  payment  of  $175,000.  The  Company  is  eligible  to  receive 
additional  payments  of  up  to  $360,000  if  certain  regulatory  and  sales  milestones  are  achieved.  The  potential  future  milestone  payments  include  up  to 
$135,000 for the achievement of specified regulatory milestones and up to $225,000 for the achievement of specified net sales milestones.

The 2021 License Agreement continues in effect until all development and commercialization activities for all 2021 Collaboration Products in the 
2021 Licensed Territory have permanently ceased. The 2021 License Agreement may be terminated by either party upon sixty days’ written notice for the 
other party’s material breach that remains uncured during such sixty-day period, or immediately upon written notice for the other party’s insolvency. Nestlé 
may also terminate the 2021 License Agreement at-will (i) with twelve months’ prior written notice, effective only on or after the third anniversary of first 
commercial sale of the first 2021 Collaboration Product in the 2021 Licensed Territory, (ii) if first commercial sale of the first 2021 Collaboration Product 
in the 2021 Licensed Territory has not occurred by the fifth anniversary of the effective date of the 2021 License Agreement, with one hundred eighty days’ 
prior written notice, which must be provided during a specified period set forth in the 2021 License Agreement, or (iii) if regulatory approval for SER-109 
is not granted after submission by the Company of a filing seeking first regulatory approval as set forth in the development and regulatory activity plan, and 
the parties fail to agree on further development of SER-109 in accordance with the terms of the 2021 License Agreement, with one hundred eighty days’ 
prior written notice, which must be provided within a specified period set forth in the 2021 License Agreement. The Company may also terminate the 2021 
License Agreement immediately upon written notice if Nestlé challenges any licensed patent in the 2021 Licensed Territory. Upon termination of the 2021 
License  Agreement,  all  licenses  granted  to  Nestlé  by  the  Company  will  terminate.  If  the  Company  commits  a  material  breach  of  the  2021  License 
Agreement, Nestlé may elect not to terminate the 2021 License Agreement but instead apply specified adjustments to the payment terms and other terms 
and conditions of the 2021 License Agreement. 

Accounting Analysis

The 2021 License Agreement represents a separate contract between Nestlé and the Company. The 2021 License Agreement is within the scope of 
Accounting Standard Update 2018-18, Collaborative Arrangements (Topic 808), and has elements that are within the scope of ASC 606 - Revenue From 
Contracts with Customers (Topic 606) and Topic 808.

The Company identified the following promises in the 2021 License Agreement that were evaluated under the scope of Topic 606: (i) delivery of a 
co-exclusive license for SER-109 to develop, commercialize and conduct medical affairs in the United States and Canada; (ii) services to be performed in 
accordance with the development and regulatory activity plan to obtain regulatory approval of SER-109 in the United States. The Company also evaluated 
whether  certain  options  outlined  within  the  2021  License  Agreement  represented  material  rights  that  would  give  rise  to  a  performance  obligation  and 
concluded that none of the options convey a material right to Nestlé and therefore are not considered separate performance obligations within the 2021 
License Agreement. 

The Company assessed the above promises and determined that the co-exclusive license for SER-109 and the services to obtain regulatory approval 
of SER-109 in the United States are reflective of a vendor-customer relationship and therefore represent performance obligations within the scope of Topic 
606. The co-exclusive license for SER-109 in the United States and Canada is considered functional intellectual property and distinct from other promises 
under  the  contract  as  Nestlé  can  benefit  from  the  license  on  its  own  or  together  with  other  readily  available  resources.  The  services  performed  by  the 
Company to obtain regulatory approval of SER-109 are not complex or specialized, could be performed by another qualified third party, are not expected to 
significantly  modify  or  customize  the  license  given  that  SER-109  is  late-stage  intellectual  property  that  has  completed  clinical  development  and  the 
services are expected to be performed over a short period of time. Therefore, the license and the services each represents a separate performance obligation 
within a contract with a customer under the scope of Topic 606 at contract inception. 

The Company considers the collaborative pre-launch activities and commercialization activities to be separate units of account within the scope of 
Topic  808  and  are  not  deliverables  under  Topic  606.  The  Company  and  Nestlé  are  both  active  participants  in  the  pre-launch  activities  and 
commercialization  activities  and  are  exposed  to  significant  risks  and  rewards  that  are  dependent  on  the  commercial  success  of  the  activities  in  the 
arrangement.

F-27

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

The up-front payment of $175,000 compensated the Company for: (i) the co-exclusive license for SER-109 to develop, commercialize and conduct 
medical  affairs  in  the  United  States  and  Canada,  (ii)  services  performed  in  accordance  with  the  development  and  regulatory  activity  plan  to  obtain 
regulatory approval of SER-109 in the United States and (iii) pre-launch activities performed by Nestlé and the Company until the first commercial sale of 
SER-109 in the United States. The commercialization activities, which include the commercial manufacturing, participation on joint steering committees 
and  medical  affairs  work,  that  occur  after  regulatory  approval  of  SER-109  in  the  United  States,  are  part  of  the  50/50  sharing  of  commercial  profits. 
Therefore, the up-front payment of $175,000 does not compensate the Company for these activities.   

The Company allocated the $175,000 between the Topic 606 unit of account and the Topic 808 unit of account by determining the standalone selling 
price  (SSP)  of  each  good  or  service.  The  selling  price  of  each  good  or  service  was  determined  based  on  the  Company’s  SSP  with  the  objective  of 
determining the price at which it would sell such an item if it were to be sold regularly on a standalone basis. The Company determined the transaction 
price under Topic 606 to be $139,500 and the Topic 808 amount to be $35,500 at the inception of the 2021 License Agreement. 

The Company determined that any variable consideration related to regulatory milestones is deemed to be fully constrained and therefore excluded 
from the transaction price due to the high degree of uncertainty and risk associated with these potential payments, as the Company determined that it could 
not assert that it was probable that a significant reversal in the amount of cumulative revenue recognized will not occur. The Company also determined that 
sales milestones relate solely to the license of intellectual property and are therefore excluded from the transaction price under the sales- or usage-based 
royalty exception of Topic 606. Revenue related to these sales milestones will only be recognized when the associated sales occur, and relevant thresholds 
are met.

The Topic 606 transaction price of $139,500 has been allocated to the co-exclusive license for SER-109 and the services performed in accordance 
with  the  development  and  regulatory  activity  plan  to  obtain  regulatory  approval  of  SER-109  in  the  United  States  based  on  the  Company’s  SSP.  The 
Company  recognized  revenue  for  the  license  performance  obligation  at  a  point  in  time,  that  is  upon  transfer  of  the  license  to  Nestlé.  As  control  of  the 
license was transferred in July 2021, the Company recognized $131,343 of collaboration revenue - related party during the year ended December 31, 2021 
pertaining  to  the  license  performance  obligation.  The  remaining  amount  of  the  Topic  606  transaction  price  of  $8,157  was  allocated  to  the  services 
performance  obligation  and  is  being  recognized  over  time  as  the  services  are  performed.  During  the  years  ended  December  31,  2022  and  2021,  the 
Company recognized $4,114  and  $2,068,  of  collaboration  revenue  -  related  party,  respectively,  related  to  the  services  performance  obligation  under  the 
2021 License Agreement.   

The amount allocated to the Topic 808 unit of accounting relates to the pre-launch activities performed prior to the first commercial sale of SER-109 

and was determined to be $35,500 based on standalone selling price. 

The Company recorded the $35,500 in total liabilities on its consolidated balance sheet at the inception of the arrangement. On a quarterly basis, the 
Company  and  Nestlé  will  provide  financial  information  about  the  pre-launch  activities  performed  by  both  parties.  The  Company  reduces  the  $35,500 
liability as the pre-launch activities are performed and it makes payments to Nestlé for the pre-launch costs Nestlé incurs. As of December 31, 2022 and 
2021, there is $34,770 and $21,098 included in accrued expenses and other current liabilities and $0 and $10,585 included in other long-term liabilities, 
respectively. 

The cost associated with pre-launch activities performed by the Company is recorded within total operating expenses in the Company’s consolidated 
statements of operations and comprehensive loss. In the years ended December 31, 2022 and 2021, the Company recognized $6,102 and $2,168 in research 
and development expenses and $8,953 and $3,383 in general and administrative expenses, respectively, associated with pre-launch activities performed.   

As the Company and Nestlé are both active participants in the pre-launch activities, the sharing of 50% of the pre-launch costs will be recognized in 
collaboration (profit) loss sharing - related party in the Company’s consolidated statements of operations and comprehensive loss. The Company recorded 
$1,004 of expense and $1,732 of income in the collaboration (profit) loss sharing line for the years ended December 31, 2022 and 2021, respectively. 

Collaboration and License Agreement with Société des Produits Nestlé S.A. (Nestlé)

Summary of Agreement

In January 2016, the Company entered into a collaboration and license agreement with Nestec Ltd., succeeded by Société des Produits Nestlé S.A. 
(together  with  NHSc  Rx  License  GmbH,  their  affiliates  and  their  subsidiaries,  “Nestlé”)  (the  “2016  License  Agreement”)  for  the  development  and 
commercialization of certain product candidates for the treatment and management of CDI and 

F-28

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

inflammatory  bowel  disease  (“IBD”),  including  UC  and  Crohn’s  disease.  The  2016  License  Agreement  supports  the  development  of  the  Company’s 
portfolio of products for CDI and IBD in markets outside of the United States and Canada (the “2016 Licensed Territory”). 

Under the 2016 License Agreement, the Company granted to Nestlé an exclusive, royalty-bearing license to develop and commercialize, in the 2016 
Licensed Territory, certain products based on its microbiome technology that are being developed for the treatment of CDI and IBD, including SER-109, 
SER-262, SER-287 and SER-301 (collectively, the “2016 Collaboration Products”). The 2016 License Agreement sets forth the Company’s and Nestlé’s 
respective obligations for development, commercialization, regulatory and manufacturing and supply activities for the 2016 Collaboration Products with 
respect to the licensed fields and the 2016 Licensed Territory.

Under  the  2016  License  Agreement,  Nestlé  agreed  to  pay  the  Company  an  upfront  cash  payment  of  $120,000,  which  the  Company  received  in 
February 2016. The Company is eligible to receive up to $285,000 in development milestone payments, $375,000  in  regulatory  payments  and  up  to  an 
aggregate of $1,125,000 for the achievement of certain commercial milestones related to the sales of the 2016 Collaboration Products. Nestlé also agreed to 
pay the Company tiered royalties, at percentages ranging from the high single digits to high teens, of net sales of 2016 Collaboration Products in the 2016 
Licensed Territory.  

Under the 2016 License Agreement, the Company is entitled to receive a $20,000 milestone payment from Nestlé following initiation of a SER-287 
Phase 2 study and a $20,000 milestone payment from Nestlé following the initiation of a SER-287 Phase 3 study. In November 2018, the Company entered 
into a letter agreement with Nestlé which modified the 2016 License Agreement to address the current clinical plans for SER-287. Pursuant to the letter 
agreement, the Company and Nestlé agreed that following initiation of the SER-287 Phase 2b study, the Company would be entitled to receive $40,000 in 
milestone payments from Nestlé, which represent the milestone payments due to the Company for the initiation of a SER-287 Phase 2 study and a Phase 3 
study.  The  SER-287  Phase  2b  study  was  initiated  and  the  $40,000  of  milestone  payments  were  received  in  December  2018.  The  letter  agreement  also 
provides scenarios under which Nestlé’s reimbursement to the Company for certain Phase 3 development costs would be reduced or delayed depending on 
the outcomes of the SER-287 Phase 2b study.

The 2016 License Agreement continues in effect until terminated by either party on the following bases: (i) Nestlé may terminate the 2016 License 
Agreement  in  the  event  of  serious  safety  issues  related  to  any  of  the  2016  Collaboration  Products;  (ii)  the  Company  may  terminate  the  2016  License 
Agreement  if  Nestlé  challenges  the  validity  or  enforceability  of  any  of  the  Company’s  licensed  patents;  and  (iii)  either  party  may  terminate  the  2016 
License Agreement in the event of the other party’s uncured material breach or insolvency. Upon termination of the 2016 License Agreement, all licenses 
granted to Nestlé by the Company will terminate, and all rights in and to the 2016 Collaboration Products in the 2016 Licensed Territory will revert to the 
Company. If the Company commits a material breach of the 2016 License Agreement, Nestlé may elect not to terminate the 2016 License Agreement but 
instead apply specified adjustments to its payment obligations and other terms and conditions of the 2016 License Agreement.

Accounting Analysis

The Company assessed the 2016 License Agreement in accordance with Topic 606 and concluded that Nestlé is a customer. The Company identified 
the following promises under the contract: (i) a license to develop and commercialize the 2016 Collaboration Products in the 2016 Licensed Territory, (ii) 
obligation  to  perform  research  and  development  services,  (iii)  participation  on  a  joint  steering  committee,  and  (iv)  manufacturing  services  to  provide 
clinical supply to complete future clinical trials. In addition, the Company identified a contingent obligation to perform manufacturing services to provide 
commercial supply if commercialization occurs, which is contingent upon regulatory approval. This contingent obligation is not a performance obligation 
at inception and has been excluded from the initial allocation as it represents a separate buying decision at market rates, rather than a material right in the 
contract. The Company assessed the promised goods and services to determine if they are distinct. Based on this assessment, the Company determined that 
Nestlé  cannot  benefit  from  the  promised  goods  and  services  separately  from  the  others  as  they  are  highly  interrelated  and  therefore  not  distinct. 
Accordingly, the promised goods and services represent one combined performance obligation and the entire transaction price was allocated to that single 
combined performance obligation. 

At contract inception, the Company determined that the $120,000 non-refundable upfront amount constituted the entirety of the consideration to be 
included in the transaction price as the development, regulatory, and commercial milestones were fully constrained. During the year ended December 31, 
2016,  the  Company  received  $10,000  from  Nestlé  in  connection  with  the  initiation  of  the  Phase  1b  study  for  SER-262  in  CDI.  During  the  year  ended 
December 31, 2017, the Company received $20,000 from Nestlé in connection with the initiation of the Phase 3 study for SER-109.  During the year ended 
December 31, 2018, the Company received $40,000 from Nestlé  in  connection  with  the  initiation  of  the  Phase  2b  study  for  SER-287.    During  the  year 
ended December 31, 2020, the Company received 

F-29

 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

$10,000 from Nestlé in connection with the initiation of the Phase 1b SER-301 study.  As of December 31, 2022, the aggregate amount of the transaction 
price allocated to the performance obligation of the 2016 License Agreement was approximately $200,000.

During  the  years  ended  December  31,  2022,  2021,  and  2020  using  the  cost-to-cost  method,  which  best  depicts  the  transfer  of  control  to  the 
customer,  the  Company  recognized  $3,014,  $10,446,  and  $11,897  of  Collaboration  revenue  –  related  party,  respectively,  relating  to  the  2016  License 
Agreement.

As  of  December  31,  2022  and  2021,  there  was  $96,689,  and  $103,817  of  deferred  revenue  related  to  the  unsatisfied  portion  of  the  performance 
obligation  under  the  Nestlé  agreements.  As  of  December  31,  2022,  deferred  revenue  is  classified  as  current  or  non-current  in  the  consolidated  balance 
sheets based on the Company’s estimate of revenue that will be recognized within the next twelve months, which is determined by the cost-to-cost method 
which measures the extent of progress towards completion based on the ratio of actual costs incurred to the total estimated costs expected upon satisfying 
the performance obligation. All costs associated with the 2016 License Agreement are recorded in research and development expense in the consolidated 
statements of operations and comprehensive loss.

AstraZeneca Research Collaboration and Option Agreement

Summary of the Agreement

In March 2019, the Company entered into a Research Collaboration and Option Agreement (the “Research Agreement”) with MedImmune, LLC, a 
wholly owned subsidiary of AstraZeneca Inc. (“AstraZeneca”), to advance the mechanistic understanding of the microbiome in augmenting the efficacy of 
cancer immunotherapy. Under the Research Agreement, the Company and AstraZeneca would conduct certain research and development activities as set 
forth on a research plan focused on the role of the microbiome in certain cancers and cancer immunotherapies, including furthering the research program 
for SER-401, in combination with AstraZeneca compounds targeting various cancers.

Pursuant  to  the  Research  Agreement,  the  Company  agreed  not  to  conduct  research  or  development  on  any  microbiome  products  specifically 
designed by the Company during the term of the Research Agreement for the treatment of cancer (“Microbiome Oncology Products”), with or on behalf of 
any third-party without the prior approval of the joint steering committee for the Research Agreement for at least three years after the effective date (the 
“Exclusivity Period”). Additionally, AstraZeneca was to pay to the Company a total of $20,000 in three equal installments, the first of which the Company 
received  in  April  2019,  the  second  of  which  the  Company  received  in  December  2019,  and  the  third  of  which  the  Company  received  in  January  2021. 
Additionally, AstraZeneca was to bear its costs of conducting activities under the research plan and to reimburse the Company for all activities performed 
under the research plan based on actual full-time employee (“FTE”) time and certain third-party costs incurred by the Company in connection therewith.

Under the Research Agreement, the Company granted to AstraZeneca an exclusive option to negotiate a worldwide, sublicensable exclusive license
under relevant intellectual property rights controlled by the Company to exploit Microbiome Oncology Products for the treatment of cancer. Additionally, 
the Company granted to AstraZeneca an additional exclusive option to obtain a worldwide, sublicensable, license under certain intellectual property rights 
arising out of the Agreement or coming into the control of the Company during the term of the Agreement, which AstraZeneca did not exercise.

In December 2020, the Company received written notice from AstraZeneca that AstraZeneca elected to terminate the Research Agreement by and in 
accordance with its terms. The termination of the Research Agreement was effective on April 2, 2021 (the “Termination Date”), which was 120 days from 
the date of the termination notice.

Accounting Analysis

The  Company  assessed  the  Research  Agreement  in  accordance  with  ASC  606  and  concluded  that  AstraZeneca  was  a  customer,  and  that  the 
promised  goods  and  services  in  the  Research  Agreement  represented  one  combined  performance  obligation  to  which  the  entire  transaction  price  was 
allocated. The Company also concluded that each option does not constitute a performance obligation at inception and was therefore excluded from the 
initial allocation since each option represents a separate buying decision at market rates, rather than a material right in the contract.

At  contract  inception,  the  Company  determined  that  the  transaction  price  was  comprised  of:  (i)  the  $20,000  fee,  which  represents  fixed 

consideration, and (ii) the estimated reimbursement of research and development costs incurred, which totaled approximately 

F-30

 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

$13,900, which represents variable consideration. The Company included the variable consideration in the transaction price at contract inception because 
the Company had determined it was not probable that a significant reversal of cumulative revenue would occur.    

The  Company  determined  that  revenue  under  the  Research  Agreement  should  be  recognized  over  time,  using  a  cost-to-cost  input  method,  as 

AstraZeneca simultaneously receives the benefit from the Company as the Company performs under the single performance obligation over time.  

In  December  2020,  the  Company  received  written  notice  that  AstraZeneca  elected  to  terminate  the  Research  Agreement.    As  a  result  of 
AstraZeneca’s  decision  to  terminate  the  Research  Agreement,  the  Company’s  performance  obligations  under  the  Research  Agreement  ended  as  of 
December 31, 2020.  The final transaction price of $23,377 is comprised of the $20,000 fixed consideration and $3,376 for the reimbursed research and 
development costs. The Company recognized its remaining deferred revenue of $15,145 in collaboration revenue in the year ended December 31, 2020.  
No collaboration revenue was recognized for the years ended December 31, 2022 and 2021, as the Company's performance obligations under the Research 
Agreement ended December 31, 2020.

Contract Balances from Contracts with Customers

The following tables present changes in the Company’s contract liabilities during the year ended December 31, 2022 and 2021:

Year ended December 31, 2022
Contract liabilities:

Deferred revenue - related party

Year ended December 31, 2021
Contract liabilities:

Deferred revenue - related party

Balance as of 
December 31, 
2021

Additions

Deductions

Balance as of 
December 31, 
2022

  $

103,817      

—      

(7,128 )   $

96,689  

Balance as of 
December 31, 
2020

Additions

Deductions

Balance as of 
December 31, 
2021

  $

108,174      

8,157      

(12,514 )   $

103,817  

During the year ended December 31, 2022, the Company recognized the following revenues as a result of changes in the contract liability balances 

in the respective periods: 

Revenue recognized in the period from:
Amounts included in the contract liability at the beginning of the period

Year Ended December 31,

2022

2021

  $

7,128     $

10,446  

When consideration is received, or such consideration is unconditionally due, from a customer prior to transferring goods or services to the customer 

under the terms of a contract, a contract liability is recorded. Revenue is recognized from the contract liability over time using the cost-to-cost method.

12.

Net Loss per Share

Basic and diluted net loss per share attributable to common stockholders was calculated as follows:

Numerator:

Net loss attributable to common stockholders

  $

(250,157 )   $

(65,578 )   $

(89,127 )

Denominator:

Weighted average common shares outstanding, basic and diluted

Net loss per share attributable to common stockholders, basic and diluted

108,077,043      
(2.31 )   $

91,702,866      
(0.72 )   $

79,789,220  

(1.12 )

  $

2022

Year Ended December 31,
2021

2020

F-31

 
 
 
 
   
   
   
 
 
     
     
     
   
 
     
     
     
   
 
 
 
   
   
   
 
 
     
     
     
   
 
     
     
     
   
 
 
 
 
 
 
 
   
 
 
     
 
 
 
 
 
 
 
 
 
   
   
 
 
     
     
   
 
     
     
   
   
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

The Company’s potential dilutive securities, which include stock options, unvested restricted common stock and shares issuable under the ESPP, 
have  been  excluded  from  the  computation  of  diluted  net  loss  per  share  as  the  effect  would  be  to  reduce  the  net  loss  per  share  and  therefore  been  anti-
dilutive. Therefore, the weighted average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to 
common stockholders is the same. The following potential common shares, presented based on amounts outstanding at each period end, were excluded 
from the calculation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an 
anti-dilutive effect:

Stock options to purchase common stock
Unvested restricted stock units
Shares issuable under employee stock purchase plan

Year Ended December 31,
2021

2022

    14,940,034       11,517,189      
734,755      
165,047      
    16,579,167       12,416,991      

1,549,540      
89,593      

2020

10,037,130  
6,500  
10,786  
10,054,416  

13.

Commitments and Contingencies

Leases

Refer to Note 7 “Leases” for discussion of the commitments associated with the Company’s lease portfolio.

Indemnification Agreements

In the ordinary course of business, the Company may provide indemnification of varying scope and terms to vendors, lessors, business partners and 
other  parties  with  respect  to  certain  matters  including,  but  not  limited  to,  losses  arising  out  of  breach  of  such  agreements  or  from  intellectual  property 
infringement claims made by third-parties. In addition, the Company has entered into indemnification agreements with members of its board of directors 
and its officers that will require the Company, among other things, to indemnify them against certain liabilities that may arise by reason of their status or 
service as directors or officers. The maximum potential amount of future payments the Company could be required to make under these indemnification 
agreements is, in many cases, unlimited. To date, the Company has not incurred any material costs as a result of such indemnifications. The Company does 
not believe that the outcome of any claims under indemnification arrangements will have a material effect on its financial position, results of operations or 
cash flows, and it has not accrued any liabilities related to such obligations in its consolidated financial statements as of December 31, 2022 or 2021.

Legal Contingencies

The  Company  accrues  a  liability  for  legal  contingencies  when  it  believes  that  it  is  both  probable  that  a  liability  has  been  incurred  and  that  the 
Company  can  reasonably  estimate  the  amount  of  the  loss.  The  Company  reviews  these  accruals  and  adjusts  them  to  reflect  ongoing  negotiations, 
settlements,  rulings,  advice  of  legal  counsel  and  other  relevant  information.  To  the  extent  new  information  is  obtained  and  the  views  on  the  probable 
outcomes of claims, suits, assessments, investigations or legal proceedings change, changes in the Company’s accrued liabilities would be recorded in the 
period in which such determination is made.

In addition, in accordance with the relevant authoritative guidance, for any matters in which the likelihood of material loss is at least reasonably 
possible, the Company will provide disclosure of the possible loss or range of loss. If a reasonable estimate cannot be made, however, the Company will 
provide disclosure to that effect. The Company expenses legal costs as they are incurred.

The Company did not  accrue  any  liabilities  related  to  legal  contingencies  in  its  consolidated  financial  statements  as  of  December 31, 2022 and 

2021.

Bacthera Long Term Manufacturing Agreement

On November 8, 2021, the Company entered into a Long Term Manufacturing Agreement with BacThera AG (“Bacthera”), a joint venture between 
Chr.  Hansen and a Lonza Group affiliate, which was amended on December 14, 2022 (the "Bacthera Agreement"). The Bacthera Agreement governs the 
general  terms  under  which  Bacthera,  or  one  of  its  affiliates,  will  (i)  construct  a  dedicated  full-scale  production  suite  for  the  Company  at  Bacthera’s 
Microbiome Center of Excellence in Visp, Switzerland, which is currently under construction; and (ii) provide manufacturing services to the Company for 
its SER-109 product and other products, as agreed to by the parties.

F-32

 
 
 
 
 
 
 
   
   
 
   
   
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Under the terms of the Bacthera Agreement, the Company agreed to pay Bacthera a total of at least 256,000 CHF (or approximately $277,000) for 
the initial term of the agreement, inclusive of the construction fees and annual operating fees. Bacthera is funding the majority of the construction costs and 
will own and control the manufacturing suite during construction. The construction fees that the Company is responsible for represent a small percentage of 
the overall construction costs and are payable upon the achievement of certain milestones related to the construction of the dedicated manufacturing suite.  
The annual operating fee includes the cost of a baseline annual batch production volume.  The Company has also agreed to pay certain other ancillary fees 
and  a  per-batch  fee  in  excess  of  the  baseline  batches.    These  fees  are  subject  to  adjustment  during  construction  for  certain  items  outside  of  Bacthera’s 
control  and  annually  against  an  agreed  index.    The  Company  will  supply  the  active  pharmaceutical  ingredients  to  Bacthera  to  enable  it  to  perform  the 
services and pay for certain other raw materials and manufacturing components, which will be acquired by Bacthera.

The Bacthera Agreement has an initial term that continues until the tenth anniversary of the earlier of (a) successful completion of construction and 

demonstration of Bacthera’s readiness for commercial production or (b) the commencement of manufacturing.  

The  initial  term  is  subject  to  renewals,  which  could  extend  the  term  to  16 years, and additional three-year  terms  thereafter.    Each  party  has  the 
ability  to  terminate  the  Bacthera  Agreement  upon  the  occurrence  of  certain  customary  conditions.    The  Company  may  also  terminate  the  Bacthera 
Agreement  for  convenience  after  a  defined  period.    In  the  event  of  a  termination,  the  Company  has  certain  financial  obligations  that  would  apply,  and 
Bacthera has agreed to grant a license to Bacthera-developed manufacturing know how, if any, and provide technical assistance to the Company, so that the 
Company  could  transfer  the  manufacturing  operations  to  itself  or  a  third  party.    The  Bacthera  Agreement  also  contains  representations,  warranties  and 
indemnity obligations as well as limitations of liability that are customary for agreements of this type. 

  The  Bacthera  Agreement  represents  a  lease  as  the  Company  will  have  the  right  to  use  the  dedicated  manufacturing  suite  for  a  period  of  time 
following  completion  of  the  construction  of  the  manufacturing  suite  and  approval  by  regulatory  authorities.  As  of  December  31,  2022,  the  lease 
commencement  date  has  not  occurred  and  therefore  the  Company  has  not  recorded  an  operating  lease  asset  or  an  operating  lease  liability  on  its 
consolidated  balance  sheets.  As  of  December  31,  2022,  the  Company  has  paid  Bacthera  $12,276,  of  which  $3,448  was  expensed  in  the  year  ended 
December  31,  2021,  and  $8,828  relate  to  the  construction  of  the  dedicated  manufacturing  suite  and  are  included  in  other  non-current  assets  in  the 
accompanying consolidated balance sheet. 

14.

Income Taxes

During the years ended December 31, 2022, 2021 and 2020, the Company recorded no income tax benefits for the net operating losses incurred in 

each year or interim period, due to its uncertainty of realizing a benefit from those items.

A reconciliation of the U.S. federal statutory income tax rate to the Company’s effective income tax rate is as follows:

Federal statutory income tax rate

Research and development tax credits
State taxes, net of federal benefit
Stock-based compensation
Uncertain tax position reserves
Other
Change in deferred tax asset valuation allowance

Effective income tax rate

F-33

2022

Year Ended December 31,
2021

2020

(21.0 )%   
(3.1 )    
(4.3 )    
0.6      
4.6      
0.3      
22.9      
— %   

(21.0 )%   
(16.6 )    
(2.8 )    
(0.4 )    
—      
0.4      
40.4      
— %   

(21.0 )%
(6.4 )
(7.8 )
(5.8 )
—  
0.2  
40.8  

— %

 
 
 
 
 
 
 
   
   
 
   
   
   
   
   
   
   
   
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

Net deferred tax assets as of December 31, 2022 and 2021 consisted of the following:

Deferred tax assets:

Net operating loss carryforwards
Research and development tax credit carryforwards
Section 174 capitalized research and development expenses
Stock-based compensation expense
Lease liability
Deferred revenue
Accrued expenses
Section 163(j) limitation
Depreciation and amortization
Other

Total deferred tax assets

Deferred tax liabilities:

Depreciation and amortization
Right of use assets

Total deferred tax liabilities

Valuation allowance

Net deferred tax assets

December 31,

2022

2021

132,560     $
48,854      
38,894      
20,048      
29,717      
29,922      
4,044      
2,303      
396      
200      
306,938     $

—      
(29,568 )    
(29,568 )    
(277,370 )   $
—     $

108,189  
53,133  
—  
16,045  
6,635  
36,666  
2,475  
1,368  
247  
274  
225,032  

—  
(4,918 )
(4,918 )
(220,114 )
—  

  $

  $

  $
  $

The Tax Cuts and Jobs Act ("TCJA") requires taxpayers to capitalize and amortize research and experimental expenditures under IRC Section 174 
for tax years beginning after December 31, 2021. This rule became effective for the Company during the year ended December 31, 2022 and resulted in the 
capitalization of research and development costs of $160,586. The Company will amortize these costs for tax purposes over five years if the research and 
development was performed in the U.S. and over 15 years if the research and development was performed outside the U.S.

As of December 31, 2022, the Company had net operating loss carryforwards (“NOLs”) for federal and state income tax purposes of $501,789 and 
$481,862, respectively. Federal NOLs of $119,800, generated before 2018, will begin expiring in varying amounts in 2035 unless utilized. The remaining 
federal NOLs of $381,989, generated after 2017, will be carried forward indefinitely and could be used to offset up to 80% of taxable income in future tax 
years.  The Company's state NOLs will expire at various times starting in 2035.  As of December 31, 2022, the Company also had available gross research 
and development tax credit carryforwards for federal and state income tax purposes of $50,248 and $12,925, respectively, which begin to expire in 2031 
and 2028, respectively. The federal research and development tax credits include an orphan drug credit carryforward of $25,623.  

Utilization of the NOLs and research and development tax credit carryforwards may be subject to a substantial annual limitation under Sections 382 
and 383 of the Internal Revenue Code ("IRC") of 1986 due to ownership changes that have occurred previously or that could occur in the future. These 
ownership changes may limit the amount of carryforwards that can be utilized annually to offset future taxable income. In general, an ownership change, as 
defined by Section 382, results from transactions increasing the ownership of certain shareholders or public groups in the stock of a corporation by more 
than 50% over a three-year period. Since its formation, the Company has raised capital through the issuance of capital stock on several occasions. These
financings, combined with the purchasing shareholders' subsequent disposition of those shares, may have resulted in a change of control or could result in a 
change of control in the future upon subsequent disposition. The Company conducted an analysis to determine if historical changes in ownership through 
December 31, 2020 would limit or otherwise restrict its ability to utilize these NOLs and research and development credit carryforwards. As a result of this 
analysis,  the  Company  does  not  believe  there  are  any  significant  limitations  on  its  ability  to  utilize  these  carryforwards.  However,  future  changes  in 
ownership after December 31, 2020 could affect the limitation in future years. Any limitation may result in expiration of a portion of the NOLs or research 
and development credit carryforwards before utilization.

The  Company  has  evaluated  the  positive  and  negative  evidence  bearing  upon  its  ability  to  realize  the  deferred  tax  assets.  Management  has 
considered the Company’s history of cumulative net losses incurred since inception and its lack of commercialization of any products or generation of any 
revenue from product sales since inception and has concluded that it is more likely than not that the Company will not realize the benefits of the deferred 
tax assets. Accordingly, a full valuation allowance has been established against 

F-34

 
 
 
 
 
 
 
   
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

the deferred tax assets as of December 31, 2022 and 2021. Management reevaluates the positive and negative evidence at each reporting period.

Changes  in  the  valuation  allowance  for  deferred  tax  assets  during  the  years  ended  December  31,  2022,  2021  and  2020  related  primarily  to  the 
increases in NOLs, research and development tax credit carryforwards and capitalized research and development  expenses pursuant to IRC Section 174, 
and stock-based compensation were as follows:

Valuation allowance at beginning of year

Decreases recorded as benefit to income tax provision
Increases recorded to income tax provision

Valuation allowance as of end of year

2022
(220,114 )   $
—      
(57,256 )    
(277,370 )   $

Year Ended December 31,
2021
(193,736 )   $
—      
(26,378 )    
(220,114 )   $

  $

  $

2020
(157,346 )
—  
(36,390 )
(193,736 )

The Company is currently under examination by the Internal Revenue Service ("IRS") for the period ended December 31, 2018 related to its 2018 
research and development tax credits ("R&D Credit(s)"). The Company has adjusted its 2018 R&D Credits and its overall federal and state R&D Credit 
carryforward  balance  from  the  Company's  inception  to  December  31,  2022,  based  on  the  most  recent  information  received  from  the  IRS  regarding  the 
examination. Also, the Company has reviewed each of its overall filing positions since inception and has not identified any additional positions that do not 
meet the more likely than not threshold. The Company does not anticipate a material change to its uncertain tax position reserves in the next 12 months. 
The changes in the Company's unrecognized tax benefits for the years ended December 31, 2022, 2021, and 2020 were as follows:

Balance at beginning of year

Increase in unrecognized tax benefits as a result of tax positions taken 
   during the year
Reduction to unrecognized tax benefits

Increases in unrecognized tax benefits as a result of tax positions taken 
   during current period

2022

Year Ended December 31,
2021

2020

  $

—     $

—     $

12,528    
—    

—    
—    

  $

12,528     $

—     $

—  

—  
—  

—  

The Company has not yet conducted a study of its research and development credit carry forwards. This study may result in further adjustment to 
the Company’s R&D Credits; however, a full valuation allowance has been provided against the Company’s R&D Credits, and if an adjustment is required, 
this adjustment would be offset by an adjustment to the valuation allowance. Thus, there would be no impact to the consolidated balance sheet or statement 
of operations if an adjustment were required. The Company had no other unrecognized tax benefits accrued for the years ended December 31, 2022 and 
2021, or related interest and penalties as of such dates. The Company will recognize any interest and penalties related to uncertain tax positions in income 
tax expense.  

The Company files tax returns as prescribed by the tax laws of the jurisdictions in which it operates.  In the normal course of business, the Company 
is subject to examination by federal and state jurisdictions, where applicable. The Company's tax years are still open under statute from 2011 to present. All 
years may be examined to the extent the tax credit or net operating loss carryforwards are used in future periods. 

15.

Related Party Transactions

As described in Note 11, in July 2021, the Company entered into the 2021 License Agreement with NHSc Pharma Partners (together with Société 
des Produits Nestlé S.A., “Nestlé”). NHSc Pharma Partners is an affiliate of two of the Company's significant stockholders, Société des Produits Nestlé 
S.A. and Nestlé Health Science U.S. Holdings, Inc. During the years ended December 31, 2022 and 2021, the Company recognized $4,114 and $133,411 of 
related party revenue, respectively, associated with the 2021 License Agreement. As of the years ended December 31, 2022 and 2021, there was $1,976 and 
$6,089 of deferred revenue related to the 2021 License Agreement, which is classified as current or non-current in the consolidated balance sheets. As of 
December 31, 2022 and 2021 there was $34,770 and $21,098 included in accrued expenses and other liabilities and $0 and $10,585 included in other long 
term liabilities, respectively, related to the 2021 License Agreement. The Company has made no payments to Nestlé during the years ended December 31, 
2022 and 2021. There was no amount due from Nestlé as of December 31, 2022 and 2021.

F-35

 
 
 
 
 
 
 
   
   
 
   
   
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
SERES THERAPEUTICS, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(amounts in thousands, except share and per share data)

As described in Note 11, in January 2016, the Company entered into the 2016 License Agreement with Société des Produits Nestlé S.A. (successor 
in interest to Nestec, Ltd.) for the development and commercialization of certain product candidates in development for the treatment and management of
CDI and IBD, including UC and Crohn’s disease. Société des Produits Nestlé S.A. and its affiliate Nestlé Health Science U.S. Holdings, Inc. are two of the 
Company's significant stockholders. During the years ended December 31, 2022, 2021, and 2020, the Company recognized $3,014, $10,446, and $11,897, 
respectively, of related party revenue associated with the 2016 License Agreement. As of December 31, 2022 and 2021, there was $94,713 and $97,728, 
respectively, of deferred revenue related to the 2016 License Agreement, which is classified as current or non-current in the consolidated balance sheets. 
The  Company  has  made  no  payments  to  Nestlé  during  the  years  ended  December  31,  2022  and  2021.  There  was  no  amount  due  from  Nestlé  as  of 
December 31, 2022 and 2021.

As described in Note 10, the Company entered into a securities purchase agreement with Flagship Pioneering Fund VII, L.P. and Nutritional Health 
LTP Fund, L.P., affiliates of Flagship, one of the Company's significant stockholders, for the sale of 8,738,243 shares of its common stock at a purchase 
price of $3.15 per share as part of the Registered Direct Offering, which closed on July 5, 2022. The Company received proceeds from Flagship of $27,525.

In July 2022, the Company entered into a Pledge and Utilization Agreement with Flagship Pioneering Labs TPC, Inc., an affiliate of Flagship, for an 
option  to  lease  certain  manufacturing  space.  The  Company  paid  $833  for  this  option  which  is  classified  in  other  non-current  assets  on  the  Company's 
condensed consolidated balance sheet as of December 31, 2022.

In July 2019, the Company entered into a sublease agreement with Flagship to sublease a portion of its office and laboratory space in Cambridge, 
Massachusetts. The term of the sublease agreement commenced in July 2019 and ended in November 2021.  Under this agreement, the Company recorded 
other income of $0 and $1,575 during the years ended December 31, 2022 and 2021. The Company received cash payments of $0 and $1,575 during the 
years ended December 31, 2022 and 2021.

16.

401(k) Savings Plan

The  Company  has  a  defined  contribution  savings  plan  under  Section  401(k)  of  the  Internal  Revenue  Code.  This  plan  covers  substantially  all 
employees who meet minimum age and service requirements and allows participants to defer a portion of their annual compensation on a pre-tax basis. 
Effective January 1, 2016, the Company elected to match 50% of the first 6% of an employee’s deferral. Company contributions are expensed in the year 
for which they are declared. During the years ended December  31,  2022,  2021,  and  2020  the  Company  recorded  expense  of  $1,921, $1,087,  and  $586, 
respectively, for 401(k) match contributions.

F-36

 
 
SERES THERAPEUTICS, INC.

2015 INCENTIVE AWARD PLAN

(AS AMENDED AND RESTATED EFFECTIVE DECEMBER 14, 2022)

Exhibit 10.1

I.PURPOSE

The Plan’s purpose is to enhance the Company’s ability to attract, retain and motivate persons who make (or are expected to make) 
important contributions to the Company by providing these individuals with equity ownership opportunities.  Capitalized terms used in the 
Plan are defined in Section XI.  This Plan constitutes an amendment and restatement of the Seres Therapeutics, Inc. 2015 Incentive Award
Plan.  

II.ELIGIBILITY

Service Providers are eligible to be granted Awards under the Plan, subject to the limitations described herein.

III.ADMINISTRATION AND DELEGATION

(a)

Administration.    The  Plan  is  administered  by  the  Administrator.    The  Administrator  has  authority  to  determine  which 
Service Providers receive Awards, grant Awards and set Award terms and conditions, subject to the conditions and limitations in the Plan.  
The  Administrator  also  has  the  authority  to  take  all  actions  and  make  all  determinations  under  the  Plan,  to  interpret  the  Plan  and  Award 
Agreements and to adopt, amend and repeal Plan administrative rules, guidelines and practices as it deems advisable.  The Administrator may 
correct defects and ambiguities, supply omissions and reconcile inconsistencies in the Plan or any Award as it deems necessary or appropriate 
to administer the Plan and any Awards.  The Administrator’s determinations under the Plan are in its sole discretion and will be final and 
binding on all persons having or claiming any interest in the Plan or any Award.

(b)

Appointment  of  Committees.    To  the  extent  Applicable  Laws  permit,  the  Board  may  delegate  any  or  all  of  its  powers 
under the Plan to one or more Committees.  The Board may abolish any Committee or re-vest in itself any previously delegated authority at 
any time. 

IV.STOCK AVAILABLE FOR AWARDS

(a)

Number of Shares.  Subject to adjustment under Section VIII and the terms of this Section IV, Awards may be made under 
the Plan covering up to the Overall Share Limit.  As of the Plan’s effective date under Section X(c), the Company will cease granting awards 
under the Prior Plans; however, Prior Plan Awards will remain subject to the terms of the applicable Prior Plan.  Shares issued under the Plan 
may consist of authorized but unissued Shares, Shares purchased on the open market or treasury Shares.

(b)

Share Recycling.  If all or any part of an Award or Prior Plan Award expires, lapses or is terminated, exchanged for cash, 
surrendered, repurchased, canceled without having been fully exercised or forfeited, in any case, in a manner that results in the Company 
acquiring  Shares  covered  by  the  Award  or  Prior  Plan  Award  at  a  price  not  greater  than  the  price  (as  adjusted  to  reflect  any  Equity 
Restructuring) paid by the Participant for such Shares or not issuing any Shares covered by the Award or Prior Plan Award, the unused Shares 
covered by the Award or Prior Plan Award will, as applicable, become or again be available for Award grants under the Plan.  Further, Shares 
delivered (either by actual delivery or attestation) to the Company by a Participant to satisfy the applicable exercise or purchase price of an 
Award or Prior Plan Award and/or to satisfy any applicable tax withholding obligation (including Shares retained by the 

1

 
Company from the Award or Prior Plan Award being exercised or purchased and/or creating the tax obligation) will, as applicable, become or 
again  be  available  for  Award  grants  under  the  Plan.    The  payment  of  Dividend  Equivalents  in  cash  in  conjunction  with  any  outstanding 
Awards or Prior Plan Awards shall not count against the Overall Share Limit.   

(c)

Incentive Stock Option Limitations.    Notwithstanding  anything  to  the  contrary  herein,  no  more  than  17,200,000  Shares 

may be issued pursuant to the exercise of Incentive Stock Options.  

(d)

Substitute  Awards.    In  connection  with  an  entity’s  merger  or  consolidation  with  the  Company  or  the  Company’s 
acquisition of an entity’s property or stock, the Administrator may grant Awards in substitution for any options or other stock or stock-based 
awards granted before such merger or consolidation by such entity or its affiliate.  Substitute Awards may be granted on such terms as the 
Administrator deems appropriate, notwithstanding limitations on Awards in the Plan.  Substitute Awards will not count against the Overall 
Share Limit, except that Shares acquired by exercise of substitute Incentive Stock Options will count against the maximum number of Shares 
that may be issued pursuant to the exercise of Incentive Stock Options under the Plan.

(e)

Non-Employee Director Compensation.  Notwithstanding any provision to the contrary in the Plan, the Administrator may 
establish compensation for non-employee Directors from time to time, subject to the limitations in the Plan.  The Administrator will from 
time to time determine the terms, conditions and amounts of all such non-employee Director compensation in its discretion and pursuant to 
the exercise of its business judgment, taking into account such factors, circumstances and considerations as it shall deem relevant from time 
to time, provided that the sum of any cash compensation, or other compensation, and the value (determined as of the grant date in accordance 
with Financial Accounting Standards Board Accounting Standards Codification Topic 718, or any successor thereto) of Awards granted to a 
non-employee  Director  as  compensation  for  services  as  a  non-employee  Director  during  any  fiscal  year  of  the  Company  may  not  exceed 
$700,000.  The Administrator may make exceptions to this limit for individual non-employee Directors in extraordinary circumstances, as the 
Administrator  may  determine  in  its  discretion,  provided  that  the  non-employee  Director  receiving  such  additional  compensation  may  not 
participate in the decision to award such compensation or in other compensation decisions involving non-employee Directors.

V.STOCK OPTIONS AND STOCK APPRECIATION RIGHTS

(a)

General.    The  Administrator  may  grant  Options  or  Stock  Appreciation  Rights  to  Service  Providers  subject  to  the 
limitations  in  the  Plan,  including  Section  IX(i)  with  respect  to  Incentive  Stock  Options.    The  Administrator  will  determine  the  number  of 
Shares  covered  by  each  Option  and  Stock  Appreciation  Right,  the  exercise  price  of  each  Option  and  Stock  Appreciation  Right  and  the 
conditions and limitations applicable to the exercise of each Option and Stock Appreciation Right.  A Stock Appreciation Right will entitle 
the  Participant  (or  other  person  entitled  to  exercise  the  Stock  Appreciation  Right)  to  receive  from  the  Company  upon  exercise  of  the 
exercisable portion of the Stock Appreciation Right an amount determined by multiplying the excess, if any, of the Fair Market Value of one 
Share on the date of exercise over the exercise price per Share of the Stock Appreciation Right by the number of Shares with respect to which 
the Stock Appreciation Right is exercised, subject to any limitations of the Plan or that the Administrator may impose and payable in cash, 
Shares valued at Fair Market Value or a combination of the two as the Administrator may determine or provide in the Award Agreement.  

(b)

Exercise Price.  The Administrator will establish each Option’s and Stock Appreciation Right’s exercise price and specify 
the exercise price in the Award Agreement.  The exercise price will not be less than 100% of the Fair Market Value on the grant date of the 
Option or Stock Appreciation Right.  

2

(c)

Duration of Options.  Each Option or Stock Appreciation Right will be exercisable at such times and as specified in the 

Award Agreement, provided that the term of an Option or Stock Appreciation Right will not exceed ten years.  

(d)

Exercise.    Options  and  Stock  Appreciation  Rights  may  be  exercised  by  delivering  to  the  Company  a  written  notice  of 
exercise, in a form the Administrator approves (which may be electronic), signed by the person authorized to exercise the Option or Stock 
Appreciation  Right,  together  with,  as  applicable,  payment  in  full  (i)  as  specified  in  Section  V(e)  for  the  number  of  Shares  for  which  the 
Award is exercised and (ii) as specified in Section IX(e) for any applicable taxes.  Unless the Administrator otherwise determines, an Option 
or Stock Appreciation Right may not be exercised for a fraction of a Share.

(e)

Payment Upon Exercise.    The  exercise  price  of  an  Option  must  be  paid  in  cash,  wire  transfer  of  immediately  available 
funds or by check payable to the order of the Company or, subject to Section X(h), any Company insider trading policy (including blackout 
periods) and Applicable Laws, by: 

(i)

if there is a public market for Shares at the time of exercise, unless the Administrator otherwise determines, (A) 
delivery  (including  telephonically  to  the  extent  permitted  by  the  Company)  of  an  irrevocable  and  unconditional  undertaking  by  a  broker 
acceptable to the Company to deliver promptly to the Company sufficient funds to pay the exercise price, or (B) the Participant’s delivery to 
the  Company  of  a  copy  of  irrevocable  and  unconditional  instructions  to  a  broker  acceptable  to  the  Company  to  deliver  promptly  to  the 
Company cash or a check sufficient to pay the exercise price; provided that such amount is paid to the Company at such time as may be 
required by the Administrator;  

by the Participant valued at their Fair Market Value;

(ii)

to the extent permitted by the Administrator, delivery (either by actual delivery or attestation) of Shares owned 

valued at their Fair Market Value on the exercise date; 

(iii)

to  the  extent  permitted  by  the  Administrator,  surrendering  Shares  then  issuable  upon  the  Option’s  exercise 

Administrator determines is good and valuable consideration; or

(iv)

to  the  extent  permitted  by  the  Administrator,  delivery  of  a  promissory  note  or  any  other  property  that  the 

(v)

any combination of the above permitted payment forms (including cash, wire transfer or check).

VI.RESTRICTED STOCK; RESTRICTED STOCK UNITS

(a)

General.    The  Administrator  may  grant  Restricted  Stock,  or  the  right  to  purchase  Restricted  Stock,  to  any  Service 
Provider, subject to the Company’s right to repurchase all or part of such shares at their issue price or other stated or formula price from the 
Participant (or to require forfeiture of such shares) if conditions the Administrator specifies in the Award Agreement are not satisfied before 
the end of the applicable restriction period or periods that the Administrator establishes for such Award.  In addition, the Administrator may 
grant to Service Providers Restricted Stock Units, which may be subject to vesting and forfeiture conditions during the applicable restriction 
period or periods, as set forth in an Award Agreement.  The Administrator will determine and set forth in the Award Agreement the terms and 
conditions for each Restricted Stock and Restricted Stock Unit Award, subject to the conditions and limitations contained in the Plan.

3

(b)

Restricted Stock.

(i)

Dividends.  Participants holding shares of Restricted Stock will be entitled to all ordinary cash dividends paid 
with  respect  to  such  shares,  unless  the  Administrator  provides  otherwise  in  the  Award  Agreement.    In  addition,  unless  the  Administrator 
provides otherwise, if any dividends or distributions are paid in Shares, or consist of a dividend or distribution to holders of Common Stock
of property other than an ordinary cash dividend, the Shares or other property will be subject to the same restrictions on transferability and 
forfeitability as the shares of Restricted Stock with respect to which they were paid.  

designee) any stock certificates issued in respect of shares of Restricted Stock, together with a stock power endorsed in blank.

(ii)

Stock Certificates.  The Company may require that the Participant deposit in escrow with the Company (or its 

(c)

Restricted Stock Units.

Settlement.  The Administrator may provide that settlement of Restricted Stock Units will occur upon or as soon 
as  reasonably  practicable  after  the  Restricted  Stock  Units  vest  or  will  instead  be  deferred,  on  a  mandatory  basis  or  at  the  Participant’s 
election, in a manner intended to comply with Section 409A.

(i)

Restricted Stock Unit unless and until the Shares are delivered in settlement of the Restricted Stock Unit.

(ii)

Stockholder  Rights.  A  Participant  will  have  no  rights  of  a  stockholder  with  respect  to  Shares  subject  to  any 

(iii)

Dividend  Equivalents.    If  the  Administrator  provides,  a  grant  of  Restricted  Stock  Units  may  provide  a 
Participant  with  the  right  to  receive  Dividend  Equivalents.    Dividend  Equivalents  may  be  paid  currently  or  credited  to  an  account  for  the 
Participant, settled in cash or Shares and subject to the same restrictions on transferability and forfeitability as the Restricted Stock Units with 
respect to which the Dividend Equivalents are granted and subject to other terms and conditions as set forth in the Award Agreement.  

VII.OTHER STOCK OR CASH BASED AWARDS

Other Stock or Cash Based Awards may be granted to Participants, including Awards entitling Participants to receive Shares to be 
delivered  in  the  future  and  including  annual  or  other  periodic  or  long-term  cash  bonus  awards  (whether  based  on  specified  Performance 
Criteria or otherwise), in each case subject to any conditions and limitations in the Plan. Such Other Stock or Cash Based Awards will also be 
available as a payment form in the settlement of other Awards, as standalone payments and as payment in lieu of compensation to which a 
Participant  is  otherwise  entitled.    Other  Stock  or  Cash  Based  Awards  may  be  paid  in  Shares,  cash  or  other  property,  as  the  Administrator 
determines.  Subject to the provisions of the Plan, the Administrator will determine the terms and conditions of each Other Stock or Cash 
Based Award, including any purchase price, performance goal (which may be based on the Performance Criteria), transfer restrictions, and 
vesting conditions, which will be set forth in the applicable Award Agreement. 

VIII.ADJUSTMENTS FOR CHANGES IN COMMON STOCK AND CERTAIN OTHER EVENTS

(a)

Equity  Restructuring.    In  connection  with  any  Equity  Restructuring,  notwithstanding  anything  to  the  contrary  in  this 
Section  VIII,  the  Administrator  will  equitably  adjust  each  outstanding  Award  as  it  deems  appropriate  to  reflect  the  Equity  Restructuring, 
which may include adjusting the number and type of securities subject to each outstanding Award and/or the Award’s exercise price or grant 
price (if applicable), granting new Awards to Participants, and making a cash payment to Participants.  The adjustments provided 

4

under  this  Section  VIII(a)  will  be  nondiscretionary  and  final  and  binding  on  the  affected  Participant  and  the  Company;  provided  that  the 
Administrator will determine whether an adjustment is equitable.

(b)

Corporate Transactions.  In the event of any dividend or other distribution (whether in the form of cash, Common Stock, 
other securities, or other property), reorganization, merger, consolidation, combination, repurchase, recapitalization, liquidation, dissolution, 
or sale, transfer, exchange or other disposition of all or substantially all of the assets of the Company, or sale or exchange of Common Stock 
or other securities of the Company, Change in Control, issuance of warrants or other rights to purchase Common Stock or other securities of 
the Company, other similar corporate transaction or event, other unusual or nonrecurring transaction or event affecting the Company or its 
financial statements or any change in any Applicable Laws or accounting principles, the Administrator, on such terms and conditions as it 
deems appropriate, either by the terms of the Award or by action taken prior to the occurrence of such transaction or event (except that action 
to give effect to a change in Applicable Law or accounting principles may be made within a reasonable period of time after such change) and 
either automatically or upon the Participant’s request, is hereby authorized to take any one or more of the following actions whenever the 
Administrator determines that such action is appropriate in order to (x) prevent dilution or enlargement of the benefits or potential benefits 
intended by the Company to be made available under the Plan or with respect to any Award granted or issued under the Plan, (y) to facilitate 
such transaction or event or (z) give effect to such changes in Applicable Laws or accounting principles:  

(i)

To provide for the cancellation of any such Award in exchange for either an amount of cash or other property 
with  a  value  equal  to  the  amount  that  could  have  been  obtained  upon  the  exercise  or  settlement  of  the  vested  portion  of  such  Award  or 
realization of the Participant’s rights under the vested portion of such Award, as applicable; provided that, if the amount that could have been 
obtained upon the exercise or settlement of the vested portion of such Award or realization of the Participant’s rights, in any case, is equal to 
or less than zero, then the Award may be terminated without payment;  

thereby, notwithstanding anything to the contrary in the Plan or the provisions of such Award;

(ii)

To  provide  that  such  Award  shall  vest  and,  to  the  extent  applicable,  be  exercisable  as  to  all  shares  covered 

(iii)

To  provide  that  such  Award  be  assumed  by  the  successor  or  survivor  corporation,  or  a  parent  or  subsidiary 
thereof, or shall be substituted for by awards covering the stock of the successor or survivor corporation, or a parent or subsidiary thereof, 
with appropriate adjustments as to the number and kind of shares and/or applicable exercise or purchase price, in all cases, as determined by 
the Administrator;  

(iv)

To  make  adjustments  in  the  number  and  type  of  shares  of  Common  Stock  (or  other  securities  or  property) 
subject to outstanding Awards and/or with respect to which Awards may be granted under the Plan (including, but not limited to, adjustments 
of the limitations in Section IV hereof on the maximum number and kind of shares which may be issued) and/or in the terms and conditions 
of (including the grant or exercise price), and the criteria included in, outstanding Awards;  

(v)

(vi)

event.

To replace such Award with other rights or property selected by the Administrator; and/or

To provide that the Award will terminate and cannot vest, be exercised or become payable after the applicable 

(c)

Administrative Stand Still.  In the event of any pending stock dividend, stock split, combination or exchange of shares, 
merger, consolidation or other distribution (other than normal cash dividends) of Company assets to stockholders, or any other extraordinary 
transaction or change affecting the Shares or the share price of Common Stock, including any Equity Restructuring or any securities offering 
or other 

5

similar transaction, for administrative convenience, the Administrator may refuse to permit the exercise of any Award for up to sixty days 
before or after such transaction.

(d)

General.  Except as expressly provided in the Plan or the Administrator’s action under the Plan, no Participant will have 
any rights due to any subdivision or consolidation of Shares of any class, dividend payment, increase or decrease in the number of Shares of 
any  class  or  dissolution,  liquidation,  merger,  or  consolidation  of  the  Company  or  other  corporation.    Except  as  expressly  provided  with 
respect to an Equity Restructuring under Section VIII(a) above or the Administrator’s action under the Plan, no issuance by the Company of 
Shares of any class, or securities convertible into Shares of any class, will affect, and no adjustment will be made regarding, the number of 
Shares subject to an Award or the Award’s grant or exercise price.  The existence of the Plan, any Award Agreements and the Awards granted 
hereunder  will  not  affect  or  restrict  in  any  way  the  Company’s  right  or  power  to  make  or  authorize  (i)  any  adjustment,  recapitalization, 
reorganization or other change in the Company’s capital structure or its business, (ii) any merger, consolidation dissolution or liquidation of 
the Company or sale of Company assets or (iii) any sale or issuance of securities, including securities with rights superior to those of the 
Shares or securities convertible into or exchangeable for Shares.  The Administrator may treat Participants and Awards (or portions thereof) 
differently under this Section VIII.

(e)

Change in Control.  Notwithstanding Section VIII(b) above, if a Change in Control occurs and Awards are not continued, 
converted, assumed, or replaced with a comparable award (as determined by the Administrator) by (i) the Company or (ii) a successor entity 
or its parent or subsidiary (an “Assumption”), and provided that the Participant has not had a Termination of Service, then immediately prior 
to  the  Change  in  Control,  such  Awards  (other  than  any  Award  that  is  regularly  scheduled  to  vest  based  on  the  attainment  of  Performance 
Criteria or other performance-based vesting conditions) will become fully vested, exercisable and/or payable, as applicable, and all forfeiture, 
repurchase  and  other  restrictions  on  such  Awards  will  lapse,  in  which  case,  such  Awards  will  be  canceled  upon  the  consummation  of  the 
Change in Control in exchange for the right to receive the Change in Control consideration payable to other holders of Shares, which may be 
on such terms and conditions as apply generally to holders of Shares under the Change in Control documents (including, without limitation, 
any escrow, earn-out or other deferred consideration provisions) or such other terms and conditions as the Administrator may provide, and 
determined by reference to the number of Shares subject to such Awards and net of any applicable exercise price; provided that to the extent 
that  any  Awards  constitute  “nonqualified  deferred  compensation”  that  may  not  be  paid  upon  the  Change  in  Control  under  Section  409A 
without  the  imposition  of  taxes  thereon  under  Section  409A,  the  timing  of  such  payments  shall  be  governed  by  the  applicable  Award 
Agreement (subject to any deferred consideration provisions applicable under the Change in Control documents); and provided, further, that 
if the amount to which a Participant would be entitled upon the settlement or exercise of such Award at the time of the Change in Control is 
equal to or less than zero, then such Award may be terminated without payment. An Award will be considered replaced with a comparable 
award if the Award is exchanged for an amount of cash or other property with a value equal to the amount that could have been obtained 
upon  the  settlement  of  such  Award  in  such  Change  in  Control  (as  determined  by  the  Administrator),  even  if  such  cash  or  other  property 
payable with respect to the unvested portion of such Award remains subject to similar vesting provisions following such Change in Control. 
Notwithstanding  the  foregoing,  the  Administrator  will  have  full  and  final  authority  to  determine  whether  an  Assumption  of  an  Award  has 
occurred in connection with a Change in Control.

IX.GENERAL PROVISIONS APPLICABLE TO AWARDS. 

(a)

Transferability.  Except as the Administrator may determine or provide in an Award Agreement or otherwise for Awards 
other than Incentive Stock Options, Awards may not be sold, assigned, transferred, pledged or otherwise encumbered, either voluntarily or by 
operation of law, except by will or the laws of descent and distribution, or, subject to the Administrator’s consent, pursuant to a domestic 
relations order, 

6

and, during the life of the Participant, will be exercisable only by the Participant.  References to a Participant, to the extent relevant in the 
context, will include references to a Participant’s authorized transferee that the Administrator specifically approves.

(b)

Documentation.    Each  Award  will  be  evidenced  in  an  Award  Agreement,  which  may  be  written  or  electronic,  as  the 

Administrator determines. Each Award may contain terms and conditions in addition to those set forth in the Plan. 

(c)

Discretion.  Except as the Plan otherwise provides, each Award may be made alone or in addition or in relation to any 
other Award.  The terms of each Award to a Participant need not be identical, and the Administrator need not treat Participants or Awards (or 
portions thereof) uniformly. 

(d)

Termination of Status.  The Administrator will determine how the disability, death, retirement, authorized leave of absence 
or any other change or purported change in a Participant’s Service Provider status affects an Award and the extent to which, and the period 
during  which,  the  Participant,  the  Participant’s  legal  representative,  conservator,  guardian  or  Designated  Beneficiary  may  exercise  rights 
under the Award, if applicable.

(e)

Withholding.  Each Participant must pay the Company, or make provision satisfactory to the Administrator for payment 
of, any taxes required by law to be withheld in connection with such Participant’s Awards by the date of the event creating the tax liability.  
The Company may deduct an amount sufficient to satisfy such tax obligations based on the minimum statutory withholding rates from any 
payment of any kind otherwise due to a Participant.  Participants may satisfy such tax obligations in cash, by wire transfer of immediately 
available funds, by check made payable to the order of the Company, or subject to Section X(h) and any Company insider trading policy 
(including  blackout  periods),  (i)  to  the  extent  permitted  by  the  Administrator,  in  whole  or  in  part  by  delivery  of  Shares,  including  Shares 
retained from the Award creating the tax obligation, valued at their Fair Market Value, (ii) if there is a public market for Shares at the time the 
tax obligations are satisfied, unless the Administrator otherwise determines, (A) delivery (including telephonically to the extent permitted by
the Company) of an irrevocable and unconditional undertaking by a broker acceptable to the Company to deliver promptly to the Company 
sufficient funds to satisfy the tax obligations, or (B) delivery by the Participant to the Company of a copy of irrevocable and unconditional 
instructions  to  a  broker  acceptable  to  the  Company  to  deliver  promptly  to  the  Company  cash  or  a  check  sufficient  to  satisfy  the  tax 
withholding;  provided  that  such  amount  is  paid  to  the  Company  at  such  time  as  may  be  required  by  the  Administrator,  or  (iii)  any 
combination of the foregoing permitted payment forms (including cash, wire transfer or check).  If any tax withholding obligation will be 
satisfied  under  clause  (i)  of  the  immediately  preceding  sentence  by  the  Company’s  retention  of  Shares  from  the  Award  creating  the  tax 
obligation and there is a public market for Shares at the time the tax obligation is satisfied, the Company may elect to instruct any brokerage 
firm determined acceptable to the Company for such purpose to sell on the applicable Participant’s behalf some or all of the Shares retained 
and  to  remit  the  proceeds  of  the  sale  to  the  Company  or  its  designee,  and  each  Participant’s  acceptance  of  an  Award  under  the  Plan  will 
constitute  the  Participant’s  authorization  to  the  Company  and  instruction  and  authorization  to  such  brokerage  firm  to  complete  the 
transactions described in this sentence. 

(f)

Amendment of Award; Repricing.  The Administrator may amend, modify or terminate any outstanding Award, including 
by substituting another Award of the same or a different type, changing the exercise or settlement date, and converting an Incentive Stock 
Option to a Non-Qualified Stock Option.  The Participant’s consent to such action will be required unless (i) the action, taking into account 
any  related  action,  does  not  materially  and  adversely  affect  the  Participant’s  rights  under  the  Award,  or  (ii)  the  change  is  permitted  under 
Section  VIII  or  pursuant  to  Section  X(f).    Notwithstanding  the  foregoing  or  anything  in  the  Plan  to  the  contrary,  the  Administrator  may, 
without the approval of the stockholders of the Company, reduce the exercise price per share of outstanding Options or Stock Appreciation 
Rights or cancel 

7

outstanding  Options  or  Stock  Appreciation  Rights  in  exchange  for  cash,  other  Awards  or  Options  or  Stock  Appreciation  Rights  with  an 
exercise price per share that is less than the exercise price per share of the original Options or Stock Appreciation Rights.

(g)

Conditions  on  Delivery  of  Stock.    The  Company  will  not  be  obligated  to  deliver  any  Shares  under  the  Plan  or  remove 
restrictions  from  Shares  previously  delivered  under  the  Plan  until  (i)  all  Award  conditions  have  been  met  or  removed  to  the  Company’s 
satisfaction, (ii) as determined by the Company, all other legal matters regarding the issuance and delivery of such Shares have been satisfied, 
including any applicable securities laws and stock exchange or stock market rules and regulations, and (iii) the Participant has executed and 
delivered to the Company such representations or agreements as the Administrator deems necessary or appropriate to satisfy any Applicable 
Laws.    The  Company’s  inability  to  obtain  authority  from  any  regulatory  body  having  jurisdiction,  which  the  Administrator  determines  is 
necessary to the lawful issuance and sale of any securities, will relieve the Company of any liability for failing to issue or sell such Shares as 
to which such requisite authority has not been obtained.

(h)

Acceleration.  The Administrator may at any time provide that any Award will become immediately vested and fully or 

partially exercisable, free of some or all restrictions or conditions, or otherwise fully or partially realizable. 

(i)

Additional Terms of Incentive Stock Options.  The Administrator may grant Incentive Stock Options only to employees of 
the Company, any of its present or future parent or subsidiary corporations, as defined in Sections 424(e) or (f) of the Code, respectively, and 
any other entities the employees of which are eligible to receive Incentive Stock Options under the Code.  If an Incentive Stock Option is 
granted to a Greater Than 10% Stockholder, the exercise price will not be less than 110% of the Fair Market Value on the Option’s grant date, 
and the term of the Option will not exceed five years.  All Incentive Stock Options will be subject to and construed consistently with Section 
422 of the Code.  By accepting an Incentive Stock Option, the Participant agrees to give prompt notice to the Company of dispositions or 
other transfers (other than in connection with a Change in Control) of Shares acquired under the Option made within (i) two years from the 
grant date of the Option or (ii) one year after the transfer of such Shares to the Participant, specifying the date of the disposition or other 
transfer  and  the  amount  the  Participant  realized,  in  cash,  other  property,  assumption  of  indebtedness  or  other  consideration,  in  such 
disposition or other transfer.  Neither the Company nor the Administrator will be liable to a Participant, or any other party, if an Incentive 
Stock Option fails or ceases to qualify as an “incentive stock option” under Section 422 of the Code .  Any Incentive Stock Option or portion 
thereof that fails to qualify as an “incentive stock option” under Section 422 of the Code for any reason, including becoming exercisable with 
respect to Shares having a fair market value exceeding the $100,000 limitation under Treasury Regulation Section 1.422-4, will be a Non-
Qualified Stock Option.

X.MISCELLANEOUS.

(a)

No Right to Employment or Other Status.  No person will have any claim or right to be granted an Award, and the grant of 
an Award will not be construed as giving a Participant the right to continued employment or any other relationship with the Company.  The 
Company expressly reserves the right at any time to dismiss or otherwise terminate its relationship with a Participant free from any liability 
or claim under the Plan or any Award, except as expressly provided in an Award Agreement.

(b)

No Rights as Stockholder; Certificates.  Subject to the Award Agreement, no Participant or Designated Beneficiary will 
have any rights as a stockholder with respect to any Shares to be distributed under an Award until becoming the record holder of such Shares.  
Notwithstanding any other provision of the Plan, unless the Administrator otherwise determines or Applicable Laws require, the Company 
will not be required to deliver to any Participant certificates evidencing Shares issued in connection with any Award 

8

and instead such Shares may be recorded in the books of the Company (or, as applicable, its transfer agent or stock plan administrator).  The 
Company may place legends on stock certificates issued under the Plan that the Administrator deems necessary or appropriate to comply with 
Applicable Laws.

(c)

Effective Date and Term of Plan.  The Plan, as amended and restated, shall become effective as of the Amendment Date. 
The Plan will remain in effect until the tenth anniversary of the day prior to the Public Trading Date, unless earlier terminated by the Board.  
No Awards may be granted under the Plan during any suspension period or after Plan termination.  Notwithstanding anything in the Plan to 
the contrary, an Incentive Stock Option may not be granted under the Plan after ten years from the earlier of (i) the date the Board adopted 
the  Plan  or  (ii)  the  date  the  Company’s  stockholders  approved  the  Plan,  but  Awards  previously  granted  may  extend  beyond  that  date  in 
accordance with the Plan.  

(d)

Amendment  of  Plan.    The  Administrator  may  amend,  suspend  or  terminate  the  Plan  at  any  time;  provided  that  no 
amendment, other than an increase to the Overall Share Limit, may materially and adversely affect any Award outstanding at the time of such 
amendment without the affected Participant’s consent.  Awards outstanding at the time of any Plan suspension or termination will continue to 
be governed by the Plan and the Award Agreement, as in effect before such suspension or termination.  The Board will obtain stockholder 
approval of any Plan amendment to the extent necessary to comply with Applicable Laws.

(e)

Provisions  for  Foreign  Participants.    The  Administrator  may  modify  Awards  granted  to  Participants  who  are  foreign 
nationals  or  employed  outside  the  United  States  or  establish  subplans  or  procedures  under  the  Plan  to  address  differences  in  laws,  rules, 
regulations or customs of such foreign jurisdictions with respect to tax, securities, currency, employee benefit or other matters.

(f)

Section 409A.

(i)

General.  The Company intends that all Awards be structured to comply with, or be exempt from, Section 409A,
such that no adverse tax consequences, interest, or penalties under Section 409A apply.  Notwithstanding anything in the Plan or any Award 
Agreement to the contrary, the Administrator may, without a Participant’s consent, amend this Plan or Awards, adopt policies and procedures, 
or take any other actions (including amendments, policies, procedures and retroactive actions) as are necessary or appropriate to preserve the 
intended  tax  treatment  of  Awards,  including  any  such  actions  intended  to  (A)  exempt  this  Plan  or  any  Award  from  Section  409A,  or  (B) 
comply with Section 409A, including regulations, guidance, compliance programs and other interpretative authority that may be issued after 
an  Award’s  grant  date.    The  Company  makes  no  representations  or  warranties  as  to  an  Award’s  tax  treatment  under  Section  409A  or 
otherwise.  The Company will have no obligation under this Section X(f) or otherwise to avoid the taxes, penalties or interest under Section 
409A  with  respect  to  any  Award  and  will  have  no  liability  to  any  Participant  or  any  other  person  if  any  Award,  compensation  or  other 
benefits under the Plan are determined to constitute noncompliant “nonqualified deferred compensation” subject to taxes, penalties or interest 
under Section 409A.

(ii)

Separation  from  Service.    If  an  Award  constitutes  “nonqualified  deferred  compensation”  under  Section  409A, 
any payment or settlement of such Award upon a termination of a Participant’s Service Provider relationship will, to the extent necessary to 
avoid  taxes  under  Section  409A,  be  made  only  upon  the  Participant’s  “separation  from  service”  (within  the  meaning  of  Section  409A), 
whether such “separation from service” occurs upon or after the termination of the Participant’s Service Provider relationship.  For purposes 
of this Plan or any Award Agreement relating to any such payments or benefits, references to a “termination,” “termination of employment” 
or like terms means a “separation from service.”

9

(iii)

Payments  to  Specified  Employees.    Notwithstanding  any  contrary  provision  in  the  Plan  or  any  Award 
Agreement,  any  payment(s)  of  “nonqualified  deferred  compensation”  required  to  be  made  under  an  Award  to  a  “specified  employee”  (as 
defined under Section 409A and as the Administrator determines) due to his or her “separation from service” will, to the extent necessary to 
avoid taxes under Section 409A(a)(2)(B)(i) of the Code, be delayed for the six-month period immediately following such “separation from 
service”  (or,  if  earlier,  until  the  specified  employee’s  death)  and  will  instead  be  paid  (as  set  forth  in  the  Award  Agreement)  on  the  day 
immediately  following  such  six-month  period  or  as  soon  as  administratively  practicable  thereafter  (without  interest).    Any  payments  of 
“nonqualified deferred compensation” under such Award payable more than six months following the Participant’s “separation from service” 
will be paid at the time or times the payments are otherwise scheduled to be made.

(g)

Limitations  on  Liability.    Notwithstanding  any  other  provisions  of  the  Plan,  no  individual  acting  as  a  director,  officer, 
other employee or agent of the Company or any Subsidiary will be liable to any Participant, former Participant, spouse, beneficiary, or any 
other  person  for  any  claim,  loss,  liability,  or  expense  incurred  in  connection  with  the  Plan  or  any  Award,  and  such  individual  will  not  be 
personally liable with respect to the Plan because of any contract or other instrument executed in his or her capacity as an Administrator, 
director, officer, other employee or agent of the Company or any Subsidiary.  The Company will indemnify and hold harmless each director,
officer, other employee and agent of the Company or any Subsidiary that has been or will be granted or delegated any duty or power relating 
to the Plan’s administration or interpretation, against any cost or expense (including attorneys’ fees) or liability (including any sum paid in 
settlement  of  a  claim  with  the  Administrator’s  approval)  arising  from  any  act  or  omission  concerning  this  Plan  unless  arising  from  such 
person’s own fraud or bad faith.

(h)

Lock-Up Period.    The  Company  may,  at  the  request  of  any  underwriter  representative  or  otherwise,  in  connection  with 
registering  the  offering  of  any  Company  securities  under  the  Securities  Act,  prohibit  Participants  from,  directly  or  indirectly,  selling  or 
otherwise transferring any Shares or other Company securities during a period of up to one hundred eighty days following the effective date 
of a Company registration statement filed under the Securities Act, or such longer period as determined by the underwriter.

(i)

Data Privacy.    As  a  condition  for  receiving  any  Award,  each  Participant  explicitly  and  unambiguously  consents  to  the 
collection, use and transfer, in electronic or other form, of personal data as described in this paragraph by and among the Company and its 
Subsidiaries  and  affiliates  exclusively  for  implementing,  administering  and  managing  the  Participant’s  participation  in  the  Plan.    The 
Company  and  its  Subsidiaries  and  affiliates  may  hold  certain  personal  information  about  a  Participant,  including  the  Participant’s  name, 
address and telephone number; birthdate; social security, insurance number or other identification number; salary; nationality; job title(s); any 
Shares held in the Company or its Subsidiaries and affiliates; and Award details, to implement, manage and administer the Plan and Awards 
(the  “Data”).    The  Company  and  its  Subsidiaries  and  affiliates  may  transfer  the  Data  amongst  themselves  as  necessary  to  implement, 
administer and manage a Participant’s participation in the Plan, and the Company and its Subsidiaries and affiliates may transfer the Data to 
third  parties  assisting  the  Company  with  Plan  implementation,  administration  and  management.    These  recipients  may  be  located  in  the 
Participant’s country, or elsewhere, and the Participant’s country may have different data privacy laws and protections than the recipients’ 
country.    By  accepting  an  Award,  each  Participant  authorizes  such  recipients  to  receive,  possess,  use,  retain  and  transfer  the  Data,  in 
electronic or other form, to implement, administer and manage the Participant’s participation in the Plan, including any required Data transfer 
to a broker or other third party with whom the Company or the Participant may elect to deposit any Shares.  The Data related to a Participant 
will be held only as long as necessary to implement, administer, and manage the Participant’s participation in the Plan.  A Participant may, at 
any time, view the Data that the Company holds regarding such Participant, request additional information about the storage and processing 
of the Data regarding such Participant, recommend any necessary corrections to the Data regarding the Participant or refuse or 

10

withdraw the consents in this Section X(i) in writing, without cost, by contacting the local human resources representative.  The Company 
may cancel Participant’s ability to participate in the Plan and, in the Administrator’s discretion, the Participant may forfeit any outstanding 
Awards if the Participant refuses or withdraws the consents in this Section X(i).  For more information on the consequences of refusing or 
withdrawing consent, Participants may contact their local human resources representative.

(j)

Severability.  If any portion of the Plan or any action taken under it is held illegal or invalid for any reason, the illegality 
or invalidity will not affect the remaining parts of the Plan, and the Plan will be construed and enforced as if the illegal or invalid provisions 
had been excluded, and the illegal or invalid action will be null and void.

(k)

Governing  Documents.    If  any  contradiction  occurs  between  the  Plan  and  any  Award  Agreement  or  other  written 
agreement between a Participant and the Company (or any Subsidiary) that the Administrator has approved, the Plan will govern, unless it is 
expressly specified in such Award Agreement or other written document that a specific provision of the Plan will not apply.

Governing Law.  The Plan and all Awards will be governed by and interpreted in accordance with the laws of the State of 
Delaware, disregarding any state’s choice-of-law principles requiring the application of a jurisdiction’s laws other than the State of Delaware.

(l)

(m)

Claw-back Provisions.  All Awards (including any proceeds, gains or other economic benefit the Participant actually or 
constructively receives upon receipt or exercise of any Award or the receipt or resale of any Shares underlying the Award) will be subject to 
any Company claw-back policy, including any claw-back policy adopted to comply with Applicable Laws (including the Dodd-Frank Wall 
Street Reform and Consumer Protection Act and any rules or regulations promulgated thereunder) as set forth in such claw-back policy or the 
Award Agreement.

(n)

Titles and Headings.  The titles and headings in the Plan are for convenience of reference only and, if any conflict, the 

Plan’s text, rather than such titles or headings, will control.

(o)

Conformity  to  Securities  Laws.    Participant  acknowledges  that  the  Plan  is  intended  to  conform  to  the  extent  necessary 
with Applicable Laws.  Notwithstanding anything herein to the contrary, the Plan and all Awards will be administered only in conformance 
with Applicable Laws.  To the extent Applicable Laws permit, the Plan and all Award Agreements will be deemed amended as necessary to 
conform to Applicable Laws.

(p)

Relationship to Other Benefits.  No payment under the Plan will be taken into account in determining any benefits under 
any pension, retirement, savings, profit sharing, group insurance, welfare or other benefit plan of the Company or any Subsidiary except as 
expressly provided in writing in such other plan or an agreement thereunder.

(q)

Broker-Assisted Sales.  In the event of a broker-assisted sale of Shares in connection with the payment of amounts owed 
by a Participant under or with respect to the Plan or Awards, including amounts to be paid under the final sentence of Section IX(e): (a) any 
Shares to be sold through the broker-assisted sale will be sold on the day the payment first becomes due, or as soon thereafter as practicable; 
(b) such Shares may be sold as part of a block trade with other Participants in the Plan in which all participants receive an average price; (c) 
the applicable Participant will be responsible for all broker’s fees and other costs of sale, and by accepting an Award, each Participant agrees 
to indemnify and hold the Company harmless from any losses, costs, damages, or expenses relating to any such sale; (d) to the extent the 
Company  or  its  designee  receives  proceeds  of  such  sale  that  exceed  the  amount  owed,  the  Company  will  pay  such  excess  in  cash  to  the 
applicable Participant as soon as reasonably practicable; (e) the Company 

11

and its designees are under no obligation to arrange for such sale at any particular price; and (f) in the event the proceeds of such sale are 
insufficient  to  satisfy  the  Participant’s  applicable  obligation,  the  Participant  may  be  required  to  pay  immediately  upon  demand  to  the 
Company or its designee an amount in cash sufficient to satisfy any remaining portion of the Participant’s obligation.

XI.DEFINITIONS

As used in the Plan, the following words and phrases will have the following meanings:

(a)

“Administrator” means the Board or a Committee to the extent that the Board’s powers or authority under the Plan have 

been delegated to such Committee.

(b)

“Amendment Date” means December 14, 2022.

(c)

“Applicable Laws” means the requirements relating to the administration of equity incentive plans under U.S. federal and 
state securities, tax and other applicable laws, rules and regulations, the applicable rules of any stock exchange or quotation system on which 
the  Common  Stock  is  listed  or  quoted  and  the  applicable  laws  and  rules  of  any  foreign  country  or  other  jurisdiction  where  Awards  are 
granted.

(d)

“Award”  means,  individually  or  collectively,  a  grant  under  the  Plan  of  Options,  Stock  Appreciation  Rights,  Restricted 

Stock, Restricted Stock Units or Other Stock or Cash Based Awards.

(e)

“Award Agreement” means a written agreement evidencing an Award, which may be electronic, that contains such terms 

and conditions as the Administrator determines, consistent with and subject to the terms and conditions of the Plan.

(f)

(g)

“Board” means the Board of Directors of the Company.

“Change in Control” means and includes each of the following: 

(i)

A transaction or series of transactions (other than an offering of Common Stock to the general public through a 
registration  statement  filed  with  the  Securities  and  Exchange  Commission  or  a  transaction  or  series  of  transactions  that  meets  the 
requirements of clauses (A) and (B) of subsection (iii) below) whereby any “person” or related “group” of “persons” (as such terms are used 
in Sections 13(d) and 14(d)(2) of the Exchange Act) (other than the Company, any of its Subsidiaries, an employee benefit plan maintained 
by the Company or any of its Subsidiaries or a “person” that, prior to such transaction, directly or indirectly controls, is controlled by, or is 
under common control with, the Company) directly or indirectly acquires beneficial ownership (within the meaning of Rule 13d-3 under the 
Exchange  Act)  of  securities  of  the  Company  possessing  more  than  50%  of  the  total  combined  voting  power  of  the  Company’s  securities 
outstanding immediately after such acquisition; or

(ii)

During  any  period  of  two  consecutive  years,  individuals  who,  at  the  beginning  of  such  period,  constitute  the 
Board together with any new Director(s) (other than a Director designated by a person who shall have entered into an agreement with the 
Company  to  effect  a  transaction  described  in  subsections  (i)  or  (iii))  whose  election  by  the  Board  or  nomination  for  election  by  the 
Company’s stockholders was approved by a vote of at least two-thirds of the Directors then still in office who either were Directors at the
beginning of the two-year period or whose election or nomination for election was previously so approved, cease for any reason to constitute 
a majority thereof; or

Company through one or more intermediaries) of (x) a merger, consolidation, reorganization, 

(iii)

The  consummation  by  the  Company  (whether  directly  involving  the  Company  or  indirectly  involving  the

12

or business combination or (y) a sale or other disposition of all or substantially all of the Company’s assets in any single transaction or series 
of related transactions or (z) the acquisition of assets or stock of another entity, in each case other than a transaction:

(A)

which results in the Company’s voting securities outstanding immediately before the 
transaction continuing to represent (either by remaining outstanding or by being converted into voting securities of the 
Company or the person that, as a result of the transaction, controls, directly or indirectly, the Company or owns, directly or 
indirectly, all or substantially all of the Company’s assets or otherwise succeeds to the business of the Company (the 
Company or such person, the “Successor Entity”)) directly or indirectly, at least a majority of the combined voting power 
of the Successor Entity’s outstanding voting securities immediately after the transaction, and

(B)

after which no person or group beneficially owns voting securities representing 50% or 
more of the combined voting power of the Successor Entity; provided, however, that no person or group shall be treated 
for purposes of this clause (B) as beneficially owning 50% or more of the combined voting power of the Successor Entity 
solely as a result of the voting power held in the Company prior to the consummation of the transaction.

Notwithstanding the foregoing, if a Change in Control constitutes a payment event with respect to any Award (or portion of any Award) that 
provides for the deferral of compensation that is subject to Section 409A, to the extent required to avoid the imposition of additional taxes 
under Section 409A, the transaction or event described in subsection (i), (ii) or (iii) with respect to such Award (or portion thereof) shall only 
constitute a Change in Control for purposes of the payment timing of such Award if such transaction also constitutes a “change in control 
event,” as defined in Treasury Regulation Section 1.409A-3(i)(5).

The Administrator shall have full and final authority, which shall be exercised in its discretion, to determine conclusively whether a Change 
in Control has occurred pursuant to the above definition, the date of the occurrence of such Change in Control and any incidental matters 
relating thereto; provided that any exercise of authority in conjunction with a determination of whether a Change in Control is a “change in 
control event” as defined in Treasury Regulation Section 1.409A-3(i)(5) shall be consistent with such regulation.

(h)

“Code” means the Internal Revenue Code of 1986, as amended, and the regulations issued thereunder.

(i)

“Committee” means one or more committees or subcommittees of the Board, which may include one or more Company 
directors or executive officers, to the extent Applicable Laws permit.  To the extent required to comply with the provisions of Rule 16b-3, it 
is intended that each member of the Committee will be, at the time the Committee takes any action with respect to an Award that is subject to 
Rule  16b-3,  a  “non-employee  director”  within  the  meaning  of  Rule  16b-3;  however,  a  Committee  member’s  failure  to  qualify  as  a  “non-
employee  director”  within  the  meaning  of  Rule  16b-3  will  not  invalidate  any  Award  granted  by  the  Committee  that  is  otherwise  validly 
granted under the Plan.  

(j)

(k)

“Common Stock” means the common stock of the Company. 

“Company” means Seres Therapeutics, Inc., a Delaware corporation, or any successor.

(l)

“Consultant” means  any  person,  including  any  adviser,  engaged  by  the  Company  or  its  parent  or  Subsidiary  to  render 
services to such entity if the consultant or adviser: (i) renders bona fide services to the Company; (ii) renders services not in connection with 
the offer or sale of securities in a capital-raising 

13

transaction and does not directly or indirectly promote or maintain a market for the Company’s securities; and (iii) is a natural person.

(m)

“Designated Beneficiary” means the beneficiary or beneficiaries the Participant designates, in a manner the Administrator 
determines,  to  receive  amounts  due  or  exercise  the  Participant’s  rights  if  the  Participant  dies  or  becomes  incapacitated.    Without  a 
Participant’s effective designation, “Designated Beneficiary” will mean the Participant’s estate.

(n)

(o)

(p)

“Director” means a Board member.

“Disability” means a permanent and total disability under Section 22(e)(3) of the Code, as amended.

“Dividend Equivalents” means a right granted to a Participant under the Plan to receive the equivalent value (in cash or 

Shares) of dividends paid on Shares.

(q)

“Employee” means any employee of the Company or its Subsidiaries.

(r)

“Equity Restructuring”  means  a  nonreciprocal  transaction  between  the  Company  and  its  stockholders,  such  as  a  stock 
dividend, stock split, spin-off or recapitalization through a large, nonrecurring cash dividend, that affects the number or kind of Shares (or 
other Company securities) or the share price of Common Stock (or other Company securities) and causes a change in the per share value of 
the Common Stock underlying outstanding Awards.

(s)

“Exchange Act” means the Securities Exchange Act of 1934, as amended.

(t)

“Fair Market Value” means, as of any date, the value of Common Stock determined as follows: (i) if the Common Stock 
is listed on any established stock exchange, its Fair Market Value will be the closing sales price for such Common Stock as quoted on such 
exchange for such date, or if no sale occurred on such date, the last day preceding such date during which a sale occurred, as reported in The 
Wall Street Journal or another source the Administrator deems reliable; (ii) if the Common Stock is not traded on a stock exchange but is 
quoted on a national market or other quotation system, the closing sales price on such date, or if no sales occurred on such date, then on the 
last date preceding such date during which a sale occurred, as reported in The Wall Street Journal or another source the Administrator deems 
reliable;  or  (iii)  without  an  established  market  for  the  Common  Stock,  the  Administrator  will  determine  the  Fair  Market  Value  in  its 
discretion.

(u)

“Greater Than 10% Stockholder” means an individual then owning (within the meaning of Section 424(d) of the Code) 
more than 10% of the total combined voting power of all classes of stock of the Company or its parent or subsidiary corporation, as defined 
in Section 424(e) and (f) of the Code, respectively.

(v)

“Incentive Stock Option” means an Option intended to qualify as an “incentive stock option” as defined in Section 422 of 

the Code.

(w)

(x)

“Non-Qualified Stock Option” means an Option not intended or not qualifying as an Incentive Stock Option.

“Option” means an option to purchase Shares.

14

(y)

“Other Stock or Cash Based Awards” means cash awards, awards of Shares, and other awards valued wholly or partially 

by referring to, or are otherwise based on, Shares or other property.

(z)

“Overall Share Limit” means the sum of (i) 2,200,000 Shares; (ii) any shares of Common Stock which are subject to Prior 
Plan Awards which become available for issuance under the Plan pursuant to Section IV(b) and (iii) an annual increase on the first day of 
each calendar year beginning January 1, 2016 and ending on and including January 1, 2025, equal to the lesser of (A) 4% of the aggregate 
number of shares of Common Stock outstanding on the final day of the immediately preceding calendar year and (B) such smaller number of 
Shares as is determined by the Board.

(aa)

“Participant” means a Service Provider who has been granted an Award.

(bb)

“Performance Criteria” mean the criteria (and adjustments) that the Administrator may select for an Award to establish 
performance goals for a performance period, which may include the following: net earnings or losses (either before or after one or more of 
interest,  taxes,  depreciation,  amortization,  and  non-cash  equity-based  compensation  expense);  gross  or  net  sales  or  revenue  or  sales  or 
revenue growth; net income (either before or after taxes) or adjusted net income; profits (including but not limited to gross profits, net profits, 
profit growth, net operation profit or economic profit), profit return ratios or operating margin; budget or operating earnings (either before or 
after taxes or before or after allocation of corporate overhead and bonus); cash flow (including operating cash flow and free cash flow or cash 
flow return on capital); return on assets; return on capital or invested capital; cost of capital; return on stockholders’ equity; total stockholder 
return; return on sales; costs, reductions in costs and cost control measures; expenses; working capital; earnings or loss per share; adjusted 
earnings or loss per share; price per share or dividends per share (or appreciation in or maintenance of such price or dividends); regulatory 
achievements  or  compliance;  implementation,  completion  or  attainment  of  objectives  relating  to  research,  development,  regulatory, 
commercial,  or  strategic  milestones  or  developments;  market  share;  economic  value  or  economic  value  added  models;  division,  group  or 
corporate financial goals; customer satisfaction/growth; customer service; employee satisfaction; recruitment and maintenance of personnel; 
human  resources  management;  supervision  of  litigation  and  other  legal  matters;  strategic  partnerships  and  transactions;  financial  ratios 
(including  those  measuring  liquidity,  activity,  profitability  or  leverage);  debt  levels  or  reductions;  sales-related  goals;  financing  and  other 
capital raising transactions; cash on hand; acquisition activity; investment sourcing activity; and marketing initiatives, any of which may be 
measured in absolute terms or as compared to any incremental increase or decrease, peer group results, or market performance indicators or 
indices.

(cc)

“Plan” means this 2015 Incentive Award Plan, as amended or restated from time to time.

(dd)

“Prior Plans” means, collectively, the Seres Therapeutics, Inc. 2012 Stock Incentive Plan and any prior equity incentive 

plans of the Company or its predecessor.

(ee)

“Prior Plan Award” means an award outstanding under the Prior Plans as of the Plan’s effective date in Section X(c).

(ff)

“Public Trading Date” means the first date upon which the Common Stock is listed (or approved for listing) upon notice 
of issuance on any securities exchange or designated (or approved for designation) upon notice of issuance as a national market security on 
an interdealer quotation system, or, if earlier, the date on which the Company becomes a “publicly held corporation” for purposes of Treasury 
Regulation Section 1.162-27(c)(1).

(gg)

“Restricted Stock” means Shares awarded to a Participant under Section VI subject to certain vesting conditions and other 

restrictions.

15

(hh)

“Restricted Stock Unit” means an unfunded, unsecured right to receive, on the applicable settlement date, one Share or an 
amount  in  cash  or  other  consideration  determined  by  the  Administrator  to  be  of  equal  value  as  of  such  settlement  date,  subject  to  certain 
vesting conditions and other restrictions.

(ii)

(jj)

“Rule 16b-3” means Rule 16b-3 promulgated under the Exchange Act.

“Section  409A”  means  Section  409A  of  the  Code  and  all  regulations,  guidance,  compliance  programs  and  other 

interpretative authority thereunder.

(kk)

“Securities Act” means the Securities Act of 1933, as amended.

(ll)

“Service Provider” means an Employee, Consultant or Director.

(mm)

“Shares” means shares of Common Stock.

(nn)

“Stock Appreciation Right” means a stock appreciation right granted under Section V.

(oo)

“Subsidiary” means any entity (other than the Company), whether domestic or foreign, in an unbroken chain of entities 
beginning  with  the  Company  if  each  of  the  entities  other  than  the  last  entity  in  the  unbroken  chain  beneficially  owns,  at  the  time  of  the 
determination, securities or interests representing at least 50% of the total combined voting power of all classes of securities or interests in 
one of the other entities in such chain.

(pp)

“Termination of Service” means the date the Participant ceases to be a Service Provider.

* * * * *

16

 
Form of Stock Option Grant Notice

SERES THERAPEUTICS, INC. 
2015 INCENTIVE AWARD PLAN

STOCK OPTION GRANT NOTICE

Capitalized terms not specifically defined in this Stock Option Grant Notice (the “Grant Notice”) have the meanings given to them in the 2015 

Incentive Award Plan (as amended from time to time, the “Plan”) of Seres Therapeutics, Inc. (the “Company”).

The Company hereby grants to the participant listed below (“Participant”) the stock option described in this Grant Notice (the “Option”), subject 

to the terms and conditions of the Plan and the Stock Option Agreement attached hereto as Exhibit A (the “Agreement”), both of which are incorporated 
into this Grant Notice by reference.

Participant:

Grant Date:

Exercise Price per Share:

Shares Subject to the Option:

Final Expiration Date:

Vesting Commencement Date:

Vesting Schedule:

Type of Option

[To be specified in individual award agreements]

☐ Incentive Stock Option ☐ Non-Qualified Stock Option

By Participant’s signature below, Participant agrees to be bound by the terms of this Grant Notice, the Plan and the Agreement. Participant has 

reviewed the Plan, this Grant Notice and the Agreement in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this 
Grant Notice and fully understands all provisions of the Plan, this Grant Notice and the Agreement. Participant hereby agrees to accept as binding, 
conclusive and final all decisions or interpretations of the Administrator upon any questions arising under the Plan, this Grant Notice or the Agreement. 

SERES THERAPEUTICS, INC.

    PARTICIPANT

By:

Print Name:

Title:

17

 
 
 
 
 
   
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
 
STOCK OPTION AGREEMENT 

Exhibit A 

Capitalized terms not specifically defined in this Agreement have the meanings specified in the Grant Notice or, if not defined in the Grant 

Notice, in the Plan. 

ARTICLE I. 
GENERAL 

1.1  Grant of Option. Pursuant to the Grant Notice to which this Agreement is attached, the Company has granted to Participant the Option 

effective as of the grant date set forth in the Grant Notice (the “Grant Date”). 

1.2   Incorporation of Terms of Plan. The Option is subject to the terms and conditions set forth in this Agreement and the Plan, which is 

incorporated herein by reference. In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan will control. 

ARTICLE II. 
PERIOD OF EXERCISABILITY 

2.1   Commencement of Exercisability. The Option will vest and become exercisable according to the vesting schedule in the Grant Notice (the 

“Vesting Schedule”) except that any fraction of a Share as to which the Option would be vested or exercisable will be accumulated and will vest and 
become exercisable only when a whole Share has accumulated. Notwithstanding anything in the Grant Notice, the Plan or this Agreement to the contrary, 
unless the Administrator otherwise determines, the Option will immediately expire and be forfeited as to any portion that is not vested and exercisable as of 
Participant’s Termination of Service for any reason. 

2.2   Duration of Exercisability. The Vesting Schedule is cumulative. Any portion of the Option which vests and becomes exercisable will remain 

vested and exercisable until the Option expires. The Option will be forfeited immediately upon its expiration. 

2.3   Expiration of Option. The Option may not be exercised to any extent by anyone after, and will expire on, the first of the following to occur: 

(a) The final expiration date in the Grant Notice; 

(b) Except as the Administrator may otherwise approve, the expiration of three (3) months from the date of Participant’s Termination 

of Service, unless Participant’s Termination of Service is for Cause or by reason of Participant’s death or Disability; 

(c) Except as the Administrator may otherwise approve, the expiration of one (1) year from the date of Participant’s Termination of 

Service by reason of Participant’s death or Disability; and 

(d) Except as the Administrator may otherwise approve, Participant’s Termination of Service for Cause. 

As used in this Agreement, “Cause” means (i) if Participant is a party to a written employment or consulting agreement with the Company or its Subsidiary 
in which the term “cause” is defined (a “Relevant Agreement”), “Cause” as defined in the Relevant Agreement, and (ii) if no Relevant Agreement exists, 
(A) the Administrator’s determination that Participant failed to substantially perform Participant’s duties (other than a failure resulting from Participant’s 
Disability); (B) the Administrator’s determination that Participant failed to carry out, or comply with any lawful and reasonable directive of the Board or 
Participant’s immediate supervisor; (C) Participant’s conviction, plea of no contest, plea of nolo contendere, or imposition of unadjudicated probation for 
any felony or indictable offense or crime involving moral turpitude; (D) Participant’s unlawful use (including being under the influence) or possession of 
illegal drugs on the premises of the Company or any of its Subsidiaries or while performing 

18

Participant’s duties and responsibilities for the Company or any of its Subsidiaries; or (E) Participant’s commission of an act of fraud, embezzlement, 
misappropriation, misconduct, or breach of fiduciary duty against the Company or any of its Subsidiaries. 

ARTICLE III. 
EXERCISE OF OPTION 

3.1   Person Eligible to Exercise. During Participant’s lifetime, only Participant may exercise the Option. After Participant’s death, any 

exercisable portion of the Option may, prior to the time the Option expires, be exercised by Participant’s Designated Beneficiary as provided in the Plan. 

3.2   Partial Exercise. Any exercisable portion of the Option or the entire Option, if then wholly exercisable, may be exercised, in whole or in 

part, according to the procedures in the Plan at any time prior to the time the Option or portion thereof expires, except that the Option may only be 
exercised for whole Shares. 

3.3 Tax Withholding. 

(a)   The Company has the right and option, but not the obligation, to treat Participant’s failure to provide timely payment in accordance with the 
Plan of any withholding tax arising in connection with the Option as Participant’s election to satisfy all or any portion of the withholding tax by requesting 
the Company retain Shares otherwise issuable under the Option. 

(b)   Participant acknowledges that Participant is ultimately liable and responsible for all taxes owed in connection with the Option, regardless of 

any action the Company or any Subsidiary takes with respect to any tax withholding obligations that arise in connection with the Option. Neither the 
Company nor any Subsidiary makes any representation or undertaking regarding the treatment of any tax withholding in connection with the awarding, 
vesting or exercise of the Option or the subsequent sale of Shares. The Company and the Subsidiaries do not commit and are under no obligation to 
structure the Option to reduce or eliminate Participant’s tax liability. 

ARTICLE IV. 
OTHER PROVISIONS 

4.1   Adjustments. Participant acknowledges that the Option is subject to adjustment, modification and termination in certain events as provided 

in this Agreement and the Plan. 

4.2   Notices. Any notice to be given under the terms of this Agreement to the Company must be in writing and addressed to the Company in care 

of the Company’s Secretary at the Company’s principal office or the Secretary’s then-current email address or facsimile number. Any notice to be given 
under the terms of this Agreement to Participant must be in writing and addressed to Participant (or, if Participant is then deceased, to the person entitled to 
exercise the Option) at Participant’s last known mailing address, email address or facsimile number in the Company’s personnel files. By a notice given 
pursuant to this Section, either party may designate a different address for notices to be given to that party. Any notice will be deemed duly given when 
actually received, when sent by email, when sent by certified mail (return receipt requested) and deposited with postage prepaid in a post office or branch 
post office regularly maintained by the United States Postal Service, when delivered by a nationally recognized express shipping company or upon receipt 
of a facsimile transmission confirmation. 

4.3   Titles. Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of this Agreement. 

4.4   Conformity to Securities Laws. Participant acknowledges that the Plan, the Grant Notice and this Agreement are intended to conform to the 

extent necessary with all Applicable Laws and, to the extent Applicable Laws permit, will be deemed amended as necessary to conform to Applicable 
Laws. 

4.5   Successors and Assigns. The Company may assign any of its rights under this Agreement to single or multiple assignees, and this 

Agreement will inure to the benefit of the successors and assigns of the 

19

 
Company. Subject to the restrictions on transfer set forth in the Plan, this Agreement will be binding upon and inure to the benefit of the heirs, legatees, 
legal representatives, successors and assigns of the parties hereto. 

4.6   Limitations Applicable to Section 16 Persons. Notwithstanding any other provision of the Plan or this Agreement, if Participant is subject to 

Section 16 of the Exchange Act, the Plan, the Grant Notice, this Agreement and the Option will be subject to any additional limitations set forth in any 
applicable exemptive rule under Section 16 of the Exchange Act (including any amendment to Rule 16b-3) that are requirements for the application of such 
exemptive rule. To the extent Applicable Laws permit, this Agreement will be deemed amended as necessary to conform to such applicable exemptive rule. 

4.7   Entire Agreement. The Plan, the Grant Notice and this Agreement (including any exhibit hereto) constitute the entire agreement of the 
parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof. 

4.8   Agreement Severable. In the event that any provision of the Grant Notice or this Agreement is held illegal or invalid, the provision will be 
severable from, and the illegality or invalidity of the provision will not be construed to have any effect on, the remaining provisions of the Grant Notice or 
this Agreement. 

4.9   Limitation on Participant’s Rights. Participation in the Plan confers no rights or interests other than as herein provided. This Agreement 

creates only a contractual obligation on the part of the Company as to amounts payable and may not be construed as creating a trust. Neither the Plan nor 
any underlying program, in and of itself, has any assets. Participant will have only the rights of a general unsecured creditor of the Company with respect to 
amounts credited and benefits payable, if any, with respect to the Option, and rights no greater than the right to receive the Shares as a general unsecured 
creditor with respect to the Option, as and when exercised pursuant to the terms hereof. 

4.10  

Not a Contract of Employment. Nothing in the Plan, the Grant Notice or this Agreement confers upon Participant any right to continue 
in the employ or service of the Company or any Subsidiary or interferes with or restricts in any way the rights of the Company and its Subsidiaries, which 
rights are hereby expressly reserved, to discharge or terminate the services of Participant at any time for any reason whatsoever, with or without Cause, 
except to the extent expressly provided otherwise in a written agreement between the Company or a Subsidiary and Participant. 

4.11  

Counterparts. The Grant Notice may be executed in one or more counterparts, including by way of any electronic signature, subject to 

Applicable Law, each of which will be deemed an original and all of which together will constitute one instrument. 

4.12  Incentive Stock Options. If the Option is designated as an Incentive Stock Option: 

(a) 

 Participant acknowledges that to the extent the aggregate fair market value of shares (determined as of the time the option with respect to 

the shares is granted) with respect to which stock options intended to qualify as “incentive stock options” under Section 422 of the Code, including the 
Option, are exercisable for the first time by Participant during any calendar year exceeds $100,000 or if for any other reason such stock options do not 
qualify or cease to qualify for treatment as “incentive stock options” under Section 422 of the Code, such stock options (including the Option) will be 
treated as non-qualified stock options. Participant further acknowledges that the rule set forth in the preceding sentence will be applied by taking the Option 
and other stock options into account in the order in which they were granted, as determined under Section 422(d) of the Code. Participant also 
acknowledges that if the Option is exercised more than three (3) months after Participant’s Termination of Service, other than by reason of death or 
disability, the Option will be taxed as a Non-Qualified Stock Option. 

(b)   Participant will give prompt written notice to the Company of any disposition or other transfer of any Shares acquired under this Agreement 

if such disposition or other transfer is made (a) within two (2) years from the Grant Date or (b) within one (1) year after the transfer of such Shares to 
Participant. Such notice will specify the date of such disposition or other transfer and the amount realized, in cash, other property, assumption of 
indebtedness or other consideration, by Participant in such disposition or other transfer. 

20

* * * * * 

21

 
Form of Restricted Stock Unit Grant Notice

SERES THERAPEUTICS, INC. 
2015 INCENTIVE AWARD PLAN

RESTRICTED STOCK UNIT GRANT NOTICE

Capitalized terms not specifically defined in this Restricted Stock Unit Grant Notice (the “Grant Notice”) have the meanings given to them in the 

2015 Incentive Award Plan (as amended from time to time, the “Plan”) of Seres Therapeutics, Inc. (the “Company”).

The Company hereby grants to the participant listed below (“Participant”) the Restricted Stock Units described in this Grant Notice (the 
“RSUs”), subject to the terms and conditions of the Plan and the Restricted Stock Unit Agreement attached hereto as Exhibit A (the “Agreement”), both of 
which are incorporated into this Grant Notice by reference. 

Participant:

Grant Date:

Number of RSUs:

Vesting Commencement Date:

Vesting Schedule:

[To be specified in individual award agreements]

By Participant’s signature below, Participant agrees to be bound by the terms of this Grant Notice, the Plan and the Agreement. Participant has 

reviewed the Plan, this Grant Notice and the Agreement in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this 
Grant Notice and fully understands all provisions of the Plan, this Grant Notice and the Agreement. Participant hereby agrees to accept as binding, 
conclusive and final all decisions or interpretations of the Administrator upon any questions arising under the Plan, this Grant Notice or the Agreement.

SERES THERAPEUTICS, INC.

    PARTICIPANT

By:

Print Name:

Title:

22

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
 
RESTRICTED STOCK UNIT AGREEMENT

Exhibit A 

Capitalized terms not specifically defined in this Agreement have the meanings specified in the Grant Notice or, if not defined in the Grant 

Notice, in the Plan.

1.1  Award of RSUs and Dividend Equivalents. 

ARTICLE I.
GENERAL

(a)  The Company has granted the RSUs to Participant effective as of the grant date set forth in the Grant Notice (the “Grant Date”). Each RSU 
represents the right to receive one Share or, at the option of the Company, an amount of cash, in either case, as set forth in this Agreement. Participant will 
have no right to the distribution of any Shares or payment of any cash until the time (if ever) the RSUs have vested.

(b)  The Company hereby grants to Participant, with respect to each RSU, a Dividend Equivalent for ordinary cash dividends paid to 

substantially all holders of outstanding Shares with a record date after the Grant Date and prior to the date the applicable RSU is settled, forfeited or 
otherwise expires. Each Dividend Equivalent entitles Participant to receive the equivalent value of any such ordinary cash dividends paid on a single Share. 
The Company will establish a separate Dividend Equivalent bookkeeping account (a “Dividend Equivalent Account”) for each Dividend Equivalent and 
credit the Dividend Equivalent Account (without interest) on the applicable dividend payment date with the amount of any such cash paid.

1.2  Incorporation of Terms of Plan. The RSUs are subject to the terms and conditions set forth in this Agreement and the Plan, which is 

incorporated herein by reference. In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan will control.

1.3  Unsecured Promise. The RSUs and Dividend Equivalents will at all times prior to settlement represent an unsecured Company obligation 

payable only from the Company’s general assets.

ARTICLE II.
VESTING; FORFEITURE AND SETTLEMENT

2.1  Vesting; Forfeiture. The RSUs will vest according to the vesting schedule in the Grant Notice except that any fraction of an RSU that would 

otherwise be vested will be accumulated and will vest only when a whole RSU has accumulated. In the event of Participant’s Termination of Service for 
any reason, all unvested RSUs will immediately and automatically be cancelled and forfeited, except as otherwise determined by the Administrator or 
provided in a binding written agreement between Participant and the Company. Dividend Equivalents (including any Dividend Equivalent Account 
balance) will vest or be forfeited, as applicable, upon the vesting or forfeiture of the RSU with respect to which the Dividend Equivalent (including the 
Dividend Equivalent Account) relates.

2.2  Settlement.

(a)  RSUs and Dividend Equivalents (including any Dividend Equivalent Account balance) will be paid in Shares or cash at the Company’s 
option as soon as administratively practicable after the vesting of the applicable RSU, but in no event more than sixty (60) days after the RSU’s vesting 
date. Notwithstanding the foregoing, the Company may delay any payment under this Agreement that the Company reasonably determines would violate 
Applicable Law until the earliest date the Company reasonably determines the making of the payment will not cause such a violation (in accordance with 
Treasury Regulation Section 1.409A-2(b)(7)(ii)), provided the Company reasonably believes the delay will not result in the imposition of excise taxes 
under Section 409A.

(b)  If an RSU is paid in cash, the amount of cash paid with respect to the RSU will equal the Fair Market Value of a Share on the day 

immediately preceding the payment date. If a Dividend Equivalent is paid 

23

in Shares, the number of Shares paid with respect to the Dividend Equivalent will equal the quotient, rounded down to the nearest whole Share, of the 
Dividend Equivalent Account balance divided by the Fair Market Value of a Share on the day immediately preceding the payment date.

Article III.
TAXATION AND TAX WITHHOLDING

3.1  Representation. Participant represents to the Company that Participant has reviewed with Participant’s own tax advisors the tax 
consequences of this Award and the transactions contemplated by the Grant Notice and this Agreement. Participant is relying solely on such advisors and 
not on any statements or representations of the Company or any of its agents.

3.2  Tax Withholding. 

(a)  The Company has the right and option, but not the obligation, to treat Participant’s failure to provide timely payment in accordance with the 

Plan of any withholding tax arising in connection with the RSUs or Dividend Equivalents as Participant’s election to satisfy all or any portion of the 
withholding tax by requesting the Company retain Shares otherwise issuable under the Award.

(b)  Participant acknowledges that Participant is ultimately liable and responsible for all taxes owed in connection with the RSUs and the 

Dividend Equivalents, regardless of any action the Company or any Subsidiary takes with respect to any tax withholding obligations that arise in 
connection with the RSUs or Dividend Equivalents. Neither the Company nor any Subsidiary makes any representation or undertaking regarding the 
treatment of any tax withholding in connection with the awarding, vesting or payment of the RSUs or the Dividend Equivalents or the subsequent sale of 
Shares. The Company and the Subsidiaries do not commit and are under no obligation to structure the RSUs or Dividend Equivalents to reduce or eliminate 
Participant’s tax liability.

(c)  Mandatory Sell to Cover 

(i)  By accepting this Award, Participant understands and agrees that as a condition of the grant of the RSUs hereunder, Participant is 

required to, and hereby affirmatively elects to (the “Sell to Cover Election”), (1) sell that number of Shares determined in accordance with this 
Section 3.2(c) as may be necessary to satisfy all applicable withholding obligations with respect to any taxable event arising in connection with 
the RSUs and similarly sell such number of Shares as may be necessary to satisfy all applicable withholding obligations with respect to any other 
awards of restricted stock units granted to Participant under the Plan or any other equity incentive plans of the Company or its predecessor, and 
(2) to allow the transfer agent (together with any other party the Company determines necessary to execute the Sell to Cover Election, the 
“Agent”) to remit the cash proceeds of such sale(s) to the Company. Furthermore, Participant directs the Company to make a cash payment equal 
to the required tax withholding from the cash proceeds of such sale(s) directly to the appropriate taxing authorities. 

(ii)  Participant hereby appoints the Agent as Participant’s agent and authorizes the Agent to (1) sell on the open market at the then 
prevailing market price(s), on the Participant’s behalf, as soon as practicable on or after the date the Shares are issued upon the vesting of the 
RSUs, that number (rounded up to the next whole number) of the Shares so issued necessary to generate proceeds to cover (x) any tax 
withholding obligations incurred with respect to such vesting or issuance and (y) all applicable fees and commissions due to, or required to be 
collected by, the Agent with respect thereto and (2) apply any remaining funds to Participant’s tax withholding obligations hereunder. Participant 
hereby authorizes the Company and the Agent to cooperate and communicate with one another to determine the number of Shares that must be 
sold pursuant to this Section 3.2(c)(ii). Participant understands that the Agent may effect sales as provided in this Section 3.2(c)(ii) in one or 
more sales and that the average price for executions resulting from bunched orders will be assigned to Participant’s account. In addition, 
Participant acknowledges that it may not be possible to sell Shares as provided by this Section 3.2(c)(ii) due to (1) a legal or contractual 
restriction applicable to Participant or the Agent, (2) a market disruption, or (3) rules 

24

 
governing order execution priority on the national exchange where the Shares may be traded. Participant further agrees and acknowledges that in 
the event the sale of Shares would result in material adverse harm to the Company, as determined by the Company in its sole discretion, the 
Company may instruct the Agent not to sell Shares as provided by this Section 3.2(c)(ii). In the event of the Agent’s inability to sell Shares, the 
Participant will continue to be responsible for the timely payment to the Company and/or its affiliates of all federal, state, local and foreign taxes 
that are required by applicable laws and regulations to be withheld, including but not limited to those amounts specified in this Section 3.2(c)(ii). 
Participant acknowledges that regardless of any other term or condition of this Section 3.2(c), the Agent will not be liable to Participant for (1) 
special, indirect, punitive, exemplary, or consequential damages, or incidental losses or damages of any kind, or (2) any failure to perform or for 
any delay in performance that results from a cause or circumstance that is beyond its reasonable control. Participant hereby agrees to execute and 
deliver to the Agent any other agreements or documents as the Agent reasonably deems necessary or appropriate to carry out the purposes and 
intent of this Section 3.2(c). The Agent is a third-party beneficiary of this Section 3.2(c). This Section 3.2(c) shall terminate not later than the 
date on which all tax withholding obligations arising in connection with the Award have been satisfied. 

(iii)  Participant has carefully reviewed this Section 3.2(c) and Participant hereby represents and warrants that on the date hereof he or 
she is not aware of any material, nonpublic information with respect to the Company or any securities of the Company, is not subject to 
any legal, regulatory or contractual restriction that would prevent the Agent from conducting sales, does not have, and will not attempt 
to exercise, authority, influence or control over any sales of Shares effected by the Agent pursuant to the Agreement, and is entering into 
the Agreement and this election to “sell to cover” in good faith and not as part of a plan or scheme to evade the prohibitions of Rule 
10b5-1 (regarding trading of the Company’s securities on the basis of material nonpublic information) under the Exchange Act. It is 
Participant’s intent that this election to “sell to cover” comply with the requirements of Rule 10b5-1(c)(1)(i)(B) under the Exchange Act 
and be interpreted to comply with the requirements of Rule 10b5-1(c) under the Exchange Act.

ARTICLE IV.
OTHER PROVISIONS

4.1  Adjustments. Participant acknowledges that the RSUs, the Shares subject to the RSUs and the Dividend Equivalents are subject to 

adjustment, modification and termination in certain events as provided in this Agreement and the Plan.

4.2  Notices. Any notice to be given under the terms of this Agreement to the Company must be in writing and addressed to the Company in 
care of the Company’s Secretary at the Company’s principal office or the Secretary’s then-current email address or facsimile number. Any notice to be 
given under the terms of this Agreement to Participant must be in writing and addressed to Participant at Participant’s last known mailing address, email 
address or facsimile number in the Company’s personnel files. By a notice given pursuant to this Section, either party may designate a different address for 
notices to be given to that party. Any notice will be deemed duly given when actually received, when sent by email, when sent by certified mail (return 
receipt requested) and deposited with postage prepaid in a post office or branch post office regularly maintained by the United States Postal Service, when 
delivered by a nationally recognized express shipping company or upon receipt of a facsimile transmission confirmation.

4.3  Titles. Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of this Agreement.

4.4  Conformity to Securities Laws. Participant acknowledges that the Plan, the Grant Notice and this Agreement are intended to conform to the 

extent necessary with all Applicable Laws and, to the extent Applicable Laws permit, will be deemed amended as necessary to conform to Applicable 
Laws.

4.5  Successors and Assigns. The Company may assign any of its rights under this Agreement to single or multiple assignees, and this 

Agreement will inure to the benefit of the successors and assigns of the Company. 

25

Subject to the restrictions on transfer set forth in the Plan, this Agreement will be binding upon and inure to the benefit of the heirs, legatees, legal 
representatives, successors and assigns of the parties hereto.

4.6  Limitations Applicable to Section 16 Persons. Notwithstanding any other provision of the Plan or this Agreement, if Participant is subject to 

Section 16 of the Exchange Act, the Plan, the Grant Notice, this Agreement, the RSUs and the Dividend Equivalents will be subject to any additional 
limitations set forth in any applicable exemptive rule under Section 16 of the Exchange Act (including any amendment to Rule 16b-3) that are requirements 
for the application of such exemptive rule. To the extent Applicable Laws permit, this Agreement will be deemed amended as necessary to conform to such 
applicable exemptive rule.

4.7  Entire Agreement. The Plan, the Grant Notice and this Agreement (including any exhibit hereto) constitute the entire agreement of the 
parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

4.8  Agreement Severable. In the event that any provision of the Grant Notice or this Agreement is held illegal or invalid, the provision will be 
severable from, and the illegality or invalidity of the provision will not be construed to have any effect on, the remaining provisions of the Grant Notice or 
this Agreement.

4.9  Limitation on Participant’s Rights. Participation in the Plan confers no rights or interests other than as herein provided. This Agreement 

creates only a contractual obligation on the part of the Company as to amounts payable and may not be construed as creating a trust. Neither the Plan nor 
any underlying program, in and of itself, has any assets. Participant will have only the rights of a general unsecured creditor of the Company with respect to 
amounts credited and benefits payable, if any, with respect to the RSUs and Dividend Equivalents, and rights no greater than the right to receive cash or the 
Shares as a general unsecured creditor with respect to the RSUs and Dividend Equivalents, as and when settled pursuant to the terms of this Agreement.

4.10 Not a Contract of Employment. Nothing in the Plan, the Grant Notice or this Agreement confers upon Participant any right to continue in 

the employ or service of the Company or any Subsidiary or interferes with or restricts in any way the rights of the Company and its Subsidiaries, which 
rights are hereby expressly reserved, to discharge or terminate the services of Participant at any time for any reason whatsoever, with or without Cause, 
except to the extent expressly provided otherwise in a written agreement between the Company or a Subsidiary and Participant.

4.11 Counterparts. The Grant Notice may be executed in one or more counterparts, including by way of any electronic signature, subject to 

Applicable Law, each of which will be deemed an original and all of which together will constitute one instrument.

* * * * * 

26

 
SERES THERAPEUTICS, INC.
2022 EMPLOYMENT INDUCEMENT AWARD PLAN

Exhibit 10.4

1.Purpose

The Plan’s purpose is to enhance the Company’s ability to attract, retain and motivate persons who are expected to make important 
contributions to the Company by providing these individuals with equity ownership opportunities.  Capitalized terms used in the Plan are 
defined in Section 11.

2.Eligibility

Eligible Individuals are eligible to be granted Awards under the Plan, subject to the limitations described herein.

3.Administration and Delegation

(a)

Administration.    The  Plan  is  administered  by  the  Administrator.    The  Administrator  has  authority  to  determine  which 
Eligible Individuals receive Awards, grant Awards and set Award terms and conditions, subject to the conditions and limitations in the Plan.  
The Administrator also has the authority to take all actions and make all determinations under the Plan, to interpret the Plan and Award 
Agreements and to adopt, amend and repeal Plan administrative rules, guidelines and practices as it deems advisable.  The Administrator 
may  correct  defects  and  ambiguities,  supply  omissions  and  reconcile  inconsistencies  in  the  Plan  or  any  Award  as  it  deems  necessary  or 
appropriate to administer the Plan and any Awards.  The Administrator may adopt procedures from time to time that are intended to ensure 
that  an  individual  is  an  Eligible  Individual  prior  to  the  granting  of  any  Awards  to  such  individual  (including  without  limitation  a 
requirement that each such individual certify to the Company prior to the receipt of an Award that he or she is not currently employed by 
the Company or a Subsidiary and, if previously so employed, has had a bona fide period of interruption of employment, and that the grant 
of Awards is an inducement material to the Eligible Individual's agreement to enter into employment with the Company or a Subsidiary).  
The Administrator’s determinations under the Plan are in its sole discretion and will be final and binding on all persons having or claiming 
any interest in the Plan or any Award.

(b)

Appointment of Committees.    To  the  extent  Applicable  Laws  permit,  the  Board  may  delegate  any  or  all  of  its  powers 
under the Plan to one or more Committees.  The Board may abolish any Committee or re-vest in itself any previously delegated authority at 
any time. 

4.Stock Available for Awards

(a)

Number of Shares.  Subject to adjustment under Section 8 and the terms of this Section 4, Awards may be made under 
the  Plan  covering  up  to  the  Overall  Share  Limit.    Shares  issued  under  the  Plan  may  consist  of  authorized  but  unissued  Shares,  Shares 
purchased on the open market or treasury Shares.

(b)

Share  Recycling.    If  all  or  any  part  of  an  Award  expires,  lapses  or  is  terminated,  exchanged  for  cash,  surrendered, 
repurchased,  canceled  without  having  been  fully  exercised  or  forfeited,  in  any  case,  in  a  manner  that  results  in  the  Company  acquiring 
Shares covered by the Award at a price not greater than the price (as adjusted to reflect any Equity Restructuring) paid by the Participant for 
such Shares or not issuing any Shares covered by the Award, the unused Shares covered by the Award will again be available for Award 
grants  under  the  Plan.    Further,  Shares  delivered  (either  by  actual  delivery  or  attestation)  to  the  Company  by  a  Participant  to  satisfy  the 
applicable exercise or purchase price of an Award and/or to satisfy any applicable tax withholding obligation (including Shares retained by 
the Company from the Award being exercised or purchased and/or creating the tax obligation) will again be available for Award grants 

 
under  the  Plan.    The  payment  of  Dividend  Equivalents  in  cash  in  conjunction  with  any  outstanding  Awards  shall  not  count  against  the 
Overall Share Limit.   

5.Stock Options and Stock Appreciation Rights

(a)

General.    The  Administrator  may  grant  Non-Qualified  Options  or  Stock  Appreciation  Rights  to  Eligible  Individuals 
subject to the conditions and limitations in the Plan.  The Administrator will determine the number of Shares covered by each Option and 
Stock Appreciation Right, the exercise price of each Option and Stock Appreciation Right and the conditions and limitations applicable to 
the exercise of each Option and Stock Appreciation Right.  A Stock Appreciation Right will entitle the Participant (or other person entitled 
to exercise the Stock Appreciation Right) to receive from the Company upon exercise of the exercisable portion of the Stock Appreciation 
Right  an  amount  determined  by  multiplying  the  excess,  if  any,  of  the  Fair  Market  Value  of  one  Share  on  the  date  of  exercise  over  the 
exercise price per Share of the Stock Appreciation Right by the number of Shares with respect to which the Stock Appreciation Right is 
exercised, subject to any limitations of the Plan or that the Administrator may impose and payable in cash, Shares valued at Fair Market 
Value or a combination of the two as the Administrator may determine or provide in the Award Agreement.  

(b)

Exercise  Price.    The  Administrator  will  establish  each  Option’s  and  Stock  Appreciation  Right’s  exercise  price  and 
specify the exercise price in the Award Agreement.  The exercise price will not be less than 100% of the Fair Market Value on the grant date 
of the Option or Stock Appreciation Right.  

(c)

Duration of Options.  Each Option or Stock Appreciation Right will be exercisable at such times and as specified in the 

Award Agreement, provided that the term of an Option or Stock Appreciation Right will not exceed ten years.

(d)

Exercise.  Options and Stock Appreciation Rights may be exercised by delivering to the Company a written notice of 
exercise, in a form the Administrator approves (which may be electronic), signed by the person authorized to exercise the Option or Stock 
Appreciation  Right,  together  with,  as  applicable,  payment  in  full  (i)  as  specified  in  Section  5(e)  for  the  number  of  Shares  for  which  the 
Award is exercised and (ii) as specified in Section 9(e) for any applicable taxes.  Unless the Administrator otherwise determines, an Option 
or Stock Appreciation Right may not be exercised for a fraction of a Share.

(e)

Payment Upon Exercise.  The exercise price of an Option must be paid in cash, wire transfer of immediately available 
funds or by check payable to the order of the Company or, subject to Section 10(i), any Company insider trading policy (including blackout 
periods) and Applicable Laws, by: 

(i)

if there is a public market for Shares at the time of exercise, unless the Administrator otherwise determines, (A) 
delivery (including telephonically to the extent permitted by the Company) of an irrevocable and unconditional undertaking by a 
broker  acceptable  to  the  Company  to  deliver  promptly  to  the  Company  sufficient  funds  to  pay  the  exercise  price,  or  (B)  the 
Participant’s  delivery  to  the  Company  of  a  copy  of  irrevocable  and  unconditional  instructions  to  a  broker  acceptable  to  the 
Company to deliver promptly to the Company cash or a check sufficient to pay the exercise price; provided that such amount is paid 
to the Company at such time as may be required by the Administrator;  

(ii)

to the extent permitted by the Administrator, delivery (either by actual delivery or attestation) of Shares owned 

by the Participant valued at their Fair Market Value;

 
(iii)

to the extent permitted by the Administrator, surrendering Shares then issuable upon the Option’s exercise valued 

at their Fair Market Value on the exercise date; 

(iv)

to  the  extent  permitted  by  the  Administrator,  delivery  of  a  promissory  note  or  any  other  property  that  the 

Administrator determines is good and valuable consideration; or

(v)

any combination of the above permitted payment forms (including cash, wire transfer or check).

6.Restricted Stock; Restricted Stock Units

(a)

General.    The  Administrator  may  grant  Restricted  Stock,  or  the  right  to  purchase  Restricted  Stock,  to  any  Eligible 
Individual, subject to the Company’s right to repurchase all or part of such shares at their issue price or other stated or formula price from 
the Participant (or to require forfeiture of such shares) if conditions the Administrator specifies in the Award Agreement are not satisfied 
before the end of the applicable restriction period or periods that the Administrator establishes for such Award and subject to the conditions 
and  limitations  in  the  Plan.    In  addition,  subject  to  the  conditions  and  limitations  in  the  Plan,  the  Administrator  may  grant  to  Eligible 
Individuals  Restricted  Stock  Units,  which  may  be  subject  to  vesting  and  forfeiture  conditions  during  the  applicable  restriction  period  or 
periods,  as  set  forth  in  an  Award  Agreement.    The  Administrator  will  determine  and  set  forth  in  the  Award  Agreement  the  terms  and 
conditions for each Restricted Stock and Restricted Stock Unit Award, subject to the conditions and limitations contained in the Plan.

(b)

Restricted Stock.

(i)

Dividends.  Participants holding shares of Restricted Stock will be entitled to all ordinary cash dividends paid 
with  respect  to  such  shares,  unless  the  Administrator  provides  otherwise  in  the  Award  Agreement.    In  addition,  unless  the 
Administrator  provides  otherwise,  if  any  dividends  or  distributions  are  paid  in  Shares,  or  consist  of  a  dividend  or  distribution  to 
holders of Common Stock of property other than an ordinary cash dividend, the Shares or other property will be subject to the same 
restrictions on transferability and forfeitability as the shares of Restricted Stock with respect to which they were paid.  

(ii)

Stock Certificates.  The Company may require that the Participant deposit in escrow with the Company (or its 

designee) any stock certificates issued in respect of shares of Restricted Stock, together with a stock power endorsed in blank.

(c)

Restricted Stock Units.

(i)

Settlement.  The Administrator may provide that settlement of Restricted Stock Units will occur upon or as soon 
as  reasonably  practicable  after  the  Restricted  Stock  Units  vest  or  will  instead  be  deferred,  on  a  mandatory  basis  or  at  the 
Participant’s election, in a manner intended to comply with Section 409A.

(ii)

Stockholder  Rights.  A  Participant  will  have  no  rights  of  a  stockholder  with  respect  to  Shares  subject  to  any 

Restricted Stock Unit unless and until the Shares are delivered in settlement of the Restricted Stock Unit.

(iii)

Dividend Equivalents.  If the Administrator provides, a grant of Restricted Stock Units may provide a Participant
with  the  right  to  receive  Dividend  Equivalents.    Dividend  Equivalents  may  be  paid  currently  or  credited  to  an  account  for  the 
Participant, settled in cash or Shares and 

 
subject to the same restrictions on transferability and forfeitability as the Restricted Stock Units with respect to which the Dividend 
Equivalents are granted and subject to other terms and conditions as set forth in the Award Agreement.  

7.Other Stock or Cash Based Awards

Other Stock or Cash Based Awards may be granted to Participants, including Awards entitling Participants to receive Shares to be 
delivered  in  the  future  and  including  annual  or  other  periodic  or  long-term  cash  bonus  awards  (whether  based  on  specified  Performance 
Criteria or otherwise), in each case subject to any conditions and limitations in the Plan. Such Other Stock or Cash Based Awards will also be 
available as a payment form in the settlement of other Awards, as standalone payments and as payment in lieu of compensation to which a 
Participant  is  otherwise  entitled.    Other  Stock  or  Cash  Based  Awards  may  be  paid  in  Shares,  cash  or  other  property,  as  the  Administrator 
determines.  Subject to the provisions of the Plan, the Administrator will determine the terms and conditions of each Other Stock or Cash 
Based Award, including any purchase price, performance goal (which may be based on the Performance Criteria), transfer restrictions, and 
vesting conditions, which will be set forth in the applicable Award Agreement. 

8.Adjustments for Changes in Common Stock and Certain Other Events

(a)

Equity  Restructuring.    In  connection  with  any  Equity  Restructuring,  notwithstanding  anything  to  the  contrary  in  this 
Section 8, the Administrator will equitably adjust each outstanding Award as it deems appropriate to reflect the Equity Restructuring, which 
may include adjusting the number and type of securities subject to each outstanding Award and/or the Award’s exercise price or grant price 
(if applicable), granting new Awards to Participants (subject to Section 10(d)), and making a cash payment to Participants.  The adjustments 
provided under this Section 8(a) will be nondiscretionary and final and binding on the affected Participant and the Company; provided that 
the Administrator will determine whether an adjustment is equitable.

(b)

Corporate Transactions.  In the event of any dividend or other distribution (whether in the form of cash, Common Stock, 
other securities, or other property), reorganization, merger, consolidation, combination, repurchase, recapitalization, liquidation, dissolution, 
or sale, transfer, exchange or other disposition of all or substantially all of the assets of the Company, or sale or exchange of Common Stock 
or other securities of the Company, Change in Control, issuance of warrants or other rights to purchase Common Stock or other securities of 
the Company, other similar corporate transaction or event, other unusual or nonrecurring transaction or event affecting the Company or its 
financial statements or any change in any Applicable Laws or accounting principles, the Administrator, on such terms and conditions as it 
deems  appropriate,  either  by  the  terms  of  the  Award  or  by  action  taken  prior  to  the  occurrence  of  such  transaction  or  event  (except  that
action to give effect to a change in Applicable Law or accounting principles may be made within a reasonable period of time after such 
change) and either automatically or upon the Participant’s request, is hereby authorized to take any one or more of the following actions 
whenever  the  Administrator  determines  that  such  action  is  appropriate  in  order  to  (x)  prevent  dilution  or  enlargement  of  the  benefits  or 
potential benefits intended by the Company to be made available under the Plan or with respect to any Award granted or issued under the 
Plan, (y) to facilitate such transaction or event or (z) give effect to such changes in Applicable Laws or accounting principles:  

(i)

to provide for the cancellation of any such Award in exchange for either an amount of cash or other property with 
a value equal to the amount that could have been obtained upon the exercise or settlement of the vested portion of such Award or 
realization of the Participant’s rights under the vested portion of such Award, as applicable; provided that, if the amount that could 
have been obtained upon the exercise or settlement of the vested portion of such Award or realization of the 

 
Participant’s rights, in any case, is equal to or less than zero, then the Award may be terminated without payment;  

(ii)

to  provide  that  such  Award  shall  vest  and,  to  the  extent  applicable,  be  exercisable  as  to  all  shares  covered 

thereby, notwithstanding anything to the contrary in the Plan or the provisions of such Award;

(iii)

to  provide  that  such  Award  be  assumed  by  the  successor  or  survivor  corporation,  or  a  parent  or  subsidiary 
thereof, or shall be substituted for by awards covering the stock of the successor or survivor corporation, or a parent or subsidiary 
thereof, with appropriate adjustments as to the number and kind of shares and/or applicable exercise or purchase price, in all cases, 
as determined by the Administrator;  

(iv)

to make adjustments in the number and type of shares of Common Stock (or other securities or property) subject 
to  outstanding  Awards  and/or  with  respect  to  which  Awards  may  be  granted  under  the  Plan  (including,  but  not  limited  to, 
adjustments of the limitations in Section 4 hereof on the maximum number and kind of shares which may be issued) and/or in the 
terms and conditions of (including the grant or exercise price), and the criteria included in, outstanding Awards;  

(v)

(vi)

event.

to replace such Award with other rights or property selected by the Administrator; and/or

to  provide  that  the  Award  will  terminate  and  cannot  vest,  be  exercised  or  become  payable  after  the  applicable 

(c)

Administrative Stand Still.  In the event of any pending stock dividend, stock split, combination or exchange of shares, 
merger,  consolidation  or  other  distribution  (other  than  normal  cash  dividends)  of  Company  assets  to  stockholders,  or  any  other 
extraordinary transaction or change affecting the Shares or the share price of Common Stock, including any Equity Restructuring or any 
securities offering or other similar transaction, for administrative convenience, the Administrator may refuse to permit the exercise of any 
Award for up to sixty days before or after such transaction.

(d)

General.  Except as expressly provided in the Plan or the Administrator’s action under the Plan, no Participant will have 
any rights due to any subdivision or consolidation of Shares of any class, dividend payment, increase or decrease in the number of Shares of 
any  class  or  dissolution,  liquidation,  merger,  or  consolidation  of  the  Company  or  other  corporation.    Except  as  expressly  provided  with 
respect to an Equity Restructuring under Section 8(a) above or the Administrator’s action under the Plan, no issuance by the Company of 
Shares of any class, or securities convertible into Shares of any class, will affect, and no adjustment will be made regarding, the number of 
Shares  subject  to  an  Award  or  the  Award’s  grant  or  exercise  price.    The  existence  of  the  Plan,  any  Award  Agreements  and  the  Awards 
granted  hereunder  will  not  affect  or  restrict  in  any  way  the  Company’s  right  or  power  to  make  or  authorize  (i)  any  adjustment, 
recapitalization, reorganization or other change in the Company’s capital structure or its business, (ii) any merger, consolidation dissolution 
or liquidation of the Company or sale of Company assets or (iii) any sale or issuance of securities, including securities with rights superior 
to those of the Shares or securities convertible into or exchangeable for Shares.  The Administrator may treat Participants and Awards (or 
portions thereof) differently under this Section 8.

(e)

Change in Control.  Notwithstanding Section 8(b) above, if a Change in Control occurs and Awards are not continued, 
converted,  assumed,  or  replaced  with  a  comparable  award  (as  determined  by  the  Administrator)  by  (i)  the  Company  or  (ii)  a  successor 
entity  or  its  parent  or  subsidiary  (an  “Assumption”),  and  provided  that  the  Participant  has  not  had  a  Termination  of  Service,  then 
immediately 

 
prior  to  the  Change  in  Control,  such  Awards  (other  than  any  Award  that  is  regularly  scheduled  to  vest  based  on  the  attainment  of 
Performance Criteria or other performance-based vesting conditions) will become fully vested, exercisable and/or payable, as applicable, 
and  all  forfeiture,  repurchase  and  other  restrictions  on  such  Awards  will  lapse,  in  which  case,  such  Awards  will  be  canceled  upon  the 
consummation of the Change in Control in exchange for the right to receive the Change in Control consideration payable to other holders of 
Shares,  which  may  be  on  such  terms  and  conditions  as  apply  generally  to  holders  of  Shares  under  the  Change  in  Control  documents 
(including, without limitation, any escrow, earn-out or other deferred consideration provisions) or such other terms and conditions as the 
Administrator may provide, and determined by reference to the number of Shares subject to such Awards and net of any applicable exercise 
price; provided that to the extent that any Awards constitute “nonqualified deferred compensation” that may not be paid upon the Change in 
Control under Section 409A without the imposition of taxes thereon under Section 409A, the timing of such payments shall be governed by 
the applicable Award Agreement (subject to any deferred consideration provisions applicable under the Change in Control documents); and 
provided, further, that if the amount to which a Participant would be entitled upon the settlement or exercise of such Award at the time of 
the Change in Control is equal to or less than zero, then such Award may be terminated without payment. An Award will be considered 
replaced with a comparable award if the Award is exchanged for an amount of cash or other property with a value equal to the amount that 
could have been obtained upon the settlement of such Award in such Change in Control (as determined by the Administrator), even if such 
cash or other property payable with respect to the unvested portion of such Award remains subject to similar vesting provisions following 
such  Change  in  Control.  Notwithstanding  the  foregoing,  the  Administrator  will  have  full  and  final  authority  to  determine  whether  an 
Assumption of an Award has occurred in connection with a Change in Control.

9.General Provisions Applicable to Awards. 

(a)

Transferability.  Except as the Administrator may determine or provide in an Award Agreement or otherwise, Awards 
may not be sold, assigned, transferred, pledged or otherwise encumbered, either voluntarily or by operation of law, except by will or the 
laws of descent and distribution, or, subject to the Administrator’s consent, pursuant to a domestic relations order, and, during the life of the 
Participant,  will  be  exercisable  only  by  the  Participant.    References  to  a  Participant,  to  the  extent  relevant  in  the  context,  will  include 
references to a Participant’s authorized transferee that the Administrator specifically approves.

(b)

Documentation.    Each  Award  will  be  evidenced  in  an  Award  Agreement,  which  may  be  written  or  electronic,  as  the 

Administrator determines. Each Award may contain terms and conditions in addition to those set forth in the Plan. 

(c)

Discretion.  Except as the Plan otherwise provides, each Award may be made alone or in addition or in relation to any 
other Award.  The terms of each Award to a Participant need not be identical, and the Administrator need not treat Participants or Awards 
(or portions thereof) uniformly. 

(d)

Termination  of  Status.    The  Administrator  will  determine  how  the  disability,  death,  retirement,  authorized  leave  of 
absence or any other change or purported change in a Participant’s Service Provider status affects an Award and the extent to which, and the 
period during which, the Participant, the Participant’s legal representative, conservator, guardian or Designated Beneficiary may exercise 
rights under the Award, if applicable.

(e)

Withholding.  Each Participant must pay the Company, or make provision satisfactory to the Administrator for payment 
of, any taxes required by law to be withheld in connection with such Participant’s Awards by the date of the event creating the tax liability.  
The Company may deduct an 

 
amount sufficient to satisfy such tax obligations based on the minimum statutory withholding rates from any payment of any kind otherwise
due to a Participant.  Participants may satisfy such tax obligations in cash, by wire transfer of immediately available funds, by check made
payable to the order of the Company, or subject to Section 10(i) and any Company insider trading policy (including blackout periods), (i) to 
the extent permitted by the Administrator, in whole or in part by delivery of Shares, including Shares retained from the Award creating the 
tax obligation, valued at their Fair Market Value, (ii) if there is a public market for Shares at the time the tax obligations are satisfied, unless 
the Administrator otherwise determines, (A) delivery (including telephonically to the extent permitted by the Company) of an irrevocable 
and unconditional undertaking by a broker acceptable to the Company to deliver promptly to the Company sufficient funds to satisfy the tax 
obligations, or (B) delivery by the Participant to the Company of a copy of irrevocable and unconditional instructions to a broker acceptable 
to the Company to deliver promptly to the Company cash or a check sufficient to satisfy the tax withholding; provided that such amount is 
paid to the Company at such time as may be required by the Administrator, or (iii) any combination of the foregoing permitted payment 
forms  (including  cash,  wire  transfer  or  check).    If  any  tax  withholding  obligation  will  be  satisfied  under  clause  (i)  of  the  immediately 
preceding sentence by the Company’s retention of Shares from the Award creating the tax obligation and there is a public market for Shares 
at the time the tax obligation is satisfied, the Company may elect to instruct any brokerage firm determined acceptable to the Company for 
such purpose to sell on the applicable Participant’s behalf some or all of the Shares retained and to remit the proceeds of the sale to the
Company or its designee, and each Participant’s acceptance of an Award under the Plan will constitute the Participant’s authorization to the 
Company and instruction and authorization to such brokerage firm to complete the transactions described in this sentence. 

(f)

Amendment  of  Award;  Repricing.    The  Administrator  may  amend,  modify  or  terminate  any  outstanding  Award, 
including  by  substituting  another  Award  of  the  same  or  a  different  type  or  changing  the  exercise  or  settlement  date.    The  Participant’s 
consent to such action will be required unless (i) the action, taking into account any related action, does not materially and adversely affect 
the Participant’s rights under the Award, or (ii) the change is permitted under Section 8 or pursuant to Section 10(g).  Notwithstanding the 
foregoing or anything in the Plan to the contrary, the Administrator may, without the approval of the stockholders of the Company, reduce 
the  exercise  price  per  share  of  outstanding  Options  or  Stock  Appreciation  Rights  or  cancel  outstanding  Options  or  Stock  Appreciation 
Rights in exchange for cash, other Awards or Options or Stock Appreciation Rights with an exercise price per share that is less than the 
exercise price per share of the original Options or Stock Appreciation Rights.

(g)

Conditions on Delivery of Stock.  The Company will not be obligated to deliver any Shares under the Plan or remove 
restrictions  from  Shares  previously  delivered  under  the  Plan  until  (i)  all  Award  conditions  have  been  met  or  removed  to  the  Company’s 
satisfaction,  (ii)  as  determined  by  the  Company,  all  other  legal  matters  regarding  the  issuance  and  delivery  of  such  Shares  have  been 
satisfied,  including  any  applicable  securities  laws  and  stock  exchange  or  stock  market  rules  and  regulations,  and  (iii)  the  Participant  has 
executed and delivered to the Company such representations or agreements as the Administrator deems necessary or appropriate to satisfy 
any Applicable Laws.  The Company’s inability to obtain authority from any regulatory body having jurisdiction, which the Administrator 
determines is necessary to the lawful issuance and sale of any securities, will relieve the Company of any liability for failing to issue or sell 
such Shares as to which such requisite authority has not been obtained.

(h)

Acceleration.  The Administrator may at any time provide that any Award will become immediately vested and fully or 

partially exercisable, free of some or all restrictions or conditions, or otherwise fully or partially realizable. 

(i)

Action Required Upon Grant of Award.  Promptly following the grant of an Award, the Company shall, in accordance 

with NASDAQ Rule 5635(c), (a) issue a press release disclosing the 

 
material terms of the Award, including the recipient(s) of the Award and the number of Shares involved and(b) provide written notice to the 
NASDAQ of the grant.

10.Miscellaneous.

(a)

No Right to Employment or Other Status.  No person will have any claim or right to be granted an Award, and the grant 
of an Award will not be construed as giving a Participant the right to continued employment or any other relationship with the Company.  
The Company expressly reserves the right at any time to dismiss or otherwise terminate its relationship with a Participant free from any 
liability or claim under the Plan or any Award, except as expressly provided in an Award Agreement.

(b)

No Rights as Stockholder; Certificates.  Subject to the Award Agreement, no Participant or Designated Beneficiary will 
have  any  rights  as  a  stockholder  with  respect  to  any  Shares  to  be  distributed  under  an  Award  until  becoming  the  record  holder  of  such 
Shares.  Notwithstanding any other provision of the Plan, unless the Administrator otherwise determines or Applicable Laws require, the 
Company will not be required to deliver to any Participant certificates evidencing Shares issued in connection with any Award and instead 
such Shares may be recorded in the books of the Company (or, as applicable, its transfer agent or stock plan administrator).  The Company 
may  place  legends  on  stock  certificates  issued  under  the  Plan  that  the  Administrator  deems  necessary  or  appropriate  to  comply  with 
Applicable Laws.

(c)

Effective Date and Term of Plan.  Unless earlier terminated by the Board, the Plan will become effective on the date it is 
approved by the Board and will remain in effect until the tenth anniversary of such date, but Awards previously granted may extend beyond 
that date in accordance with the Plan.  No Awards may be granted under the Plan during any suspension period or after Plan termination.

(d)

Stockholder  Approval  Not  Required.    It  is  expressly  intended  that  approval  of  the  Company’s  stockholders  not  be 
required as a condition of the effectiveness of the Plan, and the Plan’s provisions shall be interpreted in a manner consistent with such intent 
for all purposes. Specifically, NASDAQ Rule 5635(c) generally requires stockholder approval for equity compensation plans adopted by 
companies whose securities are listed on the NASDAQ Stock Market that provide for the delivery of equity securities to any employees, 
directors or other service providers of such companies as compensation for services. NASDAQ Rule 5635(c)(4) provides an exemption in 
certain circumstances for employment inducement awards. Notwithstanding anything to the contrary herein, in accordance with NASDAQ 
Rule  5635(c)(4),  Awards  may  only  be  granted  as  material  inducements  to  Eligible  Individuals  being  hired  or  rehired  as  Employees,  as 
applicable,  and  must  be  approved  by  (a)  the  Board,  acting  through  a  majority  of  the  Company’s  Independent  Directors  or  (b)  the 
independent Compensation Committee of the Board. Accordingly, pursuant to NASDAQ Rule 5635(c)(4), the issuance of Awards and the 
Shares issuable upon exercise or vesting of such Awards pursuant to the Plan is not subject to the approval of the Company’s stockholders.

(e)

Amendment  of  Plan.    The  Administrator  may  amend,  suspend  or  terminate  the  Plan  at  any  time;  provided  that  no 
amendment, other than an increase to the Overall Share Limit, may materially and adversely affect any Award outstanding at the time of 
such  amendment  without  the  affected  Participant’s  consent.    Awards  outstanding  at  the  time  of  any  Plan  suspension  or  termination  will 
continue to be governed by the Plan and the Award Agreement, as in effect before such suspension or termination.  The Board will obtain 
stockholder approval of any Plan amendment to the extent necessary to comply with Applicable Laws.

(f)

Provisions  for  Foreign  Participants.    The  Administrator  may  modify  Awards  granted  to  Participants  who  are  foreign 

nationals or employed outside the United States or establish subplans or 

 
procedures  under  the  Plan  to  address  differences  in  laws,  rules,  regulations  or  customs  of  such  foreign  jurisdictions  with  respect  to  tax, 
securities, currency, employee benefit or other matters.

(g)

Section 409A.

(i)

General.  The Company intends that all Awards be structured to comply with, or be exempt from, Section 409A, 
such that no adverse tax consequences, interest, or penalties under Section 409A apply.  Notwithstanding anything in the Plan or 
any Award Agreement to the contrary, the Administrator may, without a Participant’s consent, amend this Plan or Awards, adopt 
policies  and  procedures,  or  take  any  other  actions  (including  amendments,  policies,  procedures  and  retroactive  actions)  as  are 
necessary or appropriate to preserve the intended tax treatment of Awards, including any such actions intended to (A) exempt this 
Plan or any Award from Section 409A, or (B) comply with Section 409A, including regulations, guidance, compliance programs 
and  other  interpretative  authority  that  may  be  issued  after  an  Award’s  grant  date.    The  Company  makes  no  representations  or 
warranties  as  to  an  Award’s  tax  treatment  under  Section  409A  or  otherwise.    The  Company  will  have  no  obligation  under  this 
Section 10(g) or otherwise to avoid the taxes, penalties or interest under Section 409A with respect to any Award and will have no 
liability  to  any  Participant  or  any  other  person  if  any  Award,  compensation  or  other  benefits  under  the  Plan  are  determined  to 
constitute noncompliant “nonqualified deferred compensation” subject to taxes, penalties or interest under Section 409A.

(ii)

Separation  from  Service.    If  an  Award  constitutes  “nonqualified  deferred  compensation”  under  Section  409A, 
any  payment  or  settlement  of  such  Award  upon  a  termination  of  a  Participant’s  Service  Provider  relationship  will,  to  the  extent 
necessary to avoid taxes under Section 409A, be made only upon the Participant’s “separation from service” (within the meaning of 
Section 409A), whether such “separation from service” occurs upon or after the termination of the Participant’s Service Provider
relationship.    For  purposes  of  this  Plan  or  any  Award  Agreement  relating  to  any  such  payments  or  benefits,  references  to  a 
“termination,” “termination of employment” or like terms means a “separation from service.”

(iii)

Payments to Specified Employees.  Notwithstanding any contrary provision in the Plan or any Award Agreement, 
any payment(s) of “nonqualified deferred compensation” required to be made under an Award to a “specified employee” (as defined 
under Section 409A and as the Administrator determines) due to his or her “separation from service” will, to the extent necessary to 
avoid  taxes  under  Section  409A(a)(2)(B)(i)  of  the  Code,  be  delayed  for  the  six-month  period  immediately  following  such 
“separation  from  service”  (or,  if  earlier,  until  the  specified  employee’s  death)  and  will  instead  be  paid  (as  set  forth  in  the  Award 
Agreement) on the day immediately following such six-month period or as soon as administratively practicable thereafter (without 
interest).  Any payments of “nonqualified deferred compensation” under such Award payable more than six months following the 
Participant’s “separation from service” will be paid at the time or times the payments are otherwise scheduled to be made.

(h)

Limitations on Liability.  Notwithstanding any other provisions of the Plan, no individual acting as a director, officer, 
other employee or agent of the Company or any Subsidiary will be liable to any Participant, former Participant, spouse, beneficiary, or any 
other person for any claim, loss, liability, or expense incurred in connection with the Plan or any Award, and such individual will not be 
personally liable with respect to the Plan because of any contract or other instrument executed in his or her capacity as an Administrator, 
director, officer, other employee or agent of the Company or any Subsidiary.  The Company will indemnify and hold harmless each director, 
officer,  other  employee  and  agent  of  the  Company  or  any  Subsidiary  that  has  been  or  will  be  granted  or  delegated  any  duty  or  power 
relating to the Plan’s administration or interpretation, against any cost or expense (including attorneys’ fees) or liability 

 
(including any sum paid in settlement of a claim with the Administrator’s approval) arising from any act or omission concerning this Plan 
unless arising from such person’s own fraud or bad faith.

(i)

Lock-Up Period.  The Company may, at the request of any underwriter representative or otherwise, in connection with 
registering  the  offering  of  any  Company  securities  under  the  Securities  Act,  prohibit  Participants  from,  directly  or  indirectly,  selling  or 
otherwise transferring any Shares or other Company securities during a period of up to one hundred eighty days following the effective date 
of a Company registration statement filed under the Securities Act, or such longer period as determined by the underwriter.

(j)

Data Privacy.  As a condition for receiving any Award, each Participant explicitly and unambiguously consents to the 
collection, use and transfer, in electronic or other form, of personal data as described in this paragraph by and among the Company and its 
Subsidiaries  and  affiliates  exclusively  for  implementing,  administering  and  managing  the  Participant’s  participation  in  the  Plan.    The 
Company  and  its  Subsidiaries  and  affiliates  may  hold  certain  personal  information  about  a  Participant,  including  the  Participant’s  name, 
address and telephone number; birthdate; social security, insurance number or other identification number; salary; nationality; job title(s); 
any Shares held in the Company or its Subsidiaries and affiliates; and Award details, to implement, manage and administer the Plan and 
Awards  (the  “Data”).    The  Company  and  its  Subsidiaries  and  affiliates  may  transfer  the  Data  amongst  themselves  as  necessary  to 
implement, administer and manage a Participant’s participation in the Plan, and the Company and its Subsidiaries and affiliates may transfer 
the  Data  to  third  parties  assisting  the  Company  with  Plan  implementation,  administration  and  management.    These  recipients  may  be 
located in the Participant’s country, or elsewhere, and the Participant’s country may have different data privacy laws and protections than 
the recipients’ country.  By accepting an Award, each Participant authorizes such recipients to receive, possess, use, retain and transfer the 
Data, in electronic or other form, to implement, administer and manage the Participant’s participation in the Plan, including any required 
Data transfer to a broker or other third party with whom the Company or the Participant may elect to deposit any Shares.  The Data related 
to a Participant will be held only as long as necessary to implement, administer, and manage the Participant’s participation in the Plan.  A 
Participant may, at any time, view the Data that the Company holds regarding such Participant, request additional information about the 
storage and processing of the Data regarding such Participant, recommend any necessary corrections to the Data regarding the Participant or 
refuse or withdraw the consents in this Section 10(j) in writing, without cost, by contacting the local human resources representative.  The 
Company may cancel Participant’s ability to participate in the Plan and, in the Administrator’s discretion, the Participant may forfeit any 
outstanding Awards if the Participant refuses or withdraws the consents in this Section 10(j).  For more information on the consequences of 
refusing or withdrawing consent, Participants may contact their local human resources representative.

(k)

Severability.  If any portion of the Plan or any action taken under it is held illegal or invalid for any reason, the illegality 
or invalidity will not affect the remaining parts of the Plan, and the Plan will be construed and enforced as if the illegal or invalid provisions 
had been excluded, and the illegal or invalid action will be null and void.

(l)

Governing  Documents.    If  any  contradiction  occurs  between  the  Plan  and  any  Award  Agreement  or  other  written 
agreement between a Participant and the Company (or any Subsidiary) that the Administrator has approved, the Plan will govern, unless it 
is expressly specified in such Award Agreement or other written document that a specific provision of the Plan will not apply.

(m)

Governing Law.  The Plan and all Awards will be governed by and interpreted in accordance with the laws of the State of 
Delaware,  disregarding  any  state’s  choice-of-law  principles  requiring  the  application  of  a  jurisdiction’s  laws  other  than  the  State  of 
Delaware.

 
(n)

Claw-back Provisions.  All Awards (including any proceeds, gains or other economic benefit the Participant actually or 
constructively receives upon receipt or exercise of any Award or the receipt or resale of any Shares underlying the Award) will be subject to 
any Company claw-back policy, including any claw-back policy adopted to comply with Applicable Laws (including the Dodd-Frank Wall 
Street Reform and Consumer Protection Act and any rules or regulations promulgated thereunder) as set forth in such claw-back policy or 
the Award Agreement.

(o)

Titles and Headings.  The titles and headings in the Plan are for convenience of reference only and, if any conflict, the 

Plan’s text, rather than such titles or headings, will control.

(p)

Conformity to Securities Laws.  Participant acknowledges that the Plan is intended to conform to the extent necessary 
with Applicable Laws.  Notwithstanding anything herein to the contrary, the Plan and all Awards will be administered only in conformance 
with Applicable Laws.  To the extent Applicable Laws permit, the Plan and all Award Agreements will be deemed amended as necessary to 
conform to Applicable Laws.

(q)

Relationship to Other Benefits.  No payment under the Plan will be taken into account in determining any benefits under 
any pension, retirement, savings, profit sharing, group insurance, welfare or other benefit plan of the Company or any Subsidiary except as 
expressly provided in writing in such other plan or an agreement thereunder.

(r)

Broker-Assisted Sales.  In the event of a broker-assisted sale of Shares in connection with the payment of amounts owed 
by a Participant under or with respect to the Plan or Awards, including amounts to be paid under the final sentence of Section 9(e): (a) any 
Shares to be sold through the broker-assisted sale will be sold on the day the payment first becomes due, or as soon thereafter as practicable; 
(b) such Shares may be sold as part of a block trade with other Participants in the Plan in which all participants receive an average price; (c) 
the  applicable  Participant  will  be  responsible  for  all  broker’s  fees  and  other  costs  of  sale,  and  by  accepting  an  Award,  each  Participant 
agrees to indemnify and hold the Company harmless from any losses, costs, damages, or expenses relating to any such sale; (d) to the extent 
the Company or its designee receives proceeds of such sale that exceed the amount owed, the Company will pay such excess in cash to the 
applicable Participant as soon as reasonably practicable; (e) the Company and its designees are under no obligation to arrange for such sale 
at any particular price; and (f) in the event the proceeds of such sale are insufficient to satisfy the Participant’s applicable obligation, the 
Participant may be required to pay immediately upon demand to the Company or its designee an amount in cash sufficient to satisfy any 
remaining portion of the Participant’s obligation.

11.Definitions

As used in the Plan, the following words and phrases will have the following meanings:

(a)

“Administrator” means the Board or a Committee to the extent that the Board’s powers or authority under the Plan have 

been delegated to such Committee.

(b)

“Applicable Laws”  means  the  requirements  relating  to  the  administration  of  equity  incentive  plans  under  U.S.  federal
and state securities, tax and other applicable laws, rules and regulations, the applicable rules of any stock exchange or quotation system on 
which the Common Stock is listed or quoted and the applicable laws and rules of any foreign country or other jurisdiction where Awards are 
granted.

(c)

“Award” means, individually or collectively, a grant under the Plan of Options, Stock Appreciation Rights, Restricted 

Stock, Restricted Stock Units or Other Stock or Cash Based Awards.

 
(d)

“Award Agreement” means a written agreement evidencing an Award, which may be electronic, that contains such terms 

and conditions as the Administrator determines, consistent with and subject to the terms and conditions of the Plan.

(e)

(f)

“Board” means the Board of Directors of the Company.

“Change in Control” means and includes each of the following: 

(i)

a transaction or series of transactions (other than an offering of Common Stock to the general public through a 
registration statement filed with the Securities and Exchange Commission or a transaction or series of transactions that meets the 
requirements of clauses (A) and (B) of subsection (iii) below) whereby any “person” or related “group” of “persons” (as such terms 
are used in Sections 13(d) and 14(d)(2) of the Exchange Act) (other than the Company, any of its Subsidiaries, an employee benefit 
plan  maintained  by  the  Company  or  any  of  its  Subsidiaries  or  a  “person”  that,  prior  to  such  transaction,  directly  or  indirectly 
controls,  is  controlled  by,  or  is  under  common  control  with,  the  Company)  directly  or  indirectly  acquires  beneficial  ownership 
(within the meaning of Rule 13d-3 under the Exchange Act) of securities of the Company possessing more than 50% of the total 
combined voting power of the Company’s securities outstanding immediately after such acquisition; or

(ii)

during  any  period  of  two  consecutive  years,  individuals  who,  at  the  beginning  of  such  period,  constitute  the 
Board together with any new Director(s) (other than a Director designated by a person who shall have entered into an agreement 
with the Company to effect a transaction described in subsections (i) or (iii)) whose election by the Board or nomination for election 
by the Company’s stockholders was approved by a vote of at least two-thirds of the Directors then still in office who either were 
Directors at the beginning of the two-year period or whose election or nomination for election was previously so approved, cease 
for any reason to constitute a majority thereof; or

(iii)

the  consummation  by  the  Company  (whether  directly  involving  the  Company  or  indirectly  involving  the 
Company through one or more intermediaries) of (x) a merger, consolidation, reorganization, or business combination or (y) a sale 
or other disposition of all or substantially all of the Company’s assets in any single transaction or series of related transactions or (z) 
the acquisition of assets or stock of another entity, in each case other than a transaction:

(A)

which results in the Company’s voting securities outstanding immediately before the 
transaction  continuing  to  represent  (either  by  remaining  outstanding  or  by  being  converted  into  voting  securities  of  the  Company  or  the 
person that, as a result of the transaction, controls, directly or indirectly, the Company or owns, directly or indirectly, all or substantially all of 
the Company’s assets or otherwise succeeds to the business of the Company (the Company or such person, the “Successor Entity”)) directly 
or indirectly, at least a majority of the combined voting power of the Successor Entity’s outstanding voting securities immediately after the 
transaction, and

after which no person or group beneficially owns voting securities representing 50% 
or more of the combined voting power of the Successor Entity; provided, however, that no person or group shall be treated for purposes of 
this clause (B) as beneficially owning 50% or more of the combined voting power of the Successor Entity solely as a result of the voting 
power held in the Company prior to the consummation of the transaction.

(B)

Notwithstanding the foregoing, if a Change in Control constitutes a payment event with respect to any Award (or portion of any Award) that 
provides for the deferral of compensation that is subject to Section 

 
409A, to the extent required to avoid the imposition of additional taxes under Section 409A, the transaction or event described in subsection 
(i), (ii) or (iii) with respect to such Award (or portion thereof) shall only constitute a Change in Control for purposes of the payment timing of 
such Award if such transaction also constitutes a “change in control event,” as defined in Treasury Regulation Section 1.409A-3(i)(5).

The Administrator shall have full and final authority, which shall be exercised in its discretion, to determine conclusively whether a Change 
in Control has occurred pursuant to the above definition, the date of the occurrence of such Change in Control and any incidental matters 
relating thereto; provided that any exercise of authority in conjunction with a determination of whether a Change in Control is a “change in 
control event” as defined in Treasury Regulation Section 1.409A-3(i)(5) shall be consistent with such regulation.

(g)

“Code” means the Internal Revenue Code of 1986, as amended, and the regulations issued thereunder.

(h)

“Committee” means one or more committees or subcommittees of the Board, which may include one or more Company 
directors or executive officers, to the extent Applicable Laws permit.  To the extent required to comply with the provisions of Rule 16b-3, it 
is intended that each member of the Committee will be, at the time the Committee takes any action with respect to an Award that is subject 
to Rule 16b-3, a “non-employee director” within the meaning of Rule 16b-3; however, a Committee member’s failure to qualify as a “non-
employee  director”  within  the  meaning  of  Rule  16b-3  will  not  invalidate  any  Award  granted  by  the  Committee  that  is  otherwise  validly 
granted under the Plan.  

(i)

(j)

“Common Stock” means the common stock of the Company. 

“Company” means Seres Therapeutics, Inc., a Delaware corporation, or any successor.

(k)

“Consultant” means any person, including any adviser, engaged by the Company or its parent or Subsidiary to render 
services to such entity if the consultant or adviser: (i) renders bona fide services to the Company; (ii) renders services not in connection 
with the offer or sale of securities in a capital-raising transaction and does not directly or indirectly promote or maintain a market for the 
Company’s securities; and (iii) is a natural person.

(l)

“Designated  Beneficiary”  means  the  beneficiary  or  beneficiaries  the  Participant  designates,  in  a  manner  the 
Administrator  determines,  to  receive  amounts  due  or  exercise  the  Participant’s  rights  if  the  Participant  dies  or  becomes  incapacitated.  
Without a Participant’s effective designation, “Designated Beneficiary” will mean the Participant’s estate.

(m)

“Director” means a Board member.

(n)

(o)

“Disability” means a permanent and total disability under Section 22(e)(3) of the Code, as amended.

“Dividend Equivalents” means a right granted to a Participant under the Plan to receive the equivalent value (in cash or 

Shares) of dividends paid on Shares.

(p)

“Eligible Individual” means any individual who was not previously an Employee or Director hired as a new Employee 
or rehired as an Employee following a bona fide period of interruption of employment if such person is granted an Award as a material 
inducement to his or her entering into employment with the Company or a Subsidiary (within the meaning of the NASDAQ Rule 5635(c)
(4)).

(q)

“Employee” means any employee of the Company or its Subsidiaries.

 
(r)

“Equity Restructuring” means a nonreciprocal transaction between the Company and its stockholders, such as a stock 
dividend, stock split, spin-off or recapitalization through a large, nonrecurring cash dividend, that affects the number or kind of Shares (or 
other Company securities) or the share price of Common Stock (or other Company securities) and causes a change in the per share value of 
the Common Stock underlying outstanding Awards.

(s)

“Exchange Act” means the Securities Exchange Act of 1934, as amended.

(t)

“Fair Market Value” means, as of any date, the value of Common Stock determined as follows: (i) if the Common Stock 
is listed on any established stock exchange, its Fair Market Value will be the closing sales price for such Common Stock as quoted on such 
exchange for such date, or if no sale occurred on such date, the last day preceding such date during which a sale occurred, as reported in 
The Wall Street Journal or another source the Administrator deems reliable; (ii) if the Common Stock is not traded on a stock exchange but 
is quoted on a national market or other quotation system, the closing sales price on such date, or if no sales occurred on such date, then on 
the last date preceding such date during which a sale occurred, as reported in The Wall Street Journal or another source the Administrator 
deems reliable; or (iii) without an established market for the Common Stock, the Administrator will determine the Fair Market Value in its 
discretion.

(u)
of the Code.

“Incentive Stock Option” means an Option intended to qualify as an “incentive stock option” as defined in Section 422 

(v)

“Independent Director” means a Director who qualifies as “independent” within the meaning of NASDAQ Rule 5635(c)

(4), or any successor rule, as such rule may be amended from time to time.

(w)

“NASDAQ  Rule  5635(c)(4)”  means  NASDAQ  Rule  5635(c)(4),  or  any  successor  rule,  and  all  guidance  and  other 

interpretative authority thereunder, as such rule, guidance and other authority may be amended from time to time.

(x)

(y)

(z)

“Non-Qualified Stock Option” means an Option not intended to qualify as an Incentive Stock Option.

“Option” means an option to purchase Shares.

“Other Stock or Cash Based Awards” means cash awards, awards of Shares, and other awards valued wholly or partially

by referring to, or are otherwise based on, Shares or other property.

(aa)

“Overall Share Limit” means 2,500,000 Shares.

(bb)

“Participant” means an Eligible Individual who has been granted an Award.

(cc)

“Performance Criteria” mean the criteria (and adjustments) that the Administrator may select for an Award to establish 
performance goals for a performance period, which may include the following: net earnings or losses (either before or after one or more of 
interest,  taxes,  depreciation,  amortization,  and  non-cash  equity-based  compensation  expense);  gross  or  net  sales  or  revenue  or  sales  or 
revenue  growth;  net  income  (either  before  or  after  taxes)  or  adjusted  net  income;  profits  (including  but  not  limited  to  gross  profits,  net 
profits, profit growth, net operation profit or economic profit), profit return ratios or operating margin; budget or operating earnings (either 
before or after taxes or before or after allocation of corporate overhead and bonus); cash flow (including operating cash flow and free cash 
flow or cash flow return on capital); return on assets; return on capital or invested capital; cost of capital; return 

 
on stockholders’ equity; total stockholder return; return on sales; costs, reductions in costs and cost control measures; expenses; working 
capital;  earnings  or  loss  per  share;  adjusted  earnings  or  loss  per  share;  price  per  share  or  dividends  per  share  (or  appreciation  in  or 
maintenance of such price or dividends); regulatory achievements or compliance; implementation, completion or attainment of objectives 
relating  to  research,  development,  regulatory,  commercial,  or  strategic  milestones  or  developments;  market  share;  economic  value  or 
economic  value  added  models;  division,  group  or  corporate  financial  goals;  customer  satisfaction/growth;  customer  service;  employee 
satisfaction;  recruitment  and  maintenance  of  personnel;  human  resources  management;  supervision  of  litigation  and  other  legal  matters; 
strategic partnerships and transactions; financial ratios (including those measuring liquidity, activity, profitability or leverage); debt levels or 
reductions;  sales-related  goals;  financing  and  other  capital  raising  transactions;  cash  on  hand;  acquisition  activity;  investment  sourcing 
activity; and marketing initiatives, any of which may be measured in absolute terms or as compared to any incremental increase or decrease, 
peer group results, or market performance indicators or indices.

(dd)

“Plan” means this 2022 Employment Inducement Award Plan, as it may be amended and/or restated from time to time.

(ee)

“Restricted Stock” means Shares awarded to a Participant under Section 6 subject to certain vesting conditions and other 

restrictions.

(ff)

“Restricted Stock Unit” means an unfunded, unsecured right to receive, on the applicable settlement date, one Share or 
an amount in cash or other consideration determined by the Administrator to be of equal value as of such settlement date, subject to certain 
vesting conditions and other restrictions.

(gg)

(hh)

“Rule 16b-3” means Rule 16b-3 promulgated under the Exchange Act.

“Section  409A”  means  Section  409A  of  the  Code  and  all  regulations,  guidance,  compliance  programs  and  other 

interpretative authority thereunder.

(ii)

(jj)

“Securities Act” means the Securities Act of 1933, as amended.

“Service Provider” means an Employee, Consultant or Director.

(kk)

“Shares” means shares of Common Stock.

(ll)

“Stock Appreciation Right” means a stock appreciation right granted under Section 5.

(mm)

“Subsidiary” means any entity (other than the Company), whether domestic or foreign, in an unbroken chain of entities 
beginning with the Company if each of the entities other than the last entity in the unbroken chain beneficially owns, at the time of the 
determination, securities or interests representing at least 50% of the total combined voting power of all classes of securities or interests in 
one of the other entities in such chain.

(nn)

“Termination of Service” means the date the Participant ceases to be a Service Provider.

* * * * *

 
SERES THERAPEUTICS, INC.
2022 EMPLOYMENT INDUCEMENT AWARD PLAN

STOCK OPTION GRANT NOTICE

Form of Stock Option Grant Notice

Capitalized terms not specifically defined in this Stock Option Grant Notice (the “Grant Notice”) have the meanings given to them 

in the 2022 Employment Inducement Award Plan (as amended from time to time, the “Plan”) of Seres Therapeutics, Inc. (the “Company”).

The  Company  hereby  grants  to  the  participant  listed  below  (“Participant”)  the  stock  option  described  in  this  Grant  Notice  (the 
“Option”), subject to the terms and conditions of the Plan and the Stock Option Agreement attached hereto as Exhibit A (the “Agreement”), 
both of which are incorporated into this Grant Notice by reference.

Participant:

Grant Date:

Exercise Price per Share:

Shares Subject to the Option:

Final Expiration Date:

Vesting Commencement Date:

Vesting Schedule:

Type of Option:

[____________]

[____________]

$[______]

[____________]

[____________]

[____________]

[To be specified in individual award agreements]

Non-Qualified Stock Option

 
 
 
By  Participant’s  signature  below,  Participant  agrees  to  be  bound  by  the  terms  of  this  Grant  Notice,  the  Plan  and  the  Agreement.  
Participant  has  reviewed  the  Plan,  this  Grant  Notice  and  the  Agreement  in  their  entirety,  has  had  an  opportunity  to  obtain  the  advice  of 
counsel  prior  to  executing  this  Grant  Notice  and  fully  understands  all  provisions  of  the  Plan,  this  Grant  Notice  and  the  Agreement.  
Participant hereby agrees to accept as binding, conclusive and final all decisions or interpretations of the Administrator upon any questions 
arising under the Plan, this Grant Notice or the Agreement.  

SERES THERAPEUTICS, INC.

PARTICIPANT

By:

Name: 

Title:

 
 
 
 
 
 
 
 
 
 
Capitalized terms not specifically defined in this Agreement have the meanings specified in the Grant Notice or, if not defined in 

the Grant Notice, in the Plan.

STOCK OPTION AGREEMENT

ARTICLE I.
GENERAL

1.1

Grant  of  Option.    Pursuant  to  the  Grant  Notice  to  which  this  Agreement  is  attached,  the  Company  has  granted  to 

Participant the Option effective as of the grant date set forth in the Grant Notice (the “Grant Date”).

1.2

Incorporation of Terms of Plan.  The Option is subject to the terms and conditions set forth in this Agreement and the Plan, 
which is incorporated herein by reference.  In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan will 
control.

1.3

Employment  Inducement  Award.    The  Option  is  intended  to  constitute  an  “employment  inducement  award”  under 
NASDAQ Rule 5635(c)(4) that is exempt from the requirements of shareholder approval of equity compensation plans under NASDAQ Rule 
5635(c)(4). This Agreement and the terms and conditions of the Option will be interpreted consistent with such intent.

ARTICLE II.
PERIOD OF EXERCISABILITY

2.1

Commencement of Exercisability.  The Option will vest and become exercisable according to the vesting schedule in the 
Grant Notice (the “Vesting Schedule”)  except  that  any  fraction  of  a  Share  as  to  which  the  Option  would  be  vested  or  exercisable  will  be 
accumulated  and  will  vest  and  become  exercisable  only  when  a  whole  Share  has  accumulated.    Notwithstanding  anything  in  the  Grant 
Notice, the Plan or this Agreement to the contrary, unless the Administrator otherwise determines, the Option will immediately expire and be 
forfeited as to any portion that is not vested and exercisable as of Participant’s Termination of Service for any reason.

2.2

Duration  of  Exercisability.    The  Vesting  Schedule  is  cumulative.    Any  portion  of  the  Option  which  vests  and  becomes 

exercisable will remain vested and exercisable until the Option expires.  The Option will be forfeited immediately upon its expiration.

2.3

Expiration of Option.  The Option may not be exercised to any extent by anyone after, and will expire on, the first of the 

following to occur:

(a)

the final expiration date in the Grant Notice;

except as the Administrator may otherwise approve, the expiration of three (3) months from the date of 
Participant’s Termination of Service, unless Participant’s Termination of Service is for Cause or by reason of Participant’s death or Disability; 

(b)

Participant’s Termination of Service by reason of Participant’s death or Disability; and 

(c)

except  as  the  Administrator  may  otherwise  approve,  the  expiration  of  one  (1)  year  from  the  date  of 

(d)

except as the Administrator may otherwise approve, Participant’s Termination of Service for Cause. 

 
 
 
 
 
As used in this Agreement, “Cause” means (i) if Participant is a party to a written employment or consulting agreement with the Company or 
its Subsidiary in which the term “cause” is defined (a “Relevant Agreement”), “Cause” as defined in the Relevant Agreement, and (ii) if no 
Relevant Agreement exists, (A) the Administrator’s determination that Participant failed to substantially perform Participant’s duties (other 
than a failure resulting from Participant’s Disability); (B) the Administrator’s determination that Participant failed to carry out, or comply 
with any lawful and reasonable directive of the Board or Participant’s immediate supervisor; (C) Participant’s conviction, plea of no contest, 
plea of nolo contendere, or imposition of unadjudicated probation for any felony or indictable offense or crime involving moral turpitude; (D) 
Participant’s unlawful use (including being under the influence) or possession of illegal drugs on the premises of the Company or any of its 
Subsidiaries  or  while  performing  Participant’s  duties  and  responsibilities  for  the  Company  or  any  of  its  Subsidiaries;  or  (E)  Participant’s 
commission of an act of fraud, embezzlement, misappropriation, misconduct, or breach of fiduciary duty against the Company or any of its 
Subsidiaries.

ARTICLE III.
EXERCISE OF OPTION

3.1

Person Eligible to Exercise.  During Participant’s lifetime, only Participant may exercise the Option.  After Participant’s 
death, any exercisable portion of the Option may, prior to the time the Option expires, be exercised by Participant’s Designated Beneficiary 
as provided in the Plan.

3.2

Partial Exercise.  Any exercisable portion of the Option or the entire Option, if then wholly exercisable, may be exercised, 
in whole or in part, according to the procedures in the Plan at any time prior to the time the Option or portion thereof expires, except that the 
Option may only be exercised for whole Shares.

3.3

Tax Withholding.  

The Company has the right and option, but not the obligation, to treat Participant’s failure to provide 
timely payment in accordance with the Plan of any withholding tax arising in connection with the Option as Participant’s election to satisfy 
all or any portion of the withholding tax by requesting the Company retain Shares otherwise issuable under the Option.

(a)

(b)

Participant  acknowledges  that  Participant  is  ultimately  liable  and  responsible  for  all  taxes  owed  in 
connection with the Option, regardless of any action the Company or any Subsidiary takes with respect to any tax withholding obligations 
that arise in connection with the Option.  Neither the Company nor any Subsidiary makes any representation or undertaking regarding the 
treatment of any tax withholding in connection with the awarding, vesting or exercise of the Option or the subsequent sale of Shares.  The 
Company  and  the  Subsidiaries  do  not  commit  and  are  under  no  obligation  to  structure  the  Option  to  reduce  or  eliminate  Participant’s  tax 
liability.

ARTICLE IV.
OTHER PROVISIONS

4.1

Adjustments.  Participant acknowledges that the Option is subject to adjustment, modification and termination in certain 

events as provided in this Agreement and the Plan.

4.2

Notices.  Any notice to be given under the terms of this Agreement to the Company must be in writing and addressed to 
the Company in care of the Company’s Secretary at the Company’s principal office or the Secretary’s then-current email address or facsimile 
number.    Any  notice  to  be  given  under  the  terms  of  this  Agreement  to  Participant  must  be  in  writing  and  addressed  to  Participant  (or,  if 
Participant is 

 
 
 
then deceased, to the person entitled to exercise the Option) at Participant’s last known mailing address, email address or facsimile number in 
the Company’s personnel files.  By a notice given pursuant to this Section, either party may designate a different address for notices to be 
given to that party.  Any notice will be deemed duly given when actually received, when sent by email, when sent by certified mail (return 
receipt requested) and deposited with postage prepaid in a post office or branch post office regularly maintained by the United States Postal 
Service, when delivered by a nationally recognized express shipping company or upon receipt of a facsimile transmission confirmation.

4.3

Titles.  Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of 

this Agreement.

4.4

Conformity to Securities Laws.  Participant acknowledges that the Plan, the Grant Notice and this Agreement are intended 
to  conform  to  the  extent  necessary  with  all  Applicable  Laws  and,  to  the  extent  Applicable  Laws  permit,  will  be  deemed  amended  as 
necessary to conform to Applicable Laws.

4.5

Successors and Assigns.  The Company may assign any of its rights under this Agreement to single or multiple assignees, 
and this Agreement will inure to the benefit of the successors and assigns of the Company.  Subject to the restrictions on transfer set forth in 
the Plan, this Agreement will be binding upon and inure to the benefit of the heirs, legatees, legal representatives, successors and assigns of 
the parties hereto.

4.6

Limitations  Applicable  to  Section  16  Persons.    Notwithstanding  any  other  provision  of  the  Plan  or  this  Agreement,  if
Participant is subject to Section 16 of the Exchange Act, the Plan, the Grant Notice, this Agreement and the Option will be subject to any 
additional limitations set forth in any applicable exemptive rule under Section 16 of the Exchange Act (including any amendment to Rule 
16b‑3)  that  are  requirements  for  the  application  of  such  exemptive  rule.    To  the  extent  Applicable  Laws  permit,  this  Agreement  will  be 
deemed amended as necessary to conform to such applicable exemptive rule.

4.7

Entire Agreement.    The  Plan,  the  Grant  Notice  and  this  Agreement  (including  any  exhibit  hereto)  constitute  the  entire 
agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to 
the subject matter hereof.

4.8

Agreement Severable.  In the event that any provision of the Grant Notice or this Agreement is held illegal or invalid, the 
provision will be severable from, and the illegality or invalidity of the provision will not be construed to have any effect on, the remaining 
provisions of the Grant Notice or this Agreement.

4.9

Limitation on Participant’s Rights.  Participation in the Plan confers no rights or interests other than as herein provided.  
This Agreement creates only a contractual obligation on the part of the Company as to amounts payable and may not be construed as creating 
a  trust.    Neither  the  Plan  nor  any  underlying  program,  in  and  of  itself,  has  any  assets.    Participant  will  have  only  the  rights  of  a  general 
unsecured creditor of the Company with respect to amounts credited and benefits payable, if any, with respect to the Option, and rights no 
greater than the right to receive the Shares as a general unsecured creditor with respect to the Option, as and when exercised pursuant to the 
terms hereof.

4.10

Not a Contract of Employment.  Nothing in the Plan, the Grant Notice or this Agreement confers upon Participant any 
right  to  continue  in  the  employ  or  service  of  the  Company  or  any  Subsidiary  or  interferes  with  or  restricts  in  any  way  the  rights  of  the 
Company and its Subsidiaries, which rights are hereby expressly reserved, to discharge or terminate the services of Participant at any time for 
any  reason  whatsoever,  with  or  without  Cause,  except  to  the  extent  expressly  provided  otherwise  in  a  written  agreement  between  the 
Company or a Subsidiary and Participant.

 
 
 
4.11

Counterparts.    The  Grant  Notice  may  be  executed  in  one  or  more  counterparts,  including  by  way  of  any  electronic 

signature, subject to Applicable Law, each of which will be deemed an original and all of which together will constitute one instrument.

* * * * *

 
 
 
 
SERES THERAPEUTICS, INC.
2022 EMPLOYMENT INDUCEMENT AWARD PLAN

RESTRICTED STOCK UNIT GRANT NOTICE

Capitalized terms not specifically defined in this Restricted Stock Unit Grant Notice (the “Grant Notice”) have the meanings given 
to  them  in  the  2022  Employment  Inducement  Award  Plan  (as  amended  from  time  to  time,  the  “Plan”)  of  Seres  Therapeutics,  Inc.  (the 
“Company”).

The Company hereby grants to the participant listed below (“Participant”) the Restricted Stock Units described in this Grant Notice 
(the “RSUs”), subject to the terms and conditions of the Plan and the Restricted Stock Unit Agreement attached hereto as Exhibit A  (the 
“Agreement”), both of which are incorporated into this Grant Notice by reference.  

Participant:

Grant Date:

Number of RSUs:

Vesting Commencement Date:

[____________]

[____________]

[____________]

[____________]

Vesting Schedule:

[To be specified in individual award agreements]

By  Participant’s  signature  below,  Participant  agrees  to  be  bound  by  the  terms  of  this  Grant  Notice,  the  Plan  and  the  Agreement.  
Participant  has  reviewed  the  Plan,  this  Grant  Notice  and  the  Agreement  in  their  entirety,  has  had  an  opportunity  to  obtain  the  advice  of 
counsel  prior  to  executing  this  Grant  Notice  and  fully  understands  all  provisions  of  the  Plan,  this  Grant  Notice  and  the  Agreement.  
Participant hereby agrees to accept as binding, conclusive and final all decisions or interpretations of the Administrator upon any questions 
arising under the Plan, this Grant Notice or the Agreement.

SERES THERAPEUTICS, INC.

PARTICIPANT

By:

Print Name: 

Title:

 
 
 
 
 
 
 
 
 
 
Capitalized terms not specifically defined in this Agreement have the meanings specified in the Grant Notice or, if not defined in 

the Grant Notice, in the Plan.

RESTRICTED STOCK UNIT AGREEMENT

1.1

Award of RSUs and Dividend Equivalents.  

ARTICLE I.
GENERAL

(a)

The Company has granted the RSUs to Participant effective as of the grant date set forth in the Grant 
Notice (the “Grant Date”).  Each RSU represents the right to receive one Share or, at the option of the Company, an amount of cash, in either 
case, as set forth in this Agreement.  Participant will have no right to the distribution of any Shares or payment of any cash until the time (if 
ever) the RSUs have vested.

(b)

The  Company  hereby  grants  to  Participant,  with  respect  to  each  RSU,  a  Dividend  Equivalent  for 
ordinary cash dividends paid to substantially all holders of outstanding Shares with a record date after the Grant Date and prior to the date the 
applicable RSU is settled, forfeited or otherwise expires.  Each Dividend Equivalent entitles Participant to receive the equivalent value of any 
such ordinary cash dividends paid on a single Share.  The Company will establish a separate Dividend Equivalent bookkeeping account (a 
“Dividend  Equivalent  Account”)  for  each  Dividend  Equivalent  and  credit  the  Dividend  Equivalent  Account  (without  interest)  on  the 
applicable dividend payment date with the amount of any such cash paid.

1.2

Incorporation  of  Terms  of  Plan.    The  RSUs  are  subject  to  the  terms  and  conditions  set  forth  in  this  Agreement  and  the 
Plan, which is incorporated herein by reference.  In the event of any inconsistency between the Plan and this Agreement, the terms of the 
Plan will control.

1.3

Unsecured  Promise.    The  RSUs  and  Dividend  Equivalents  will  at  all  times  prior  to  settlement  represent  an  unsecured 

Company obligation payable only from the Company’s general assets.

1.4

Employment  Inducement  Award.    The  RSUs  are  intended  to  constitute  an  “employment  inducement  award”  under 
NASDAQ Rule 5635(c)(4) that is exempt from the requirements of shareholder approval of equity compensation plans under NASDAQ Rule 
5635(c)(4).  This agreement and the terms and conditions of the RSUS will be interpreted consistent with such intent.

ARTICLE II.
VESTING; FORFEITURE AND SETTLEMENT

2.1

Vesting; Forfeiture.  The RSUs will vest according to the vesting schedule in the Grant Notice except that any fraction of 
an  RSU  that  would  otherwise  be  vested  will  be  accumulated  and  will  vest  only  when  a  whole  RSU  has  accumulated.    In  the  event  of 
Participant’s Termination of Service for any reason, all unvested RSUs will immediately and automatically be cancelled and forfeited, except 
as otherwise determined by the Administrator or provided in a binding written agreement between Participant and the Company.  Dividend 
Equivalents (including any Dividend Equivalent Account balance) will vest or be forfeited, as applicable, upon the vesting or forfeiture of the 
RSU with respect to which the Dividend Equivalent (including the Dividend Equivalent Account) relates.

 
 
 
2.2

Settlement.

(a)

RSUs and Dividend Equivalents (including any Dividend Equivalent Account balance) will be paid in 
Shares or cash at the Company’s option as soon as administratively practicable after the vesting of the applicable RSU, but in no event more 
than  sixty  (60)  days  after  the  RSU’s  vesting  date.    Notwithstanding  the  foregoing,  the  Company  may  delay  any  payment  under  this 
Agreement  that  the  Company  reasonably  determines  would  violate  Applicable  Law  until  the  earliest  date  the  Company  reasonably 
determines the making of the payment will not cause such a violation (in accordance with Treasury Regulation Section 1.409A-2(b)(7)(ii)), 
provided the Company reasonably believes the delay will not result in the imposition of excise taxes under Section 409A.

(b)

If an RSU is paid in cash, the amount of cash paid with respect to the RSU will equal the Fair Market 
Value of a Share on the day immediately preceding the payment date.  If a Dividend Equivalent is paid in Shares, the number of Shares paid 
with  respect  to  the  Dividend  Equivalent  will  equal  the  quotient,  rounded  down  to  the  nearest  whole  Share,  of  the  Dividend  Equivalent 
Account balance divided by the Fair Market Value of a Share on the day immediately preceding the payment date.

ARTICLE III.
TAXATION AND TAX WITHHOLDING

3.1

Representation.  Participant represents to the Company that Participant has reviewed with Participant’s own tax advisors 
the tax consequences of this Award and the transactions contemplated by the Grant Notice and this Agreement.  Participant is relying solely 
on such advisors and not on any statements or representations of the Company or any of its agents.

3.2

Tax Withholding.  

(a)

The Company has the right and option, but not the obligation, to treat Participant’s failure to provide 
timely  payment  in  accordance  with  the  Plan  of  any  withholding  tax  arising  in  connection  with  the  RSUs  or  Dividend  Equivalents  as 
Participant’s election to satisfy all or any portion of the withholding tax by requesting the Company retain Shares otherwise issuable under 
the Award.

(b)

Participant  acknowledges  that  Participant  is  ultimately  liable  and  responsible  for  all  taxes  owed  in 
connection with the RSUs and the Dividend Equivalents, regardless of any action the Company or any Subsidiary takes with respect to any 
tax withholding obligations that arise in connection with the RSUs or Dividend Equivalents.  Neither the Company nor any Subsidiary makes 
any representation or undertaking regarding the treatment of any tax withholding in connection with the awarding, vesting or payment of the 
RSUs or the Dividend Equivalents or the subsequent sale of Shares.  The Company and the Subsidiaries do not commit and are under no 
obligation to structure the RSUs or Dividend Equivalents to reduce or eliminate Participant’s tax liability.

(c)  Mandatory Sell to Cover 

(i)

By  accepting  this  Award,  Participant  understands  and  agrees  that  as  a  condition  of  the  grant  of  the  RSUs
hereunder, Participant is required to, and hereby affirmatively elects to (the “Sell to Cover Election”), (1) sell that number of Shares 
determined in accordance with this Section 3.2(c) as may be necessary to satisfy all applicable withholding obligations with respect 
to any taxable event arising in connection with the RSUs and similarly sell such number of Shares as may be necessary to satisfy all 
applicable withholding obligations with respect to any other awards of restricted stock units granted to Participant under the Plan or 
any other equity incentive plans of the Company or its predecessor, and (2) to allow the transfer agent (together with any other party 

|US-DOCS\137823120.2||

A-2

 
 
the Company determines necessary to execute the Sell to Cover Election, the “Agent”) to remit the cash proceeds of such sale(s) to 
the Company.  Furthermore, Participant directs the Company to make a cash payment equal to the required tax withholding from the 
cash proceeds of such sale(s) directly to the appropriate taxing authorities. 

(ii)

Participant  hereby  appoints  the  Agent  as  Participant’s  agent  and  authorizes  the  Agent  to  (1)  sell  on  the  open 
market at the then prevailing market price(s), on the Participant’s behalf, as soon as practicable on or after the date the Shares are 
issued  upon  the  vesting  of  the  RSUs,  that  number  (rounded  up  to  the  next  whole  number)  of  the  Shares  so  issued  necessary  to 
generate  proceeds  to  cover  (x)  any  tax  withholding  obligations  incurred  with  respect  to  such  vesting  or  issuance  and  (y)  all 
applicable fees and commissions due to, or required to be collected by, the Agent with respect thereto and (2) apply any remaining 
funds  to  Participant’s  tax  withholding  obligations  hereunder.    Participant  hereby  authorizes  the  Company  and  the  Agent  to 
cooperate and communicate with one another to determine the number of Shares that must be sold pursuant to this Section 3.2(c)
(ii).  Participant understands that the Agent may effect sales as provided in this Section 3.2(c)(ii) in one or more sales and that the 
average  price  for  executions  resulting  from  bunched  orders  will  be  assigned  to  Participant’s  account.    In  addition,  Participant 
acknowledges  that  it  may  not  be  possible  to  sell  Shares  as  provided  by  this  Section  3.2(c)(ii)  due  to  (1)  a  legal  or  contractual 
restriction  applicable  to  Participant  or  the  Agent,  (2)  a  market  disruption,  or  (3)  rules  governing  order  execution  priority  on  the 
national exchange where the Shares may be traded. Participant further agrees and acknowledges that in the event the sale of Shares 
would  result  in  material  adverse  harm  to  the  Company,  as  determined  by  the  Company  in  its  sole  discretion,  the  Company  may 
instruct the Agent not to sell Shares as provided by this Section 3.2(c)(ii).  In the event of the Agent’s inability to sell Shares, the 
Participant will continue to be responsible for the timely payment to the Company and/or its affiliates of all federal, state, local and 
foreign  taxes  that  are  required  by  applicable  laws  and  regulations  to  be  withheld,  including  but  not  limited  to  those  amounts 
specified in this Section 3.2(c)(ii).  Participant acknowledges that regardless of any other term or condition of this Section 3.2(c), 
the  Agent  will  not  be  liable  to  Participant  for  (1)  special,  indirect,  punitive,  exemplary,  or  consequential  damages,  or  incidental 
losses  or  damages  of  any  kind,  or  (2)  any  failure  to  perform  or  for  any  delay  in  performance  that  results  from  a  cause  or 
circumstance  that  is  beyond  its  reasonable  control.      Participant  hereby  agrees  to  execute  and  deliver  to  the  Agent  any  other 
agreements  or  documents  as  the  Agent  reasonably  deems  necessary  or  appropriate  to  carry  out  the  purposes  and  intent  of  this 
Section 3.2(c). The Agent is a third-party beneficiary of this Section 3.2(c).  This Section 3.2(c) shall terminate not later than the 
date on which all tax withholding obligations arising in connection with the Award have been satisfied. 

(iii)

Participant has carefully reviewed this Section 3.2(c) and Participant hereby represents and warrants that 
on  the  date  hereof  he  or  she  is  not  aware  of  any  material,  nonpublic  information  with  respect  to  the  Company  or  any 
securities  of  the  Company,  is  not  subject  to  any  legal,  regulatory  or  contractual  restriction  that  would  prevent  the  Agent 
from  conducting  sales,  does  not  have,  and  will  not  attempt  to  exercise,  authority,  influence  or  control  over  any  sales  of 
Shares  effected  by  the  Agent  pursuant  to  the  Agreement,  and  is  entering  into  the  Agreement  and  this  election  to  “sell  to 
cover” in good faith and not as part of a plan or scheme to evade the prohibitions of Rule 10b5-1 (regarding trading of the 
Company’s securities on the basis of material nonpublic information) under the Exchange Act.  It is Participant’s intent that 
this  election  to  “sell  to  cover”  comply  with  the  requirements  of  Rule  10b5-1(c)(1)(i)(B)  under  the  Exchange  Act  and  be 
interpreted to comply with the requirements of Rule 10b5-1(c) under the Exchange Act.

|US-DOCS\137823120.2||

A-3

 
 
ARTICLE IV.
OTHER PROVISIONS

4.1

Adjustments.  Participant acknowledges that the RSUs, the Shares subject to the RSUs and the Dividend Equivalents are 

subject to adjustment, modification and termination in certain events as provided in this Agreement and the Plan.

4.2

Notices.  Any notice to be given under the terms of this Agreement to the Company must be in writing and addressed to 
the Company in care of the Company’s Secretary at the Company’s principal office or the Secretary’s then-current email address or facsimile 
number.    Any  notice  to  be  given  under  the  terms  of  this  Agreement  to  Participant  must  be  in  writing  and  addressed  to  Participant  at 
Participant’s last known mailing address, email address or facsimile number in the Company’s personnel files.  By a notice given pursuant to 
this Section, either party may designate a different address for notices to be given to that party.  Any notice will be deemed duly given when 
actually received, when sent by email, when sent by certified mail (return receipt requested) and deposited with postage prepaid in a post 
office  or  branch  post  office  regularly  maintained  by  the  United  States  Postal  Service,  when  delivered  by  a  nationally  recognized  express 
shipping company or upon receipt of a facsimile transmission confirmation.

4.3

Titles.  Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of 

this Agreement.

4.4

Conformity to Securities Laws.  Participant acknowledges that the Plan, the Grant Notice and this Agreement are intended 
to  conform  to  the  extent  necessary  with  all  Applicable  Laws  and,  to  the  extent  Applicable  Laws  permit,  will  be  deemed  amended  as 
necessary to conform to Applicable Laws.

4.5

Successors and Assigns.  The Company may assign any of its rights under this Agreement to single or multiple assignees, 
and this Agreement will inure to the benefit of the successors and assigns of the Company.  Subject to the restrictions on transfer set forth in 
the Plan, this Agreement will be binding upon and inure to the benefit of the heirs, legatees, legal representatives, successors and assigns of 
the parties hereto.

4.6

Limitations  Applicable  to  Section  16  Persons.    Notwithstanding  any  other  provision  of  the  Plan  or  this  Agreement,  if
Participant is subject to Section 16 of the Exchange Act, the Plan, the Grant Notice, this Agreement, the RSUs and the Dividend Equivalents 
will be subject to any additional limitations set forth in any applicable exemptive rule under Section 16 of the Exchange Act (including any 
amendment  to  Rule  16b-3)  that  are  requirements  for  the  application  of  such  exemptive  rule.    To  the  extent  Applicable  Laws  permit,  this 
Agreement will be deemed amended as necessary to conform to such applicable exemptive rule.

4.7

Entire Agreement.    The  Plan,  the  Grant  Notice  and  this  Agreement  (including  any  exhibit  hereto)  constitute  the  entire 
agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to 
the subject matter hereof.

4.8

Agreement Severable.  In the event that any provision of the Grant Notice or this Agreement is held illegal or invalid, the 
provision will be severable from, and the illegality or invalidity of the provision will not be construed to have any effect on, the remaining 
provisions of the Grant Notice or this Agreement.

4.9

Limitation on Participant’s Rights.  Participation in the Plan confers no rights or interests other than as herein provided.  
This Agreement creates only a contractual obligation on the part of the Company as to amounts payable and may not be construed as creating 
a trust.  Neither the Plan nor any 

|US-DOCS\137823120.2||

A-4

 
 
underlying program, in and of itself, has any assets.  Participant will have only the rights of a general unsecured creditor of the Company 
with respect to amounts credited and benefits payable, if any, with respect to the RSUs and Dividend Equivalents, and rights no greater than 
the  right  to  receive  cash  or  the  Shares  as  a  general  unsecured  creditor  with  respect  to  the  RSUs  and  Dividend  Equivalents,  as  and  when 
settled pursuant to the terms of this Agreement.

4.10

Not a Contract of Employment.  Nothing in the Plan, the Grant Notice or this Agreement confers upon Participant any 
right  to  continue  in  the  employ  or  service  of  the  Company  or  any  Subsidiary  or  interferes  with  or  restricts  in  any  way  the  rights  of  the 
Company and its Subsidiaries, which rights are hereby expressly reserved, to discharge or terminate the services of Participant at any time for 
any  reason  whatsoever,  with  or  without  Cause,  except  to  the  extent  expressly  provided  otherwise  in  a  written  agreement  between  the 
Company or a Subsidiary and Participant.

4.11

Counterparts.    The  Grant  Notice  may  be  executed  in  one  or  more  counterparts,  including  by  way  of  any  electronic 

signature, subject to Applicable Law, each of which will be deemed an original and all of which together will constitute one instrument.

|US-DOCS\137823120.2||

* * * * *

A-5

 
 
SERES THERAPEUTICS, INC.

NON-EMPLOYEE DIRECTOR COMPENSATION PROGRAM

(as amended effective February 17, 2023)(the “Effective Date”)

Exhibit 10.5

Non-employee  members  of  the  board  of  directors  (the  “Board”)  of  Seres  Therapeutics,  Inc.  (the  “Company”)  shall 
receive cash and equity compensation as set forth in this Non-Employee Director Compensation Program (this “Program”).  The 
cash  and  equity  compensation  described  in  this  Program  shall  be  paid  or  be  made,  as  applicable,  automatically  and  without 
further action of the Board (other than the determination by the Compensation and Talent Committee of the number of shares 
subject to an Initial Award as set forth in Section II(A)), to each member of the Board who is not an employee of the Company or 
any  parent  or  subsidiary  of  the  Company  (each,  a  “Non-Employee  Director”)  who  is  entitled  to  receive  such  cash  or  equity 
compensation, unless such Non-Employee Director declines the receipt of such cash or equity compensation by written notice to 
the Company.  This Program shall remain in effect until it is revised or rescinded by further action of the Board.  This Program 
may  be  amended,  modified  or  terminated  by  the  Board  at  any  time  in  its  sole  discretion.    The  terms  and  conditions  of  this 
Program shall supersede any prior cash and/or equity compensation arrangements for service as a member of the Board between 
the Company and any of its Non-Employee Directors.  No Non-Employee Director shall have any rights hereunder, except with 
respect to stock options granted pursuant to the Program.  

I.  CASH COMPENSATION

A.  Annual Retainers.  Each Non-Employee Director shall receive an annual retainer of $45,000 for service on 

the Board.  

retainers:

B.   Additional Annual Retainers.  In addition, each Non-Employee Director shall receive the following annual 

Chairman of the Board or Lead Independent Director shall receive an additional annual retainer of $35,000 for such service.

1.    Chairman  of  the  Board  or  Lead  Independent  Director.    A  Non-Employee  Director  serving  as 

2.   Audit Committee.  A Non-Employee Director serving as Chairperson of the Audit Committee shall 
receive an additional annual retainer of $20,000 for such service. A Non-Employee Director serving as a member other than the 
Chairperson of the Audit Committee shall receive an additional annual retainer of $10,000 for such service.

3.  Compensation  and  Talent  Committee.    A  Non-Employee  Director  serving  as  Chairperson  of  the 
Compensation and Talent Committee shall receive an additional annual retainer of $15,000 for such service. A Non-Employee 
Director serving as a member other than the Chairperson of the Compensation and Talent Committee shall receive an additional 
annual retainer of $7,500 for such service.

|US-DOCS\138718768.2||

 
 
 
 
 
 
 
 
4.    Nominating  and  Corporate  Governance  Committee.    A  Non-Employee  Director  serving  as 
Chairperson of the Nominating and Corporate Governance Committee shall receive an additional annual retainer of $10,000 for 
such  service.  A  Non-Employee  Director  serving  as  a  member  other  than  the  Chairperson  of  the  Nominating  and  Corporate 
Governance Committee shall receive an additional annual retainer of $5,000 for such service. 

5.   Science and Clinical Development Committee.  A Non-Employee Director serving as Chairperson 
of the Science and Clinical Development Committee shall receive an additional annual retainer of $15,000 for such service. A 
Non-Employee Director serving as a member other than the Chairperson of the Science and Clinical Development Committee 
shall receive an additional annual retainer of $7,500 for such service. 

C.  Payment of Retainers.    The  annual  retainers  described  in  Sections  I(A)  and  I(B)  shall  be  earned  on  a  quarterly 
basis based on a calendar quarter and shall be paid in cash by the Company in arrears not later than the fifteenth day following 
the end of each calendar quarter.  In the event a Non-Employee Director does not serve as a Non-Employee Director, or in the 
applicable positions described in Section I(B), for an entire calendar quarter, the retainer paid to such Non-Employee Director 
shall  be  prorated  for  the  portion  of  such  calendar  quarter  actually  served  as  a  Non-Employee  Director,  or  in  such  position,  as 
applicable.

II.  EQUITY COMPENSATION 

Non-Employee  Directors  shall  be  granted  the  equity  awards  described  below.    The  awards  described  below  shall  be 
granted  under  and  shall  be  subject  to  the  terms  and  provisions  of  the  Company’s  2015  Incentive  Award  Plan  or  any  other 
applicable Company equity incentive plan then-maintained by the Company (the “Equity Plan”) and shall be granted subject to 
award agreements, including attached exhibits, in substantially the form previously approved by the Board.  All applicable terms 
of  the  Equity  Plan  apply  to  this  Program  as  if  fully  set  forth  herein,  and  all  grants  of  stock  options  hereby  are  subject  in  all 
respects to the terms of the Equity Plan and the applicable award agreement.  For the avoidance of doubt, the share numbers in 
Sections II(A) and II(B) shall be subject to adjustment as provided in the Equity Plan, including without limitation with respect to 
any stock dividend, stock split, reverse stock split or other similar event affecting the Company’s common stock that is effected 
prior to the Effective Date.

A. 

Initial  Awards.    Each  Non-Employee  Director  who  is  initially  elected  or  appointed  to  the  Board  after  the 
Effective Date shall receive an option to purchase shares of the Company’s common stock on the date of such initial election or 
appointment in an amount determined by the Compensation and Talent Committee prior to such initial election or appointment 
and  subject  to  the  terms  and  provisions  of  the  Equity  Plan,  including  without  limitation  Section  IV.(e)  thereto.  The  awards 
described in this Section II(A) shall be referred to as “Initial Awards.”  No Non-Employee Director shall be granted more than 
one Initial Award. 

B.  Subsequent Awards.  A Non-Employee Director who (i) has been serving as a Non-Employee Director on the 
Board for at least six months as of the date of any annual meeting of the Company’s stockholders after the Effective Date and (ii) 
will continue to serve as a Non-Employee Director immediately following such meeting, shall be automatically granted an option 
to purchase 35,000 shares of the Company’s common stock on the date of such annual meeting.  The awards 

|US-DOCS\138718768.2||

 
 
 
 
 
 
described  in  this  Section  II(B)  shall  be  referred  to  as  “Subsequent  Awards.”    For  the  avoidance  of  doubt,  a  Non-Employee 
Director elected for the first time to the Board at an annual meeting of the Company’s stockholders shall only receive an Initial 
Award in connection with such election, and shall not receive any Subsequent Award on the date of such meeting as well.  

C.  Termination of Service of Employee Directors.  Members of the Board who are employees of the Company 
or  any  parent  or  subsidiary  of  the  Company  who  subsequently  terminate  their  service  with  the  Company  and  any  parent  or 
subsidiary of the Company and remain on the Board will not receive an Initial Award pursuant to Section II(A) above, but to the 
extent that they are otherwise entitled, will receive, after termination from service with the Company and any parent or subsidiary 
of the Company, Subsequent Awards as described in Section II(B) above.  

D.  Terms of Awards Granted to Non-Employee Directors

equal the Fair Market Value (as defined in the Equity Plan) of a share of common stock on the date the option is granted. 

1.    Exercise Price.  The per share exercise price of each option granted to a Non-Employee Director shall 

2. 

Vesting.    Each  Initial  Award  shall  vest  and  become  exercisable  in  four  substantially  equal  annual 
installments following the date of grant, such that the Initial Award shall be fully vested on the fourth anniversary of the date of 
grant, subject to the Non-Employee Director continuing in service as a Non-Employee Director through each such vesting date.  
Each Subsequent Award shall vest and become exercisable on the earlier of the first anniversary of the date of grant or the day
immediately prior to the date of the next annual meeting of the Company’s stockholders occurring after the date of grant, in either 
case subject to the Non-Employee Director continuing in service on the Board as a Non-Employee Director through each such 
vesting date.  Unless the Board otherwise determines, any portion of an Initial Award or Subsequent Award which is unvested or 
unexercisable at the time of a Non-Employee Director’s termination of service on the Board as a Non-Employee Director shall be 
immediately forfeited upon such termination of service and shall not thereafter become vested and exercisable.  All of a Non-
Employee Director’s Initial Awards and Subsequent Awards shall vest in full immediately prior to the occurrence of a Change in 
Control (as defined in the Equity Plan), to the extent outstanding at such time.

shall be ten (10) years from the date the option is granted. 

3.  Term.  The maximum term of each stock option granted to a Non-Employee Director hereunder 

|US-DOCS\138718768.2||

* * * * *

 
 
 
 
 
 
 
 
Exhibit 10.28

[***] Certain informaon in this document has been excluded pursuant to Regulaon S-K, Item (601)(b)(10). Such excluded informaon 
is both (i) not material and (ii) the type that the Registrant treats as private or confidenal.

AMENDMENT TO LONG TERM MANUFACTURING AGREEMENT

THIS  AMENDMENT  (the  “Amendment”),  to  that  certain  Long  Term  Manufacturing  Agreement  by  and  between  Seres 
Therapeucs, Inc. and BacThera AG, dated as of November 8, 2021 (the “LTMA”), is made and entered into as of December 14, 2022 by 
and  between  Seres  Therapeucs,  Inc.  (“Seres”),  a  corporaon  organized  and  exisng  under  the  laws  of  Delaware,  having  its  principal 
place  of  business  at  200  Sidney  Street,  Cambridge,  MA  02139,  USA;  and  BacThera  AG,  a  joint  venture  between  Chr.  Hansen  A/S  and 
Capsugel Belgium NV, a Lonza Group Affiliate, (“Lonza”), having a place of business at Hochbergerstrasse 60A, 4057 Basel, Switzerland 
(“Bacthera”).  Seres and Bacthera may be referred to herein individually as a “Party” or collecvely as the “Pares.”

WHEREAS,  pursuant  to  Secon  10.2  of  Exhibit  1  to  the  LTMA,  Bacthera  has  proposed  two  adjustments  to  the  CapEx  Target  (defined 
therein); and  

WHEREAS, pursuant to Secon 12.1 of Exhibit 1 to the LTMA, Bacthera has proposed certain changes to the Work (defined therein).

NOW,  THEREFORE,  in  consideraon  of  the  mutual  covenants  and  obligaons  set  forth  herein,  and  for  other  good  and  valuable 
consideraon, the receipt and sufficiency of which is hereby acknowledged, the Pares agree as follows:

1.

1.1

1.2

2.

2.1

2.2

3.

3.1

DEFINITIONS

The definion of Product(s) in the LTMA shall be revised to “SER-109 and other products, as agreed to by both Pares”.

Capitalized terms not defined in this Amendment shall have the definion ascribed to them in the LTMA. 

CHANGE ORDER 

Change Order. The Change Order aached hereto as Exhibit 1, totaling [***], is hereby accepted and agreed to by the Pares.  

Addional Scope. Bacthera  agrees  to  complete  development  of  Spray  Drying  technologies  Proof  of  Concept  for  Seres  at  the 
Hørsholm Facility [***].

CAPEX TARGET ADJUSTMENTS

First Adjustment. Pursuant to Secon 10.2(a)(i) of Exhibit 1 to the LTMA, the Pares hereby agree that the First Adjustment shall 
not exceed [***]. The Adjusted CapEx Target shall not exceed [***] including the Change Order.

1

 
 
 
3.2

4.

4.1

4.2

5.

5.1

6.

6.1

7.

7.1

Second  Adjustment.  Purusant  to  Secon  10.2(a)(ii)  of  Exhibit  1  to  the  LTMA,  the  Pares  hereby  agree  that  the  Second 
Adjustment shall not exceed [***](1) which is [***]. 

FINAL CAPEX AMOUNT

Final  CapEx  Amount.  The  Pares  agree  that  following  the  adjustments  to  the  CapEx  Target  and  the  Change  Order,  the  Final 
CapEx Amount shall not exceed [***](2).  

Reducons. Consistent with Secon 10.2 of Exhibit 1 to the LTMA, Bacthera will [***]. 

MILESTONE PAYMENTS 

The table in Secon 11.1(a) of Exhibit 1 to the LTMA is hereby replaced with the following: 

MILESTONE

MILESTONE PAYMENT (CAPEX TARGET) 

Contract Signature 

[***]

[***]

[***]

[***]

BUDGET UPDATES

[***].

MISCELLANEOUS

[***]

[***]

[***]

[***]

[***]

Counterparts.  This  Amendment  may  be  executed  simultaneously  in  any  number  of  counterparts,  any  one  of  which  need  not 
contain  the  signature  of  more  than  one  Party  but  all  such  counterparts  taken  together  will  constute  one  and  the  same 
agreement.

[Signature page follows]

2

 
 
 
I  W  W,  the  Pares  have  caused  this  Agreement  to  be  executed  by  their  respecve  duly  authorized  officers  as  of  the 
Effecve Date, each copy of which will for all purposes be deemed to be an original.

SIGNED BY:
FOR AND ON BEHALF OF
SERES THERAPEUTICS, INC.

/s/ Eric D. Shaff
NAME ERIC D. SHAFF
TITLE PRESIDENT, CEO
DATE December 17, 2022 | 1:11PM PST

SIGNED BY:
For and on behalf of
BacThera AG

/s/ [***]  
Name [***]
Title [***]
Date December 20, 2022

SIGNED BY:
For and on behalf of
BacThera AG

/s/ [***]
Name [***]
Title [***]
Date December 20, 2022

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
[***]

Exhibit 1 
Change Order 

 
 
 
 
 
 
CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

Exhibit 23.1

We hereby consent to the incorporation by reference in the Registration Statements on Form S-8 (Nos. 333-269081, 333-263134, 333-
253776, 333-236824, 333-230092, 333-223514, 333-210171 and 333-205253) and Form S-3 (Nos.333-244401, 333- 237033 and 333-216735) 
of Seres Therapeutics, Inc. of our report dated March 7, 2023 relating to the financial statements and the effectiveness of internal control over 
financial reporting, which appears in this Form 10-K.

/s/PricewaterhouseCoopers LLP
Boston, Massachusetts 
March 7, 2023

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 31.1

I, Eric D. Shaff, certify that:

1. I have reviewed this Annual Report on Form 10-K of Seres Therapeutics, Inc.;

CERTIFICATIONS

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

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

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 

financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 

Exchange Act Rules 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 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 report our conclusions about the 

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

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

recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to 
materially affect, the registrant’s internal control over financial reporting; and

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

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

(a) 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 7, 2023

By: 

/s/ Eric D. Shaff
Eric D. Shaff
President and Chief Executive Officer
(Principal Executive Officer)

  
 
 
 
 
 
 
 
Exhibit 31.2

I, David Arkowitz, certify that:

1. I have reviewed this Annual Report on Form 10-K of Seres Therapeutics, Inc.;

CERTIFICATIONS

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

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

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 

financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 

Exchange Act Rules 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 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 report our conclusions about the 

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

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

recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to 
materially affect, the registrant’s internal control over financial reporting; and

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

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

(a) 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 7, 2023

By: 

/s/ David Arkowitz
David Arkowitz
Executive Vice President, Chief Financial Officer and Head of 
Business Development
(Principal Financial and Accounting Officer)

  
 
 
 
 
 
 
 
 
CERTIFICATION PURSUANT TO 
18 U.S.C. SECTION 1350, 
AS ADOPTED PURSUANT TO 
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002 

Exhibit 32.1

I, Eric D. Shaff, President and Chief Executive Officer of Seres Therapeutics, Inc. (the “Company”), hereby certify, pursuant to 18 U.S.C. §1350, as 
adopted pursuant to §906 of the Sarbanes-Oxley Act of 2002, that, to the best of my knowledge:

(1)

(2)

The Annual Report on Form 10-K of the Company for the period ended December 31, 2022 (the “Report”) fully complies with the 
requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the 
Company.

March 7, 2023

/s/ Eric D. Shaff
Eric D. Shaff

President and Chief Executive Officer
(Principal Executive Officer)

  
 
 
 
 
 
CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

Exhibit 32.2

I, David Arkowitz, Executive Vice President, Chief Financial Officer and Head of Business Development of Seres Therapeutics, Inc. (the “Company”), 
hereby certify, pursuant to 18 U.S.C. §1350, as adopted pursuant to §906 of the Sarbanes-Oxley Act of 2002, that, to the best of my knowledge:

(1)

(2)

The Annual Report on Form 10-K of the Company for the period ended December 31, 2022 (the “Report”) fully complies with the 
requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the 
Company.

March 7, 2023

/s/ David Arkowitz
David Arkowitz

Executive Vice President, Chief Financial Officer and Head of Business 
Development
(Principal Financial and Accounting Officer)