Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

FORM 10-K

FORM 10-K

(Mark One)

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

For the fiscal year ended December 31 2018

, 2021

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 001-35817

CANCER GENETICS,

VYANT BIO, INC.

(Exact name of registrant as specified in its charter)

 

Delaware04-3462475
Delaware04-3462475

(State or other jurisdiction

of

incorporation or organization)

(I.R.S. Employer

Identification No.)
201

2 Executive Campus

2370 State Route 17 North 2nd Floor

Rutherford, 70, Suite 310

Cherry Hill, NJ 07070

08002

(201) 528-9200

479-1357

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

 

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

Title of each classTrading SymbolName of each exchange on which registered
Common Stock, $0.0001 par value per shareNASDAQ CapitalVYNTThe Nasdaq Stock Market LLC

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

 

Indicate by check if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ¨Noý

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes: ¨    No:  ý

No:

Indicate by check mark if 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:  ýYes: ☒ No: ¨

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Website; if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes:  ýYes: ☒ No: ¨

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form  10-K.  ý

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

Large accelerated filer¨Accelerated filer¨
Non-accelerated filer
¨  (do not check if a smaller reporting company)
Smaller reporting companyý
Emerging growth company¨

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

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

Indicate by check mark if the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes: ¨    No:  ý

No: ☒

The aggregate market value of the voting and non-voting common equity held by non-affiliates of the registrant was $20.6 $80.7million on June 30, 2018,2021, the last business day of the registrant’s most recently completed second fiscal quarter, based on the closing price of $0.89$3.03 on that date.

Indicate the number of shares outstanding of each of the registrant’s classes of common equity, as of March 27, 2019:

15, 2022:

Class
ClassNumber of Shares
Common Stock, $.0001 par value56,276,22228,998,169

Documents incorporated by reference

None.


Portions of the registrant’s proxy statement for the 2019 annual meeting of stockholders to be filed pursuant to Regulation 14A within 120 days after the registrant’s fiscal year ended December 31, 2018, are incorporated by reference in Part III of this Form 10-K.



TABLE OF CONTENTS


This report contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements that are not historical facts. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “could,” “would,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “projects,” “predicts,” “potential,” or the negative of those terms, and similar words expressions and comparable terminology intended to identify forward-looking statements. These statements reflect ourthe Company’s current views with respect to future events and are based on assumptions and subject to risks and uncertainties including those set forth below and under Part I, Item 1A, “Risk Factors” in this annual report on Form 10-K. Given these uncertainties, you should not place undue reliance on these forward-looking statements. These forward-looking statements represent ourthe Company’s estimates and assumptions only as of the date of this annual report on Form 10-K and, except as required by law, we undertakethe Company undertakes no obligation to update or review publicly any forward-looking statements, whether as a result of new information, future events or otherwise after the date of this annual report on Form 10-K. You should read this annual report on Form 10-K and the documents referenced in this annual report on Form 10-K and filed as exhibits completely and with the understanding that ourthe Company’s actual future results may be materially different from what we expect. We qualifythe Company expects. The Company qualifies all of ourits forward-looking statements by these cautionary statements. Such statements may include, but are not limited to, statements concerning the following:

our strategic plans;
our ability to discover and develop novel therapeutics;
our ability to license any therapeutics we develop to larger companies;
the ability of our licensees to achieve milestones under future licensing agreements that will generate revenue for us;
our ability to secure strategic and clinical co-development partnerships with pharmaceutical and biotechnology companies;
our ability to make capital expenditures and to finance operations;
our cash position;
our ability to effectively manage current and future collaboration partnerships, joint venture or acquisition initiatives undertaken by the Company;
our ability to develop and build infrastructure and teams to manage our research and development, partnering and clinical development activities;
our ability to continue to retain and hire key talent;
our ability to sell the vivoPharm business and effectively operate the business during the sales process;
our ability to deter cyberattacks on our business;
our ability to obtain compounds used for drug discovery and development could be affected as a result of the tensions between Ukraine and Russia; and
the impact of COVID-19 on the economy, demand for our services and products and our operations, including measures taken by government authorities to address the pandemic, which may precipitate or exacerbate other risks and/or uncertainties.

2

PART I

Item 1.Business.

Overview

Vyant Bio, Inc. (the “Company”, “Vyant Bio”, “VYNT” or “we”), is an innovative biotechnology company reinventing drug discovery for complex neurodevelopmental and neurodegenerative disorders. Our central nervous system (“CNS”) drug discovery platform combines human-derived organoid models of brain disease, scaled biology, and machine learning. Our platform is designed to: 1) elucidate disease pathophysiology; 2) formulate key therapeutic hypotheses; 3) identify and validate drug targets, cellular assays, and biomarkers to guide candidate molecule selection; and 4) guide clinical trial patient selection and trial design. Our current programs are focused on identifying repurposed and novel small molecule clinical candidates for rare CNS genetic disorders including Rett Syndrome (“Rett”), CDKL5 Deficiency Disorders (“CDD”) and familial Parkinson’s Disease (“PD”). The Company’s management believes that drug discovery needs to progressively shift as the widely used preclinical models for predicting safe and effective drugs have under-performed, as evidenced by the time and cost of bringing novel drugs to market. As a result, Vyant Bio is focused on combining sophisticated data science capabilities with highly functional human cell derived disease models. We leverage our ability to achieve profitability by increasing salesidentify validated targets and molecular-based biomarkers to screen and test thousands of our laboratory tests and services andsmall molecule compounds in human diseased 3D brain organoids in order to continually develop and commercializecreate a unique approach to assimilating biological data that supports decision making iteratively throughout the discovery phase of drug development to identify both novel and innovative laboratory testsrepurposed drug candidates.

In December 2021, the Company’s Board of Directors approved a plan to sell the vivoPharm Pty Ltd (“vivoPharm”) business to allow the Company to focus on the development of neurological developmental and services focused on oncologydegenerative disease therapeutics. We engaged an investment banker in December 2021 to sell the vivoPharm business before the end of 2022.

StemoniX Merger

On March 30, 2021, Vyant Bio, formerly known as Cancer Genetics, Inc. (“CGI”), completed its business combination (the “Merger”) with StemoniX, Inc., a Minnesota corporation (“StemoniX”), in accordance with the Agreement and immuno-oncology;

our abilityPlan of Merger and Reorganization, dated as of August 21, 2020 (the “Initial Merger Agreement”) by and among the Company, StemoniX and CGI Acquisition, Inc., a Minnesota corporation and wholly-owned subsidiary of the Company (“Merger Sub”), as amended by Amendment No. 1 thereto made and entered into as of February 8, 2021 (the “First Amendment”) and Amendment No. 2 thereto made and entered into as of February 26, 2021 (the “Second Amendment”) (the Initial Merger Agreement, as amended by the First Amendment and Second Amendment, the “Merger Agreement”), pursuant to extend,which Merger Sub merged with and amendinto StemoniX, with StemoniX surviving the financial covenants in our existing credit agreementsMerger as a wholly-owned subsidiary of the Company.

The Merger was accounted for as a reverse acquisition with StemoniX being the accounting acquirer of CGI using the acquisition method of accounting. Under acquisition accounting, the assets and raise additional capital to meet our liquidity needs;

our ability to improve efficiency of billing and collection processes;
with respect to Clinical Services, our ability to obtain reimbursement from governmentalliabilities (including executory contracts, commitments and other third-party payors for our testsobligations) of CGI, as of March 30, 2021, the closing date of the Merger, were recorded at their respective fair values and services;
our abilityadded to execute on our marketing and sales strategy for our tests and services and gain acceptancethe historical accounts of our tests and servicesStemoniX. The excess of purchase price consideration over the fair values of the identifiable net assets was recorded as goodwill. The total consideration paid by StemoniX in the market;
our abilityMerger amounted to keep pace$59.9 million, which represents the fair value of CGI’s 11,007,186 shares of Common Stock or $50.74 million, 2,157,686 Common Stock warrants or $9.04 million and 55,907 Common Stock options outstanding on the closing date of the Merger with rapidly advancing market and scientific developments;
our ability to realize anticipated benefits froma fair value of $139 thousand. In addition, at the vivoPharm, Pty Ltd. acquisition;
our ability to satisfy U.S. (including FDA) and international regulatory requirementseffective time of the Merger, existing StemoniX shareholders received an additional 804,711 incremental shares in accordance with respect to our tests and services, many of which are new and still evolving;
our ability to maintain our present customer base and obtain new customers;
our ability to clinically validate our pipeline of tests currently in development;
competition from clinical laboratory services companies, tests currently available or new tests that may emerge;
our ability to maintain our clinical and research collaborations and enter into new collaboration agreements with highly regarded organizationsthe conversion ratio set forth in the fieldMerger Agreement.

Effective with the Merger, the historical financial statements of oncology so that, among other things, we have access to thought leadersStemoniX, as the accounting acquiror, became the historical financial statements of the Company under U.S. generally accepted accounting principles (“US GAAP”) and Cancer Genetics, Inc. was renamed Vyant Bio, Inc. Therefore, the underlying operations of CGI and subsidiaries are consolidated in the fieldVyant Bio consolidated financial statements from March 30, 2021 onward. The discussions regarding the Company’s business herein reflect the operations of StemoniX prior to the Merger as well as the post-Merger combined operations of Vyant Bio and toStemoniX.

vivoPharm Business

vivoPharm has a robust number of samples to validate our tests;

potential product liability or intellectual property infringement claims;
our dependency on third-party manufacturers to supply or manufacture our tests;
our ability to attract and retain a sufficient number of scientists, clinicians, sales personnel and other key personnel with extensive experience in oncology and immuno-oncology, who are in short supply;
our ability to obtain or maintain patents or other appropriate protection for the intellectual property in our proprietary tests and services;
our dependency on the intellectual property licensed to us or possessed by third parties;
our ability to expand internationally and launch our tests and services in emerging markets, such as China and Japan; and
our ability to adequately support future growth.

PART I
Item 1.Business.

Overview

We are an emerging leader in enabling precision medicine in oncology by providing multi-disciplinary diagnostic and data solutions, facilitating individualized therapies through our diagnostic tests, services and molecular markers. We develop, commercialize and provide molecular- and biomarker-based tests and services, including proprietary preclinical oncology and immuno-oncology services, that enable biotech and pharmaceutical companies engaged in oncology and immuno-oncology trials to better select candidate populations and reduce adverse drug reactions by providing information regarding genomic and molecular factors influencing subject responses to therapeutics. Through our clinical services, we enable physicians to personalize the clinical management of each individual patient by providing genomic information to better diagnose, monitor and inform cancer treatment. We have a comprehensive, disease-focused oncology testing portfolio, and an extensivelarge set of anti-tumor referenced data based on xenograft, syngeneic predictive xenograft and syngeneicorthotopic tumor models. Our tests and techniques target a wide range of indications, covering all ten of the top cancers in prevalence in the United States, with additional unique capabilities offered by our FDA-cleared Tissue of Origin® test for identifying difficultmodels to diagnose tumor types or poorly differentiated metastatic disease. Following the acquisition of vivoPharm Pty Ltd (“vivoPharm”) we provide discovery services such as contract research services, focused primarily on predictive and unique specialized studiesmodels to guide drug discovery with a major focus in immuno-oncology. vivoPharm offers a suite of protocols and development programs in the oncologystandard of care (“SoC”) data and immuno-oncology fields.

We are currently executing a strategy of partnering with pharmaceutical and biotech companies and clinicians as oncology diagnostic specialists by supporting therapeutic discovery, development and patient care from bench to bedside. Pharmaceutical and biotech companies are increasingly attracted to work with us to provide molecular profiles on clinical trial participants. Similarly, we believe the oncology industry is undergoing a rapid evolution in its approach to diagnostic, prognostic and treatment outcomes (theranostic) testing, embracing precision testing and individualized medicine as a means to drive higher standards of patient treatment and disease management. These profiles may help identify biomarker and genomic variations that may be targetable for developing novel personalized therapeutics, or that may be responsible for differing responses to existing oncology therapies, thereby increasing the efficiency of trials while lowering costs. We believe tailored and combination therapies can revolutionize oncology care through molecular- and biomarker-based testing services, enabling physicians and researchers to target the factors that make each patient and disease unique.

We believe the next shift in cancer management will bring together testing capabilities for germline, or inherited mutations, and somatic mutations that arise in tissues over the course of a lifetime. We have created a unique position in the industry by providing both targeted somatic analysis of tumor sample cells alongside germline analysis of an individual's non-cancerous cells' molecular profile as we attempt to continue achieving milestones in precision medicine.

Cancer is genetically-driven and constitutes a diverse class of diseases with various causes, each characterized by abnormal and proliferative cell growth. Many types of cancers are becoming increasingly understood at a molecular level and it is possible to attribute specific cancers to identifiable genetic changes in these abnormal cells. Cancer cells contain modified genetic material compared to normal cells. Common genetic abnormalities correlated to cancer include gains or losses of genetic material (translocations) on specific chromosomal regions (loci) or changes in specific genes (mutations) that ultimately result in detrimental changes in molecular expression patterns and regular pathways followed by cancerous or pre-cancerous conditions. Understanding the differences in these changes supports clinicians to identify and stratify different forms of cancer in order to optimize patient treatment and patient management. Therefore, understanding and analysis of cancer at the molecular and pathway regulatory level is not only useful for diagnostic purposes, but we also believe it can play an important role in disease management and prognosis. We believe the technology we deploy can apply predictive information which has the potential to dramatically improve treatment outcomes for patients living with cancer. Our molecular- and biomarker-based tests for cancer aim to limit subjectivity from the diagnostic phase, and add prognostic information, thus enabling personalized treatments based on cancer analysis at its most essential level.

Our business is based on demand for molecular- and biomarker-based tests and services from three main sectors, including biotechnology and pharmaceutical companies, cancer centers and hospitals, and the research community. Biotechnology and pharmaceutical companies engaged in designing and running clinical trials to determine the value and efficacy of oncology and immuno-oncology treatments and therapeutics continuously benefit from our services. We believe trial participants' likelihood of experiencing either favorable or adverse responses to the trial treatment may be influenced or dependent on genomic factors. Our testing services will increase trial efficiency, subject safety and trial success rates. Clinicians and oncologists in cancer centers and hospitals seek such testing since these methods produce higher value and more accurate cancer diagnostic information than traditional analytical methods. Our proprietary and unique disease-focused tests aim to provide actionable

information that can guide patient management decisions, potentially resulting in decreased costs for patients while streamlining therapy selection. We offer preclinical test systems supporting our clinical diagnostic and prognostic offerings at early stages, valued by pharmaceutical industry, biotechnology companies and academic research centers. In particular our preclinical development of biomarker detection methods, response to immuno-oncology directed novel treatments and early prediction of clinical outcome is supported by our extended portfolio of orthotopic, xenografts and syngeneic tumor test systems as a unique service offering in the immuno-oncology space.

With the acquisition of vivoPharm on August 15, 2017, we expanded our Discovery Service capabilities. vivoPharm is a contract research organization (“CRO”) that specializes in planning and conducting unique, specialized studies to guide drug discovery and development programs with a concentration in oncology and immuno-oncology.programs. These studies range from early compound selection to developing comprehensive sets of in vitro and in vivo data, as needed for FDA Investigational New Druginvestigational new drug (“IND”) applications. vivoPharm has developed industry recognized capabilitiesapplications as required by regulatory bodies, such as the United States Food and Drug Administration (“FDA”), the European Medicines Agency (“MEA”) and Therapeutic Goods Administration (“TGA”) in early phase development andAustralia.vivoPharm’s current discovery especially in immuno-oncology models, tumor micro-environment studies, specialized pharmacology services and PDx (patient derived xenograft) model studies that support basic discovery,include preclinical and phase 1 clinical trials. vivoPharm’s studies have been utilized to support over 250 IND submissions to date across a range of therapeutic indications, including lymphomas, leukemia, GI-cancers, liver cancer, pancreatic cancer, non-small cell lung cancer, and other non-cancer rare diseases. vivoPharm is presently serving over 50 biotechnology and pharmaceutical companies across four continents in over 100anti-tumor efficacy, good laboratory practice (“GLP”) compliant toxicity studies and trials with highly specialized development, clinical and preclinical research. Over the past 15 years, vivoPharm has also generated an extensive library of human xenograft and syngeneic tumor models, including subcutaneous, orthotopic and metastatic models. vivoPharm offers services in assessment of safety, toxicology and bioanalytic services for small and bio-molecules.bio-molecule analytical services. vivoPharm provides the tools and testing methods for companies and researchers seeking to identify and to develop new compounds and molecular-based biomarkers for diagnostics and therapeutics.

3

With the acquisition, we added three

vivoPharm’s international locations, enablingpresence enables it to access to additional global market opportunities. vivoPharm’sopportunities. vivoPharm’s headquarters in Melbourne, VIC, Australia specializes in safety and toxicology studies, including mammalian, genetic and in vitro,, along with bioanalytical services including immune-analytical capabilities. vivoPharm’svivoPharm operates from multiple locations in Melbourne (VIC) and Adelaide (SA). vivoPharm’s U.S.-based laboratory, located at the Hershey Center for Applied Research in Hershey, Pennsylvania, primarily focuses on screening and efficacy testing for a wide range of pharmaceutical and chemical products. The third location, in Munich, Germany, hosts project management and marketing personnel.business development personnel for the European customers.

As of December 31, 2021, the Company has accounted for vivoPharm as discontinuing operations. For further information, see section entitled “Discontinuing Operations” later in this Part I, and Note 3, Discontinuing Operations, to the Company’s Consolidated Financial Statements included in Part II. Item 8 herein.

Business Strategy

Drug Discovery

The Company’s strategy is to continue building a unique and robust “human-first” drug discovery platform to discover repurposed and novel therapeutics to treat neurodevelopmental and neurodegenerative diseases, initially focusing on rare CNS genetic disorders including Rett, CDD and familial PD. Key to the Company’s strategy is the development and continued enhancement of specialized disease models by utilizing human-derived induced pluripotent stem cells (“iPSC”) to generate three dimensional organoids that exhibit spontaneous synchronized neuronal activity that can be detected in a high-throughput fashion. Vyant Bio has industrialized the production of iPSC-derived organoids into standard multi-well plate formats that we believe are sufficiently robust and reproducible to enable high throughput drug screening and provide insightful data for optimized selection of therapeutic candidates.

The human organoid platform is combined with software analytics and machine learning systems, branded by the Company as its proprietary AnalytiX™ system. This integrated approach enables standardized, high-throughput screening of drug candidates to establish t human efficacy prior to conducting human clinical studies, mitigating or in some cases avoiding the inadequacies of testing in clonal cell lines or preclinical animal models. The Company believes that its technologies will permit drug discovery in human disease areas that are difficult to address using current methodologies, such as brain diseases, accelerate preclinical drug discovery and development, reduce risk of clinical failure, predict with greater degrees of confidence and, ultimately, reduce the cost of discovering new therapeutic agents. The Company’s strategy is to strive to file two IND applications with the FDA starting in 2023. The Company intends to license its therapeutic candidates to third parties before or after Phase I clinical trials for subsequent clinical development and receive a mixture of upfront payments, licensing fees, milestone-based fees, and ongoing royalty payments.

The Company began transforming its Maple Grove, Minnesota facility to a high throughput manufacturing and screening facility in the fourth quarter of 2021 to expand the Company’s research and development capabilities. This transition is in line with the Company’s strategy to leverage its iPSC technology to pursue wholly owned and partnered drug discovery projects that yield higher valued proprietary therapeutic assets. This facility transformation is expected to be completed in the second half of 2022. Previously, the Company derived revenue from the sale of iPSC-based microOrganTM plates to pharmaceutical, biotechnology and research customers and through the performance of Discovery as a Service (“DaaS”) for these customers. The Company anticipates revenue generated from these activities will substantially cease in the first half of 2022 as the Company plans to use those resources to support its internal disease model and therapeutic drug development. The Company is also exploring potential opportunities to out-license access to its proprietary iPSC technologies to be used by pharmaceutical and biotechnology companies in their internal drug discovery programs.

Therapeutic Programs

The Company is actively seeking to discover repurposed and novel (New Chemical Entity, or “NCE”) lead candidates for Rett, CDD and familial PD which will become the foundation of the Company’s therapeutic platform. The Company’s therapeutic asset pipeline is as follows:

Rett Syndrome (“Rett”)

Rett is a rare genetic neurological disorder that occurs almost exclusively in girls and leads to severe impairments, affecting nearly every aspect of the child’s life including their ability to speak, walk, eat, and even breathe easily. The hallmark of Rett is near constant repetitive hand movements. Rett is usually recognized in children between 6 to 18 months as they begin to miss developmental milestones or lose abilities they had gained. Rett is caused by mutations on the X chromosome in a gene called MECP2. There are more than 900 different mutations found on the MECP2 gene. Most of these mutations are found in eight different “hot spots.” Rett is not a degenerative disorder with individuals living to middle age or beyond. Rett occurs worldwide in 1 of every 10,000 female births and is even rarer in boys. Rett can present with a wide range of disability ranging from mild to severe. The course and severity of Rett is determined by the location, type and severity of the mutation and X-inactivation. A 2022 report from Mellalta estimates the total global market opportunity for Rett therapeutic treatments is approximately $1.5 billion.

4

We execute

The Company currently has two programs focused on Rett, that were identified based on a phenotypic screen of the SMART library provided by the International Rett Syndrome Foundation on our Rett patient-derived organoids: a repurposing candidate (VYNT0126) and several novel compounds.

The VYNT0126 molecule is a promising repurposed candidate for several reasons. The compound has already been approved by the FDA as a cognition-enhancing medication for dementia related to Alzheimer’s disease, and there is readily available safety data. VYNT0126 exhibits a consistent dose-dependent rescue of the functional diseased Rett phenotype on our Rett patient-derived organoids and across additional functional readouts such as multielectrode electrophysiology assays, and cellular phenotypes (synaptogenesis).

The Company is also pursuing novel compounds for Rett identified in the SMART screen in collaboration with Atomwise (as described below). We are applying machine learning to drive compound progression and we expect to complete our hit-to-lead optimization efforts in 2022 and commence IND-enabling studies in the first half of 2023.

CDKL5 Deficiency Disorder (“CDD”)

CDD is a neurodevelopmental condition characterized by early-onset seizures, intellectual delay, and motor dysfunction. Although crucial for proper brain development, the precise targets of CDKL5 and its relation to patients’ symptoms are under investigation. Our microBrain organoid screening platform enlightens cellular, molecular, and neural network mechanisms of genetic epilepsy that we are researching to ultimately promote novel therapeutic opportunities for patients. While genetic testing is currently available to determine if patients have mutation in the CDKL5 gene, the limited knowledge of pathology has hindered development of therapeutics, leaving CDD as an ultra-rare disease with a defined unmet medical need and no currently approved therapeutic treatments.

The Company’s researchers screened approximately 5,200 custom library compounds composed of FDA approved molecules, molecules that passed Phase 1 clinical trials, and a panel of phenotypic screening compounds. This effort led to the potential to identify both internal NCE’s and potential repurposing molecules. Approximately 288 compounds showed some degree of rescue of the CDD hyperexcitability phenotype, and we are conducting further confirmatory screening followed by dose response studies and pharmacologic deconvolution. In collaboration with Cyclica (as described below), we are applying machine learning to identity in silico molecules for screening of 3 novel CDD targets. To drive hit-to-lead optimization we are establishing in vitro binding and cell-based functional assays for these targets to examine the relationship between target potency and degree of phenotypic rescue.

Parkinson’s Disease (“PD”)

PD is a progressive neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. PD symptoms generally develop slowly over time and include tremors, muscle rigidity, gait and balance problems, and slow, imprecise movements. PD afflicts more than 10 million people worldwide, with 60,000 new cases per annum diagnosed in the US alone, typically middle-aged and elderly people. The market strategyfor therapeutics to treat the many symptoms and different types of Parkinson’s disease is expected to expand to $7.2 billion by finding synergies2028, according to business intelligence provider Coherent Market Insights.

The etiology of PD is poorly understood but it is widely accepted that a combination of genetics and alignment acrossenvironmental factors are the three aforementioned industry groupscause. About 10-15 percent of people with PD have a family history of the condition, and family-linked cases can result from genetic mutations in a group of genes, including GBA, LRRK2, PARK2, PARK7, PINK1 or the SNCA gene.

Joint Venture and Collaborations

Joint Venture

Atomwise Joint Venture

On December 3, 2019, StemoniX announced a non-exclusive joint venture with Atomwise, Inc., a San Francisco based company, which combines StemoniX’s human microOrgan platform with Atomwise’s structure-based Artificial Intelligence (“AI”) technology to utilize relativelyenable the same technologies to deliver results-oriented informationrapid discovery and insights which we believe is or will become important to drug development and disease management. Our tests and services address the limitations of traditional approaches to cancer therapeutics, including reliance on human inspection of specimens and interpretation of clinical measurements, and inter-institutional variability. Our suite of clinical and biopharma services aim to remove subjectivity from diagnoses and additionally provide information that may influence treatment selection that cannot be obtained from anatomic pathology and staining techniques alone. Our Discovery Services aim to accelerate the development of novel treatment candidatessmall molecule therapies. The joint venture is initially targeting Rett. In the joint venture, Atomwise is using its AI technology to analyze billions of compounds in silico to identify potent and precision medicine in oncology.selective binders for proteins that are important for Rett. StemoniX is currently testing the compounds on its human microBrain 3D disease model to determine biological activity. We believe this joint effort will decrease the level of personalized treatment required to optimize a patient's treatment regimen and to maximize clinical trial success rates may be significantly improved through the use of molecular- and biomarker-based cancer characterization.


The following table lists our market strategy by customer category:

Customer CategoryTypes of CustomersNature of Services
Biopharma Services• Pharmaceutical and Biotech companies performing clinical trialsBiopharma Services provide companies with customized solutions for patient stratification and treatment selection through an extensive suite of molecular- and biomarker-based testing services, DNA- and RNA- extraction and customized assay development and trial design consultation.
Clinical Services
• Hospitals
• Cancer Centers
• Clinics
Clinical services provide information on diagnosis, prognosis and predicting treatment outcomes (theranosis) of cancers to guide patient management.
Discovery Services
• Pharmaceutical and Biotech companies
• Academic Institutions
• Government-Sponsored Research Institutions
Discovery services, including preclinical anti-tumor efficacy, GLP compliant toxicity studies, small molecular and biologics analytical services, provide the tools and testing methods for companies and researchers seeking to identify and to develop new compounds and molecular-based biomarkers for diagnostics and treatment of disease.


In 2018, we generated approximately 54% of our revenue from Biopharma Services, approximately 27% from Clinical Services and approximately 19% from Discovery Services. In 2017, we generated approximately 50% of our revenue from Biopharma Services, approximately 37% from Clinical Services and approximately 13% from Discovery Services, including the acquisition of vivoPharm in August of 2017.

We utilize relatively the same proprietary and nonproprietary molecular diagnostic tests and technologies across all of our service offerings to deliver results-oriented information important to cancer treatment and patient management. Our portfolio primarily includes comparative genomic hybridization (CGH) microarrays, gene expression tests, next generation sequencing (NGS) panels, and DNA fluorescent in situ hybridization (FISH) probes. We provide our testing services from our Clinical Laboratory Improvement Amendments (“CLIA”) - certified and College of American Pathologists (“CAP”) - accredited laboratories in Rutherford, NJ and Raleigh, NC. We offer preclinical services such as predictive tumor models, human orthotopic xenografts and syngeneic immuno-oncology relevant tumor models in our Hershey, PA facility, and a leader in the field of immuno-oncology preclinical services in the United States. This service is supplemented with GLP toxicology and extended bioanalytical services in our Australian based facility in Bundoora, VIC.

Market Overview

United States Clinical Oncology Market Overview

Despite many advances in the treatment of cancer, it remains one of the greatest areas of unmet medical need. In 2018, the World Health Organization attributed 9.6 million deaths globally to cancer, which is about 1 in 6 deaths. Within the United States, cancer is the second most common cause of death, exceeded only by heart disease, accounting for nearly one out of every four deaths. The Agency for Healthcare Research and Quality estimated that the direct medical treatment costs of cancer in the United States for 2015 were $80.2 billion. The incidence, deaths and economic loss caused by cancer are staggering. The following table published by The American Cancer Society shows estimated new cases and deaths in 2018 in the United States for selected major cancer types:

Cancer Type Estimated New Cases Estimated Deaths
Bladder 81,190
 17,240
Breast (Female - Male) 266,120 - 2,550
 40,920 - 480
Colon and Rectal (Combined) 140,250
 50,630
Endometrial 63,230
 11,350
Kidney (Renal Cell and Renal Pelvis) Cancer 65,340
 14,970
Leukemia (All Types) 60,300
 24,370
Liver and Intrahepatic Bile Duct 42,220
 30,200
Lung (Including Bronchus) 234,030
 154,050
Melanoma 91,270
 9,320
Non-Hodgkin's Lymphoma 74,680
 19,910
Pancreatic 55,440
 44,330
Prostate 164,690
 29,430
Thyroid 53,990
 2,060

References
1.    American Cancer Society: Cancer Facts and Figures 2018. Atlanta, GA: American Cancer Society, 2018. Also available online. Last accessed February
26, 2018.

United States and International Clinical Trials Market Overview

The United States is currently a world leader in biopharmaceutical research and development and manufacturing. In Fiscal Year 2019, the National Cancer Institute received a budget of $5.74 billion, an increase of $79 million over FY 2018, to issue grants to support research, with a targeted investment in enhanced and early detection of disease through the analysis of circulating biomarkers using minimally invasive methods,traditional medicinal chemistry timeline as well as a focused investment in cancer prevention and treatment including research on new vaccines to prevent cancer-causing infections and investigational immuno-oncology drugs and drug combinations. The Pharmaceutical Research and Manufacturersincrease the number of America (PhRMA) reportspromising compounds that the average cost to develop a drug, including trial failures, can be as high as $2.6 billiontested, and the approval process from developmentthereby result in an efficient path to market may be as

long as 15 years. According to the National Cancer Institute, since the 1990s, cancer death rates in the United States have declined 23%, and approximately 83% of life expectancy increases in cancer patients are due to new treatments and oncology medications.

Outside of the United States, particularly in our targeted geographies of the Europe and Asia Pacific (“APAC”) regions, growth in the pharmaceuticals and clinical trials market is continuing, and trials are increasingly becoming more complex. Growth in the European pharma market is anticipated to be driven largely by the United Kingdom, Germany, Spain, France and Italy. The sizesuccessful drug development. Each party owns 50% of this marketventure and is expectedrequired to grow 25% between 2017fund their respective development activities related to this arrangement.

5

Ordaos Collaboration

We had a collaboration to design and 2022, accountingqualify biomarker-specific small protein therapeutics in an arrangement that included Ordaos’ generative AI technology to accelerate and optimize small protein (50 to 100 amino acids) drug discovery and development processes. In this collaboration, Ordaos provided a pipeline of digitally optimized therapeutics for nearly 70% of the European pharma market by 2022. Germany is forecasted to have the highest increase in market value during this 5-year span. APAC’s location provides access to large patient pools within favorable regulatory environments, and a strong intellectual property regime and available infrastructure. The pharmaceutical market in APAC is expected to grow by 8.7% CAGR from 2015 to 2021, boasting a contract research organization market that is the fastest growing in the world.


While oncology drugs have the potential to be among the most personalized therapeutics, very few have successfully made it to market. The application of pharmacogenomics to oncology clinical trials enables researchers to better predict differences in drug response, efficacy and toxicity among trial participants, as well as to optimize treatment regimens based on these differences. According to IMS Health, it is estimated that by 2020, half of all pharmaceutical sales in the United States will be from specialty drugs, a category of drugs including oncology treatments tailored to patients’ genomic profiles. We believe a growing demand for faster development of personalized medicines and more effective clinical trials are growth drivers of this market, and our core expertise is pharmacogenomics, or the study of genetic analysis based on a patient's response to a particular therapy or drug.

China Clinical Oncology and Biopharma Market Overview

The Chinese biopharma market is currently the third largest pharma market globally, after the United States and Japan. With more than one fifth of the world's population, China is an important market for pharmaceutical and biotech products and China's minister of health has pledged that the country will spend an additional $11.8 billion to advance biotech innovation from 2015 to 2020 in its 13th five-year plan. Cancer is one of the leading public health problems in China, representing approximately 25% of all deaths in urban areas and 21% in rural areas. Over the past 30 years, the risk factors for cancer in China have been increasing, including an aging population, decreased environmental conditions and westernization of diet and lifestyle. We recently announced a licensing transaction with a Chinese company based in Beijing, China who will be launching our Tissue of Origin® test in China, to assist in the care of Chinese patients. We plan to continue exploring opportunities to license our proprietary tests to select business partners operating laboratory services in China, where governmental regulations prevent human samples and personal data, including healthfurther development. Preliminary data from being exported fromnewly-designed optimized proteins indicates the country.

Our Strategy

design parameters generated an improved class of proteins that were sufficient to predict ELISA EC50 binding in nanomolar (“nM”) range. We remain focused on delivering our comprehensive cancer profiling and state of the art molecular testing capabilities and servicesare working together to a diverse group of market participants, including:

Biotechnology companies;
Pharmaceutical companies;
Cancer centers;
Community hospitals; and
Research centers

These participants require biomarker-based assessment of cancer and biomarker-based information to collect key data setsfurther optimize proteins for their clinical trials, or as direct care providers, to understand and manage therapeutic development, the patient, their cancer and customized therapy choices. We believe that our integrated approach to rapidly translate research insights about the genetics and molecular mechanisms of cancer into the clinical setting, combined with our approach to diagnostic testing, will lead to improved clinical decision-making, and will become a key component in the standard of care for personalized cancer treatment. Our approach is to develop and commercialize proprietary molecular and biomarker-based tests and services to enable us to provide a full service solution to improve the diagnosis, prognosis and treatment of targeted cancers and to better predict successful therapeutic targets andfuture drug candidates, differences in drug response, efficacy and toxicity among clinical trial participants, as well as to optimize treatment regimens based on these differences. To achieve this, and in order of our focus and priority, we intend to:

Leverage our specialized, disease-focused genomic and molecular knowledge, insights and portfolio to secure

additional collaborations or partnerships with leading biotech and pharmaceutical companies and clinical research organizations. Oncology drugs have the potential to be among the most personalized of therapeutics, and yet few have successfully made it to market. In an effort to improve the outcome of these trials, and more rapidly advance targeted therapeutics, the biotechnology and pharmaceutical community is increasingly looking to companies like us that have both extensive disease insights and comprehensive testing services as they move toward biomarker-based therapeutics. We believe our comprehensive, disease-focused testing portfolio, which covers the 10 most prevalent solid and hematological cancers in the United States, positions us to help the biotech and pharmaceutical community with clinical trials and companion diagnostic development in areas of our core expertise.

Leverage our acquisition of vivoPharm to deepen relationships with our existing clients and to expand our unique portfolio of Discovery Service offerings in the United States and internationally. Biotech and Pharmaceutical companies engaged in the identification of therapeutic targets and novel oncology and immuno-oncology treatments often require support in trial design, assay development, preclinical research and clinical research and trial management. vivoPharm’s suite of oncology-focused services, including proprietary tumor models, enables us to increase our market share in drug identification, drug rescue and drug repurposing studies. We believe vivoPharm’s capabilities provide us opportunities to deepen our relationships with existing customers through additional Discovery and downstream molecular work.

Leverage our growing preclinical business to seek synergies across our biopharma sales teams in the U.S., Europe and Australia, to provide our integrated service offerings. We believe that by combining the efforts of our business development teams inside of our existing and prospective biopharma clients, we can leverage our capabilities from preclinical development of biomarker detection methods, responses to immuno-oncology directed novel treatments and early prediction of clinical outcomes, supported by our extended portfolio of orthotopic, xenografts and syngeneic tumor test systems, to help drive our access to support immuno-oncology therapies in Phase I through Phase IV trials.

Leverage our biopharma business development team and our relationships with global central laboratories to expand our customer base. By leveraging our clinical and biopharma sales force in the United States, along with our relationships with international central laboratories and clinical research organizations, we are able to target our sales and marketing efforts to meet the needs of an expanding and diverse customer segment

Continue our focus on translational oncology and drive innovation and cost efficiency in diagnostics by continuing to develop next generation sequencing offerings independently and through collaborations with academic and cancer research centers and other key opinion leaders and their organizations. Translational oncology refers to our focus on bringing novel research insights that characterize cancer at the genomic level directly and rapidly into the clinical setting with the overall goal of improving value to patients and providers in the treatment and management of disease. We believe that continuing to develop our existing platforms and next generation sequencing panels will enable significant growth and efficiencies within our business.

Engage key strategic partners in the U.S. and abroad to leverage our intellectual propoerty portfolio and unique capabilities to grow our revenue. We entered into a strategic partnership in China to license our Tissue of Origin® test in that region; we announced a supply agreement with Agilent Technologies to expand the distribution of our proprietary FHACT probe internationally, anddevelopment.

Cyclica Collaboration

On August 12, 2021, we entered into a partnershipnon-exclusive Strategic Collaboration Agreement (“SCA”) with CellariaCyclica, Inc., a Toronto, Ontario-based company that uses a proprietary AI and machine learning (“ML”) platform to identify potential new therapeutic targets, re-purposed compounds, and NCEs. In this collaboration we are currently focusing on identifying new targets and NCE for CDD,. The collaboration combines patient-derived neural organoids of the Company’s human-first neural platform with Cyclica’s in-silico platform to generate a disease-based, proteome-wide, discovery platform. The clinically linked biological signal of the CDD organoids and their responses to biologically active compounds drives the Cyclica platform to generate high-quality predictions for therapeutic targets based on their proprietary knowledge and structure-based algorithms. The predictions are tested in the U.S.Company’s platform, and if verified, advanced into AI/ML-based NCE synthesis. Together the platforms enable rapid interrogation of the human proteome to characterize Cellaria’s pipelineaccelerate the discovery of commercialnew cures for this debilitating disease and custom-developed biopharma productsthe SCA has identified four novel targets, three of which are being actively pursued under the SCA. The Company owns all inventions and discoveries resulting from the collaboration (“Work Product”). Cyclica is entitled to create innovative modelsa decreasing percentage of any consideration that provide detailed, and patient-specific, assessmentthe Company receives for the sale, licensing, or other disposition of response to therapy.


Continue to aggressively manage our cost structure. We are focused on aggressively managing our operating costs while continuing to seek additional revenue growth opportunities. We are implementing measures to streamline costs across our laboratory facilities, includingWork Product, ranging from the consolidationmid-double digits in the early preclinical stages of our operations, integrating administrative functions across our US operations, implementing a cloud-based laboratory management system across all of our sites, along with key financial enterprise resource planning and human resource systems that enable greater efficiency.

Our Service Offerings

Our business is based on demand for molecular- and biomarker-based characterization of cancers from three main sectors: (1) biotechnology and pharmaceutical companies, (2) cancer centers and hospitals, and (3) the research community. Our services are sought by biotechnology and pharmaceutical companies engaged in designing and running clinical trials, from pre-clinical to post market surveillance, for their value and efficacy in oncology and immuno-oncology treatments and therapeutics. We believe trial participants' likelihood of experiencing either favorable or adverse responsesdevelopment down to the trial treatment can be

determined first bymid-single digits from and after late-stage clinical development.

OrganoTherapeutics Collaboration

On March 29, 2022, we announced a collaboration with OrganoTherapeutics to advance our extended portfolio of orthotopic, xenografts and syngeneic tumor test systems, and in early development through biomarker testing, thereby increasing trial efficiency, participant safety and trial success rates. Biotechnology and pharmaceutical companies also seek our services in preclinical trial design and drug development, in order to effectively and efficiently select those therapeutic candidates most likely to progress to clinical treatment options. Our services are also sought by researchers and research groups seeking to identify biomarkers and panels and develop methods for diagnostic technologies and tests for disease. Clinicians and oncologists in cancer centers and hospitals seek molecular-based testing since these methods often produce higher value and more accurate cancer diagnostic information than traditional analytical methods. Our proprietary and unique disease-focused tests aim to provide actionable information that can guide patient management decisions, potentially resulting in decreased costs for patients while streamlining therapy selection. We continue to pursue the strategy of trying to demonstrate increased value and efficacy with payors who wish to contain costs and academic collaborators seeking to develop new insights and cures.


We utilize relatively the same proprietary tests and services, non-proprietary tests and technologies across each of these businesses to deliver results-oriented information important to drug discovery, cancer treatment and patient management.

Biopharma Services

Biopharma Services include laboratory and testing services performed for biotechnology and pharmaceutical companies engaged in clinical trials. Our Biopharma Services focuswork on providing these clients with oncology specific and non-oncology genetic testing services for phase I-IV trials along with critical support of ancillary services. These services include: biorepository, clinical trial logistics, clinical trial design, bioinformatics analysis, customized assay development. DNA and RNA extraction and purification, genotyping, gene expression and biomarker analyses. We also seek to apply our expertise in laboratory developed tests (“LDTs”) to assist in developing and commercializing drug-specific companion diagnostics. We have established business relationships with key instrument manufacturers to support their platforms in the market, and to drive acceptance among biopharmaceutical sponsors developing innovative immuno-oncology therapies.

Industry research has shown many promising drugs have produced disappointing results in clinical trials. For example, a 2016 article by the University of Michigan reported that 1 in 50 cancer drug candidates make it to the clinical market. Given such a high failure rate of oncology drugs, combined with constrained budgets for biotech and pharmaceutical companies, there is a significant need for drug developers to utilize molecular diagnostics to decrease these failure rates. For specific molecular-targeted therapeutics, the identification of appropriate biomarkers indicativelead compounds to address the complexities of disease type or prognosis may help to optimize clinical trial patient selectionParkinson’s Disease, with our initial focus on the GBA and increase trial success rates by helping clinicians identify patientsLRRK2 familial mutations. Haploinsufficiency of the GBA gene which makes the enzyme glucocerebrosidase is the most common genetic mutation that are most likely to benefit from a therapy based on their individual genomic profile.

Our Select One® offering was created specifically to help the biopharmaceutical communitycauses PD. People with clinical trials and companion diagnostic development in areas of our core expertise. We believe that oncology drugs and immuno-oncology therapiesPD who have the potentialGBA mutation tend to be among the most personalized of therapeutics, and yet few have successfully made it to market. In an effort to improve the outcome of these trials, andexperience motor symptom deficits sooner, cognitive decline more rapidly advanced targeted therapeutics,and have particular difficulty with their gait and postural balance.

NIH Collaboration

In April 2019, the biotechnology and pharmaceutical community is increasingly looking to companies that have both proprietary disease insights and comprehensive testing services as they move toward biomarker-based therapeutics, combination studies and immuno-oncology pathways.


The United States National Institutes of Health reported over 95,000 clinical trials were being conducted in the United States as of March 2017, and over 15,000 of these trials were actively recruiting participants for studies with oncology pharmaceuticals or biologics. Molecular- and biomarker-based testing services have been altering the clinical trials landscape by providing biotech and pharmaceutical companies with information about trial subjects' genetic profiles that may be able to inform researchers whether or not a subject will benefit from the trial drug or will experience adverse effects. Streamlined subject selection and stratification, and tailored therapies selected to maximally benefit each group of subjects may increase the number of trials that result in approved therapies and make conducting clinical trials more efficient and less costly for biotech and pharmaceutical companies. In 2017, 46 new drugs were approved by the FDA, and over a quarter of these drugs were oncology-focused, highlighting the potential value of incorporating genomic information into oncology clinical trial design.

In addition to the tests and services provided to biotech and pharmaceutical companies, we are developing NGS panels focused on pharmacogenomics and oncology that will inform researchers of trial subjects' drug sensitivities.

We provide the following services to biotech and pharmaceutical companies and researchers conducting clinical trials:

Genotyping and Pharmacogenomics Testing Services

Over 400 genotyping assays including drug metabolizing enzymes, transporters and receptors.

Over 19 validated gene expression assays.

TestingCenter for the FDA's Pharmacogenomic (PGx) Biomarkers in Drug Labels recommended panel.

LossAdvancement of heterozygosity and copy number detection assays.

We also utilize our laboratories to provide clinical trial services to biotech and pharmaceutical companies and clinical research organizations to improveTranslational Sciences (“NCATS”), the efficiency and economic viability of clinical trials. Our clinical trials services leverage our knowledge of clinical oncology and molecular diagnostics and our laboratories’ fully integrated capabilities. Our Select One® program integrates clinical information into the drug discovery process in order to provide customized solutionsinstitute charged with finding better technology models for patient stratification and treatment. By utilizing biomarkers, we intend to optimize the clinical trial patient selection. This may result in an improved success rate of the clinical trial and may eventually help biotech and pharmaceutical companies to select patients that are most likely to benefit from a therapy based on their genetic profile. We believe we are one of only a few laboratories with the capability to combine somatic and germline mutational analyses in clinical trials.

From a laboratory infrastructure standpoint, we possess capabilities in histology, immunohistochemistry (IHC), flow cytometry, cytogenetics and fluorescent in-situ hybridization (FISH), as well as sophisticated molecular analysis techniques, including next generation sequencing. This allows for comprehensive esoteric testing within one lab enterprise, with our CAP-accredited biorepository serving as a central hub for specimen tracking. Using this approach, we are able to support demanding clinical trial protocols requiring multiple assays and techniques aimed at capturing data on multiple biomarkers. Our suite of available testing platforms allows for highly customized clinical trial design which is supported by our dedicated group of development scientists and technical personnel.

Through this combination of a variety of esoteric testing platforms powered by a team of experienced scientists, we offer a rare comprehensive approach to clinical trial support. As trial design becomes increasingly complex to cater to more specific drug targets and patient populations, a single-source solution for esoteric testing, we believe that clinical result generation and reporting is becoming more valuable than ever.

Examples of clinical trial services offered:

Flow cytometrySelection of individual antibodies in multiple myeloma, leukemia, lymphomas, and therapy response
KaryotypingGenome-wide detection of aberrations at low resolution that have a diagnostic or prognostic significance
FISHProbe library for the detection of gene abnormalities in chromosomes indicated in hematological and solid tumors
Anatomic pathologyFull IHC library with over 180 antibodies available
Exome sequencingSequencing of the protein-encoding genes in a genome
DNA and RNA sequencingSequencing to determine the presence and quantity of RNA or DNA in a specimen
Next Generation sequencingProprietary and custom-designed panels to deep sequence genomic material to identify substitutions, insertions and deletions, and rearrangements of genetic material
Cell-free DNA analysisMulti-gene next generation sequencing panel for lung cancer to detect tumor-derived cell-free DNA obtained from a blood draw
DNA and RNA microarrayMeasures expression levels of a large number of genes simultaneously
Sanger sequencingDNA sequencing for validation of next generation sequencing results, and for smaller scale sequencing projects
Fragment size analysisAnalysis technique where DNA fragments are separated by size and used for mutation detection
DNA and RNA extraction and purificationExtraction and isolation of DNA and RNA from a wide variety of sample types for immediate testing or for storage
Biostatistics and BioinformaticsDesign and review of client assays and analysis of datasets
Biorepository and sample logisticsCollection, shipping guidance and storage of bio-specimens and related nucleic acid samples


We also offer our clinical trial services customers our branded Select One® program, which integrates clinical information into the drug discovery process in order to provide customized solutions for patient stratification and treatment. By utilizing biomarkers, we intend to optimize the clinical trial patient selection process. This may result in an improved success rate of the clinical trial and may eventually help biotech and pharmaceutical companies to select patients that are most likely to benefit from a therapy based on their genetic profile. We believe we are one of only a few laboratories with the capability to combine somatic and germline mutational analyses in clinical trials.

Our Select One® clinical trial services are aimed at developing customizable tests and techniques utilizing our proprietary tests and laboratory services to provide enhanced genetic signature analysis and more comprehensive understanding of complex diseases at earlier stages. We leverage our knowledge of clinical oncology and molecular diagnostics and provide access to our genomic database and assay development capabilities for the development and validation of companion diagnostics. This potentially enables companies to reduce the costs associated with development by determining earlier in the development process if they should proceed with additional clinical studies. We have been chosen by leading biotech and pharmaceutical companies including Gilead Sciences Inc., GlaxoSmithKline, and H3 Bio (a division of Eisai) to provide clinical trial services and molecular profiling for patient selection and monitoring. Additionally, through our services we gain further insights into disease progression and the latest drug development that we can incorporate into our proprietary tests and services.

We also provide genetic testing for drug metabolism to aid biotech and pharmaceutical companies identify subjects' likely responses to treatment, allowing these companies to conduct more efficient and safer clinical trials. We believe pharmacogenomics drug metabolism testing helps deliver the promise of personalized medicine by enabling researchers to tailor therapies in development to differences in patients' genomic profiles.

Clinical Services

We provide our oncology and immuno-oncology tests and services to oncologists and pathologists at hospitals, cancer centers, and physician offices. Our portfolio contains proprietary tests to target cancers that are difficult to prognose and predict treatment outcomes through currently available mainstream techniques. We utilize an expansive range of non-proprietary tests and technologies to provide a comprehensive profile for each patient we serve. Clinical testing is available through anatomic pathology, flow cytometry, karotype, FISH, liquid biopsy and molecular diagnostics (including next generation sequencing and gene expression panels).

Our comprehensive testing services for cancer are utilized in the diagnosis, prognosis and prediction of treatment outcomes (theranosis) of cancer patients as clinicians demand more precise and more comprehensive evaluation of their patients. We believe our ability to rapidly translate research insights about the genetics and molecular mechanisms of cancer into the clinical setting will improve patient treatment and management and that this approach can become a key component in the standard of care for personalized cancer treatment. We utilize highly skilled scientists, pathologists and hematologists in our laboratories, with 46% of individuals holding advanced degrees. These individuals assist our customers in integrating and technically assessing the testing results for their patients.

Our clinical services strategy is focused on direct sales to oncologists and pathologists at hospitals, cancer centers, and physician offices in the United States, and expanding our relationships with leading distributors and medical facilities in emerging markets. As part of our market strategy for our clinical services, we offer the branded testing programs described below.

CompleteTM Program. Our CompleteTM program is our branded program offering a unique suite of common and proprietary tests that assist clinicians in determining the best treatment options to improve patient outcomes. Each CompleteTM program integrates the latest diagnostic and prognostic biomarkers across multiple testing methodologies. We offer Complete testing for a number of hematological cancers and solid tumors, including AML, CLL, DLBCL, MDS, myeloproliferative neoplasms (MPN), colorectal, lung and breast cancers.

Tissue of Origin® Test. Our FDA-cleared Tissue of Origin® test, or TOO®, is a gene expression test that is indicated when there is clinical uncertainty about a poorly differentiated or undifferentiated, or a metastatic tumor where the primary tissue of cancer development is unknown. The Tissue of Origin® test we believe is currently the only FDA-cleared test of its kind on the market, and can determine the most likely tissue of origin of a patient tumor sample from the fifteen most common tumor types - including thyroid, breast, pancreas, colon, ovarian and prostate - which account for ninety percent of all incidences of solid tissue tumors, by measuring the expression levels of 2,000 individual genes. TOO® is supported by extensive analytical and clinical validation data from robust, multi-center clinical studies. We believe TOO® can reduce the need for repeated testing, examinations, imaging and biopsy procedures by providing clinicians with the primary tissue type with greater certainty than

traditional diagnostic techniques. This in turn empowers physicians to select the correct type of treatment earlier in the course of the patient’s therapy.

In addition, we have developed the SummationTM Report which, we believe, provides an integrated view of a patient's test results and diagnosis in a user-friendly, visually appealing format for clinicians. Our licensed pathologists and licensed laboratory directors prepare these SummationTM Reports based on the clinical information and diagnosis provided by our laboratory professionals. All of our testing technologies are integrated into a Summation Report to allow oncologists to efficiently arrive at a definitive diagnosis and drive complete and effective decisions.

Discovery Services

Through our recent acquisition of vivoPharm in 2017, we offer proprietary preclinical test systems supporting our clinical diagnostic and prognostic offerings at early stages, valued by the pharmaceutical industry, biotechnology companies and academic research centers. In particular, our preclinical development of biomarker detection methods, response to immuno-oncology directed novel treatments and early prediction of clinical outcome is supported by our extended portfolio of orthotopic, xenografts and syngeneic tumor test systems. vivoPharm specializes in conducting studies tailored to guide drug development, starting from compound libraries and ending with a comprehensive set of in vitro and in vivo data and reports, as needed for Investigational New Drug filing. vivoPharm operates in AAALAC accredited and GLP-compliant audited facilities. We provide our preclinical services, with a focus on efficacy models, from our Hershey, PA facility for the U.S. and European markets, and supplemented with GLP toxicology and extended bioanalytical services in our Australia-based facility in Bundoora, VIC.

Our Discovery Services provide the tools and testing methods for companies and researchers seeking to identify new molecular- and biomarker-based indicators for disease and to determine the pharmacogenomics, toxicity and efficacy of potential therapeutic candidate compounds. Discovery Services we offer include development of both xenograft and syngeneic animal models, toxicology and genetic toxicology services, pharmacology testing, pathology services, and validation of biomarkers for diseases including cancers. We also provide consulting, guidance and preparation of samples and clinical trial design. We believe the ability to analyze variations in biomarkers, tumor cells and compounds, and to interpret results into meaningful predictors of disease or indicators of therapeutic success is essential to discovering new molecular markers for cancer, new therapeutics, and targets for therapies.

Our Disease-Focused Testing Portfolio

Our disease-focused testing capabilities include our portfolio of proprietary tests, along with a comprehensive range of non-proprietary oncology-focused tests and laboratory services. We have a comprehensive oncology testing portfolio, spanning ten of the most prevalent solid and hematological cancers, including the FDA-cleared test for tumors of unknown origin, our FDA-cleared Tissue of Origin®, or TOO® test. With the exception of the TOO® test, we offer our proprietary tests in the United States as laboratory-developed tests, or LDTs, and internationally as CE-marked in vitro diagnostic medical devices. The non-proprietary testing services we offer are focused in part on the specific oncology categories where we are developing our proprietary tests. We believe that there is significant synergy in developing and marketing a complete set of tests and services that are disease-focused and delivering those tests and services in a comprehensive manner to help guide and inform treatment decisions. The insights that we develop in delivering non-proprietary services are often leveraged in the development of our proprietary programs and in the validation of our proprietary programs.

Our proprietary tests are molecular- and biomarker-based genomic tests: microarrays, probes, gene expression panels, liquid biopsy and next generation sequencing. Each is directed at identifying specific genetic aberrations in cancer cells that serve as markers for diagnosis, prognosis and theranosis. We offer microarrays, next generation sequencing, gene expression and FISH probes because each serves a unique diagnostic or prognostic function. FISH- based tests, or probes, offer great sensitivity while microarrays provide a more comprehensive analysis of the cancer genome, NGS panels offer a method of detecting mutations or chromosomal aberrations of lesser frequency while gene expression can identify which genes are affected when the cancer type is unknown, and liquid biopsy techniques provide a method of isolating and detecting rare cells, such as tumor cells, circulating in a patient's blood, enabling a less invasive approach than tissue biopsy to obtain cells for additional biomarker analysis through one or more of the aforementioned tests. The tables below list and describes our proprietary tests that target hematologic cancers, HPV-associated cancers, solid tumors, hereditary cancers and immuno-oncology biomarkers.

Hematological Cancers

As a group, hematologic cancers (cancers of the blood, bone marrow or lymph nodes) display significant clinical, pathologic and genetic complexity. Traditionally, diagnosis relies mostly on pathologic examination, flow cytometry and detection of only

a few genetic markers. Importantly, the clinical course of the six main subtypes of these neoplasms ranges from indolent (follicular lymphoma) to aggressive (diffuse large B-cell lymphoma, mantle cell lymphoma and multiple myeloma), or mixed (chronic lymphocytic leukemia/small lymphocytic lymphoma, or CLL/SLL). Most risk-stratification for treatment decisions were traditionally based on clinical features of the disease. Few molecular prognostic biomarkers were utilized in a clinical setting. There remains an unmet medical need for robust biomarkers for the diagnosis, prognosis, theranosis and overall patient management in B-cell cancers. Given the higher frequency of these malignancies in the United States than in other countries due to relativelylong lifespans and an aging population, we expect significant clinical demand for our tests and services that are focused on hematological cancers.

Our Proprietary Tests for Hematological Cancers

TestTargeted CancersTechnology & Advantages
Focus::NGS®

Focus::AML™

Focus::CLL™

Focus::DLBCL&FL™

Focus::Lymphoma™

Focus::MCL™

Focus::MDS™

Focus::MPN™

Focus::Myeloid™

Focus: Myeloma™

•     Chronic Lymphocytic Leukemia (CLL)
•     Myeloid Cancers
-    Myelodysplastic Syndromes (MDS)
-    Acute Myeloid Leukemia (AML)
-    Myeloproliferative Neoplasms (MPN)
•     B-Cell Lymphomas
•     Follicular Lymphoma
•     Mantle Cell Lymphoma (MCL)
•     Focus::NGS® is our family of next generation sequencing tests developed for the analysis of genomic alterations to determine, guide and inform diagnosis, prognosis and theranosis of particular hematological cancers and solid tumors.
• Next generation sequencing performs massively parallel sequencing, which is able to detect biomarker mutations and aberrations that are present at very low levels in a single test, and which may be missed by other, less sensitive methodologies.
• Our proprietary lymphoma NGS panels provide powerful and clinically validated tools for the molecular characterization of lymphomas. These targeted panels report on clinically actionable gene mutations present in the most common types of B-cell lymphomas, and have been used to power clinical trials, clinical work-up, management and therapy selection in lymphoma patients.
• Our proprietary myeloid NGS panels provide actionable information for improved diagnosis, prognosis and risk stratification for myeloid malignancies. Based on the panel results, we believe patients are able to receive the most suitable treatment tailored to their unique cancer.

HPV-Associated Cancers

HPV-associated cancers, including cervical, anal, and head and neck cancers, are caused by infection with high-risk variants of human papillomavirus (HPV), and are responsible for approximately 4% of all cancer diagnoses worldwide. Cervical cancer is the third most common cancer among women. According to the National Institutes of Health while there(“NIH”), and StemoniX entered into a Research Collaboration Agreement (“RCA”). The RCA is part of the HEAL (Helping to End Addiction Long-Term) Initiative, a multi-institute effort to fight the opioid epidemic, and screening of over 300 compounds has been completed. The analysis by the NIH was supported with AnalytiX, described above, and provided an unbiased and deep analysis of the microBrain waveforms. The resulting output was developed into a joint publication that demonstrated how the Company’s neural platform responds across a wide range of chemicals and drugs and can be used to separate different mechanisms of action. More importantly, the joint project validated a high-throughput, human-based platform for further insight into drug action and provided a foundation for future drug development that would treat pain without opioids with a goal of combatting the opioid crisis.

6

Competition

The pharmaceutical industry is intensely competitive, where a company’s proprietary advancements in science and technology play a critical role in its competitive advantage. Any product candidates that we may successfully discover and develop, may compete with existing therapies, or new therapies that may become available in the future. Our commercial opportunities could be reduced or eliminated if our competitors develop and commercialize products that are more effective, have fewer side effects, are more convenient or are less expensive than 100 types of HPV, approximately 15 typesany products that we may develop.

At this time, our primary competitors are consideredother pharmaceutical and biotechnology or biomedical development companies that are trying to discover and develop compounds to be cancer-causing, with only 2 strains being responsible for 70% of cervical cancer cases worldwide. Cervical cancer may be detected by traditional methods, including Pap smears and liquid cytology, where cervical cells obtained by Pap smear are observed by a pathologist, or by HPV typing, which identifies the strain of HPV virus presently infecting the patient. Neither of these techniques is able to identify the likelihood of the HPV-infection’s developing into cancerous or precancerous lesions. According to the National Cancer Institute, about 50 million Pap smear tests to detect HPV are performedused in the United States each year. It is estimated that approximately 2 million patients have abnormal Pap smear test resultstreatment of Rett, CDKL5, PD and are referred for biopsy/colposcopy as a resultother CNS diseases, including those companies already doing so. Some of such tests. However, only approximately 12,000 of these patients will develop cervical cancer. It is believed that early detection of HPV-associated cancersthose companies include Acadia Pharmaceuticals (NASDAQ:ACAD), Anavex Life Sciences (NASDAQ:AVXL) Biogen (NASDAQ:BIIB), Pfizer Inc. (NYSE:PFE), Abbvie Plc (NYSE:ABBV), Novartis AG (NYSE:NVS), GlaxoSmithKline Plc (NYSE:GSK), Merck & Co. Inc. (NYSE:MRK), Eli Lilly & Co. (NYSE: LLY), Johnson & Johnson (NYSE:JNJ), Roche Holding AG (VTX:ROG), Zogenix (NASDAQ:ZGNX), UCB (Euronext:UCB) and lesions most likely to progress to cancer could eliminate unnecessary biopsies/colposcopies and thereby reduce health care costs.


Our Proprietary Tests for HPV-Associated Cancers


TestTargeted CancersTechnology & Advantages
FHACT®
•     HPV-Associated Cancers
-    Cervical Cancer
-    Anal Cancer
-    Head & Neck Cancers
•     FHACT® is our proprietary, 4-color FISH-based DNA probe designed to identify aberrations in four important chromosomal regions that have been implicated in cancers associated with infection by the human papilloma virus (HPV): cervical, anal and oropharyngeal.
•     FHACT® is designed to determine copy number changes of four particular genomic regions by fluorescent in situ hybridization (FISH)Marinus Pharmaceuticals, Inc. (NASDAQ:MRNS). These regions of DNA give specific information about the progression from HPV infection to cervical cancer, in particular the stage and subtype of disease.
•     FHACT® is designed to enable earlier detection of abnormal cells and can identify the additional genomicbiomarkers that allow for the prediction of cancer progression.
•     FHACT® is designed to leverage the same Pap smear sample taken from the patient during routine screening, thus reducing the burden on the patient while delivering greater information to the clinician.
•     We offer an application of FHACT® as an LDT for cervical cancer and are developing applications for additional cancer targets.
•     We have obtained CE marking for FHACT®, which allows us to market the test in the European Economic Area.

Solid Tissue Cancers

The term “solid tumors” encompasses abnormal masses of cells that do not include fluid areas (e.g. blood) or cysts. Solid tumors are composed of abnormal cell growths that originate in organs or soft tissue and are normally named after the types of cells that form them. Examples of solid tumors include breast cancer, lung cancer, ovarian cancer and melanoma. Solid tumors may be benign (not cancerous) or malignant (cancerous) and may spread from their primary tissue of origin to other locations in the body (metastasis). There are over 200 individual chemotherapeutic drugs available for combatting solid tumor cancers. Selection of an appropriate course of treatment for a patient may depend on identification of the gene mutation or mutations present in their particular cancer and on determining the cancer’s tissue of origin. Metastatic tumors with an uncertain primary site can be a difficult clinical problem. In tens of thousands of oncology patients every year, no confident diagnosis is ever issued, making standard-of-care treatment impossible.

Our Proprietary Tests for Solid Tissue Cancers

TestTargeted CancersTechnology & Advantages
Tissue of Origin®
•     Solid Tissue Cancers
-    Thyroid
-    Breast
-    Non-Small Cell Lung Cancer (NSCLC)
-    Gastric
-    Pancreas
-    Colorectal
-    Liver
-    Bladder
-    Kidney
-    Non-Hodgkin’s Lymphoma
-    Melanoma
-    Ovarian
-    Sarcoma
-    Testicular Germ Cell
-    Prostate
•     Tissue of Origin® (TOO®) is FDA-cleared, Medicare-reimbursed, and provides extensive analytical and clinical validation for statistically significant improvement in accuracy over other methods.
•     TOO® is a gene expression test that is used to identify the origin in cancer cases that are metastatic and/or poorly differentiated and unable to be typed by traditional testing methods.
•     TOO® increases diagnostic accuracy and confidence in site-specific treatment decisions, and leads to a change in patient treatment based on results 65% of the time it is used.
•     TOO® assesses 2,000 genes, covering 15 of the most common tumor types and 90% of all solid tumors.
•     In the fourth quarter of 2015, we acquired the TOO® test through our acquisition of substantially all of the assets of Response Genetics, Inc.
Focus::Oncomine™

Oncomine Dx Target Test

Liquid::Lung cf-DNA™
•     Solid Tissue Cancers
-    Lung
-    Colorectal
-    Melanoma
-    Breast
-    Bladder
-    Thyroid
•     Focus::Oncomine™is one test in our family of next generation sequencing tests developed for the analysis of genomic alterations to determine, guide and inform diagnosis, prognosis and theranosis of solid tumors.
•     Focus::Oncomine™ is designed to cover hotspot mutations of 35 unique genes that have clinical utility in various different types of solid tumors, allowing for the detection of 989 hotspot variants, including single nucleotide variants (SNVs), with a very low input DNA material.
•     We make available Thermo-Fisher’s Oncomine Dx Target Test, which is an NGS-based companion diagnostic that simultaneously screens tumor samples for multiple biomarkers associated with three FDA-approved therapies for non-small cell lung cancer, including the combined therapy of dabrafenib and trametinib, crizotinib or gefitinib.
•     The biomarkers included in Focus::Oncomine™ and the Oncomine Dx Tartet Test were selected based on information in the Oncomine Knowledgebase, which compiles genomic information from clinical trials, and were confirmed with industry-leading pharmaceutical partners. The results of the assay should be interpreted in the context of available clinical, pathologic, and laboratory information.
•     Liquid::Lung- cfDNA™ is our multi-gene cell-free DNA next generation sequencing panel for lung cancer, which covers 11 critical genes and over 150 key hotspots related to lung cancer.
•     Liquid::Lung- cfDNA™ is CLIA-validated and can detect lung tumor-derived cell-free DNA (cfDNA) obtained from the plasma fraction of blood.

Focus::Renal™•     Kidney
•     Focus::Renal™, a highly-sensitive NGS panel, detects mutations of 76 renal cancer-related genes, as well as genome-wide copy number changes, and critical single nucleotide variants (SNVs), all in a single test, that enable precision diagnosis, prognosis, and therapy selection for renal cancer patients.
•     Focus::Renal™ is the only NGS panel to simultaneously detect genome-wide copy number changes, SNP genotypes along with mutations in 76 renal cancer-related genes, covering relevant drug pathways.
•     Focus::Renal™ can be performed on a wide variety of patient specimen types, such as needle biopsies, fine-needle aspirates, and resected specimens using both formalin-fixed paraffin-embedded (FFPE) and fresh/fresh-frozen specimens, including the ones with minimal starting material.
UroGenRA®
•     Kidney
-    Clear Cell Renal Cell Carcinoma (ccRCC)
-    Chromophobe Renal Cell Carcinoma (chrRCC)
-    Papillary Renal Carcinoma (pRCC)
-    Oncocytoma (OC)
•     Prostate
•     Bladder
•     UroGenRA® has 101 regions of the human genome represented, and these regions can be used for gain/loss evaluation in urogenital neoplasms including kidney, prostate and bladder.
•     UroGenRA®-Kidney Array-CGH provides genomic diagnostic information to assist routine histology in the subtyping of ccRCC, chrRCC and OC from either core needle biopsies or resected specimens.
•     UroGenRA®-Kidney assesses 16 genomic regions that have diagnostic significance in the four main renal cortical neoplasm subtypes.
•     Result from UroGenRA®-Kidney are analyzed using our proprietary algorithm KidneyPath™ to classify specimens as normal, undetermined, or into one of the four main renal cortical neoplasm subtypes.

Hereditary Cancers

Hereditary cancer syndromes are inherited conditions in which an individual has a greater than normal lifetime risk of developing certain types of cancer, and are caused by gene mutations that are passed from parents to children. In a family with a hereditary cancer syndrome, one or more types of cancers may be present in several family members, may develop at an early age, or one person may develop more than one type of cancer. Hereditary cancer syndromes are estimated to account for up to 10% of all cancer diagnoses in the United States. Many of the gene mutations that cause hereditary cancers have been identified, and genetic testing may identify whether an individual’s cancer is due to one of these inherited genes. Genetic testing for family members who have not been diagnosed with cancer can also reveal whether they are at an increased risk for developing hereditary cancers.

Our Proprietary Hereditary Cancer Test


TestTargeted CancersTechnology & Advantages
Focus::HERSite™

Focus::BRCA™
•     Breast
•     Ovarian
•     Focus::HERSite™and Focus::BRCA™ are in our family of next generation sequencing tests developed for the analysis of genomic alterations to determine, guide and inform diagnosis, prognosis and theranosis of some of the most prevalent hereditary cancers.
•     Focus::HERSite™ analyzes the 16 most common genes associated with breast and ovarian cancers in a single reaction, and provides comprehensive coverage of the BRCA1 and BRCA2 genes.
•     Focus::BRCA™ targets germline mutations, insertions and deletions in the BRCA1 and BRCA2 genes associated with Hereditary Breast and Ovarian Cancer Syndrome (HBOC), and mutations in which may impart an increased lifetime risk of breast, ovarian and prostate cancer.
•     The mutations responsible for HBOC are inherited in an autosomal dominant manner and typically include single nucleotide variants (SNVs) and small insertions. Focus::HERSite™ and FOCUS:BRCA™ are designed to detect these mutations, as well as larger insertions and deletions in their target genes.

Immuno-Oncology Testing

Immuno-oncology encompasses a method of cancer treatment that harnesses the power of a patient’s own immune system to combat cancer growth and development. Abnormal cells are ordinarily destroyed by the body’s immune system before these cells are able to proliferate and develop into a tumor. In some cancers, abnormal cells have developed mutations allowing them to avoid the body’s natural defenses and these cells are not destroyed by the immune system. Immuno-oncology aims to either activate the immune system to recognize and destroy these cancer cells, or to turn off the mechanisms cancer cells develop than enable them to avoid detection by the immune system, thereby permitting the immune system to recognize and eliminate them.

We believe immuno-oncology is rapidly increasing in clinical practice and presents a unique market opportunity when combined with precision testing and traditional and combination oncology therapies. During 2016 and 2017, with increased interest throughout 2018, we launched a comprehensive immuno-oncology testing portfolio for use in clinical trials, translational research, and therapy selection for patients. This portfolio is available for clinical trials, patient care, and translational research utilizing multiple technological platforms through our licensed New Jersey laboratory facility. Our portfolio of immuno-oncology tests includes immunohistochemistry (IHC)-based tests that can detect novel biomarkers like PD-1 and PD-L1, MMR, CTLA4 and flow cytometry-based tests and panels that can assess immune response against cancers by evaluating subsets of immunomodulatory and effector cells. We also offer an NGS-based targeted RNA sequencing test that can measure expression levels of drug targets, evaluate tumor mutational burden, assess tumor neo-epitopes and total immune cell composition. Many of these assays are also available for clinical use and are CLIA- and New York State-approved.

Sales and Marketing

Our sales and marketing efforts consist of both direct and indirect efforts, with the majority of efforts focused on direct sales in the United States, Europe and Asia Pacific regions. The table below summarizes our sales approach by geography and customer segment:


United StatesClinical Sales
-

-

-

Collaborate with leading research universities and institutions that enable the validation of our new tests.
Work with community-based cancer centers that need a reliable and collaborative partner for cancer testing.
Build relationships with individual thought leaders in oncology, hematology and pathology to deliver services that provide value to their patients.
Biopharma Sales
-

-


Collaborate with scientific development teams at pharmaceutical companies on studies involving translational medicine and genotyping.
Build relationships in the research and development segment to identify partners with a need for preclinical efficacy and toxicity studies and biomarker discovery studies.
Discovery Sales-Collaborate with preclinical development teams at pharmaceutical and biotech companies on studies involving tumor models and therapeutic candidate compound testing.
Europe and Asia PacificBiopharma Sales
-

-

Leverage US-based and local companies conducting clinical trials with a component of those trials occurring in European or Asia Pacific populations.
Collaborate with scientific development teams at biotech and pharmaceutical companies and government agencies on studies involving tests and services.
Discovery Sales-Collaborate with preclinical development teams at pharmaceutical and biotech companies on studies involving tumor models and therapeutic candidate compound testing.

Our U.S. and European business development and sales professionals have scientific backgrounds in hematology, pathology, and laboratory services, with many years of experience in biopharmaceutical and clinical oncology sales, esoteric laboratory sales from leading biopharmaceutical, pharmaceutical or specialty reference laboratory companies. We currently have a team of 10 business development and sales professionals in the United States and 2 in Europe. We support our sales force with clinical specialists who bring deep domain knowledge in the design and use of our tests and services.

We also promote our tests and services through marketing channels commonly used by the biopharma and pharmaceutical industries, such as internet, medical meetings and broad-based publication of our scientific and economic data. In addition, we provide easy-to-access information to our customers over the internet through dedicated websites. Our customers value easily accessible information in order to quickly review patient or study information. We do not, however, market our tests directly to individual patients or consumers.

Research and Development Collaborations

We have collaborations with leading oncology centers and community-based hospitals and use specialized knowledge to develop proprietary diagnostic tests as well as non-clinical services such as biopharmaceutical and discovery services. Additionally, many of these centers have obtained Specialized Programs of Research Excellence status, as designated by the National Cancer Institute. Our collaborations with these centers give us access to large datasets of information and, together with our internal expertise, we can develop our proprietary tests.

Below is a summary of our active key collaborations. In certain cases we have formal written agreements with collaborators and in other cases we have no written agreement with our collaborators or only informal written arrangements.

Collaborating InstitutionPrinciple Investigator(s)Focus of Collaboration
North Shore-Long Island Jewish Health System, New York
Dr. Kanti Rai
Dr. Nicholas Chiorazzi
Clinical validation of biomarkers and signatures for CLL diagnosis and therapeutic response
Columbia University, New York
Dr. Azra Raza
Dr. Siddhartha Mukherjee
Identification of genomic biomarkers for myeloid cancers
Keck Medicine of University of Southern California, California
Dr. Imran Siddiqi

Dr. Giri Ramsingh
Identification and evaluation of genomic biomarkers for lymphoid and myeloid malignancies
Transposable elements as prognostic biomarkers in acute myeloid leukemia
University of Southern California, California, & HTG Molecular, Arizona
Dr. Heinz-Josef Lenz and Dr. Yu Sunakawa

Gene expression analysis using an immuno-oncology panel for measurement of response to immune therapy

Groupe Hospitalier Pitié Salpétriere, Paris
Analyzing the variability of genomic alterations in renal cancer

Huntsman Cancer Center Institute, University of Utah, Utah
Dr. Neeraj AgarwalEvaluation of biomarkers for kidney cancer diagnosis and therapeutic response and liquid biopsy assay development
Huntsman Cancer Center Institute, University of Utah, Utah and Pfizer
Validation of biomarkers to predict Stutent response and liquid biopsy assay development
UCLA, California
Dr. Brian ShuchEvaluation of biomarkers in NGS Focus::Renal™ to stratify and monitor patients

Competition

With respect to our clinical services, our principal competition comes from existing mainstream diagnostic methods and laboratories that pathologists and oncologists use and have used for many years or decades. It may be difficult to change the methods or behavior of the referring pathologists and oncologists to incorporate our molecular diagnostic testing in their practices. In addition, companies offering capital equipment and kits or reagents to local pathology laboratories represent another source of potential competition. These kits are used directly by the pathologist, which can facilitate adoption.

We also face competition from companies that currently offer or are developing products to profile genes, gene expression or protein biomarkers in various cancers. Precision medicine is a new area of science,academic institutions and we cannot predict what tests others will develop that may compete with or provide results superior to the results we are able to achieve with the tests we develop. Our competitors include public companies such as NeoGenomics, Inc., Quest Diagnostics, LabCorp., Abbott Laboratories, Inc., Johnson & Johnson, Roche Molecular Systems, Inc., bioTheranostics, Inc., Genomic Health, Inc., Myriad Genetics Inc., Foundation Medicine, Inc., Invitae Corp., and many private companies. We expect that pharmaceutical and biotech companies will increasingly focus attention and resources on the personalized diagnostic sector as the potential and prevalence increases for molecularly targeted oncology therapies approved by FDA along with companion diagnostics. With respect to our clinical laboratory business we face competition from companies such as Genoptix Medical Laboratory, NeoGenomics, Inc., Bio-Reference Laboratories, Inc. (a division of Opko), LabCorp, MDx Health, Quest Diagnostics and Invitae Corp. With respect to our Discovery Services, including our CRO services, we face competition from companies that offer or are developing animal models for tumors and that have capabilities in toxicology and pharmacology testing. Our competitors in our Discovery Services business include Champions Oncology, Crown BioScience (recently acquired by JSR Life Sciences), Eurofins Scientific, and Explora Biolabs.

Additionally, projects related to the molecular mechanisms driving cancer development have received increased government funding,agencies, both in the United States and internationally. The National Cancer Institutes' Cancer Moonshotabroad.

Intellectual Property

Patents and Trade Secrets

We protect and expand our intellectual property primarily through a combination of patent filings, trade secrets and exclusive/non-exclusive in-licensing. For processes and products that can be reverse-engineered, we typically file utility patent applications.

Regarding our patent portfolio, the Company does not rely on a singular patent to execute our business plan. Our objective is anticipated to increase both patient awareness and federal government fundingcreate a significant barrier to entry for research and clinical trials. The Federal Government has committed $1.8 billion over a 7 year period to fund the 21st Century Cures Act. As more information regarding cancer genomics and biomarkers becomes available to the public, we anticipate that more products aimed at identifying targeted treatment options will be developed and that these products may compete with ours. In addition, competitors may develop their own versions of our tests in countries where we did not applyby applying for patents or wherenot only on our patents have not issuedlead products and compete with us in those countries, including encouragingprocesses but also on possible workarounds. Our intellectual property portfolio (including both owned patent applications and licensed-in technology) covers stem cells, manufacturing processes, product packaging, digital cellular electronics, cell micro-environments and structure, and cell networks. Each patent application includes its own strategy, which may involve the use of their test by physicians or patients in other countries.


Third-Party Suppliers

We maintain control, validationprovisional patent application filings and quality assurance over our NGS panels, DNA microarraysrelated domestic and probes. Our microarrays and NGS panels are designed in our facility by our scientists and technicians using stateforeign patent applications that claim the benefits of the art genomic mappingprovisional applications and analysis software. that are intended to provide the Company coverage in key geographical markets. Our patent portfolio is designed to grow with our Company.

The specifications forCompany has 12 issued patents in various countries globally, defined in the table below:

TITLE COUNTRYAPP NUMBER PATENT NUMBER GRANT DATE PRIORITY DATE PUBLICATION NUMBER
METHOD OF FABRICATING CELL ARRAYS AND USES THEREOF Japan 2017-530976 6510649 Apr 12, 2019 Aug 28, 2014 2017532061
METHOD OF FABRICATING CELL ARRAYS AND USES THEREOF Singapore 11201701540P 11201701540P May 22, 2020 Aug 28, 2014  
METHOD OF FABRICATING CELL ARRAYS AND USES THEREOF United States of America 14/839,170 10,625,234 Apr 21, 2020 Aug 28, 2014 US20160059203A1
SURFACE ENERGY DIRECTED CELL SELF ASSEMBLY United States of America 15/199,419 11,248,212 Feb 15, 2022 Jun 30, 2015 US20170002324A1
METHOD OF MANUFACTURING OR DIFFERENTIATING MAMMALIAN PLURIPOTENT STEM CELLSOR PROGENITOR CELLS USING A HOLLOW FIBER BIOREACTOR United States of America 15/293,563 10,760,053 Sep 1, 2020 Oct 15, 2015 US20170107488A1
CELL MEDIUM FORMULATION FOR CELL STABILIZATION Switzerland 17701262.2 3402330 Dec 29, 2021 Jan 12, 2016 3402330
CELL MEDIUM FORMULATION FOR CELL STABILIZATION Germany 17701262.2 602017051503.5 Dec 29, 2021 Jan 12, 2016 3402330
CELL MEDIUM FORMULATION FOR CELL STABILIZATION European Patent Office 17701262.2 3402330 Dec 29, 2021 Jan 12, 2016 3402330
CELL MEDIUM FORMULATION FOR CELL STABILIZATION France 17701262.2 3402330 Dec 29, 2021 Jan 12, 2016 3402330
CELL MEDIUM FORMULATION FOR CELL STABILIZATION United Kingdom 17701262.2 3402330 Dec 29, 2021 Jan 12, 2016 3402330
PROJECTED CAPACITIVE MULTI ELECTRODE EUKARYOTIC CELL ARRAY United States of America 15/588,154 11,054,408 Jul 6, 2021 May 6, 2016 US20170322194A1
HIGH THROUGHPUT OPTICAL ASSAY OF HUMAN MIXED CELL POPULATION SPHEROIDS United States of America 16/035,039 11,193,159 Dec 7, 2021 Jul 14, 2017 US20190017097A1

We believe our NGS panels are sent to Thermo Fisher Scientific (Ion Torrent) and Illumina for final manufacturing. Our NGS panels are manufactured under strict quality control and compliance. Upon manufacturing our custom, proprietary NGS panels, they are shipped back to our Rutherford facility for testing and acceptance.


We also currently rely on contracted manufacturers and collaborative partners to produce materials necessary for our FHACT® and FDA-cleared Tissue of Origin® tests. We plan to continue to rely on these manufacturers and collaborative partners to manufacture these materials. We order laboratory and research supplies from large national laboratory supply companies. We do not believe a short term disruption from any one of these suppliers would have a material effect on our business.

Patents and Proprietary Technology

Our business develops proprietary tests that enable oncologists and pathologists at hospitals, cancer centers, and physician offices to properly diagnose and inform cancer treatment. We rely on a combination of owned and licensed-in patents, patent applications, trademarks,covering both our products and processes and our ownership of intellectual property that provides protection against anticipated workarounds by potential competitors, and trade secrets know-how,is a unique advantage.

7

Trademarks

The Company has the following registered trademarks: StemoniX, microHeart, microBrain, microKidney, microNerve, microLiver, microTumor, microPancreas, BeYourCure, Person-on-a-Plate, Clinical Trial on-a-Plate, and microOrgan VyantBio, Vyant Bio, and Human-powered and the following pending trademark application: Biological Intelligence. In addition, the Company claims common law trademark rights with respect to the mark AnalytiX.

Licenses

The Company licenses multiple patents and protocols from the University of California, San Diego, as well as various contractual arrangements,from (1) Academia Japan for technology that we need in order to protectcreate and sell induced pluripotent stem cells, (2) ID Pharma for the proprietary aspectsSendai virus vector technology, and (3) the Max Plank Innovation GmbH for mid-brain organoid production.

In the context of our technology. We may also license our technologydrug development effort, whenever possible, we obtain licenses from customers to others.use the data we collect while providing drug screening services to those customers. We believe that no single patent, technology, trademark, intellectual property asset or license is materialthis data will have significant value to our business as it refines its screening models.

IDP License Agreement

StemoniX entered into a whole.


Our patent portfolio consists of 20 issued U.S. patents, 5 pending U.S. applications, and more than 40 foreign patents.We manage our patent assets to safeguard them and to maximize their value. Our key patents include:

Hematological cancers. We have two U.S. patents (U.S. Patent Nos. 8,580,713 and 8,557,747)Non-Exclusive License Agreement (the “IDP License Agreement”) with ID Pharma Co., directed to MatBA®Ltd., a microarrayJapanese corporation (“IDP”) effective as of January 29, 2016. Under the terms of the IDP License Agreement, IDP has granted StemoniX a royalty bearing, non-exclusive and non-transferable license in the United States and, upon exercise of the option described below, worldwide, to use the technology and processes covered by certain patents owned by IDP (the “IDP Licensed Patents”) to (i) generate iPSCs covered by the IDP Licensed Patents and differentiated cells derived from such iPSCs (collectively, the “IDP Licensed Products”), (ii) sell the IDP Licensed Products that are differentiated cells, and (iii) provide services involving the IDP Licensed Products (the “IDP Licensed Services”).

Pursuant to the IDP License Agreement, StemoniX agreed to pay IDP a non-credible and non-refundable up-front fee. The IDP License Agreement provides StemoniX the option, at any time during the term of the IDP License Agreement, to pay IDP an additional non-creditable and non-refundable fee in exchange for detecting (and distinguishing) particular typesthe rights to sell the IDP Licensed Products and IDP Licensed Services worldwide. Additionally, StemoniX has agreed to pay IDP a single digit percentage royalty on net sales of mature B cell neoplasms present in typical non-Hodgkin’s lymphoma, Hodgkin’s lymphomaIDP Licensed Products sold by StemoniX. Royalties are payable within 60 days after the close of each consecutive 12-month period after the effective date of the IDP License Agreement, and chronic lymphocytic leukemia. Theseannual minimum royalties apply. The IDP License Agreement may be terminated by either party upon an uncured breach of any material provision of the IDP License Agreement by the other party and under certain other circumstances.

Academia Japan License Agreement

StemoniX signed an Amended and Restated Non-Exclusive License Agreement (the “AJ License Agreement”) with iPS Academia Japan, Inc., a Japanese corporation (“Academia Japan”) effective as of April 1, 2017. Under the terms of the AJ License Agreement, Academia Japan has granted StemoniX a royalty bearing, non-exclusive, non-transferable license to use the technology and processes covered by two groups of patents cover our trademarked MatBA® microarrayowned by Academia Japan (collectively, the “AJ Licensed Patents”) to (i) develop, make, use, sell, have sold by one or more distributors, offer to sell and are directedhave offered to bothsell by one or more distributors iPSCs covered by the microarray itselfAJ Licensed Patents and differentiated cells derived from such iPSCs (collectively, the “AJ Licensed Products”), and (ii) provide services involving the AJ Licensed Products (the “AJ Licensed Services”). Similarly, StemoniX granted Academia Japan a non-exclusive, worldwide, royalty free license to certain of its patents solely for academic and educational purposes.

Pursuant to the AJ License Agreement, StemoniX has agreed to pay Academia Japan a non-creditable and non-refundable upfront fee as well as associated methodologies designedrunning royalties for the AJ Licensed Patents, with single digit percentage royalties payable at varying rates depending on the applicable group of AJ Licensed Patents and the applicable group of AJ Licensed Products and/or AJ Licensed Services.

The AJ License Agreement may be terminated by Academia Japan upon a material, uncured breach of the AJ License Agreement by StemoniX, and under certain other circumstances.

Manufacturing and Supply

We manufacture iPSC microOrgans at our facilities in Maple Grove, Minnesota and La Jolla, California. We do not have any manufacturing facilities or personnel for our therapeutic assets. We expect to detect the particular type of mature B cell neoplasm present in a patient. The MatBA® microarray patents issued from the first ofrely on third parties to manufacture our family of applicationstherapeutic product candidates for preclinical and clinical testing.

Sales and Marketing

We have and plan to utilize third-party, specialized business development firms to support our internal staff as we pursue licenses for our proprietary disease models and, once developed, our therapeutic assets.

Government Regulation

Government authorities in the microarray space. The termUnited States, at the federal, state and local level, and other countries extensively regulate, among other things, the research, development, testing, manufacture, quality control, approval, labeling, packaging, storage, record-keeping, promotion, advertising, distribution, marketing and export and import of these patents runs through 2030.


Solid Tumors.products such as those we are developing. A new drug must be approved by the FDA before it may be legally marketed in the United States. We have 12 U.S. patents, including (U.S. Patent Nos. 7,049,059, 7,560,543, 7,732,144, 8,586,311, 8,026,062, 6,956,111, 6,905,821, 7,005,278, 6,686,155, 7,138,507, as well as numerous foreign patents. These patents relateare subject to certain aspects of the gene expression technology usedvarious government regulations in our solid tumor tests. The term of these patents runs through 2023.

We have four U.S. patents (U.S. Patent Nos. 8,977,506, 8,321,137, 7,747,547 and 8,473,217) covering our Tissue of Origin® Test. These patents are directed at systems and methods for detecting biological features in solid tumors. The term of these patents run through 2030.

Urogenital cancers. We have two U.S. patents (U.S. Patent Nos. 8,603,948 and 8,716,193) directed to a novel, highly sensitive and specific probe panel which detects the type of renal cortical neoplasm present in a biopsy sample. These patents cover a probe that permits diagnosis of the predominant subtypes of renal cortical neoplasms without the use of invasive methods and provides a molecular cytogenetic method for detecting and analyzing the type of renal cortical neoplasm present in a renal biopsy sample. The term of these patents runs through 2027.

HPV-Associated Cancers. We have three U.S. patents (U.S. Patent Nos. 9,157,129, 8,865,882 and 8,883,414) that cover methods for detecting HPV-associated cancers used in our FHACT® test. The term of these patents run through 2031.

FISH Probes. We have two patents covering our FISH probes. These patents cover probes and methodologies designed to detect and analyze particular chromosomal translocations (genetic lesions) associatedconnection with a wide range of cancers using a technique known as FISH and serve as the backbone for several of our other pending patent applications, which are more specifically geared towards other probes (and methodologies). The term of these patents run through 2022.

In addition to patents, we hold twenty-six U.S. registered trademarks, including a federal registration for the term “CGI” as well as three U.S. trademark applications and one foreign trademark registration for certain of our proprietary tests and services. Our

strategic use of distinctive trademarks has garnered increased name recognition and brand awareness for our tests and services within the industry.

Through our clinical laboratory in Rutherford, New Jersey, we provide several clinical services that utilize our proprietary trade secrets. In particular, we maintain trade secrets with respect to specimen accessioning, sample preparation, and certain aspects of cytogenetic and molecular analyses. All of our trade secrets are kept under strict confidence, and we take all reasonable steps, including the use of non-disclosure agreements and confidentiality agreements, to ensure that our confidential information is not unlawfully disseminated. We also conduct training sessions on the importance of maintaining and protecting trade secrets with our scientific staff and laboratory directors and supervisors.

In the past, we had licensed certain intellectual property, including patents, from the University of Southern California, the National Cancer Institute for a number of extraction methodologies and related technologies for some of our solid tumor tests, and the National Cancer Institute or Stanford University for the development of diagnostic assaysour pipeline.

U.S. Drug Development and predictive models. However, we no longer utilize these technologies in our consolidated facility in New Jersey.


Our success in remaining an innovator in the diagnostic services industry by continuing to develop and introduce new tests, technology and services will depend, in part, on our ability to license new and improved technologies on favorable terms. Other companies or individuals, including our competitors, may obtain patents or other property rights on tests and processes that may be performing, particularly in such emerging areas as gene-based testing that could prevent or interfere with our ability to develop, perform or sell our tests or operate our business.

Operations and Production Facilities

We are underway with the implementation of a “best-of-breed” enterprise laboratory management system licensed from multiple business partners to support a fully-integrated system across two of our U.S.-based sites. We anticipate this system to be on-line by the end of 2019. In addition to harmonizing our workflow, improving our turn-around times, and creating better operational efficiencies, it will allow us to connect with electronic medical records providers to facilitate seamless communication between our clinical laboratories and the oncologist or pathologist at the test ordering site. We do this integration through utilizing HL7 interfaces, which are standard in health care information technology systems. We currently employ HL7 for its integration with a revenue cycle management company, as well as with electronic medical records partners. The use of the HL7 interface allows systems written in different languages and running on different platforms to be able to talk to each other through the use of an abstracted data layer. This means that we do not have to spend significant extra time designing and developing common communications protocols when integrating with other electronichealth records systems or billing systems providers.

When a customer obtains a specimen from a patient for oncology testing, he or she will complete a requisition form (either by hand or electronically, or via electronic medical records technology), and package the specimen for shipment to us. Once we receive the specimen at our laboratory and we enter all pertinent information about the specimen into our clinical laboratory information system, one of our laboratory professionals prepares the specimen for diagnosis. The prepared specimen is sent to one of our pathologists or medical directors who is experienced in making the diagnosis requested by the referring oncologist or pathologist.

After diagnosis, our pathologist uses our laboratory information systems to prepare a comprehensive report, which includes any relevant images associated with the specimen. Our clinical reporting portal, cgireports.com, allows a referring oncologist or pathologist to access his/her test results in real time in a secure manner, consistent with the privacy and security requirements of HIPAA. The reports are generated in industry standard PDF formats which allows for high definition color images to be reproduced clearly. This portal has been fully operational at our facilities since 2011.

In most cases we provide both the technical analysis and professional diagnosis, although we also fulfill requests from oncologists and pathologists for only one service or the other. If an oncologist or pathologist at the hospital, cancer center, reference laboratory or physician office requires only the analysis, we prepare the data and then return it to the referring oncologist or pathologist for assessment and diagnosis.

Quality Assurance

We are committed to maintaining a standard of clinical excellence and to providing reliable and accurate laboratory services to our customers. To that goal, our independent Quality Assurance Unit (QAU) has implemented a comprehensive and integrated Quality Management System (QMS) designed to drive consistent high quality testing services while ensuring the highest ethical standards across our enterprise. We believe this commitment and execution of our quality systems is a key differentiator in our biopharma services business.

Our QMS documents quality assurance policies as well as the quality control procedures that are necessary to ensure we offer a consistently high quality of testing services. Our quality management program is designed to satisfy all the requirements necessary for local, state, and federal regulations as our laboratories are both CLIA-certified and CAP-accredited (including our biorepository), and comply with states’ heightened standards (such as California and New York State) in order to maintain licensures, permits and regulatory approvals applicable to our business. In addition, our QMS satisfies the Food and Drug Administration (FDA) requirements for clinical trials studies conduct, computer systems validation, electronic records and signatures, and the Good Clinical Laboratory Practices (GCLP). For additional information on our clinical laboratory licensure and permitting, please review our Risk Factors.

The overall goal of the QMS is to ensure that all patient results meet laboratory specifications and client specifications during the pre-analytical, analytical, and post-analytical phases of sample management and reporting of results. The system is maintained and continually improved through the regular use and review of our quality policies, customers’ and employees’ feedback, internal and external audit or inspection results, corrective and preventive actions, key performance indicator trends, data analysis, continuous monitoring of testing methods and management review. To date, while inspected several times by FDA, we have not received any findings of violations or inspection citations on FDA’s Form 483.

The management team at each of our licensed and permitted laboratory facilities ensures that equipment and reagents are properly selected, qualified, maintained and disposed of according to established procedures and manufacturer's instructions. All clinical assays performed in our laboratories are validated per applicable state and federal regulations prior to being processed in the laboratory as diagnostic testing services. We provide training for all personnel as required under CLIA and applicable state clinical laboratory regulations, which includes comprehensive training on our QMS, assigned work processes and technical procedures. We also provide continuing education programs for the ongoing professional development of all laboratory employees.

Quality indicators, which are metrics related to ensuring accurate and reliable test results, are routinely tracked at each of our facilities and are compared to previously determined benchmarks. These indicators are reviewed periodically by our clinical management team and include key performance indicators (such as test volume, turn-around-time (TAT), number of abnormal case, number of failures), non-conformance indicators (deviations, corrective and preventives actions), proficiency testing reports, and customer satisfaction surveys. We leverage third-party provided proficiency testing whenever practicable to provide objective analysis of our QMS and procedures, and we implement internal review protocols for assays for which third-party proficiency testing is not available.

Our facilities and QMS are audited internally on a periodic basis for compliance with applicable regulations, policies, analytical plans and internal standard operating procedures. Any needed revisions to the QMS that are identified through these audits are made to ensure continued compliance with applicable standards, and we believe that all pertinent regulations of the Clinical Laboratory Improvement Amendments (CLIA), Centers for Diseases Control (CDC) Occupational Safety and Health Administration (OSHA), Environmental Protection Agency (EPA), and FDA are satisfied within our QMS.

Customer satisfaction is another key to successful implementation of our QMS. We routinely monitor customer input and complaints, and actively solicit feedback from customers by way of survey. Our management team encourages employees to communicate any concerns they may have with respect to scientific misconduct, quality and safety.

In addition to maintaining a robust QMS, we have defined a plan approved by the Business Continuity Plan Team that covers a wide range of disaster recovery and business continuity issues including data recovery. Both the business continuity and disaster recovery plans are reviewed on an annual basis.

Third-Party Payor Reimbursement

Depending on the billing arrangement and applicable law, we may be reimbursed for clinical services by: third-party payors that provide coverage to the patient, such as an insurance company, managed care organization or a governmental payor program; physicians or other authorized parties (such as hospitals or independent laboratories) that order testing service or otherwise refer the services to us; or the patient. In 2018, we derived approximately 8% of our total revenue from Medicare and 19% of our total revenue from other third party payors that includes managed care organizations and other health care providers. In 2017, we derived approximately 25% of our total revenue from other third party payors, including managed care organizations and other health care insurance providers, and 12% from Medicare.We are not currently reimbursed by any party for testing or clinical services performed in the European Union on samples from EU persons, and therefore we believe we are not yet subject to reimbursement and pricing requirements under European Economic Area (“EEA”) or EEA member state law.

Regulation

In the United States, where there is a coverage policy, contract or agreement in place, we bill the third-party payor, the hospital


or referring laboratory as well as the patient (for deductibles and coinsurance or copayments, where applicable) in accordance with the policy, contractual terms and applicable law. Where there is no coverage policy, contract or agreement in place, we pursue reimbursement on behalf of each patient on a case-by-case basis and rely on applicable billing standards to guide our claims. In addition, we have implemented a patient financial assistance program (CGI MAP Program) that is consistent with Federal guidelines. In states that have so-called “direct billing” laws, which require clinical laboratories to submit invoices directly to the patient, and not through the physician or health care provider, we comply with such requirements.

We are reimbursed for three categories of tests: (1) genetic and molecular testing; (2) anatomic pathology and immunohistochemistry testing and (3) general immunology and flow cytometry. In the United States, reimbursement under the Medicare program for the diagnostic services that we offer is based on either the Medicare Physician Fee Schedule (PFS) or Medicare Clinical Laboratory Fee Schedule (CLFS). The PFS is subject to geographic adjustments and is updated annually; this was the case for the CLFS, as well, until January 1, 2018. Starting January 1, 2018, the CLFS is updated every three years, and it is not subject to geographic adjustments or multifactor productivity adjustments. Medical services provided to Medicare beneficiaries that are performed by physicians or that require a degree of physician supervision or other involvement, such as pathology tests, are generally reimbursed under the Medicare PFS, whereas clinical diagnostic laboratory tests are generally reimbursed under the CLFS. Most of the services that we provide for Medicare beneficiaries are for genetic and molecular testing, which are reimbursed as clinical diagnostic laboratory tests under the CLFS. There is currently no copayment or deductible required for tests paid under the CLFS, although Congress periodically has considered implementing such a requirement. Services paid for under the PFS are subject to copayments and deductibles.

In addition, Congress routinely lowered or eliminated the update factor that would otherwise apply to the applicable CLFS payment. For example, under the health care reform legislation, passed in 2010, payments under the CLFS were reduced by 1.75% through 2015 and, in addition, a productivity adjustment, further reducing payment rates also was imposed. In addition, in February 2012, Congress passed the Middle Class Tax Relief and Job Creation Act of 2012, which required that the CLFS be “rebased” by -2%. As a result of these changes, for 2015 the CLFS was reduced by -.25%.

In 2014, Congress passed the Protecting Access to Medicare Act (PAMA) which changes the way CMS establishes Medicare reimbursement rates for clinical laboratory services under the CLFS. Under PAMA Sec. 216, certain laboratories (including our laboratories that provide clinical services) are required to report the amount that they are paid by private payors and the associated volumes for each test beginning in January 2017. CMS is to use this data to calculate a weighted median for each test. The first data collection period was January 1 through June 30, 2016, private payor rates and the associated volumes were reported to CMS between January 1 and May 30, 2017, and the new rates became effective on January 1, 2018. The law limits the amount by which a CLFS reimbursement rate can be reduce from year to year (10 percent in each of the first three years and 15 percent in each of the three subsequent years). This data collection and reporting process will be repeated every three years for most tests, although price and volume data for Advanced Diagnostic Laboratory Tests (ADLTs) will be reported every year ADLTs receive special payment treatment under the law, being paid initially at the test’s actual list price, and afterwards having the weighted median adjusted annually to closely reflect the current private payor market. A test that meets the definition of an ADLT does not automatically become one under PAMA; rather, the laboratory offering the test voluntarily applies for ADLT designation for such a test. It is possible that some of our tests could be considered ADLTs, which will require us to report prices annually. In addition, we may also be required to obtain a code from CMS or an entity that it designates for our tests that have not previously had a code.

Tests that meet the criteria for being considered new advanced tests will be paid at actual list charge during an initial period of three calendar quarters. Once the initial period is over, payment for new, advanced tests would be based on the weighted median private payor rate reported by the single laboratory that performs the new ADLT. Advanced tests are tests furnished by only one laboratory that include a unique algorithm and, at a minimum, are an analysis of RNA, DNA or proteins or are cleared or approved by the FDA. Applicable laboratories must report data that includes the payment rate (reflecting all discounts, rebates, coupons and other price concessions) and the volume of each test that was paid by each private payor (including health insurance issuers, group health plans, Medicare Advantage plans and Medicaid managed care organizations). The definition of “applicable” lab may exclude certain types of laboratories that generally received more favorable pricing than other laboratories, and thus the make-up of laboratories reporting pricing data to CMS under the proposed rule may result in lower overall pricing data. Beginning in 2017, the Medicare payment rate for each clinical diagnostic lab test is equal to the weighted median amount for the test from the most recent data collection period. For example, laboratories were required to collect private payor data from January 1, 2016 through June 30, 2016 and report it to CMS by March 31, 2017. The new Medicare CLFS rates (based on weighted median private payor rates) were released in November 2017 and were effective on January 1, 2018. Also for the years 2017 through 2019, the amount of reduction in the Medicare rate (if any) shall not exceed 10 percent from the prior year’s rate and for the years 2020 through 2022, any reduction shall not exceed 15 percent from the prior year’s rate. It is too early to predict the impact on reimbursement for our tests reimbursed under the CLFS, though we believe the government’s goal is to reduce Medicare program payments for CLFS tests. Specifically, CMS states that it anticipates the

effect of the proposed rule on the Medicare program to save $360 million in program payments for CLFS tests furnished in FY 2017, and to save $5.14 billion over 10 years. CMS has also proposed that a laboratory’s failure to comply with reporting obligations, or a laboratory that makes a misrepresentation or omission in reporting required information, would be a violation of the Civil Monetary Penalties Law. Also under PAMA, CMS is required to adopt temporary billing codes to identify new tests and new advanced diagnostic laboratory tests that have been cleared or approved by the FDA. For an existing test that is cleared or approved by the FDA and for which Medicare payment is made, CMS is required to assign a unique billing code if one has not already been assigned by the agency. Further, PAMA provides special payment status to “advanced diagnostic laboratory tests,” or ADLTs, to allow such ADLTs to be paid using their actual list charge amount during a certain time frame. We cannot determine at this time the full impact of the new law on our business, financial condition and results of operations. CMS also adopts regulations and policies, from time to time, revising, limiting or excluding coverage or reimbursement for certain of the tests that we perform. Likewise, many state governments are under budget pressures and are also considering reductions to their Medicaid fees. Further, Medicare, Medicaid and other third party payors audit for overutilization of billed services. Even though all tests performed by us are ordered by our clients, who are responsible for establishing the medical necessity for the tests ordered, we may be subject to recoupment of payments, as the recipient of the payments for such tests, in the event that a third party payor such as CMS determines that the tests failed to meet all applicable criteria for payment. When third party payors like CMS revise their coverage regulations or policies, our costs generally increase due to the complexity of complying with additional administrative requirements. Furthermore, Medicaid reimbursement and regulations vary by state. Accordingly, we are subject to varying administrative and billing regulations, which also increase the complexity of servicing such programs and our administrative costs. Finally, state budget pressures have encouraged states to consider several courses that may impact our business, such as delaying payments, restricting coverage eligibility, service coverage restrictions and imposing taxes on our services.

Certain of our tests are paid under the Medicare PFS, rather than the CLFS. Tests paid for under the PFS are based on “relative value units” (RVUs) established for each service. These RVUs are then multiplied by a conversion factor to arrive at a monetary amount. Until recently, each year, CMS calculated an update to this conversion factor based on a formula included in the Medicare law, referred to as the Sustainable Growth Rate (SGR) Formula. When it applied, this SGR formula often would require a decrease in reimbursement unless Congress acted to overturn this result. As a result, Congress consistently passed legislation to prevent implementation of significant cuts that would otherwise be effective. For 2014, CMS had projected the reimbursement cut resulting from the SGR formula would be approximately 20 percent, unless Congress acted to prevent the reduction.

On April 16, 2015, President Obama signed the Medicare and CHIP Reauthorization Act (MACRA. MACRA repealed the provisions related to the Medicare SGR formula and implements a new physician payment system that is designed to reward the quality of care. In addition, it extended the current Medicare Physician Fee Schedule rates through June 2015, and then increased them by 0.5 percent for the remainder of 2015. Beginning on January 1, 2016, the rates are scheduled to increase annually by 0.5 percent, through 2019. For 2020 through 2025 payments will be frozen, although payment will be adjusted to account for performance on certain quality metrics under the Merit-Based Incentive Payment Systems (MIPS) or to reflect physician participation in alternative payment models (APMs). For 2026 and subsequent years, qualified APM participants receive an annual 0.75% update on Medicare physician payment rates, while those not participating receive a 0.25% annual payment update, plus any applicable MIPS-based payment adjustments. It is too early to determine how these changes may impact our business.

On October 30, 2015, CMS issued the Medicare Physician Fee Schedule Final Rule for 2016, which set out policies that were effective January 2016. Among those policy changes are reductions in the payments for flow cytometry and immunohistochemistry, two types of tests that we frequently perform. CMS has also stated that certain of these same tests may be considered "misvalued" which means they could be subject to additional scrutiny in the future. The CY 2017 Physician Fee Schedule final rule reduced reimbursement rates for flow cytometry by approximately 19%. However, CMS did not finalize its proposal to combine flow cytometry codes 88184 and 88185 into one code. In the CY 2018 Physician Fee Schedule final rule, reimbursement for flow cytometry (additional markers) and immunohistochemistry was reduced further. At this time, we are still assessing the potential impact of these changes. On July 12, 2018, CMS proposed a change to the definition of “applicable lab” in the 2019 Physician Fee Schedule Proposed Rule to include a broader category of laboratories and may alter our reimbursement in ways that are unforeseeable at this time.

Medicare also has policies that may limit when we can bill directly for our services and when we must instead bill another provider, such as a hospital. When the testing that we perform is done on a specimen that was collected while the patient was in the hospital, as either an inpatient or outpatient, we may be required to bill the hospital for some of our services, rather than the Medicare program, depending on whether or not the service was ordered more than 14 days after the patient’s discharge from the hospital and depending on the nature of the test. In the CY 2018 Outpatient Prospective Payment System final rule, CMS finalized a policy that permits a laboratory to bill the Medicare program directly for molecular pathology tests and ADLTs

under certain conditions: (1) the test is performed following the hospital outpatient’s discharge; (2) the specimen was collected during a hospital encounter; (3) it was medically appropriate to have collected the specimen during the hospital encounter; (4) the results of the test do not guide treatment during the hospital encounter; and (5) the test was reasonable and medically necessary for treatment of an illness. These requirements are complex and time-consuming and, depending on what they require, and the administrative burden associated with these requirements may affect our ability to collect for our services.

In addition, as part of the Middle Class Tax Relief and Job Creation Act of 2012, signed into law by President Obama on February 22, 2012, Congress eliminated the special billing rule that had allowed laboratories to bill Medicare for the technical component of certain pathology services furnished to patients of qualifying hospitals. Effective July 1, 2012, independent laboratories, like our laboratories, are required to bill the hospital, rather than the Medicare Program, for the technical component of these services in most instances.

Our reimbursement rates from private third-party payors can vary based on whether we are considered to be an “in-network” provider, a participating provider, a covered provider or an “out-of-network” provider. These definitions can vary from insurance company to insurance company, but we are generally considered an “out of network” or non- participating provider in the vast majority of our cases. It is not unusual for a company that offers highly specialized or unique testing to be an “out of network” provider. An “in-network” provider usually has a contracted arrangement with the insurance company or benefits provider. This contract governs, among other things, service-level agreements and reimbursement rates. In certain instances an insurance company may negotiate an “in-network” rate for our testing rather than pay the typical “out-of-network” rate. An “in-network” provider usually has rates that are lower per test than those that are “out-of-network”, and that rate is based on the Medicare CLFS. The discount rate varies based on the insurance company, the testing type and the often times the specifics of the patient’s insurance plan. The varying rates may affect our ability to receive reimbursement that is sufficient to cover the costs of our services.

We have contracts with commercial insurance carriers that provide access to certain of our tests. When a test is covered as part of these contracts it is paid at the rate stated in the contract. The Company also has preferred provider agreements and when a claim is processed through one of these organizations, reimbursement is based on usual and customary fees in the specific geography with a discount applied. It is not clear at this time the effect geographic rate variance will have on our business.

Billing Codes for Third-Party Payor Reimbursement

CPT codes are the main data code set used by physicians, hospitals, laboratories and other health care professionals to report separately-payable clinical laboratory tests for reimbursement purposes. The CPT coding system is maintained and updated on an annual basis by the American Medical Association. Although there is no specific code to report microarrays for oncology, such as our MatBA®-CLL, there are existing codes that describe all of the steps in our MatBA®-CLL testing process. We currently use a combination of different codes to describe the various steps in our testing process. Many of the CPT codes used to bill for molecular pathology tests such as ours have been significantly revised by the CPT Code Editorial Panel. These new codes replace the more general “stacking” codes that were previously used to bill for these services with more test-specific codes, which became effective January 2013. In the CY 2013 Physician Fee Schedule Final Rule, which was issued in November 2012, CMS stated that it had determined it would pay for molecular pathology tests as clinical laboratory tests, which are payable on the Clinical Laboratory Fee Schedule (CLFS), rather than as physician services payable under the Physician Fee Schedule (PFS). CMS also stated that it would “gapfill” the new codes; that is, ask the contractors to determine a reasonable price for the new codes. This process was completed in 2013. Starting January 1, 2018, these codes have been priced based on the weighted median of private payor rates reported to CMS by certain laboratories, in the same way that all other tests on the CLFS are.

Among the codes that have been created by the American Medical Association’s CPT Editorial Panel is a specific subset of codes called Multi-analyte Assays with Algorithmic Analysis (MAAAs). These tests typically use an algorithm applied to certain specific components to arrive at a score that is used to predict a particular clinical outcome. CMS stated that it will not issue a categorical determination for all MAAA tests, but will consider on its own merits each individual test that is classified by the CPT as a MAAA. On September 25, 2015, CMS released its Preliminary Determinations for new CPT codes effective in 2016, including several new MAAA CPT codes. CMS had proposed "crosswalking" these codes to an unrelated test, resulting in a significant cut in their reimbursement. However, on November 17, 2015, CMS reversed its policy and directed that the tests be gapfilled by the local contractors. It is expected that many of these MAAA codes may be considered and reimbursed as ADLTs For 2017, none of our revenue was derived from tests that may be considered MAAAs.

As of January 1, 2014 we are utilizing the “Not Otherwise Classified” (NOC) codes when billing for some of our MAAAtests. The reimbursement policies for the NOC codes vary from payor to payor with regard to specific tests, although some payors adopt other payors’ policies as their own. This extends our revenue cycle for these particular tests, where the normal timeframe for reimbursement of a claim is approximately 90 to 180 days. These tests can take upwards of a year or more to be reimbursed. There can be no guarantees that Medicare and other payors will establish positive or adequate coverage policies or reimbursement rates

in the future. We continue to work with Medicare and managed care plans to obtain billing codes for our tests, however it is uncertain to determine the results of these efforts. A specific code for our tests does not assure an adequate coverage policy or reimbursement rate. Please see the section entitled “Legislative and Regulatory Changes Impacting Clinical Laboratory Tests” for further discussion of certain legislative and regulatory changes to these billing codes and the impact on our business.

Coverage and Reimbursement for Our Proprietary Tests

We have been able to receive reimbursement for our tests from some payors based on their established policies, including major commercial third-party payors.

The current landscape with payors is generally as follows:

Commercial Third-party Payors and Patient Pay. Where there is a coverage policy in place, we bill the payor and the patient in accordance with the established policy and state and federal law. Where there is no coverage policy in place, we pursue reimbursement on behalf of each patient on a case-by-case basis. Our efforts in obtaining reimbursement based on individual claims, including pursuing appeals or reconsiderations of claims denials, take a substantial amount of time, and bills may not be paid for many months, if at all. Furthermore, if a third-party payor denies coverage after final appeal, payment may not be received at all. We are working to decrease risks of nonpayment by implementing a revenue cycle management system. Third party payors are still establishing payment policies for panel-based tests.

Medicare and Medicaid. We believe that as much as 30% to 40% of our future market for our tests may be derived from patients covered by Medicare and Medicaid.

We cannot predict whether, or under what circumstances, payors will reimburse our proprietary tests. Payment amounts can also vary across individual policies. Denial of coverage by payors, or reimbursement at inadequate levels, would have a material adverse impact on market acceptance of our tests. Payors who currently reimburse us for our tests may decide not to in the future. We cannot predict which payors who currently cover our tests will continue to do so in the future.

Legislative and Regulatory Changes Impacting Clinical Laboratory Tests

From time to time, Congress has revised the Medicare statute and the formulas it establishes for both the Medicare Clinical Laboratory Fee Schedule (CLFS) and the Physician Fee Schedule (PFS). The payment amounts under the Medicare fee schedules are important not only for our reimbursement under Medicare, but also because the schedules often are used as a basis for establishing the payment amounts set by other third party payors. For example, state Medicaid programs are prohibited from paying more than the Medicare fee schedule limit for clinical laboratory services furnished to Medicaid recipients.

Until December 31, 2017, under the statutory formula for clinical laboratory fee schedule amounts, increases were made annually based on the Consumer Price Index for All Urban Consumers (CPI-U) as of June 30 for the previous twelve-month period. From 2004 through 2008, Congress eliminated the CPI-U update in the Medicare Prescription Drug, Improvement and Modernization Act of 2003. In addition, for years 2009 through 2013, the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”) mandated a 0.5% cut to the CPI-U. Accordingly, the update for 2009 was reduced to 4.5% and negative 1.9% for 2010. In March 2010, President Obama signed into law the Affordable Care Act (ACA), which, among other things, imposed additional cuts to the Medicare reimbursement for clinical laboratories. The ACA replaced the 0.5% cut enacted by MIPPA with a “productivity adjustment” that reduced the CPI-U update in payments for clinical laboratory tests. In 2011, the productivity adjustment was -1.2%. In addition, the ACA included a separate 1.75% reduction in the CPI-U update for clinical laboratories for the years 2011 through 2015. On February 22, 2012, President Obama signed the MCTRJCA, which mandated an additional change in reimbursement for clinical laboratory services payments. This legislation required CMS to reduce the Medicare clinical laboratory fee schedule by 2% in 2013, which in turn served as a base for 2014 and subsequent years. Based on the changes required by ACA and MCTRJCA, payment for clinical laboratory services were reduced by approximately 0.25% for 2015.

With respect to our diagnostic services for which we are reimbursed under the Medicare Physician Fee Schedule, because of the statutory formula, the “Sustainable Growth Rate” (SGR), the rates would have decreased for the past several years if Congress failed to intervene. In the past, when the application of the statutory formula resulted in lower payment, Congress has passed interim legislation to prevent the reductions. On November 1, 2012, the Centers for Medicare & Medicaid Services(CMS) issued its CY 2013 Medicare PFS Final Rule. In that rule, CMS called for a reduction of approximately 26.5% in the 2013 conversion factor that is used to calculate physician reimbursement. However, the American Taxpayer Relief Act of 2012, which was signed into law on January 2, 2013, prevented this proposed reduction and kept the existing reimbursement rate in effect until December 31, 2013.


For 2014, CMS projected the cut to reimbursement for services furnished under the PFS would be about 24%, unless Congress acted. However, on December 18, 2013, Congress passed legislation that enacted a 0.5% update in the conversion factor, which will be effective until March 31, 2014.On April 1, 2014, President Obama signed the Protecting Access to Medicare Act of 2014, or PAMA. PAMA extended the 0.5 percent increase through March 31, 2015 and made other changes to laboratory reimbursement discussed below. As discussed above, on April 16, 2015, President Obama signed MACRA, which replaces the SGR process with an alternative payment system.

In addition to the reductions described above, our Medicare payments under both the CLFS and the PFS are also subject to an additional 2% reduction, as a result of “sequestration.” Payments are reduced automatically because the Joint Select Committee on Deficit Reduction, which was created by congress in 2011, was unable to agree on a set of deficit reduction recommendations for Congress to vote on. The reduction is scheduled to continue until 2025.

For the years ended December 31, 2018 and December 31, 2017, approximately 8% and 12%, respectively, of our total revenues are derived from Medicare generally and any changes to the physician fee schedule that result in a decrease in payment could adversely impact our revenues and results of operations.

In addition, periodically CMS also changes its payment policies related to laboratory reimbursement in ways that could have an impact on the revenues of the Company. For example, in CY 2013 PFS Final Rule, CMS included a reduction of certain relative value units and geographic adjustment factors used to determine reimbursement for a number of commonly used pathology codes, including CPT codes 88300, 88302, 88304, and 88305. In particular, the CY 2013 PFS Final Rule implemented a cut of approximately 33% in the global billing code for 88305 and a 52% cut in the Technical Component of that code. These codes describe services that we must perform in connection with our tests and we bill for these codes in connection with the services that we provide. In the CY 2013 PFS Final Rule, CMS also announced how it intended to set prices for the new molecular diagnostic tests, for which the American Medical Association had adopted over 100 new codes. In that rule, CMS announced it intended to continue to pay for the new molecular codes on the CLFS rather than move them to the Physician Fee Schedule, as some stakeholders had urged. It would then request that the Medicare Administrative Contractors “gapfill” the new codes and set an appropriate price for them. That “gapfilling” process took place over 2013 and CMS announced the new prices for these codes in September, 2013. The median of the prices set by the contractors became the new prices for these codes, effective January 1, 2014.

In the CY 2014 PFS Proposed Rule, issued on July 8, 2013, CMS made two proposals that could affect laboratory reimbursement. First, CMS made a proposal to change how it establishes the RVUs used to calculate payments under the PFS. Under this proposal, where a service was paid at a lower rate in the hospital based on the hospital Outpatient Prospective Payment System (OPPS) than it is under the PFS, CMS proposed to reduce the RVUs for that service in order to equalize the payment between the two systems. This change, if implemented, would have resulted in approximately a 25% cut in aggregate payments to independent laboratories. In the CY 2014 PFS Final Rule, however, CMS chose not to implement this proposal, although it stated that it would develop a revised proposal in the future. At this point, it is impossible to know what the impact of such a proposal might be on the Company, were it to be proposed again and finalized.

In addition, in the CY 2014 PFS Proposed Rule, CMS also noted that payments for many codes paid under the Clinical Laboratory Fee Schedule have not been revised to reflect technological advances that have occurred since the CLFS was first developed in 1984. The Social Security Act gave the Secretary of Health and Human Services, acting through CMS, the authority to adjust prices on the CLFS that the Secretary believed were “justified by technological changes.” CMS therefore proposed that it would begin to review all codes on the CLFS and adjust them to reflect technological changes, a process that it expected would take about five years. However, in April of 2014, Congress passed the Protecting Access to Medicare Act (PAMA), which eliminated that provision of the Social Security Act and, consequently, the Secretary’s authority to implement its plan to adjust payments based on technological advances.

In PAMA, Congress also changed the way CMS establishes Medicare reimbursement rates for clinical laboratory services on the CLFS. Under PAMA Sec. 216, certain laboratories are required to report the amount that they are paid by third party payors and the associated volume for each test on the CLFS beginning in January 2016. CMS will use this data to calculate a weighted median for each test. The first data collection period was January 1 through June 30, 2016, private payor rates and associated volumes were reported between January 1 and May 30, 2017, and the new rates became effective on January 1, 2018. The law limits the amount by which a CLFS reimbursement rate can be reduced from year to year (10 percent in each of the first three years and 15 percent in each of the three subsequent years). This data collection and reporting process will be repeated every three years for most tests, although laboratories that offer Advanced Diagnostic Laboratory Tests (“ADLTs”) will report private payor rates for those tests every year. A test that meets the definition of an ADLT does not automatically become one under PAMA; rather, the laboratory offering the test voluntarily applies for ADLT designation for such a test. It is possible that some of our tests could be considered ADLTs, and if we applied for ADLT designation for such tests, we would be required to report prices for those tests

annually. In addition, we may also be required to obtain a code from CMS or an entity that it designates for our tests that have not previously had a unique code.

CMS made several other changes in recent Medicare PFS rules that impact our business. In the CY 2015 PFS Final Rule, CMS implemented a policy that bundles payment for the examination of 10 or more prostate biopsies for an individual patient, rather than paying separately for each individual procedure as had been done previously. This will result in a significant reduction in reimbursement on each of these procedures. That year it also developed new prices for Immunohistochemistry procedures, based on new CPT codes that were developed to describe the procedures. In the CY 2016 final rule, CMS finalized standard times for certain pathology clinical labor tasks, and in the CY 2017 final rule, it said it may adopt standard times for other pathology labor tasks in the future. In 2014, CMS also implemented an edit under its National Correct Coding Initiative, under which it will pay only for a single unit of service when we perform a FISH (Fluorescent In Situ Hybridization) test. As many FISH tests require two or more probes, this change will also reduce the reimbursement received by the Company.

Further, with respect to the Medicare Program, Congress has proposed on several occasions to impose a 20% coinsurance on patients for clinical laboratory tests reimbursed under CLFS, which would require us to bill patients for these amounts. Because of the relatively low reimbursement for many clinical laboratory tests, in the event that Congress ever were to enact such legislation, the cost of billing and collecting for these services would often exceed the amount actually received from the patient and effectively increase our costs of billing and collecting.

Finally, some of our Medicare claims may be subject to policies issued by Palmetto GBA, the current Medicare Administrative Contractor for Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. In 2013, Palmetto issued a Local Coverage Determination that affects coverage, coding and billing of many molecular diagnostic tests. Under this Local Coverage Determination, Palmetto will not cover any molecular diagnostic tests, including our tests, unless the test is expressly included in a National Coverage Determination issued by CMS or a Local Coverage Determination or coverage article issued by Palmetto. Currently, laboratory providers may submit coverage determination requests to Palmetto for consideration and apply for a unique billing code for each test (which is a separate process from the coverage determination). In the event that a non-coverage determination is issued, the laboratory must wait six months following the determination to submit a new request. In addition, effective May 1, 2012, Palmetto implemented the Molecular Diagnostic Services Program (“MolDx”), under which, among other things, a laboratory must use a newly-assigned unique test identifier when submitting a claim for a molecular test. These unique test identifiers enable Palmetto to measure utilization and apply coverage determinations. Denial of coverage by Palmetto, or reimbursement at inadequate levels, would have a material adverse impact on market acceptance of our tests. Certain other Medicare contractors are also following the policies adopted by Palmetto for molecular diagnostic tests.

Governmental Regulations

Clinical Laboratory Improvement Amendments of 1988 and State Regulation

As a diagnostic service provider, we are required to hold certain federal, state and local licenses, certifications and permits to conduct our business. As to federal certifications, in 1988, Congress passed the Clinical Laboratory Improvement Amendments (“CLIA”) establishing quality standards for all laboratories testing to ensure the accuracy, reliability and timeliness of patient test results regardless of where the test was performed. Our U.S.-based laboratories are CLIA accredited. Under CLIA, a laboratory is defined as any facility which performs laboratory testing on specimens derived from humans for the purpose of providing information for the diagnosis, prevention or treatment of disease, or the impairment of, or assessment of health. CLIA also requires that we hold a certificate applicable to the type of work we perform and comply with certain standards. CLIA further regulates virtually all clinical laboratories by requiring they be accredited by the federal government and comply with various operational, personnel, facilities administration, quality and proficiency requirements intended to ensure that their clinical laboratory testing services are accurate, reliable and timely. CLIA compliance and accreditation is also a prerequisite to be eligible to receive payment for services provided to governmental payor program beneficiaries. CLIA is user-fee funded. Therefore, all costs of administering the program must be covered by the regulated facilities, including certification and survey costs.

We are subject to survey and inspection every two years to assess compliance with program standards, and may be subject to additional unannounced inspections. Laboratories performing high complexity testing are required to meet more stringent requirements than laboratories performing less complex tests. In addition, a laboratory like ours that is certified as “high complexity” under CLIA may obtain analyte specific reagents, which are used as the basis for diagnostic tests that are developed and validated for use in examinations the laboratory performs itself known as laboratory-developed tests (“LDTs”).

We participate in the oversight program of the College of American Pathologists (“CAP”). Under CMS requirements, accreditation by CAP is sufficient to satisfy the requirements of CLIA. Therefore, because we are accredited by CAP, we are deemed to also comply with CLIA.

CLIA also provides that a state may adopt laboratory regulations that are more stringent than those under federal law, and a number of states have implemented their own more stringent laboratory regulatory schemes. State laws may require that laboratory personnel meet certain qualifications, specify certain quality controls, or prescribe record maintenance requirements. Our clinical operations at our Rutherford laboratory are required to meet certain state laboratory licensing and other requirements, which in some areas are more stringent than CLIA requirements. Our laboratories are required hold the required licenses and accreditations obtained from the applicable state agencies in which we operate. Two states, New York and Washington, are CLIA-exempt, however, and as such have their own regulatory requirements to which we may be subject to. CMS deemed both New York and Washington as CLIA-exempt because their licensing and supervisory programs are more stringent than that run by CMS and the CDC. New York requires clinical laboratories who accept specimens from New York residents to have both a CLIA and New York Clinical Laboratory Evaluation Program (CLEP) permit. CLEP approval can take up to a year, and can be costly and time consuming. Washington State does not require clinical laboratories to have a CLIA permit, but does require the clinical laboratory to apply for a Washington State lab permit. In general, several state clinical laboratory laws generally require that laboratories and/or laboratory personnel meet certain qualifications. State clinical laboratory laws also generally require laboratories to develop certain quality assurance metrics and to maintain certain records. Several states, including Rhode Island, Florida, Maryland, New York and Pennsylvania, require that clinical laboratories hold “out of state” licenses or permits to test specimens from patients residing in those states, even though the laboratory is not located in such state. From time to time, other states may require out of state laboratories to obtain licensure in order to accept specimens from the state. If we identify any other state with such requirements or if we are contacted by any other state advising us of such requirements, we intend to follow instructions from the state regulators as to how we should comply with such requirements. In addition, the New York Department of Health separately approves certain LDTs offered to New York State patients. The Company has obtained the requisite approvals for its LDTs.

Our Rutherford, New Jersey laboratory is licensed and in good standing under the State Departments of Health standards for New Jersey, New York, Pennsylvania, California, Florida and Maryland. If we are found to be out of compliance with applicable federal and state statutory or regulatory standards we may be subject to suspension, restriction or revocation of our laboratory license, civil money penalties, and temporary revocation of Medicare billing privileges. A noncompliant laboratory may also be found guilty of a misdemeanor under applicable state laws. A finding of noncompliance, therefore, may result in harm to our business.

Our Hershey, Pennsylvania and Melbourne, Australia research laboratory facilities comply with Good Laboratory Practices (“GLP”) to the extent required by the FDA, Environmental Protection Agency, USDA, Organization for Economic Co-operation and Development (OECD), as well as other international regulatory agencies. Furthermore, our early-stage discovery work, which is not subject to GLP standards, is typically carried out under a quality management system or internally developed quality systems. Our facilities are regularly inspected by U.S. and other regulatory compliance monitoring authorities, our clients' quality assurance departments, and our own internal quality assessment program. We are also accredited by AAALAC International, a private, nonprofit organization that promotes the humane treatment of animals in science through voluntary accreditation and assessment programs. We volunteer to participate in the AAALAC’s program to demonstrate our commitment to responsible animal care and use, in addition to our compliance with local, state and federal laws that regulate animal research.

FDA

The U.S. Food and Drug Administration (“FDA”) regulates the sale or distribution, in interstate commerce, of medical devicesdrugs under the Federal Food, Drug, and Cosmetic Act and its implementing regulations (“FDCA”),. The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local and foreign statutes and regulations require the expenditure of substantial time and financial resources. Failure to comply with the applicable U.S. requirements at any time during the product development process, approval process or after approval may subject an applicant to administrative or judicial sanctions. These sanctions could include the FDA’s refusal to approve pending applications, withdrawal of an approval, a clinical hold, warning letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, refusals of government contracts, restitution, disgorgement or civil or criminal penalties. Any agency or judicial enforcement action could have a material adverse effect on us.

Once a drug candidate is identified for development, it enters the preclinical testing stage. Preclinical tests include laboratory evaluations of product chemistry, toxicity and formulation, as well as animal studies. An ND sponsor must submit the results of the preclinical tests, together with manufacturing information and analytical data, to FDA as part of the IND. The sponsor must also include a protocol detailing, among other things, the objectives of the first phase of clinical trials, the parameters to be used in monitoring the safety of the trial, and the effectiveness criteria to be evaluated should the first phase lend itself to an efficacy evaluation. Some preclinical testing may continue even after the IND is submitted. The IND automatically becomes effective thirty (30) days after receipt by FDA, unless FDA, within the 30-day time period, places the clinical trial on a clinical hold. Clinical holds also may be imposed by the FDA at any time before or during clinical trials due to safety concerns about on-going or proposed clinical trials or non-compliance with specific FDA requirements, and the trials may not begin or continue until the FDA notifies the sponsor that the hold has been lifted.

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All clinical trials must be conducted under the supervision of one or more qualified investigators in accordance with FDA good clinical practice (“GCP”) requirements, which include a requirement that all research subjects provide their informed consent in writing for their participation in any clinical trial. Clinical trials must be conducted under protocols detailing the objectives of the trial, dosing procedures, subject selection and exclusion criteria and the safety and/or effectiveness criteria to be evaluated. Each protocol must be submitted to FDA as part of the IND, and timely safety reports must be submitted to FDA and the investigators for serious and unexpected adverse events. An Institutional Review Board (“IRB”) at each institution participating in the clinical trial must review and approve each protocol before a clinical trial may commence at the institution and must also approve the information regarding the trial as well as the consent form that must be provided to each trial subject or his or her legal representative, monitor the study until completed and otherwise comply with all applicable IRB regulation.

Human clinical trials are typically conducted in three sequential phases that may overlap or be combined in certain cases:

Phase 1: The compound is initially introduced into healthy human subjects and tested for safety, dosage tolerance, absorption, metabolism, distribution and excretion and, if possible, to gain an early indication of its effectiveness. In most cases, initial Phase 1 clinical trials are conducted with healthy volunteers. However, where the compound being evaluated is for the treatment of severe or life-threatening diseases, such as cancer, and especially when the product may be too toxic to ethically administer to healthy volunteers, the initial human testing may be conducted on patients with the target disease or condition. Sponsors sometimes subdivide their Phase 1 clinical trials into Phase 1a and Phase 1b clinical trials. Phase 1b clinical trials are typically aimed at confirming dosage, pharmacokinetics and safety in a larger number of patients. Some Phase 1b studies evaluate biomarkers or surrogate markers that may be associated with efficacy in patients with specific types of diseases or conditions.

Phase 2: This phase involves clinical trials in a limited patient population to identify possible adverse effects and safety risks, to preliminarily evaluate the efficacy of the product for specific targeted diseases or conditions and to confirm dosage tolerance and appropriate dosage.

Phase 3: Phase 3 clinical trials are undertaken to further evaluate dosage, clinical efficacy and safety in an expanded patient population, generally at geographically dispersed clinical study sites. These clinical trials, often referred to as “pivotal” clinical trials, are intended to establish the overall risk-benefit ratio of the compound and provide, if appropriate, an adequate basis for product labeling.

FDA or the sponsor may suspend a clinical trial at any time on various grounds, including any finding that the research subjects or patients are being exposed to an unacceptable health risk. Similarly, an IRB can suspend or terminate approval of a clinical trial at its institution if the clinical trial is not being conducted in accordance with the IRB’s requirements or if the drug has been associated with unexpected, serious harm to study subjects. In addition, clinical trials may be overseen by an independent group of qualified experts organized by the sponsor, known as a data safety monitoring board or committee. Depending on its charter, this committee may determine whether a trial may move forward at designated check points based on access to certain data from the trial.

Post-approval trials may also be conducted after a drug receives initial marketing approval. These trials, often referred to as “Phase 4” trials, are used to gain additional experience from the treatment of patients in the intended therapeutic indication. In certain instances, FDA may mandate the performance of such clinical trials as a condition of approval of a drug.

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During the development of a new drug, sponsors are given several opportunities to meet with FDA. These meetings can provide an opportunity for the sponsor to share information about the progress of the application or clinical trials, for the FDA to provide advice, and for the sponsor and the FDA to reach agreement on the next phase of development. These meetings may occur prior to the submission of an IND, at the end of Phase 2 clinical trials, or before a New Drug Application (“NDA”) is ultimately submitted. Sponsors typically use the meetings at the end of the Phase 2 trials to discuss Phase 2 clinical results and present plans for the pivotal Phase 3 clinical trials that they believe will support approval of the new drug. Meetings at other times may be made upon request.

Concurrent with clinical trials, companies typically complete additional animal and laboratory studies, develop additional information about the chemistry and physical characteristics of the drug, and finalize a process for manufacturing the product in commercial quantities in accordance with FDA’s current Good Manufacturing Practices (“cGMP”) requirements. The manufacturing process must consistently produce quality batches of the drug, and, among other things, the manufacturer must develop methods for testing the identity, strength, quality and purity of the final drug. In addition, appropriate packaging must be selected and tested, and stability studies must be conducted to demonstrate the effectiveness of the packaging and that the compound does not undergo unacceptable deterioration over its shelf life.

While the IND is active, progress reports summarizing the results of ongoing clinical trials and nonclinical studies performed since the last progress report must be submitted on at least an annual basis to FDA, and written IND safety reports must be submitted to FDA and investigators for serious and unexpected adverse events, findings from other studies suggesting a significant risk to humans exposed to the same or similar drugs, findings from animal or in vitro diagnostic test kits, reagentstesting suggesting a significant risk to humans, and instruments usedany clinically important, increased incidence of a serious adverse reaction compared to perform diagnostic testing. Certainthat listed in the protocol or investigator brochure.

There are also requirements governing the submission of certain clinical trials and completed trial results to public registries. Sponsors of certain clinical trials of FDA-regulated products are required to register and disclose specified clinical trial registration and results information, which is made publicly available at www.clinicaltrials.gov. Failure to properly report clinical trial results can result in civil monetary penalties. Disclosure of clinical trial results can often be delayed until the new product or new indication being studied has been approved.

U.S. review and approval process

The results of product development, preclinical and other non-clinical studies and clinical trials, along with descriptions of the manufacturing process, analytical tests conducted on the chemistry of the drug, proposed labeling and other relevant information are submitted to FDA as part of an NDA. The submission of an NDA is subject to the payment of substantial user fees; a waiver of which may be obtained under certain limited circumstances.

FDA reviews NDAs to determine, among other things, whether the product is safe and effective for its intended use and whether it is manufactured in a cGMP-compliant manner, which will assure and preserve the product’s identity, strength, quality and purity. Under the Prescription Drug User Fee Act (“PDUFA”), FDA has a goal of ten months from the date of “filing” of a standard, completed NDA for a new molecular entity to review and act on the submission. This review typically takes twelve months from the date the NDA is submitted to FDA because FDA has approximately two months to make a “filing” decision after the application is submitted. FDA conducts a preliminary review of all NDAs within the first sixty days after submission, before accepting them for filing, to determine whether they are sufficiently complete to permit substantive review. FDA may request additional information rather than accept an NDA for filing. In this event, the NDA must be resubmitted with the additional information. The resubmitted application also is subject to review before the FDA accepts it for filing.

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FDA may refer an application for a new drug to an advisory committee within FDA. An advisory committee is a panel of independent experts, including clinicians and other scientific experts, that reviews, evaluates and provides a recommendation as to whether and under what conditions the application should be approved. FDA is not bound by the recommendations of such devices must undergo premarketan advisory committee, but it considers advisory committee recommendations carefully when making decisions.

Before approving an NDA, FDA will also inspect the facility where the product is manufactured. FDA will not approve an application unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and are adequate to assure consistent production of the product within required specifications. Before approving an NDA, FDA may also inspect one or more clinical trial sites to assure compliance with GCP requirements.

After the FDA evaluates an NDA, it will issue an approval letter or a Complete Response Letter. A Complete Response Letter indicates that the review cycle of the application is complete, and the application will not be approved in its present form. A Complete Response Letter usually describes the specific deficiencies in the NDA identified by FDA priorand may require additional clinical data, such as an additional pivotal Phase 3 trial or other significant and time-consuming requirements related to commercializationclinical trials, nonclinical studies or manufacturing. If a Complete Response Letter is issued, the sponsor must resubmit the NDA, addressing all of the deficiencies identified in the letter, or withdraw the application. Even if such data and information are submitted, FDA may decide that the NDA does not satisfy the criteria for approval. An approval letter authorizes commercial marketing of the drug with prescribing information for specific indications.

The Pediatric Research Equity Act (“PREA”) requires IND sponsors to conduct pediatric clinical trials for most drugs, for a new active ingredient, new indication, new dosage form, new dosing regimen or new route of administration. Under PREA, original NDAs and supplements must contain a pediatric assessment unless the devicesponsor has received a deferral or waiver. The required assessment must evaluate the safety and effectiveness of the product for the claimed indications in all relevant pediatric subpopulations and support dosing and administration for each pediatric subpopulation for which the product is safe and effective. The sponsor or FDA may request a deferral of pediatric clinical trials for some or all of the pediatric subpopulations. A deferral may be granted for several reasons, including a finding that the drug is ready for approval for use in adults before pediatric clinical trials are complete or that additional safety or effectiveness data needs to be collected before the pediatric clinical trials begin. FDA must send a non-compliance letter to any sponsor that fails to submit the required assessment, keep a deferral current or fails to submit a request for approval of a type exemptedpediatric formulation.

If a drug receives FDA approval, the approval may be limited to specific diseases and dosages, which could restrict the commercial value of the product. In addition, FDA may require testing and surveillance programs to monitor the safety of approved products which have been commercialized and may require a sponsor to conduct post-marketing clinical trials, which are designed to further assess a drug’s safety and effectiveness after NDA approval. FDA may also place other conditions on approval, including a requirement for a risk evaluation and mitigation strategy (“REMS”) to assure the safe use of the drug. If FDA concludes a REMS is needed, the sponsor of the NDA must submit a proposed REMS. FDA will not approve the NDA without an approved REMS, if required. A REMS could include medication guides, physician communication plans or elements to assure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. Any of these limitations on approval or marketing could restrict the commercial promotion, distribution, prescribing or dispensing of products. Marketing approval may be withdrawn for non-compliance with REMS or other regulatory requirements, or if problems occur following initial marketing.

Post-approval requirements

Once an approval is granted, FDA may withdraw the approval if compliance with regulatory standards is not maintained or if problems occur after the drug reaches the market. Later discovery of previously unknown problems with a drug may result in restrictions on the drug or even complete withdrawal of the drug from the market. After approval, some types of changes to the approved drug, such as adding new indications, certain manufacturing changes and additional labeling claims, are subject to further FDA review and approval. Manufacturers and other entities involved in the manufacture and distribution of approved drugs are required to register their establishments with FDA and certain state agencies and are subject to periodic unannounced inspections by statuteFDA and certain state agencies for compliance with cGMP regulations and other laws and regulations.

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Any drug product manufactured or distributed by us pursuant to FDA’s exerciseFDA approval will be subject to continuing regulation by FDA, including, among other things, record-keeping requirements, reporting of adverse experiences with the drug, providing FDA with updated safety and efficacy information, drug sampling and distribution requirements, complying with certain electronic records and signature requirements, and complying with FDA promotion and advertising requirements. FDA strictly regulates labeling, advertising, promotion and other types of information regarding approved drugs that are placed on the market, and imposes requirements and restrictions on drug manufacturers, such as those related to direct-to-consumer advertising, the prohibition on promoting products for uses or in patient populations that are not described in the product’s approved labeling (known as “off-label use”), industry-sponsored scientific and educational activities, and promotional activities involving the internet. Discovery of previously unknown problems or the failure to comply with the applicable regulatory requirements may result in restrictions on the marketing of a product for a certain indication or withdrawal of the product from the market as well as possible civil or criminal sanctions. Failure to comply with the applicable governmental requirements at any time during the product development process, approval process or after approval, may subject an applicant or manufacturer to administrative or judicial civil or criminal sanctions and adverse publicity. FDA sanctions could include refusal to approve pending applications, withdrawal of an approval, clinical holds on post-marketing clinical trials, enforcement discretion.letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, refusals of government contracts, mandated corrective advertising or communications with doctors, debarment, restitution, disgorgement of profits, or civil or criminal penalties.

Expedited development and review programs

The FDA to date, has not exercised its authority to actively regulateadministers a number of programs that can expedite the development and usereview of LDTsnew drugs.

The fast track designation program is intended to expedite or facilitate the process for reviewing new drug products that meet certain criteria. Specifically, new drugs are eligible for fast track designation if they are intended to treat a serious or life-threatening disease or condition and demonstrate the potential to address unmet medical needs for the disease or condition. With regard to a fast track product, FDA may consider for review sections of the NDA on a rolling basis before the complete application is submitted, if the sponsor provides a schedule for the submission of the sections of the NDA, FDA agrees to accept sections of the NDA and determines that the schedule is acceptable, and the sponsor pays any required user fees upon submission of the first section of the NDA.

A product is eligible for priority review if it is intended to treat a serious condition, and if approved, would provide a significant improvement in safety or efficacy compared to currently marketed products. FDA will attempt to direct additional resources to the evaluation of an application for a new drug designated for priority review in an effort to facilitate the review. FDA endeavors to review applications with priority review designations within six months of the filing date, as compared to ten months for review of NDAs under its current PDUFA review goals.

In addition, a product may be eligible for accelerated approval. Drugs intended to treat serious or life-threatening diseases or conditions may be eligible for accelerated approval upon a determination that the product has an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit, or on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that 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. As a condition of approval, the FDA may require that a sponsor of a drug receiving accelerated approval perform adequate and well-controlled post-marketing clinical trials. Drugs receiving accelerated approval may be subject to expedited withdrawal procedures if the sponsor fails to conduct the required post-marketing trials or if such trials fail to verify the predicted clinical benefit. In addition, the FDA currently requires as ours as medical devices and therefore we do not believe that our LDTs currently require premarket clearance or approval.


Section 1143a condition for accelerated approval pre-approval of promotional materials, which could adversely impact the timing of the commercial launch of the product.

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The Food and Drug Administration Safety and Innovation Act signed(“FDASIA”) established a category of drugs referred to as “breakthrough therapies” that may be eligible to receive breakthrough therapy designation. A sponsor may seek FDA designation of a compound as a “breakthrough therapy” if the product is intended, alone or in combination with one or more other products, to treat a serious or life-threatening disease or condition and preliminary clinical evidence indicates that the product may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. The designation includes all of the fast track program features, as well as more intensive FDA interaction and guidance. The breakthrough therapy designation is a distinct status from both accelerated approval and priority review, which can also be granted to the same drug if relevant criteria are met. If a product is designated as breakthrough therapy, FDA will work to expedite the development and review of such drug.

Fast track designation, priority review and breakthrough therapy designation do not change the standards for approval but may expedite the development or approval process. However, even if a product qualifies for one or more of these programs, FDA may later decide that the product no longer meets the conditions for qualification or decide that the time period for FDA review or approval will not be shortened.

Orphan drug designation

Under the Orphan Drug Act, FDA may grant orphan designation to a drug 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 a drug product available in the United States for this type of disease or condition will be recovered from sales of the product. Orphan designation must be requested before an NDA is submitted. After FDA grants orphan designation, the identity of the therapeutic agent and its potential orphan use are publicly disclosed by FDA. Orphan designation does not convey any advantage in or shorten the duration of the regulatory review and approval process.

If a product that has orphan designation subsequently receives the first FDA approval for the disease or condition for which it has such designation, the product is entitled to orphan product exclusivity, which means that FDA may not approve any other applications to market the same drug for the same indication for seven years, except in limited circumstances, such as a showing of clinical superiority to the product with orphan exclusivity or inability to manufacture the product in sufficient quantities. The designation of such drug also entitles a party to financial incentives such as opportunities for grant funding towards clinical trial costs, tax advantages and user-fee waivers. However, competitors, may receive approval of different products for the indication for which the orphan product has exclusivity or obtain approval for the same product but for a different indication for which the orphan product has exclusivity. Orphan exclusivity also could block the approval of one of our compounds for seven years if our compound is determined to be contained within the competitor’s product for the same indication or disease, or if a competitor obtains approval of the same drug as defined by the PresidentFDA. In addition, if an orphan designated product receives marketing approval for an indication broader than what is designated, it may not be entitled to orphan exclusivity.

Marketing exclusivity

Market exclusivity provisions under the FDCA can delay the submission or approval of certain marketing applications. The FDCA provides a five-year period of non-patent marketing exclusivity within the United States to the first applicant to obtain approval of an NDA for a new chemical entity. A drug is a new chemical entity if FDA has not previously approved any other new drug containing the same active moiety, which is the molecule or ion responsible for the action of the drug substance.

During the exclusivity period, the FDA may not approve or even accept for review an abbreviated new drug application (“ANDA”), or an NDA submitted under Section 505(b)(2) (a “505(b)(2) NDA”), submitted by another company for another drug based on July 9, 2012, requiresthe same active moiety, regardless of whether the drug is intended for the same indication as the original innovative drug or for another indication, where the applicant does not own or have a legal right of reference to all the data required for approval. However, an application may be submitted after four years if it contains a certification of patent invalidity or non-infringement to one of the patents listed with the FDA by the innovator NDA holder.

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The FDCA alternatively provides three years of marketing exclusivity for an NDA, or supplement to an existing NDA, if new clinical investigations, other than bioavailability studies, that were conducted or sponsored by the applicant are deemed by the FDA to notify Congress at least 60 days priorbe essential to issuing a draft or final guidance regulating LDTS and provide detailsthe approval of the anticipated action. On July 31, 2014, FDA notified Congress pursuant toapplication, for example new indications, dosages or strengths of an existing drug. This three-year exclusivity covers only the FDASIA that it intended to issue draft Guidances that would regulate LDTs. On October 3, 2014,modification for which the drug received approval on the basis of the new clinical investigations and does not prohibit the FDA issued two separate draft guidances: “Frameworkfrom approving ANDAs or 505(b)(2) NDAs for Regulatory Oversightdrugs containing the active ingredient for the original indication or condition of Laboratory Developed Tests (LDTs)” (“The Framework Draft Guidance”)use. Five-year and “FDA Notification and Medical Device Reporting for Laboratory Developed Tests” (the “Notification Draft Guidance.”). Inthree-year exclusivity will not delay the Framework Draft Guidance, FDA states that after the Guidances are finalized, it no longer would exercise enforcement discretion with respect to most LDTs and instead would, regulate them insubmission or approval of a risk-based manner consistent with the existing classification of medical devices.


The Framework Draft Guidance states that within six months after the Guidances were finalized, all laboratoriesfull NDA. However, an applicant submitting a full NDA would be required to give noticeconduct or obtain a right of reference to the FDA and provide basic information concerning the natureall of the LDTs offered.preclinical studies and adequate and well-controlled clinical trials necessary to demonstrate safety and effectiveness.

Pediatric exclusivity is another type of marketing exclusivity available in the United States. Pediatric exclusivity provides for an additional six months of marketing exclusivity attached to another period of exclusivity if a sponsor conducts clinical trials in children in response to a written request from the FDA. The FDA then would begin


issuance of a phased-in reviewwritten request does not require the sponsor to undertake the described clinical trials. In addition, orphan drug exclusivity, as described above, may offer a seven-year period of marketing exclusivity, except in certain circumstances.

Foreign Sales

Sales outside the LDTs available, based onUnited States of potential drug compounds we develop will also be subject to foreign regulatory requirements governing human clinical trials and marketing for drugs. The requirements vary widely from country to country, but typically the risk associated with the tests. For the highest risk LDTs, which the FDA classifies as Class III devices, the Framework Draft Guidance stated that the FDA would begin to require premarket review within 12 months after the Guidance was finalized. Other high risk LDTs would be reviewed over the next fourregistration and approval process takes several years and then lower risk tests (Class II tests) would be reviewed in the following four to nine years. The Framework Draft Guidance stated that FDA expected to issue a separate Guidance describing the criteria for its risk-based classification 18-24 months after the Guidances were finalized.


On November 18, 2016, the FDA stated that it would not be issuing final guidance on regulation of LDTs and, instead, it would outline its view of an appropriate risk-based approach to LDTs. On January 13, 2017, the FDA released a “Discussion Paper on Laboratory Developed Tests” that synthesizes the feedback that the agency received from various stakeholders on FDA regulation of LDTs “with the hope that it advances public discussion on LDT oversight.” The FDA stated in the introduction to the discussion paper: “The synthesis does not represent the formal thinking of the FDA, nor is it enforceable…This document does not represent a final version of the LDT draft guidance documents that were published in 2014.” Rather, its purpose is to allow for further public discussion and to give Congress a chance to develop a legislative solution. The discussion paper sets forth a prospective oversight framework that would focus on new and significantly modified high- and moderate-risk LDTs and under which LDTs marketed before the effective date of the framework would not be expected to comply withrequires significant resources. In most or all FDA regulatory requirements. Also exempt would be low-risk LDTs, LDTs for rare diseases, and others. Premarket review would be phased in over four years, and those tests introduced between the framework’s effective date and their phase-in date could continue to be offered for clinical use during the period of premarket review. FDA would expand its third-party premarket review program to include LDTs and coordinate with and leverage existing programs, such as New York State’s Clinical Laboratory Evaluation Program and the programs run by organizations run by CLIA to accredit laboratories.

A number of Congressional committees reportedly continue to work with various stakeholders to consider different approaches to regulation of LDTs. It is unclear at this time whether those committees and stakeholders can reach consensus around an approach and develop legislation and whether Congress would pass any such legislation. FDA Commissioner Scott Gottlieb has stated publicly that it would be preferable for Congress to develop a clear legislative framework for the FDA to implement, rather than for the FDA to regulate LDTs through guidance documents. On August 3, 2018, FDA provided Congressional committee staff technical assistance on the discussion draft entitled the Diagnostic Accuracy and Innovation Act (DAIA). In FDA’s technical assistance, FDA reiterated that it supported the goal of legislation to create pathways to market for all in vitro clinical tests (IVCTs). We are monitoring developments in Congress, and in the meantime, we maintain our CLIA accreditation, which permits the use of LDTs for diagnostics purposes.

In addition to the Draft Guidances discussed above,cases, if the FDA has taken other actions that could have an impact on our business. In 2013,not approved a potential drug compound for sale in the FDA issued Final GuidanceUnited States, the potential drug compound may be exported for industry regarding appropriate labeling and distribution practices for in vitro diagnostic products intended for research or investigational use only. FDA’s guidance cautions that labeling or distribution practices that conflict with research or investigational use (e.g., use in clinical diagnostic applications) could subject products shipped with research or investigational use labeling to all applicable requirementssale outside of the FDCA as well as enforcement action. As a result of this guidance from the FDA, component suppliers for our LDTs may no longer be willing to distribute components to our clinical laboratory. If this were to occur, we could not produce our LDTs.

On August 6, 2014, the FDA also issued its Final Guidance on In Vitro Companion Diagnostic Devices. According to the Guidance, companion diagnostic devices areUnited States, only if it has been approved in vitro diagnostic devices that provide information that is essential for the safe and effective use of a corresponding therapeutic product. The Guidance notes that in most circumstances, FDA expects to approve or clear a companion diagnostic device and its corresponding therapeutic product contemporaneously, based on the labelany one of the therapeutic product. On July 15, 2016, the FDA released the draft guidance, “Principles for Codevelopment of an In Vitro Companion Diagnostic Device with a Therapeutic Product.” This draft guidance is intended to serve as a guide to assist therapeutic sponsors and in vitro companion diagnostics sponsors in co-developing therapeutic products with an accompanying companion diagnostic, and in fulfilling the FDA’s applicable regulatory requirements. If it were determined that any of our tests qualified as In Vitro Companion Diagnostic Devices then we might be required to file an application for marketing authorization with the FDA (e.g., either a 510(k) or a PMA, depending on the nature of the particular test).

Post-market Regulation

Our Tissue of Origin® test obtained clearance under section 510(k) of the FDCA. After a device, such as our Tissue of Origin® test, is cleared or approved for marketing, numerous and pervasive regulatory requirements continue to apply once the test is marketed, including FDA’s current good manufacturing practice requirements. Since we do not offer our FDA-approved product infollowing: the European Economic Area (“EEA”) weUnion, Canada, Australia, New Zealand, Japan, Israel, Switzerland and South Africa. There are not currently subject to post-market regulation in the EEA or any member state.


specific FDA regulations that govern this process.

Health Insurance Portability and Accountability Act

The FDA has broad regulatory compliance and enforcement powers. If the FDA determines that a company has failed to comply with applicable regulatory requirements, it can take a variety of compliance or enforcement actions, which may result in any of the following sanctions:


warning letters, untitled letters, fines, injunctions, consent decrees and civil penalties;

recalls, withdrawals, or administrative detention or seizure of products;

operating restrictions or partial suspension or total shutdown of production;

refusing or delaying requests for 510(k) marketing clearance or PMA approvals of new products or modified products;

reconsideration of 510(k) clearances or PMA approvals that have already been granted;

refusal to grant export approvals for products; and/or

criminal prosecution.

In addition, FDA could publicly issue a safety notice related to our test or request updates to our product labeling, including the addition of warnings, precautions, or contraindications.

Health Insurance Portability and Accountability Act, as amended by the Health Information Technology for Economic and Clinical Health Act (“HITECH”), and implementing regulations thereunder (collectively, “HIPAA”) requires certain healthcare providers, health plans and healthcare clearinghouses who conduct specified electronic healthcare transactions (“covered entities”), as well as their independent contractors and agents who conduct certain activities involving protected health information on their behalf (“business associates”) to comply with enumerated requirements relating to the privacy, security and transmission of protected health information. Failure to comply with HIPAA can result in corrective action, as well as civil fines and penalties and government oversight. Among other changes, HITECH Act”)

Undermade HIPAA security standards directly applicable to business associates, increased the administrative simplification provisions of HIPAA, as amended bytiered civil and criminal fines and penalties that may be imposed against covered entities, business associates and possibly other persons, and gave state attorneys general new authority to file actions to enforce HIPAA. Further, the breach notification rule implemented under HITECH Act,requires covered entities to notify affected individuals, the United StatesU.S. Department of Health and Human Services has issued regulations which establish uniform standards governingOffice of Civil Rights (“OCR”), the conduct of certain electronic health care transactions and protecting the privacy and security of Protected Health Information used or disclosed by health care providers and other covered entities. For further discussion ofagency that enforces HIPAA, and for breaches affecting more than 500 individuals, the impact on our business, see the section entitled “Risk Factors-Risks Relatedmedia, of any breaches of unsecured protected health information. HIPAA does not create a private right of action for individuals, though individuals may submit complaints related to Our Business-We are requiredHIPAA to comply with laws governing the transmission, security and privacy of health information that require significant compliance costs, and any failure to comply with these laws could result in material criminal and civil penalties.”OCR.

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European General Data Protection Regulation


The collection and use of personal health data in the European Union had previously been governed by the provisions of the Data Protection Directive, which has been replaced by the General Data Protection Regulation (“GRPR”) which became effective on May 25, 2018 While the Data Protection Directive did not apply to organizations based outside the EU, the GDPR has expanded its reach to include any business, regardless of its location, that provides goods or services to residents in the EU. This expansion would incorporate ourthe Company’s clinical trial activities in EU members states. The GDPR imposes strict requirements on controllers and processors of personal data, including special protections for “sensitive information” which includes health and genetic information of data subjects residing in the EU. GDPR grants individuals the opportunity to object to the processing of their personal information, allows them to request deletion of personal information in certain circumstances, and provides the individual with an express right to seek legal remedies in the event the individual believes his or her rights have been violated. Further, the GDPR imposes strict rules on the transfer of personal data out of the European Union to the United States or other regions that have not been deemed to offer “adequate” privacy protections. Failure to comply with the requirements of the GDPR and the related national data protection laws of the European Union Member States, which may deviate slightly from the GDPR, may result in fines of up to 4% of global revenues,revenue, or € 20,000,000,€20,000,000, whichever is greater. As a result of the implementation of the GDPR, wethe Company may be required to put in place additional mechanisms ensuring compliance with the new data protection rules.


Our

The Company’s research activities in the EU are currently limited to non-human preclinical studies, and as such, we dothe Company does not collect, store, maintain, process, or transmit any Personal Data (as that term is defined under the GDPR) of trial subjects. However, since wethe Company currently havehas three employees located in the EU, ourits processing and transfer for employee Personal Data is subject to GDPR requirements. We haveThe Company has implemented a privacy and security program that is designed to adhere to the requirements of the GDPR in order to protect employee Personal Data, and in the event we progressthe Company progresses to research or clinical trials involving humans, to protect participant Personal Data. However, there is significant uncertainty related to the manner in which data protection authorities will seek to enforce compliance with GDPR. For example, it is not clear if the authorities will conduct random audits of companies doing business in the EU, or if the authorities will wait for complaints to be filed by individuals who claim their rights have been violated. Enforcement uncertainty and the costs associated with ensuring GDPR compliance be onerous and adversely affect our


the Company’s business, financial condition, results of operations and prospects. As a result, wethe Company cannot predict the impact of the GDPR regulations on ourits current or future business, either in the US or the EU.

Federal, State and Foreign Fraud and Abuse Laws

The federal Anti-Kickback Statute prohibits, among other things, knowingly and willfully offering, paying, soliciting or receiving remuneration to induce or in return for purchasing, leasing, ordering or arranging for the purchase, lease or order of any health care item or service reimbursable under a governmental payor program. The definition of “remuneration” has been broadly interpreted to include anything of value, including gifts, discounts, credit arrangements, payments of cash, waivers of co-payments, ownership interests and providing anything at less than its fair market value. Recognizing that the Anti-Kickback Statute is broad and may technically prohibit many innocuous or beneficial arrangements within the health care industry, the Department of Health and Human Services has issued a series of regulatory “safe harbors.” These safe harbor regulations set forth certain provisions, which, if met, will assure health care providers and other parties that they will not be prosecuted under the federal Anti- Kickback Statute. Although full compliance with these provisions ensures against prosecution under the federal Anti-Kickback Statute, the failure of a transaction or arrangement to fit within a specific safe harbor does not necessarily mean that the transaction or arrangement is illegal or that prosecution under the federal Anti-Kickback Statute will be pursued. For further discussion of the impact of federal and state health care fraud and abuse laws and regulations on our business, see the section entitled “Risk Factors-Risks Related to Our Business-We are subject to federal and state health care fraud and abuse laws and regulations and could face substantial penalties if we are unable to fully comply with such laws.”

In addition to the administrative simplification regulations discussed above, HIPAA also created two new federal crimes: health care fraud and false statements relating to health care matters. The health care fraud statute prohibits knowingly and willfully executing a scheme to defraud any health care benefit program, including private payors. A violation of this statute is a felony and may result in fines, imprisonment or exclusion from governmental payor programs such as the Medicare and Medicaid programs. The false statements statute prohibits 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 health care benefits, items or services. A violation of this statute is a felony and may result in fines, imprisonment or exclusion from governmental payor programs.

Finally, another development affecting the health care industry is the increased enforcement of the federal False Claims Actand, in particular, actions brought pursuant to the False Claims Act’s “whistleblower” or “qui tam” provisions. The False Claims Act imposes liability on any person or entity that, among other things, knowingly presents, or causes to be presented, a false or fraudulent claim for payment by a federal governmental payor program. The qui tam provisions of the False Claims Act allow a private individual to bring actions on behalf of the federal government alleging that the defendant has defrauded the federal government by submitting a false claim to the federal government and permit such individuals to share in any amounts paid by the entity to the government in fines or settlement. In addition, various states have enacted false claim laws analogous to the federal False Claims Act, although many of these state laws apply where a claim is submitted to any third-party payor and not merely a governmental payor program. When an entity is determined to have violated the False Claims Act, it may be required to pay up to three times the actual damages sustained by the government, plus civil penalties ranging from $11,181 to $22,363 for each false claim violation that occurred after January 15, 2018. (Those whose false claims violations that occurred before January 15, 2018 could be liable for treble damages plus lower civil monetary penalties.)

Additionally, in Europe various countries have adopted anti-bribery laws providing for severe consequences, in the form of criminal penalties and/or significant fines, for individuals and/or companies committing a bribery offense. Violations of these anti-bribery laws, or allegations of such violations, could have a negative impact on our business, results of operations and reputation. For instance, in the United Kingdom, under the new Bribery Act 2010, which went into effect in July 2011, a bribery occurs when a person offers, gives or promises to give a financial or other advantage to induce or reward another individual to improperly perform certain functions or activities, including any function of a public nature. Bribery of foreign public officials also falls within the scope of the Bribery Act 2010. Under the new regime, an individual found in violation of the Bribery Act of 2010 faces imprisonment of up to 10 years. In addition, the individual can be subject to an unlimited fine, as can commercial organizations for failure to prevent bribery.

Physician Self-Referral Prohibitions

Under a federal law directed at “self-referral,” commonly known as the “Stark Law,” there are prohibitions, with certain exceptions, on Medicare and Medicaid payments for laboratory tests referred by physicians who personally, or through a family member, have an investment or ownership interest in, or a compensation arrangement with, the clinical laboratory performing the tests. A person who engages in a scheme to circumvent the Stark Law’s referral prohibition may be fined up to $100,000 for each such arrangement or scheme. In addition, any person who presents or causes to be presented a claim to the Medicare or Medicaid programs in

violation of the Stark Law is subject to civil monetary penalties of up to $15,000 per claim submission, an assessment of up to three times the amount claimed and possible exclusion from participation in federal governmental payor programs. Claims submitted in violation of the Stark Law may not be paid by Medicare or Medicaid, and any person collecting any amounts with respect to any such prohibited claim is obligated to refund such amounts. Violation of the Stark Law may also result in violation of the False Claims Act. Unlike the Anti-kickback Statute, a person does not need to have intent to violate the Stark Law; this is a strict liability statute; merely violating the Stark Law on its face may result in fines, recoupments, and exclusion from federal health care programs. Many states have comparable laws that are not limited to Medicare and Medicaid referrals.

We are also subject to California’s Physician Ownership and Referral Act, or PORA as well as other state laws with self-referral restrictions.

Both the Stark Law and PORA contain an exception for referrals made by physicians who hold investment interests in a publicly traded company that has stockholders’ equity exceeding $75 million at the end of its most recent fiscal year or on average during the previous three fiscal years, and which satisfies certain other requirements. In addition, both the Stark Law and PORA contain an exception for compensation paid to a physician for personal services rendered by the physician. Following our acquisition of Response Genetics in the fourth quarter of 2015, we have compensation arrangements with a number of physicians for personal services, such as speaking engagements and specimen tissue preparation. These arrangements were structured with terms intended to comply with the requirements of the personal services exception to Stark Law and PORA.

However, we cannot be certain that regulators would find these arrangements to be in compliance with Stark Law, PORA or similar state laws. If we are deemed to not be in compliance by the applicable regulators, we would be required to refund any payments we receive pursuant to a referral prohibited by these laws to the patient, the payor or the Medicare program, as applicable.

Corporate Practice of Medicine

Approximately thirty (30) states have enacted laws prohibiting business corporations, such as us, from practicing medicine and employing or engaging physicians to practice medicine, generally referred to as the prohibition against the corporate practice of medicine. These laws, which vary among the states that have enacted them, are designed to prevent interference in the medical decision-making process by anyone who is not a licensed physician. Violation of these laws may result in civil or criminal fines, as well as sanctions imposed against us and/or the professional through licensure proceedings.

Other Regulatory Requirements


Our

The Company’s laboratory is subject to federal, state and local regulations relating to the handling and disposal of regulated medical waste, hazardous waste and biohazardous waste, including chemical, biological agents and compounds, blood and bone marrow samples and other human tissue. Typically, we usethe Company uses outside vendors who are contractually obligated to comply with applicable laws and regulations to dispose of such waste. These vendors are licensed or otherwise qualified to handle and dispose of such waste.


OSHA has established extensive requirements relating to workplace safety for health care employers, including requirements to develop and implement programs to protect workers from exposure to blood-borne pathogens by preventing or minimizing any exposure through needle stick or similar penetrating injuries.

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Discontinuing Operations

vivoPharm Business

In December 2021, the Company’s Board of Directors approved a plan to sell the vivoPharm business to focus the Company on the development of neurological developmental and degenerative disease therapeutics. As noted in Note 3 to the Company’s Consolidated Financial Statements contained in Part II. Item 8 herein, we have accounted for the vivoPharm business as discontinuing operations as of December 31, 2021. We plan to sell the vivoPharm business during 2022.

Overview - vivoPharm

vivoPharm offers preclinical services such as predictive tumor models, human orthotopic xenografts and syngeneic immuno-oncology relevant tumor models in its Hershey, PA facility, and is a leader in the field of immuno-oncology preclinical services and orthotopic predictive models. This service is supplemented with GLP toxicology and extended bioanalytical services in the Company’s Australian-based facilities in Melbourne, Victoria, and Adelaide, South Australia.

The vivoPharm business is based on demand for preclinical and discovery services from biotechnology and pharmaceutical companies, academia and the research community. Biotechnology and pharmaceutical companies engaged in drug development with the desire to run clinical trials to determine the safety and effectiveness of treatments and therapeutics continuously benefit from its services. vivoPharm’s preclinical development of biomarker detection methods, response to immuno-oncology directed novel treatments and early prediction of clinical outcome is supported by its extended portfolio of orthotopic, xenografts and syngeneic tumor test systems as a specialized service offering in the immuno-oncology space.

vivoPharm has developed industry recognized capabilities in early phase development and discovery, especially in immuno-oncology models, tumor micro-environment studies, and specialized pharmacology services that support basic discovery, preclinical and phase 1 clinical trials. vivoPharm’s studies have been utilized to support over 300 IND submissions to date across a range of therapeutic indications, including lymphomas, leukemia, breast cancer, GI-cancers, liver cancer, pancreatic cancer, non-small cell lung cancer, and other non-cancer rare diseases. vivoPharm is presently serving over 50 biotechnology and pharmaceutical companies across four continents in over 100 studies and trials with highly specialized development, clinical and preclinical research. Over the past 18 years, vivoPharm has also generated an extensive library of human xenograft and syngeneic tumor models, including subcutaneous, orthotopic and metastatic models. vivoPharm offers its expertise in small and bio-molecules.

vivoPharm continues to leverage its international presence to access global market opportunities. vivoPharm’s headquarters in Australia specializes in safety and toxicology studies, including mammalian, genetic and in vitro, along with bioanalytical services including immune-analytical capabilities. vivoPharm operates from multiple locations in Victoria and South Australia. vivoPharm’s U.S.-based laboratory, located at the Hershey Center for Applied Research in Hershey, Pennsylvania, primarily focuses on screening and efficacy testing for a wide range of pharmaceutical and chemical products. The third location, in Munich, Germany, hosts project management and business development personnel.

vivoPharm Market Overview

United States Clinical Oncology Market Overview

Despite many advances in the treatment of cancer, it remains one of the greatest areas of unmet medical need. In 2021, the World Health Organization attributed 10 million deaths globally to cancer, which prior to the COVID-19 was approximately about 1 in 6 deaths. Within the United States, excluding COVID-19 related deaths, cancer is the second most common cause of death, exceeded only by heart disease, accounting for nearly one out of every four deaths.

United States and International Clinical Trials Market Overview

The global preclinical Contract Research Organization (“CRO”) market size was valued at $4.5 billion in 2020 and is expected to grow at a compound annual growth rate (“CAGR”) of 8.1% from 2021 to 2028. Increased R&D budget for drug development is leading to rising demand for preclinical CRO services, thus boosting the market growth during the forecast period, according to a September 2021 report published by Grand View Research, Inc. Outside of the United States, growth in the pharmaceuticals and clinical trials market is continuing, and trials are increasingly becoming more complex. Growth in the European pharma market is anticipated to be driven largely by the United Kingdom, Germany, Spain, France and Italy.

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While oncology drugs have the potential to be among the most personalized therapeutics, very few successfully make it to market. The application of pharmacogenomics to oncology clinical trials enables researchers to better predict differences, initially driven by data derived in preclinical research. The Company believes a growing demand for faster development of personalized medicines and more effective clinical trials are growth drivers of this market, and its core expertise is preclinical efficacy, toxicity and bioanalytical services.

vivoPharm has a particularly strong set of experiences working in the preclinical area of checkpoint inhibitors and specifically immunotherapies. Drug development is continuing to attract biotech companies transforming scientific innovation into practice-changing cancer drugs, thereby driving demand for vivoPharm’s services. When considering druggable targets within the different immuno-oncology drug classes, T cell immunomodulators and cell therapies had the largest increase in new targets in the past 2 years, which suggests that more innovation is going into these drug classes than the other immune-oncology drug classes.

vivoPharm is currently focused on delivering its pre-clinical CRO and drug discovery services to a diverse group of market participants, including biotechnology and pharmaceutical companies; governmental agencies; and academic research centers. These participants require syngeneic and xenograft tumor models to support the development of novel biomarkers and increasing technological expertise to collect key data sets for their clinical trials, understand and manage therapeutic development and design customized therapy choices. vivoPharm believes that its approach to rapidly translate research insights about the genetics and molecular mechanisms of cancer into the research community will lead to innovative products being developed, particularly in the area of immuno-oncology therapies.

vivoPharm’s Service Offerings

vivoPharm’s focus on the preclinical market, its services are primarily sought by biotechnology and pharmaceutical companies engaged in designing and preparing to run clinical trials, for their value and efficacy in oncology and immuno-oncology treatments and therapeutics. vivoPharm believes trial participants’ likelihood of experiencing either favorable or adverse responses to the trial treatment can be determined first by its extended portfolio of orthotopic, xenografts and syngeneic tumor test systems, and in early development through biomarker identification and development, thereby increasing trial efficiency, participant safety and trial success rates. Biotechnology and pharmaceutical companies also seek vivoPharm’s services in preclinical trial design and drug development, in order to effectively and efficiently select those therapeutic candidates most likely to progress to clinical treatment options. vivoPharm’s services are also sought by researchers and research groups seeking to identify biomarkers and panels and develop methods for diagnostic technologies and tests for disease.

vivoPharm Discovery Services

vivoPharm offers proprietary preclinical test systems valued by the pharmaceutical industry, biotechnology companies and academic research centers. In particular, vivoPharm’s preclinical development of biomarker detection methods, response to immuno-oncology directed novel treatments and early prediction of clinical outcome is supported by its extended portfolio of orthotopic, xenografts and syngeneic tumor test systems. vivoPharm specializes in conducting studies tailored to guide drug development, starting from compound libraries and ending with a comprehensive set of in vitro and in vivo data and reports, as needed for Investigational New Drug filing. vivoPharm operates in AAALAC accredited and GLP-compliant audited facilities. vivoPharm provides its preclinical services, with a focus on efficacy models, from its Hershey, PA facility for the U.S. and European markets, and supplemented with GLP toxicology and extended bioanalytical services in its Australia-based facility in Melbourne, Victoria, and Adelaide, South Australia.

vivoPharm’s Discovery Services provide the tools and testing methods for companies and researchers seeking to identify new molecular- and biomarker-based indicators for disease and to determine the pharmacogenomics, safety and effectiveness of potential therapeutic candidate compounds. Discovery Services offered include development of both xenograft and syngeneic animal models, toxicology and genetic toxicology services, pharmacology testing, pathology services, and validation of biomarkers for diseases including cancers. vivoPharm also provides consulting, guidance and preparation of samples and clinical trial design. vivoPharm believes the ability to analyze variations in biomarkers, tumor cells and compounds, and to interpret results into meaningful predictors of disease or indicators of therapeutic success is essential to discovering new molecular markers for cancer, new therapeutics, and targets for therapies.

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vivoPharm executes its market strategy by delivering results-oriented information and insights which we believe is or will become important to drug discovery and development and ultimately to accelerated therapy approvals and commercialization.

vivoPharm’s Discovery Services aim to accelerate the development of novel treatment candidates and precision medicine, with a current focus in oncology. vivoPharm believes the level of personalized treatment required to optimize a patient’s treatment regimen and to maximize clinical trial success rates may be significantly improved using molecular- and biomarker-based characterization.

Solid Tissue Cancers

The term “solid tumors” encompasses abnormal masses of cells that do not include fluid areas (e.g., blood) or cysts. Solid tumors are composed of abnormal cell growths that originate in organs or soft tissue and are normally named after the types of cells that form them. Examples of solid tumors include breast cancer, lung cancer, ovarian cancer and melanoma. Solid tumors may be benign (not cancerous) or malignant (cancerous) and may spread from their primary tissue of origin to other locations in the body (metastasis). There are over 200 individual chemotherapeutic drugs available for combating solid tumor cancers. Selection of an appropriate course of treatment for a patient may depend on identification of the gene mutation or mutations present in their particular cancer and on determining the cancer’s tissue of origin. Metastatic tumors with an uncertain primary site can be a difficult clinical problem. In tens of thousands of oncology patients every year, no confident diagnosis is ever issued, making standard-of-care treatment impossible.

Sales and Marketing

vivoPharm’s sales and marketing efforts consist of both direct and indirect efforts, with the majority of efforts focused on direct sales in the United States, Europe and Australia. vivoPharm collaborates with preclinical development and translational science teams at pharmaceutical and biotech companies on studies involving tumor models and therapeutic candidate compound testing.

vivoPharm’s U.S. and European business development and sales professionals have scientific backgrounds in hematology, pathology, and laboratory services, with many years of experience in biopharmaceutical and clinical oncology sales, esoteric laboratory sales from leading biopharmaceutical, pharmaceutical or specialty reference laboratory companies. VivoPharm currently has a team of four business development and sales professionals in the United States and Europe.

vivoPharm also promotes its services through marketing channels commonly used by the biopharma and pharmaceutical industries, such as internet, medical meetings and broad-based publication of its scientific and economic data. In addition, vivoPharm provides easy-to-access information to its customers over the internet through dedicated websites. vivoPharm’s customers value easily accessible information in order to quickly review patient or study information.

Competition

The largest competitors in the global preclinical CRO market are companies like Pharmaceutical Product Development, LLC (US), MD Biosciences (US)., IQVIA (US), PAREXEL International Corporation (US), Envigo (US), Charles River (US), Inotiv (US), ICON PLC (Dublin), PRA Health Sciences (US), Medpace (US), Laboratory Corporation of America Holdings (US), WuXi AppTec (China) and Eurofins Scientific (Luxembourg). The players operating in the global preclinical CRO market are focusing on product unveilings, along with intensifying their global presence by entering untouched markets.

Projects related to the molecular mechanisms driving cancer development have received increased government funding, both in the United States and internationally. The National Cancer Institutes’ Cancer Moonshot is anticipated to increase both patient awareness and federal government funding for research and clinical trials. The Federal Government has committed $1.8 billion over a 7-year period to fund the 21st Century Cures Act. As more information regarding cancer genomics and biomarkers becomes available to the public, vivoPharm anticipates that more products aimed at identifying targeted treatment options will be developed and that these products may compete with its products.

Third-Party Suppliers

vivoPharm currently relies on third-party suppliers for its specialized research and scientific instrumentation and related supplies of reagents, tumor cell lines, and other inventory for it to successfully perform its CRO services for its customers. vivoPharm does not believe a short-term disruption from any one of these suppliers would have a material effect on its business, nor has vivoPharm experienced any material disruptions due to COVID-19.

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Operations and Production Facilities

As a preclinical oncology CRO, vivoPharm’s leased facilities are built to house immunocompromised mice, conventional rodents and specialized models. They incorporate surgical suites, gowning rooms, and holding rooms. In order to ensure an environment of utmost sterility, while also minimizing the workload by negating dependency on cage-wash infrastructure, vivoPharm relies on its landlords and licensors to manage the vivariums at its animal facilities. This allows for capacity utilization flexibility and focus of time and energy into scientific endeavors.

Quality Assurance

vivoPharm is committed to maintaining a standard of excellence and to providing reliable and accurate laboratory services to its customers. To that goal, vivoPharm’s independent Quality Assurance Unit (“QAU”) has implemented a comprehensive and integrated Quality Management System (“QMS”) designed to drive consistent high quality testing services while ensuring the highest ethical standards across its business. vivoPharm’s QMS satisfies FDA requirements for nonclinical studies conduct and content, computer systems validation, electronic records and signatures, and GLP.

vivoPharm Governmental Regulations

vivoPharm’s Pennsylvania and Australia research laboratory facilities comply with GLP” to the extent required by the FDA, Environmental Protection Agency, USDA, Organization for Economic Co-operation and Development (“OECD”), as well as other international regulatory agencies. Furthermore, vivoPharm’s early-stage discovery work, which is not subject to GLP standards, is typically carried out under a quality management system or internally developed quality systems. vivoPharm’s facilities are regularly inspected by U.S. and other regulatory compliance monitoring authorities, its clients’ quality assurance departments, and its own internal quality assessment program.

Other Discontinuing Operations

In July 2019, CGI sold all assets related to its BioPharma and Clinical businesses. As of December 31, 2021, $409 thousand of liabilities relating to these businesses are classified as other current liabilities – discontinuing operations on the Company’s consolidated balance sheets.

Employees and Human Capital Management

As of March 15, 2022, we had 34 full-time employees, including 8 with Ph.D. degrees in our continuing Vyant Bio and StemoniX operations. Of these employees, 24 are in research and development and 10 are general and administrative. As of March 15, 2022, we had 38 full-time employees in our vivoPharm business, including 10 with Ph.D. degrees. We have never had a work stoppage, and none of our employees are represented by a labor organization or under any collective-bargaining arrangements. We consider our employee relations to be good.

Our human capital management objectives include, as applicable, identifying, recruiting, retaining, incentivizing and integrating our existing and new employees, advisors and consultants. The principal purposes of our equity and cash incentive plans, along with a comprehensive benefits package and a 401(k) plan, are to attract, retain and reward personnel through the granting of stock-based and cash-based compensation awards.

The Company’s employees are in high demand in the industries in which we operate. We have experienced higher employee turnover in the past year given the demand for our employees and overall employment market conditions, including increased salaries and a high number of job openings, which have been part of the “Great Resignation” that has been experienced by many companies that are highly dependent on human capital talent. The retention of our employees is a high priority as well as recruiting key talent to meet our business goals.

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Segment and Geographical Information


We operate

The Company operates in one reportable business segment and derive revenue from multiple countries, with 93%61% and 94%80% of its continuing operations revenue coming from the United States in fiscal year 20182021 and 2017,2020, respectively.


Research and Development

For the years ended December 31, 2018 and 2017, our research and development expenses were $2.5 million and $4.8 million, respectively, principally in connection with our efforts to develop our proprietary tests and validate those tests, which were relocated from our Los Angeles location to our New Jersey lab facility.

Employees

As of December 31, 2018, we had a total of 150 full-time and 18 part-time employees, with 18 employees in business development, sales and marketing, 76 employees in clinical services, 25 employees in clinical trials and 31 employees in general and administrative. During 2018, we reduced our headcount by approximately 38 as the result of consolidating our Los

Angeles, CA facility to operations in New Jersey and North Carolina. None of our employees are represented by a labor union, and we consider our employee relations to be good.

Corporate and Available Information


We were

The Company was incorporated in the State of Delaware on April 8, 1999. On July 16, 2014 we purchased substantially allMarch 30, 2021, the Company completed its Merger with StemoniX, which is now a wholly-owned subsidiary of the assets of Gentris Corporation (“Gentris”), a laboratory specializing in pharmacogenomics profiling for therapeutic development, companion diagnostics and clinical trials.


On August 18, 2014 we entered into two agreements by which we acquired BioServe Biotechnologies (India) Pvt. Ltd. (“BioServe”), a premier genomics services provider serving both the research and clinical markets in India, and as a result of the acquisition, BioServe became a subsidiary of ours. On April 26, 2018, we sold BioServe to Reprocell, Inc., for $1.9 million, including $1.6 million in cash at closing and up to an additional $300,000 conditioned on Reprocell meeting specified revenue targets, of which, we were paid $212,500 as the final contingent amount owed to us.

On August 15, 2017, we purchased all of the outstanding stock of vivoPharm, with its principal place of business in Victoria, Australia.

OurCompany.

The Company’s principal executive offices are located at 2012370 State Route 17 North, 2nd Floor, Rutherford, New Jersey 07070. Our70 West, Two Executive Campus, Suite 310, Cherry Hill, NJ 08002-4102. The Company’s telephone number is (201) 528-9200479-1357 and ourthe corporate website address is www.cancergenetics.com. We include ourwww.vyantbio.com. The Company included the website address in this annual report on Form 10-K only as an inactive textual reference and dodoes not intend it to be an active link to ourthe Company website. The information on ourthe website is not incorporated by reference in this annual report on Form 10-K.


This annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and all amendments to those reports, as well as other documents we filethe Company files with the U.S. Securities and Exchange Commission (“SEC”), are available free of charge through the Investors section of ourthe Company website at https://ir.vyantbio.com/sec-filings as soon as reasonably practicable after such material is electronically filed with or furnished to the SEC. The public can obtain documents that we filethe Company files with the SEC at www.sec.gov.


This report includes the following trademarks, service marks and trade names owned by us: MatBA®, UroGenRA®, FHACT®, FReCaD™, Expand Dx™, Summation™, Select One®, DLBCL Complete™, Cervixcyte™, Leuka™, CGI®, CLL Complete®, Focus::NGS™, Focus::Myeloid™, Focus::CLL™, Tissue of Origin®, TOO®, Powered by CGI™ and Empowering Personal Cancer Treatment®. These trademarks, service marks and trade names are the property of Cancer Genetics, Inc. and its affiliates.


Item 1A.Risk Factors.

Item 1A. Risk Factors

An investment in our common stock involves a high degree of risk including the risk of a loss of your entire investment. You should carefully consider the risks and uncertainties described below and the other information contained in this report and ourthe other reports we filed with the Securities and Exchange Commission. The risks set forth below are not the only ones facing us. Additional risks and uncertainties may exist that could also adversely affect our business, operations and financial condition. If any of the following risks actually materialize, our business, financial condition and/or operations could suffer. In such event, the value of our common stock could decline, and you could lose all or a substantial portion of the money that you payhave paid for our common stock.

Summary of Risk Factors

We have a history of net losses, expect to incur net losses in the future and may never achieve sustained profitability.
We have limited experience in drug discovery and drug development, and we have never advanced a drug to human development or had a drug approved alone or with collaborators.
We may not be successful in our efforts to identify or discover drug candidates and may fail to capitalize on programs, collaborations, or drug candidates that may present a greater commercial opportunity or for which there is a greater likelihood of success.
We do not have any experience in clinical development and have not advanced any drug candidates into clinical development.
Clinical trials are expensive, time-consuming and difficult to design and implement, and have traditionally had high attrition.
Our future revenue is unpredictable and operating results are expected to fluctuate from period to period.
Our business is subject to risks arising from epidemic diseases, such as the global outbreak of COVID-19.

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The regulatory approval processes of the FDA and comparable foreign authorities are lengthy, time consuming, expensive and inherently challenging, and if we or our collaborators are ultimately unable to obtain regulatory approval for our drug candidates, our business could be significantly limited.
Our success depends upon achieving a critical mass of customers and strategic relationships.
We may acquire other businesses or make investments in other companies or technologies that could harm operating results, dilute its stockholders’ ownership, increase debt or cause us to incur significant expense.
We may not be able to sell the vivoPharm business and/or any sales we consummate may not produce the desired results.
If we are unable to obtain and maintain patent and other intellectual property protection for our products and processes, or if the scope of the patent and other intellectual property protection obtained is not sufficiently broad, our competitors could develop and commercialize products similar or identical to ours, and our ability to successfully commercialize our technology and products may be adversely affected.
The loss or transition of any member of our senior management team or the inability to attract and retain highly skilled scientists, clinicians and salespeople could adversely affect our business.
If we are unable to manage growth, our prospects may be limited, and our future results of operations may be adversely affected.
Because we do not expect to pay cash dividends for the foreseeable future, you must rely on appreciation of our common stock price for any return on your investment. Even we change that policy, we may be restricted from paying dividends on our common stock.

Risks Relating to the Our Financial Condition and Capital Requirements


We have a history of net losses; welosses, expect to incur net losses in the future and we may never achieve sustained profitability.


We have historically incurred substantial net losses. We incurredhad net losses of $20.4$40.9 million and $20.8$8.7 million for fiscalthe years ended December 31, 20182021 and 2017, respectively. From our inception in April 1999 through December 31, 2018, we2020, respectively, and had an accumulated deficit of $157.7$78.8 million as of December 31, 2021. The 2021 results including a net loss from discontinuing operations of $22.3 million, which includes a $20.2 million goodwill impairment charge as well as continuing operations non-cash expenses of $4.8 million and merger related costs of $2.3 million. We expect losses to continue principally as a result of difficulties in being able to collect cash from certain third-party payors or obtain reimbursement at adequate prices, or at all, for tests provided to our Clinical Services customers, ongoing research and development expenses and sales and marketing costs.continue. These losses have had, and will continue to have, an adverse effect on our working capital, total assets and stockholders’ equity. Because of the numerous risks and uncertainties associated with our research, developmentrevenue growth and commercialization efforts,costs associated with being a public company, we are unable to predict when we will become profitable, and we may never become profitable. Even if we do achieve profitability, we may not be able to sustain or increase profitability on a quarterly or annual basis. Our inability to achieve, and then maintain, profitability would negatively affect our business, financial condition, results of operations and cash flows.


Our

Prior to the Merger and receipt of the net proceeds of the financings that were a condition of the Merger, recurring losses from operations have raised substantial doubt regarding our ability to continue as a going concern.

Atconcern, and we may need to raise additional capital by issuing securities or debt or through licensing arrangements, which may cause dilution to stockholders or restrict operations or proprietary rights.

For the years ended December 31, 2018,2021 and 2020, we had net cash used in operating activities from continuing operations of $16.5 million and $5.8 million, respectively. We expect our expenses to increase in connection with our ongoing activities.

The Company had cash position and historycash equivalents of losses required management to assess our ability to continue operating$20.6 million as a going concern, according to Financial Accounting Standards Board Accounting Standards Update No. 2014-15, Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern (“ASU 2014-15”). We did not have sufficient cash at December 31, 20182021. The Company’s management has projected that the Company’s cash on hand, together with net proceeds from the planned sale of the vivoPharm business during 2022 as well as proceeds from sales of common stock pursuant to the Purchase Agreement (as defined below) with Lincoln Park Capital, LLC will be adequate to fund normalthe Company’s currently planned operations forinto the next twelve months. In addition,second quarter of 2023. Such estimate may prove to be wrong, and we have beencould use our available capital resources sooner than we currently expect, and/or the capital resources that we are assuming will be present could fail to materialize at the amounts we project or at all

For instance, changing circumstances, some of which may be beyond our control, could cause us to consume capital significantly faster than we currently anticipate, and we may need to seek additional funds sooner than planned. Future capital requirements depend upon many factors, including, but not limited to:

the rate at which invest in our disease model and therapeutic drug development;
the rate at which we are able to enter into strategic relationships;
the extent to which we commence development activities for new therapeutic indications;
the response of competitors to our products and services;
the costs of preparing, filing and prosecuting patent applications, maintaining and protecting our intellectual property rights including enforcing and defending intellectual property related claims; and
the costs of operating as a public company.

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We may seek additional capital through a combination of public and private equity offerings, debt financings, strategic partnerships and alliances, licensing arrangements or monetization transactions. To the extent that we raise additional capital through the sale of equity, convertible debt securities or other equity-based derivative securities, our existing shareholders’ ownership interest will be diluted, and the terms may include liquidation or other preferences that adversely affect shareholder rights. Any indebtedness we incur would result in violation of certain financialincreased fixed payment obligations and could involve restrictive covenants, under our debt agreements. While our lenders have conditionally agreed to forbear from exercising their rights and remedies resulting from existing and potential defaults, our ability to continuesuch as a going concern is dependentlimitations on our ability to comply with the forbearance conditionsincur additional debt, limitations on our ability to acquire or license intellectual property rights and other debt agreement covenants, raiseoperating restrictions that could adversely impact our ability to conduct our business. Furthermore, the issuance of additional securities, whether equity or debt, capital and/by us, or spin-off non-core assetsthe possibility of such issuance, may cause the market price of our common stock to decline and existing shareholders may not agree with our financing plans or the terms of such financings. If we raise additional cash. These factors raise substantial doubt aboutfunds through strategic partnerships and alliances, licensing arrangements or monetization transactions with third parties, we may have to relinquish valuable rights to our abilitytechnologies, or our products, or grant licenses on terms unfavorable to continue as a going concern.


We have hired Raymond James & Associates, Inc. as our financial advisor to assist with evaluating strategic alternatives. Such alternatives could include raising more capital, the acquisition of another company and/or complementary assets, the sale of the Company or another type of strategic partnership. We can provide no assurances that our current actions will be successful or thatus. Adequate additional sources of financing withmay not be available to us on favorableacceptable terms, or at all. If we are unable to raise additional funds when needed, we may be required to delay, limit, reduce or terminate our product development or future commercialization efforts or grant rights to develop and market products that we would otherwise prefer to develop and market ourselves.

Our future revenue is unpredictable and operating results are expected to fluctuate from period to period.

The emerging nature of the markets in which we compete make it difficult for us to accurately forecast our revenue in any given period.

Historically, most of our revenue has been derived from our vivoPharm business, which we have committed to a plan to sell. Revenue from StemoniX have historically derived from the sale of iPSC-based microOrgan plates to pharmaceutical, biotechnology and research customers or the performance of DaaS for these customers. We anticipate revenue generated from these activities will substantially cease in the first half of 2022, and we will focus on our therapeutic drug discovery and development using our iPSC human disease models. Therefore, we will not generate revenue until we are able to successfully develop and discover drug candidates and partner with pharmaceutical and biotechnology companies and other industry partners.

To date, we have not generated revenue from licensing our iPSC disease models or therapeutic assets. Additionally, our ability to obtain license and/or subscription agreements with pharmaceutical companies and other industry partners is unproven, and in the best of circumstances it may take several months or more in order to enter into such agreements. There can be no assurances that we will be successful in entering into collaborations with pharmaceutical companies, artificial intelligence/technology and other industry partners. Moreover, even after entering into such agreements, it may take months or years before they generate revenue, if at all.


The consolidated financial statements do not include any adjustments that might be necessary should the Company be unable to continue as a going concern.

We are in default of financial covenants in the credit agreements with our senior lenders, which are subject to forbearance agreements that expire on April 15, 2019, and our asset-based revolving line of credit agreement matures on April 15, 2019. We are also in default under the Credit Agreement with NovellusDx Ltd.

We have been in violation of certain of the financial and other covenants under our asset-based revolving line of credit agreement (“ABL”) with Silicon Valley Bank (“SVB”) and our term loan agreement (the “Term Loan”) with Partners for Growth IV, L.P. (“PFG”). On August 20, 2018, the Company received waivers from its senior lenders for the covenant violations for the months of July and August 2018. In consideration of these waivers, we agreed to reduce the maximum borrowings under the ABL from $6.0 million to $3.0 million, and agreed to enter into a binding and enforceable agreement satisfactory to each lender by August 31, 2018 with respect to a merger or other business combination transaction between the Company and an unrelated third party satisfactory to each lender (the “Transaction Condition”). While we were in violation of the Transaction Condition as of August 31, we subsequently entered into a binding and enforceable agreement satisfactory to each lender on September 18, 2018 by entering into a Merger Agreement with NovellusDx Ltd. (“Novellus”) and the other

parties thereto (which was subsequently terminated in December 2018) (the “Novellus Merger Agreement”). On November 19, 2018, we obtained waivers from our lenders for the covenant violations for the months of September, October and November 2018, conditioned upon the Company raising $3,000,000 through the sale of its equity securities or issuance of subordinated debt by November 30, 2018 (the “Financing Condition”).

On January 16, 2019, we entered into a Forbearance and Fifth Amendment to Amended and Restated Loan and Security Agreement (the “Forbearance and Amendment”) with SVB, further amending the ABL, and a Forbearance Agreement and Modification No. 4 to Loan and Security Agreement (the “Forbearance and Modification”) with PFG, further amending the Term Loan.

The Forbearance and Amendment with SVB, among other things, (i) amended the interest rate under the ABL to be 2.25% per annum above the Wall Street Journal prime rate (7.75% at December 31, 2018); (ii) requires us to comply with certain milestones in connection with progressing towards a potential strategic transaction satisfactory to SVB with an anticipated closing date of on or before April 15, 2019, similar to the Transaction Condition in our August 2018 waivers (the “Milestones”), (iii) provides for SVB’s forbearance of its rights and remedies resulting from certain existing and potential events of default under the ABL stated in the Forbearance and Amendment (but not a waiver) until the earlier of (a) the occurrence of an additional event of default or (b) February 28, 2019; provided such date shall be automatically extended to April 15, 2019 so long as we are in compliance with the Milestones required as of such date and (iv) extends the Revolving Line Maturity Date (as defined in the ABL) to April 15, 2019. Absent the covenant waivers, we would be required to make monthly interest payments at the default rate (10.75%).

The Forbearance and Modification with PFG, among other things, (i) requires the Company to comply with certain milestones in connection with progress in towards a potential strategic transaction satisfactory to PFG with an anticipated closing date of on or before April 15, 2019, similar to the Transaction Condition in our August 2018 waivers (the “PFG Milestones”), (ii) provides for PFG’s forbearance of its rights and remedies resulting from certain existing and potential events of default under the Term Loan stated in the Forbearance and Modification (but not a wavier) until the earlier of (a) the occurrence of an additional event of default or (b) February 28, 2019; provided such date shall be automatically extended to April 15, 2019 so long as the Company is in compliance with the PFG Milestones required as of such date. Absent the covenant waivers, we would be required to make monthly interest payments at the default rate (17.50%).

The Company will not be able to close on a strategic transaction on or before April 15, 2019. No assurance can be given that the Company will be able to extend the maturity of the ABL beyond April 15, 2019 or extend the forbearances with SVB and PFG beyond April 15, 2019. However, we are in discussions with SVB and PFG about possible extensions of the forbearance agreements.

As a result of the termination of the Novellus Merger Agreement in December 2018, pursuant to the Credit Agreement (the “Novellus Credit Agreement”), dated September 18, 2018, between us and NovellusDx Ltd., the $1.5 million advance previously made to us in connection with the signing of the Novellus Merger Agreement, plus interest thereon, would have become due and payable, but for the subordination agreements described below. The interest rate under the Novellus Credit Agreement was increased to the lesser of 21% per annum and the maximum rate permitted by applicable law. In addition, NovellusDx Ltd. has the right to convert all, but not less than all, of the outstanding balance under the Novellus Credit Agreement into shares of our common stock at a conversion price of $0.606 per share.

Pursuant to subordination agreements entered into in connection with the Novellus Credit Agreement on September 18, 2018, NovellusDx Ltd.’s ability to be repaid under the Novellus Credit Agreement is subject to subordination to the ABL and the Term Loan. Novellus has asserted that its obligation to standstill under its subordination agreements will not be applicable at a time when the Company attains certain levels of unrestricted cash, as a result of the Company purportedly having improperly terminated the Novellus Merger Agreement. The Company does not believe it improperly terminated the Novellus Merger Agreement.

Our default under the Novellus Credit Agreement may also be deemed to be a default under the obligations to SVB and PFG.

Any default under any financing agreement or material agreement of ours (other than the Novellus Credit Agreement) may also be deemed to be a default under the obligations due under the Convertible Promissory Note (the “Iliad Note”), dated July 17, 2018, in the aggregate principal amount of $2,625,000.00 to Iliad Research and Trading, L.P. (“Iliad”).

Pursuant to subordination agreements entered into in connection with the Iliad Note on July 17, 2018, Iliad’s ability to be repaid under the Iliad Note is subject to subordination to the ABL and the Term Loan. However, the Iliad Note and the subordination agreements between Iliad and our senior lenders provide that on an Event of Default (as defined in the Iliad

Note), Iliad may obtain injunctive relief that would prohibit the Company from issuing any equity securities unless the outstanding balance due to Iliad is paid in full simultaneously with such issuance. On February 15, 2019, the Company entered into a standstill agreement with Iliad. The standstill agreement, among other things, (i) provided that Iliad would not seek to redeem any portion of the Iliad Note until March 10, 2019 (the “Standstill”); (ii) increased the outstanding balance of the Iliad Note by approximately $139,000, representing a fee to Iliad for such Standstill; and (iii) allowed the Company the option to elect that Iliad not seek to redeem any portion of the Iliad Note until April 15, 2019, provided that upon such election the outstanding balance of the Iliad Note would increase again by approximately $63,000. The Company elected to extend the Standstill until April 15, 2019.

We currently have limited funds and we will need to raise additional capital to fund our operations.

We will need to raise additional financing to fund our operations. At December 31, 2018, we had unrestricted cash and cash equivalents of $0.2 million. Net cash used in operating activities was $12.6 million and $13.6 million for the years ended December 31, 2018 and 2017, respectively. We have continued to have negative cash flow in the first quarter of 2019.

Even with the net proceeds of approximately $5.4 million received in our offerings of common stock that were consummated on January 14, 2019 and January 31, 2019 (the “Offering Proceeds”), we have limited availability under our asset-based revolving line of credit agreement with Silicon Valley Bank.

The Company has retained Raymond James & Associates, Inc. as a financial advisor to assist the Company in its evaluation of a broad range of financial and strategic alternatives to enhance shareholder value, including additional capital raising transactions, the acquisition of another company or complementary assets or the potential sale or merger of the Company, disposition of non-core assets, or another type of strategic partnership. There is no assurance that the review of strategic alternativesany revenue generated will result in the Company changing its business plan, pursuing any particular transaction, if any, or, if it pursues any such transaction, that it will be completed. The Company does not expect to make further public comment regarding the strategic review until the Board of Directors has approved a specific transaction or otherwise deems disclosure of significant developments is appropriate.

We believe that our current cash and availability under our revolving line of credit, together with the Offering Proceeds, will support operations for approximately 3 months from the date of this report, assuming we are able to negotiate an extension of the maturity date of the ABL and an extension of the forbearances with SVB and PFG. We can provide no assurances that any additional sources of financing will be available to us on favorable terms, if at all, when needed. Our forecast of the period of time through which our current financial resources will be adequate to support our operations andrecover the costs

For these reasons, it is difficult for us to supportpredict, when, if ever, we will generate revenue and become profitable.

Our operating results are likely to fluctuate substantially from period to period as a result of several factors, many of which are beyond our general and administrative, sales and marketing and research and development activities are forward-looking statements and involve risks and uncertainties. Absent sufficient additional financing, we may be unable to remain a going concern.control. These factors include:

the ability to derive licensing contracts for Company-identified drug candidates or Company developed human iPSC disease models;
the ability to enter into successful strategic relationships;
the unpredictable expenses associated with drug development and clinical trials;
the amount and timing of operating costs and capital expenditures relating to expansion of our operations;
the announcement or introduction of new or enhanced technologies, products, or services by competitors; and
the ability to attract and retain qualified personnel.

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Additional financing may be from the sale of equity or convertible or other debt securities in a public or private offering, from an additional or new credit facility or from a strategic partnership coupled with an investment in us or a combination of forms. We continue to evaluate our operations and take steps to improve our operating cash flow. We can provide no assurances that our current actions will be successful or that any additional sources of financing will be available to us on favorable terms, if at all, when needed. Furthermore, certain provisions of the securities purchase agreements we entered into in May 2016 and September 2016, may limit our ability to raise additional capital on favorable terms, or at all, including a prohibition on entering into variable rate transactions, such as an equity line, while the 5-year warrants issued in May and September 2016 remain outstanding. Our convertible debt facility entered into in July 2018 has a similar limitation on variable rate financings. Our failure to raise additional capital and in sufficient amounts when needed may significantly impact our ability to operate our business. For further discussion of our liquidity requirements, see the section titled “Liquidity and Capital Resources-Capital Resources and Expenditure Requirements.”

We also may need to raise capital to expand our business to meet our long-term business objectives, including to:
increase our sales and marketing efforts to drive market adoption and address competitive developments;
fund development, validation and marketing efforts of current and future tests;
comply with current and evolving regulatory requirements;
further expand our clinical laboratory operations;
expand our technologies into other types of cancer;
acquire, license or invest in technologies;
acquire or invest in complementary businesses or assets; and
finance capital expenditures and general and administrative expenses.


Our present and future funding requirements and our forecast of the period of time through which our current financial resources will be adequate to support our operations will depend on many factors, including:
our ability to achieve revenue growth;
our ability to extend and amend our credit agreements;
our ability to continue to reduce our costs and improve our operational efficiency;
our ability to develop and obtain approvals for our new diagnostic tests and the costs associated with such research and development activities;
our ability to execute on our marketing and sales strategy for our tests and services and gain acceptance of our tests and services in the market;
our ability to obtain adequate reimbursement from governmental and other third-party payors for our tests and services;
the costs, scope, progress, results, timing and outcomes of the clinical trials of our diagnostic tests;
the costs of operating and enhancing our laboratory facilities;
the costs of additional general and administrative personnel;
the timing of and the costs involved in regulatory compliance, particularly if the regulations relating to laboratory developed tests (“LDTs”) change;
the timing of and costs involved in regulatory compliance, particularly if the regulations relating the PPACA (Patient Protection and Affordable Care Act) change;
the costs of maintaining, expanding and protecting our intellectual property portfolio, including potential litigation costs and liabilities;
the effect of competing technological and market developments;
costs related to international expansion; and
our ability to secure financing and the amount thereof.

The various ways we could raise additional capital carry potential risks. If we raise funds by issuing equity securities, dilution to our stockholders could result. Any equity securities issued also could provide for rights, preferences or privileges senior to those of holders of our common stock. If we raise funds by issuing debt securities, those debt securities would have rights, preferences and privileges senior to those of holders of our capital stock. The terms of debt securities issued or borrowings pursuant to a credit agreement could impose significant restrictions on our operations and increase our interest expense. If we raise funds through collaborations and licensing arrangements, we might be required to relinquish significant rights to our technologies or tests, or grant licenses on terms that are not favorable to us.

Additional equity or debt financing might not be available on reasonable terms, if at all. If we cannot secure additional funding when needed, we may have to delay, reduce the scope of or eliminate one or more research and development programs or sales and marketing initiatives. In addition, we may have to work with a partner on one or more of our development programs, which could lower the economic value of those programs to us.

We

CGI identified a material weakness in ourits internal control over financial reporting. If we are not able to remediate the material weakness and otherwise maintain an effective system of internal control over financial reporting, the reliability of ourits financial reporting, investor confidence in us and the value of our common stock could be adversely affected.


As a public company, we are required to maintain internal control over financial reporting and to report any material weaknesses in such internal controls. Section 404 of SOX, or the Sarbanes-Oxley Act (“Section 404,404”) requires that we evaluate and determine the effectiveness of our internal controls over financial reporting and provide a management report on internal control over financial reporting. A material weakness is a deficiency, or combination of deficiencies, in internal control over financial reporting such that there is a reasonable possibility that a material misstatement of annual or interim financial statements will not be prevented or detected and corrected on a timely basis.


During the fourth quarteraudit for the 2020 fiscal year of 2017, weCGI, the accounting predecessor (as the Merger was a reverse merger) and legal acquiror of StemoniX, identified a material weakness in our internal control over financial reporting related to our controls over accounting for uncollectible Clinical Services revenue, which prevented the Company from identifyingpotential impairment of intangible assets. This material weakness was not remediated at the time of the Merger and properly recording contractual allowances duringtherefore, became part of the fourth quarter. Aspost-Merger internal control structure of Vyant Bio. This accounting requires us to record an impairment charge if the carrying amount of the asset group is not recoverable and is in excess of the fair value of the asset group. CGI’s calculation of undiscounted future cash flows resulted in a result, amountsconclusion that should have been reported as reductions in revenue were instead reported as bad debt expense. no impairment was necessary, however, we could not supply supporting evidence that its calculation was accurate.

We are committed to remediating the material weakness. We have begunbegan the process of implementing changes to ourits internal control over financial reportingintangible assets to remediate the control deficiencies that gave rise to the material weakness, including further improvements in our processes and analysesimplemented the following enhancements to internal controls to address this material weakness:

Hired a new CFO with significant experience in internal controls, US GAAP and financial forecasting;
Established a financial planning and analysis function in June 2021 to analyze, forecast and report on the Company’s operations; and
Developed a financial model to forecast vivoPharm revenue based on inputs from management.

We determined that the underlying revenue forecasting model to support the estimatedetermination of cash flows for our vivoPharm business contained data input errors that required additional analysis and validation during the first quarter of 2022. While these data errors did not impact our assessment of the allowance for doubtful accountscarrying value of our vivoPharm business as of December 31, 2021, the redesign of this control and the related bad debt expense and performing a comprehensive reviewongoing testing of the need for additional corporate accounting and financial personnel, supplemented by external resources as appropriate, with the requisite skill and technical expertise. We had expected this deficiency to be corrected as part of the implementation of ASU 2014-09 effective January 1, 2018.


However, during the fourth quarter of 2018, we noted that the material weakness in our revenue and cash receipts process has continued in 2018 as our remediation efforts wereits operational effectiveness will not adequate.occur until 2022. As a result, additional amounts had to be recorded as bad debt expense for older balances. Based on a changethe Company concluded that the deficiency in financial leadership in late November 2018, we have demonstrated a commitment to remediate the material weakness in a timely fashion. We have begun the process of implementing changes to our internal control over financial reporting related to remediate the control deficiencies that gaverevenue and cash flow forecasting would give rise to the level of a material weakness including further improvementsas of December 31, 2021. The Company expects to remediate this control in our processes2022 through enhanced data validation and analyses that support the estimate of the allowance for doubtful accounts and the related bad debt expense. We have noted the need for additional corporate accounting and financial personnel, supplemented by external resources as appropriate, with the requisite skill and technical expertise. We expect this deficiencymanagement review.

Our ability to be corrected by the end of 2019.


If our steps are insufficient to successfully remediate the material weakness and otherwise establish and maintain an effective system of internal control over financial reporting could impact the reliability of our financial reporting, investor confidence in us and the value of our common stock could be materially and adversely affected. Effective internal control over financial reporting is necessary for us to provide reliable and timely financial reports and, together with adequate disclosure controls and procedures, are designed to reasonably detect and prevent fraud. Any failure to implement required new or improved controls, or difficulties encountered in their implementation could cause us to fail to meet ourits reporting obligations. For as long as we are a “smaller reporting company” under the U.S. securities laws, our independent registered public accounting firm will not be required to attest to the effectiveness of our internal control over financial reporting pursuant to Section 404. An independent assessment of the effectiveness of our internal control over financial reporting could detect problems that our management’s assessment might not. Undetected material weaknesses in our internal control over financial reporting could lead to financial statement restatements and require us to incur the expense of remediation.

Moreover, we

We do not expect that disclosure controls or internal control over financial reporting will prevent all errorerrors and all fraud. A control system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that the control system’s objectives will be met. Further, the design of a control system must reflect the fact that there are resource constraints and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, have been detected. Failure of ourits control systems to prevent error or fraud could materially adversely impact us.

Risks Relating to Our Business and Strategy

Our business is subject to risks arising from epidemic diseases, such as the global outbreak of COVID-19.

The outbreak of COVID-19, which has been declared by the World Health Organization to be a pandemic, has spread across the globe and is impacting worldwide economic activity. A pandemic, including COVID-19 or other public health epidemic, poses the risk that we or our employees, contractors, suppliers, courier delivery services and other partners may be prevented from conducting business activities for an indefinite period of time, including due to spread of the disease within these groups or due to shutdowns that may be requested or mandated by governmental authorities.

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We are engaged in shareholder litigation.

Following periods

The continued spread of volatilityCOVID-19 and its variants, and the measures taken by the governments of countries affected could disrupt the supply chain of material needed for our business and could delay future projects from commencing due to COVID-19 related impacts on the demand for our services and therefore have a material adverse effect on business, financial condition and results of operations.

Many of our customers worldwide were impacted by COVID-19 and temporarily closed their facilities which impacted revenue in the market pricefirst half of a company’s securities, securities class action litigation has often been instituted against companies. On April 5, 2018 and April 12, 2018, purported stockholders2020 for our StemoniX business. While the impact of the Company filed nearly identical putative class action lawsuits in the U.S. District Court for the District of New Jersey, against the Company, Panna L. Sharma, John A. Roberts, and Igor Gitelman, captioned Ben Phetteplace v. Cancer Genetics, Inc. et al., No. 2:18-cv-05612 and Ruo Fen Zhang v. Cancer Genetics, Inc. et al., No. 2:18-06353, respectively. The complaints alleged violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and SEC Rule 10b-5 basedpandemic on allegedly false and misleading statements and omissions regarding our business operational,has lessened, the global outbreak of COVID-19 continues with new variants and financial results. The lawsuits sought, among other things, unspecified compensatory damages in connection with purchases ofis impacting the way we operate our stock between March 23, 2017 and April 2, 2018,business as well as interest, attorneys’ fees,in certain circumstances limiting the availability of lab supplies. The extent to which the COVID-19 pandemic may impact the our future business will depend on future developments, which are highly uncertain and costs. On August 28, 2018, the Court consolidated the two actions in one action captioned In re Cancer Genetics, Inc. Securities Litigation (the “Securities Litigation”) and appointed shareholder Randy Clarkcannot be predicted with confidence, such as the lead plaintiff. On October 30, 2018,availability and effectiveness of vaccines, the lead plaintiff filed an amended complaint, adding Edward Sitar as a defendant and seeking, among other things, compensatory damages in connection with purchases of CGI stock between March 10, 2016 and April 2, 2018. On December 31, 2018, Defendants filed a motion to dismiss the amended complaint for failure to state a claim. The Company is unable to predict the ultimate outcomeduration of the Securities Litigationoutbreak, travel restrictions and therefore cannot estimate possible lossessocial distancing in the United States and other countries, business closures or rangesbusiness disruptions, and the effectiveness of losses,actions taken in the United States and other countries to contain and treat the disease.

We are actively monitoring the impact of the COVID-19 pandemic on its business, results of operations and financial condition. The full extent to which the COVID-19 pandemic will directly or indirectly impact our business, results of operations and financial condition in the future is unknown at this time and will depend on future developments that are highly unpredictable.

We face competition in drug discovery from other biotechnology, pharmaceutical, artificial intelligence and other drug discovery companies and technologies and our operating results may be negatively affected if any.

we fail to compete effectively.

The biotechnology, pharmaceutical and drug discovery and development industries are intensely competitive and subject to rapid and significant technological change. We have competitors in a number of jurisdictions, many of which have substantially greater name recognition, commercial infrastructures and financial, technical and personnel resources than we have. Established competitors may invest heavily to quickly discover and develop novel compounds that could make our drug candidates obsolete or uneconomical. Any new product that competes with an approved product may need to demonstrate compelling advantages in efficacy, cost, convenience, tolerability and safety to be commercially successful. In recent years drug discovery has integrated biology, chemistry and technology, including machine learning, augmented and artificial intelligence as well as several forms of human cells to accelerate research and development activities and its effectiveness and efficiency. Other competitive factors, including generic competition, could force us to lower prices or could result in reduced sales. In addition, on June 1, 2018, September 20, 2018, and September 25, 2018, purported stockholders of the Company filed nearly identical derivative lawsuits on behalf of the Company in the U.S. District Court for the District of New Jerseynew products developed by others could emerge as competitors to our drug candidates. If we are not able to compete effectively against the Company (as a nominal defendant) andour current and former membersfuture competitors, our business will not grow and our financial condition and operations will suffer.

We have limited experience in drug discovery, drug development, disease model development and clinical development, and we have never advanced a drug to human development or had a drug approved alone or with collaborators.

The convergence in drug discovery of human organoid disease models along with new in silico technologies including artificial intelligence, machine learning, and new chemistry creation is unproven. There is limited evidence that such an approach will reduce time and risk around preclinical development. Regarding our business model to date, we are pursuing two distinct but parallel tracks to identify novel and repurposed drug therapies: we develop and license access to human cell-derived disease models, and in conjunction with applying data science and in vivo testing, use this technology to identify candidates to bring through the discovery phase which we plan to then partner with pharmaceutical companies to pursue clinical development and commercialization. We may also out license our iPSC disease model development capabilities to strategic partners to co-develop drugs associated with such disease models. To date, we have made very limited independent drug discovery efforts, have not licensed our iPSC disease models and no assurances can be given that we will be successful in generating revenue from these activities.

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The Company’s Boardstrategy is to attempt to file approximately two investigational new drug (“IND”) applications with United States Food and Drug Administration (“FDA”) starting in 2023 and perform clinical trials up through Phase I. We do not have any experience in clinical development and have not advanced any drug candidates into clinical development. Our lack of Directorsexperience in conducting clinical development activities may adversely impact the likelihood that we will be successful in advancing our programs, if we are not able to find experienced partners. Further, any predictions you make about the future success or viability of our internal drug discovery programs may not be as accurate as they could be if we had a history of conducting clinical trials and currentdeveloping our own drug candidates.

In addition, as our internal drug discovery business grows, we may encounter unforeseen expenses, difficulties, complications, delays, and former officersother known and unknown factors. Our internal drug discovery business may need to transition to a business capable of the Company. The three cases are captioned: Bell v. Sharma et al., No. 2:18-cv-10009-CCC-MF, McNeece v. Pappajohn et al., No. 2:18-cv-14093, and Workman v. Pappajohn, et al., No. 2:18-cv-14259 (the “Derivative Litigation”). The complaints allege claims for breach of fiduciary duty, violations of Section 14(a) of the Securities Exchange Act of 1934 (premised upon alleged omissions in the Company’s 2017 proxy statement), and unjust enrichment, and allege that the individual defendants failed to implement and maintain adequate controls, which resulted in ineffective disclosure controls and procedures, and conspired to conceal this alleged failure. The lawsuits seek, among other things, damages and/or restitution to the Company, appropriate equitable relief to remedy the alleged breaches of fiduciary duty, and attorneys’ fees and costs. On November 9, 2018, the Court in the Bell v. Sharma action entered a stipulation filed by the parties staying the Bell action until


the Securities Litigation is dismissed, with prejudice, and all appeals have been exhausted; or the defendants’ motion to dismiss in the Securities Litigation is denied in whole or in part; or either of the parties in the Bell action gives 30 days’ notice that they no longer consent to the stay. On December 10, 2018, the parties in the McNeece action filed a stipulation that is substantially identical to the Bell stipulation. On February 1, 2019, the Court in the Workman action granted a stipulation that is substantially identical to the Bell stipulation. The Company is unable to predict the ultimate outcome of the Derivative Litigation and therefore cannot estimate possible losses or ranges of losses, if any.
Additional shareholder lawsuits may be filed in the future.supporting clinical development activities. We may not be successful in defending ourselves in litigation or arbitration which may result in large judgments or settlements against us, anysuch a transition.

Our approach to the discovery and development of which could have a negative effectdrug candidates based on our business, financial condition, cash flowsmicroOrgan plates and results of operations. Additionally, lawsuits can be expensive to defend, whether or not they have merit,our AnalytiX tools is novel and the defense of these actions may divert the attention of our managementunproven, and other resources that would otherwise be engaged in managing our business. Our liability insurance coverage may not be sufficient to satisfy, or may not cover, any expenses or liabilities that may arise.


Our outstanding warrants and stock options may have an adverse effect on the market price of shares of our common stock.

As of March 11, 2019, we had issued and outstanding warrants to purchase 12,053,541 shares of our common stock at a weighted-average exercise price of $3.14 per share and outstanding options to purchase an aggregate of 2,344,171 shares of our common stock at a weighted-average exercise price of $4.79 per share. We also had approximately 3,745,800 shares issuable upon the conversion of the Iliad Note, at a conversion price of $0.80 per share, and approximately 2,661,364 shares issuable upon the conversion of the outstanding balance under the Novellus Credit Agreement at a conversion price of $0.606 per share. The sale, or even the possibility of sale, and the uncertainty with respect to the timing of any sales, of the shares underlying these securities, particularly the warrants, could have an adverse effect on the market price of our common stock and on our ability to obtain future financing at prices we deem satisfactory, or at all. If and to what extent these warrants and/or options are exercised, you may experience dilution to your holdings.

We are not currently in compliance with the continued listing requirements for the Nasdaq Capital Market. If we do not regain compliance and continue to meet the continued listing requirements, our common stock may be delisted from the Nasdaq Capital Market, which could affect the market price and liquidity for our common stock and reduce our ability to raise additional capital.
Our common stock is listed on the Nasdaq Capital Market. In order to maintain that listing, we must satisfy minimum financial and other requirements including, without limitation, a requirement that our closing bid price be at least $1.00 per share, and that we hold an annual meeting of stockholders within twelve months of the end of our fiscal year.
On January 29, 2019, the Company received written notice from the Listing Qualifications Staff of The Nasdaq Stock Market (“Nasdaq”) notifying the Company that it was required to seek stockholder approval of the execution of the Novellus Credit Agreement, under which the Company was advanced $1.5 million, the outstanding balance of which, including interest, is convertible, at the option of Novellus, into shares of common stock at a conversion price of $0.606 per share, due to the potential for the Company, upon a conversion of such outstanding balance, with interest, to be required to issue common stock at a discount to the market price of the common stock on the day of execution of such agreement in excess of 20% of the pre-transaction outstanding shares of common stock, pursuant to Nasdaq Listing Rule 5635(d) (the “Approval Requirement”). The obligation was convertible into 2,475,248 shares (or approximately 8.9% of the Company’s outstanding common stock) on the date of entry into the Novellus Credit Agreement. The Company had contemplated that the Novellus Credit Agreement would be paid off or otherwise retired in advance of any time at which the outstanding balance under such agreement could have been convertible into common stock in excess of the 20% threshold, due to both the Novellus Merger Agreement and the Novellus Credit Agreement having end dates of March 31, 2019. However, as the Novellus Merger Agreement was terminated in December 2018 before shareholder approval was sought, the Company potentially may be required to issue shares of common stock upon conversion under such agreement in excess of such threshold at a future date.

Nasdaq’s notice had no immediate effect on the listing of the common stock on the Nasdaq Capital Market. Under Nasdaq Listing Rule 5810(c)(2)(C), the Company had 45 calendar days from January 29, 2019, or until March 15, 2019, to submit to Nasdaq a plan to regain compliance with the Approval Requirement, which the Company submitted on March 15, 2019. If Nasdaq accepts the Company’s plan, Nasdaq may grant an extension of up to 180 calendar days from January 29, 2019, or July 28, 2019, to regain compliance. If Nasdaq does not accept the Company’s plan, the Company will have the right to appeal such decision to a Nasdaq hearings panel. There can be no assurance that Nasdaq will accept the Company’s plan or that the Company will be able to regain compliance with the Approval Requirement or maintain compliance with any other Nasdaq requirement in the future.


On January 3, 2019, we received written notice from the Listing Qualifications Staff Nasdaq notifying us that we no longer comply with Nasdaq Listing Rule 5620(a) due to our failure to hold an annual meeting of stockholders within twelve months of the end of our fiscal year ended December 31, 2017 (the “Annual Meeting Requirement”). We had contemplated holding our 2018 annual meeting of stockholders simultaneously with seeking stockholder approval of the Novellus Merger Agreement. As the Novellus Merger Agreement was terminated in December 2018 before any approval was sought, we still need to schedule an annual meeting.
Nasdaq’s notice had no immediate effect on the listing of our common stock on the Nasdaq Capital Market. Under Nasdaq Listing Rule 5810(c)(2)(G), we had 45 calendar days from January 3, 2019, or until February 19, 2019, to submit to Nasdaq a plan to regain compliance with the Annual Meeting Requirement, which we submitted on February 19, 2019. If Nasdaq accepts our plan, Nasdaq may grant an extension of up to 180 calendar days from December 31, 2018, the date of our fiscal year end for our last fiscal year, or July 1, 2019, to regain compliance. If Nasdaq does not accept our plan, we will have the right to appeal such decision to a Nasdaq hearings panel.
There can be no assurance that Nasdaq will accept our plan or that we will be able to regain compliance with the Annual Meeting Requirement or maintain compliance with any other Nasdaq requirement in the future.
On November 13, 2018, we received a written notice from Nasdaq indicating that we are not in compliance with the minimum bid price requirement for continued listing on the Nasdaq Capital Market. We have 180 calendar days in which to regain compliance, or until May 13, 2019. We can regain compliance if at any time during this 180 day period the bid price of our common stock closes at or above $1.00 per share for a minimum of ten consecutive business days.
We intend to monitor the closing bid price of our common stock and consider our available options to resolve our noncompliance with the minimum bid price requirement, which may include submitting for approval by our stockholders a proposal to grant discretionary authority to our board of directors to amend our certificate of incorporation to effect a reverse split of our outstanding shares of common stock within an appropriate range, with the exact reverse split ratio to be decided and publicly announced by the board of directors prior to the effective time of the amendment to our certificate of incorporation. No determination regarding our response has been made at this time. There can be no assurance that we will be able to regain compliance with the minimum bid price requirement or we will otherwise be in compliance with other Nasdaq listing criteria.
If we fail to regain compliance with the minimum bid requirement, the Annual Meeting Requirement or the Approval Requirement or to meet the other applicable continued listing requirements for the Nasdaq Capital Market in the future and Nasdaq determines to delist our common stock, the delisting could adversely affect the market price and liquidity of our common stock and reduce our ability to raise additional capital. In addition, if our common stock is delisted from Nasdaq and the trading price remains below $5.00 per share, trading in our common stock might also become subject to the requirements of certain rules promulgated under the Exchange Act, which require additional disclosure by broker-dealers in connection with any trade involving a stock defined as a “penny stock” (generally, any equity security not listed on a national securities exchange or quoted on Nasdaq that has a market price of less than $5.00 per share, subject to certain exceptions).

Risks Relating to Our Business and Strategy

If we are unable to increase sales of our tests and services or to successfully develop and commercialize other proprietary tests, our revenues will be insufficient for us to achieve profitability.

We currently derive substantially all of our revenues from our testing services and laboratory and CRO services at the premarket stage. We have only recently begun offering our proprietary Focus::NGS® panels through our CLIA-certified, CAP-accredited and state licensed laboratories. We are in varying stages of research and development for other diagnostic tests that we may offer.

Biopharma Services are services and tests provided to pharmaceutical and biotech companies and clinical research organizations in connection with phase I, phase II or phase III studies for development of therapeutic drugs. The nature of these services is that they tend to come in relatively large projects but episodically, rather than providing steady sources of revenues. It is unclear at this stage of our developmentknow whether we will be able to maintaindevelop any products of commercial value.

We are leveraging our microOrgan plates and grow the numberour AnalytiX tools to attempt to create a pipeline of pharmaceuticaldrug candidates for patients whose diseases have not been adequately addressed to date by other approaches, and biotech companiesto identify drug candidates with a higher likelihood of success in clinical trials. While we believe that our technology may potentially enable drug research and clinical development that is more efficient than conventional drug research organizations who will avail themselvesand development, our approach is both novel and unproven. Because our approach is both novel and unproven, the cost and time needed to discover our drug candidates is difficult to predict, and our efforts may not result in the discovery and development of commercially viable medicines or therapies. We may also be incorrect about the effects of any drug candidates we pursue on disease states, which may limit the utility of our services,approach or how regular a flowthe perception of drug development projectsthe utility of our approach. Furthermore, our estimates of our defined patient populations available for study and treatment may be lower than expected, which could adversely affect our or our partners’ ability to conduct clinical trials and may also adversely affect the size of any market for medicines we willmay license for commercialization. Our approach may not result in time savings, higher success rates or reduced costs as we expect it to, and if not, we may not attract collaborators or develop new drugs as quickly or cost effectively as expected and therefore we may not be able to commercialize our approach as expected at this time.

We may never realize return on our investment of resources and cash in our drug discovery collaborations.

We intend to use our high-throughput drug screening on our microOrgan plate technology and use our data science-based AnalytiX tools to quickly test and evaluate a drug for toxicity and efficacy. We believe such technologies, which we have developed at significant expense, will provide us or our collaborators with valuable drug discovery insights. Our collaborators could include start-up, pre-commercial biotechnology, in silico and large-scale pharmaceutical companies. When we engage in drug discovery with these collaborators, we will strive to receive a mixture of upfront payments, including licensing fees, milestone-based fees, and ongoing royalty payments in addition to any charges for in vivo, in vitro and in silico testing, and our SaaS services. However, we have not yet been successful in generating any significant payments or contracts using this business model and may never be.

We may never enter into any material drug discovery collaborations nor realize return on our investment of resources and cash in our drug discovery collaborations. Drug discovery is complex, capital intensive and is prone to high failure rates and uncertain outcomes. Our drug discovery collaborators may incur additional costs or experience delays in completing, or ultimately be unable to complete, the development and commercialization of any drug candidates. In addition, our ability to realize return from our drug discovery collaborations is subject to the following risks, among others:

drug discovery collaborators have significant discretion in determining the amount and timing of efforts and resources that they will apply to our collaborations and may not perform their obligations as expected;
drug discovery collaborators may not pursue development or commercialization of any drug candidates for which we are entitled to option fees, milestone payments, or royalties or may elect not to continue or renew development or commercialization programs based on results of clinical trials or other studies, changes in the collaborator’s strategic focus or available funding, or external factors, such as an acquisition, that divert resources or create competing priorities;

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drug discovery collaborators may delay clinical trials for which we are entitled to milestone payments;
we may not have access to, or may be restricted from disclosing, certain information regarding our collaborators’ drug candidates being developed or commercialized and, consequently, may have limited ability to inform our stockholders about the status of, and likelihood of achieving, milestone payments or royalties under such collaborations;
drug discovery collaborators could independently develop, or develop with third parties, products that compete directly or indirectly with any drug candidates and products for which we are entitled to milestone payments or royalties if the collaborator believes that the competitive products are more likely to be successfully developed or can be commercialized under terms that are more economically attractive;
drug candidates discovered in drug discovery collaborations with us may be viewed by our collaborators as competitive with their own drug candidates or products, which may cause our collaborators to cease to devote resources to the commercialization of any such drug candidates;
drug discovery collaborators may begin to perceive us to be a competitor more generally, particularly if we advance our internal drug discovery programs, and therefore may be unwilling to continue then existing collaborations with us or to enter into new collaborations with us;
a drug discovery collaborator may fail to comply with applicable regulatory requirements regarding the development, manufacture, distribution, or marketing of a drug candidate or product, which may impact our ability to receive milestone payments;
disagreements with drug discovery collaborators, including disagreements over intellectual property or proprietary rights, contract interpretation, or the preferred course of development, might cause delays or terminations of the research, development, or commercialization of drug candidates for which we are eligible to receive milestone payments, or might result in litigation or arbitration;
drug discovery collaborators may not properly obtain, maintain, enforce, defend or protect our intellectual property or proprietary rights or may use our proprietary information in such a way as to potentially lead to disputes or legal proceedings that could jeopardize or invalidate our or their intellectual property or proprietary information or expose us and them to potential litigation;
drug discovery collaborators may infringe, misappropriate, or otherwise violate the intellectual property or proprietary rights of third parties, which may expose us to litigation and potential liability;
drug discovery collaborators could suffer from operational delays as a result of global health impacts, such as the COVID-19 pandemic; and
drug discovery collaborations may be terminated prior to our receipt of any significant value from the collaboration.

Any drug discovery collaborations we enter into may not lead to development or commercialization of drug candidates that results in our receipt of fees, milestone payments, or royalties in a timely manner, or at all. If any drug discovery collaborations that we enter into do not result in the successful development and commercialization of drug products that result in fees, milestone payments, or royalties to us, we may not receive return on the resources we have invested in the drug discovery collaboration. Moreover, even if a drug discovery collaboration initially leads to the achievement of milestones that result in payments to us, it may not continue to do so.

We also will likely rely on collaborators for the development and potential commercialization of drug candidates we discover internally when we believe it will help maximize the commercial value of the drug candidate. Such collaborators may not achieve the research, development, regulatory and sales milestones for those development candidates that result in material payments to us.

We may not be successful in our efforts to identify or discover drug candidates and may fail to capitalize on programs, collaborations, or drug candidates that may present a greater commercial opportunity or for which there is a greater likelihood of success.

Research programs to identify new drug candidates require substantial technical, financial human resources, and external expertise. As a newly formed organization of existing technologies, we have not yet developed any drug candidates, and we may fail to identify potential drug candidates for clinical development. Similarly, a key element of our business plan is to expand the use of our technology in drug discovery collaborations with third parties. A failure to demonstrate the utility of our platform by successfully using it ourselves to discover internal drug candidates could harm our business prospects.

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Because we have limited resources, we focus our research programs on diseases where we have some know-how and where we believe there is a meaningful commercial opportunity, among other factors. The focus of our initial internal drug discovery programs is in the area of neurological disorders including Rett Syndrome, CDLK5 Deficiency Disorder, and Parkinson’s Disease. We may forego or delay pursuit of opportunities with certain programs, collaborations, or drug candidates or for indications that later prove to have greater commercial potential. However, the development of any drug candidate we pursue may ultimately prove to be unsuccessful or less successful than another potential drug candidate that we might have chosen to pursue on a more aggressive basis with our capital resources. If we do not accurately evaluate the commercial potential for a particular drug candidate, we may relinquish valuable rights to that drug candidate through strategic collaboration, partnership, licensing, or other arrangements in cases in which it would have been more advantageous for us to retain development and commercialization rights to such drug candidate. Alternatively, we may allocate internal resources to a drug candidate in a therapeutic area in which it would have been more advantageous to enter into a collaboration.

If we are not able to establish or maintain collaborations to develop and commercialize any of the disease models we develop or drug candidates we discover, we may have to alter our development and commercialization plans for those disease models and drug candidates and our business could be adversely affected.

We have not yet established license collaborations for our disease models and related AnalytiX tools. We expect to rely on future collaborators for either the development of our disease models or leverage such licensed models for drug discovery. We face significant competition in seeking appropriate collaborators for these activities, and a number of more established companies may also be pursuing such collaborations.

We have also not yet identified any drug candidates or advanced any of our drug discovery programs past the discovery stage and into preclinical studies or human clinical trials. We expect to rely on future collaborators for the development and potential commercialization of drug candidates we discover internally when we believe it will help maximize the commercial value of the drug candidate. We face significant competition in seeking appropriate collaborators for these activities, and a number of more established companies may also be pursuing such collaborations. These established companies may have a competitive advantage over us due to their size, financial resources, and greater clinical development and commercialization expertise. Whether we reach a definitive agreement for such collaborations will depend, among other things, upon our assessment of the collaborator’s resources and expertise, the terms and conditions of the proposed collaboration, and the proposed collaborator’s evaluation of a number of factors. Those factors may include the design or results of preclinical studies and clinical trials, the likelihood of approval by the FDA or similar regulatory authorities outside the United States, the potential market for the subject drug candidate, the costs and complexities of manufacturing and delivering such drug candidate to patients, the potential of competing products, the existence of uncertainty with respect to our ownership of technology, which can exist if there is a challenge to such ownership without regard to the merits of the challenge, and industry and market conditions generally. The collaborator may also consider alternative drug candidates or technologies for similar indications that may be available to collaborate on and whether such a collaboration could be more attractive than the one with us for our drug candidate. Collaborations are complex and time-consuming to negotiate and document. In addition, there have been a significant number of recent business combinations among large biopharmaceutical companies that have resulted in a reduced number of potential future collaborators.

If we are unable to reach agreements with suitable collaborators on a timely basis, on acceptable terms or at all, we may have to curtail the development of a drug candidate, reduce, or delay its development program or one or more of our other development programs, or increase our expenditures and undertake development or commercialization activities at our own expense. If we elect to fund and undertake development or commercialization activities on our own, we may need to obtain additional expertise and additional capital, which may not be available to us on acceptable terms or at all. If we fail to enter into collaborations and do not have sufficient funds or expertise to undertake the necessary development and commercialization activities, we may not be able to further develop any drug candidates or bring them to market.

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Our drug discovery collaborators will have significant discretion in determining when to make announcements, if any, about the status of our collaborations, including about clinical developments and timelines for advancing collaborative programs, and the price of our common stock may decline as a result of announcements of unexpected results or developments.

Our drug discovery collaborators will have significant discretion in determining when to make announcements about the status of our collaborations, including about preclinical and clinical developments and timelines for advancing the collaborative programs. While as a general matter we intend to periodically report on the status of our collaborations, our drug discovery collaborators may wish to report such information more or less frequently than we intend to or may not wish to report such information at all unless legally required to do so. The price of our common stock may decline as a result of the public announcement of unexpected results or developments in our collaborations or as a result of our collaborators withholding such information.

If any current or future collaborators are unable to successfully complete clinical development, obtain regulatory approval for, or commercialize any drug candidates, or experience delays in doing so, our business may be materially harmed.

The success of any current or future collaborators’ development and commercialization programs will depend on several factors associated with our collaborators’ operations, including the following:

acceptable data based on in vitro or in silico screenings;
acceptable data at the completion of necessary preclinical studies to enable the initiation of clinical trials;
successful enrollment of patients in, and the completion of, the clinical trials;
acceptance by the FDA or other regulatory agencies of regulatory filings for any drug candidates we and our current or future collaborators may develop;
expanding and maintaining a workforce of experienced scientists and others to continue to develop any drug candidates;
obtaining and maintaining intellectual property protection and regulatory exclusivity for any drug candidates we and our current or future collaborators may develop;
making arrangements with third-party manufacturers for, or establishing, clinical and commercial manufacturing capabilities;
establishing sales, marketing, and distribution capabilities for drug products and successfully launching commercial sales, if and when approved;
acceptance of any drug candidates we and our current or future collaborators may develop, if and when approved, by patients, the medical community, and third-party payors;
effectively competing with other therapies;
obtaining and maintaining coverage, adequate pricing, and adequate reimbursement from third-party payors, including government payors;
patients’ willingness to pay out-of-pocket in the absence of coverage and/or adequate reimbursement from third-party payors; or
maintaining a continued acceptable safety profile following receipt of any regulatory approvals.

Many of these factors are beyond our control, including clinical outcomes, the regulatory review process, potential threats to our intellectual property rights, and the manufacturing, marketing, and sales efforts of any current or future collaborator. Clinical drug development involves a lengthy and expensive process, with an uncertain outcome. If we or our current or future collaborators are unable to develop, receive marketing approval for, and successfully commercialize any drug candidates, or if we or they experience delays as a result of any of these factors or otherwise, we may need to spend significant additional time and resources, which would adversely affect our business, prospects, financial condition, and results of operations.

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The use of any of our drug candidates in clinical trials may expose us to liability claims, which may cost us significant amounts of money to defend against or pay out, causing our business to suffer.

The nature of our business exposes us to potential liability risks inherent in the testing, manufacturing and marketing of our drug candidates. If any of our drug candidates enter clinical trials or become marketed products, they could potentially harm people or allegedly harm people possibly subjecting us to costly and damaging product liability claims. Some of the patients who participate in clinical trials are already ill when they enter a trial or may intentionally or unintentionally fail to meet the exclusion criteria. The waivers we obtain may not be enforceable and may not protect us from existing customers.


Discovery Servicesliability or the costs of product liability litigation. Although we intend to obtain product liability insurance that we believe is adequate, we are servicessubject to the risk that include proprietary preclinical test systems supporting our clinical diagnosticinsurance will not be sufficient to cover claims. The insurance costs along with the defense or payment of liabilities above the amount of coverage could cost us significant amounts of money and prognostic offerings at early stages, supportingmanagement distraction from other elements of the pharmaceutical industry, biotechnology companiesbusiness, causing our business to suffer.

Clinical trials are expensive, time-consuming and academic research centers. In particular,difficult to design and implement, and have traditionally had high attrition.

Before obtaining marketing approval from the FDA or other comparable foreign regulatory authorities for the sale of our drug candidates, we or our collaborators must complete preclinical development and extensive clinical trials to demonstrate the safety and efficacy of biomarker detection methods, responseour drug candidates. We currently plan to immuno-oncology directeddesign, fund and operate Phase 1 clinical trials and the license our drug candidates and rely on our collaboration partners to undertake future clinical trial funding and related activities. Clinical testing is expensive and can take many years to complete, and its outcome is inherently uncertain. Failure can occur at any time during the clinical trial process. We and our collaborators may experience delays in their clinical trials and it is unknown whether clinical trials will begin on time, need to be redesigned, enroll patients on time or be completed on schedule, if at all. Clinical trials can be delayed for a variety of reasons, including delays related to:

we and our collaboration partner’s funding and operational execution;
regulatory requirements for prolonged in vivo dosing regimens due to proposed treatment protocols;
the FDA or comparable foreign regulatory authorities requiring additional preclinical assessment of the candidate or disagreeing as to the design or implementation of clinical studies;
obtaining regulatory authorizations to commence a trial or consensus with regulatory authorities on trial designs;
reaching agreement on acceptable terms with prospective contract research organizations, or CROs, and clinical trial sites, the terms of which can be subject to extensive negotiation and may vary significantly among different CROs and trial sites;
diversion of healthcare resources to combat epidemics, such as the COVID-19 pandemic;
obtaining institutional review board, or IRB, approval at each site, or independent ethics committee, or IEC, approval at any sites outside the United States;
dependence on the needs and timing of third-party collaborators;
changes to clinical trial protocols;
recruiting suitable patients to participate in a trial in a timely manner and in sufficient numbers;
clinical sites deviating from trial protocol or dropping out of a trial;
addressing patient safety concerns that arise during the course of a trial;
having patients complete a trial or return for post-treatment follow-up;
imposition of a clinical hold by regulatory authorities, including as a result of unforeseen safety issues or side effects or failure of trial sites to adhere to regulatory requirements;
the occurrence of serious adverse events in trials of the same class of agents conducted by other companies or institutions;
subjects choosing an alternative treatment for the indications for which we are developing our drug candidates, or participating in competing trials;
adding a sufficient number of clinical trial sites;
manufacturing sufficient quantities of a drug candidate for use in clinical trials;
challenges in transporting the drug candidate to investigation sites;
lack of adequate funding to continue the clinical trial;

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selection of clinical end points that require prolonged periods of clinical observation or analysis of the resulting data;
failure to meet deadlines for annual reports or untimely review of reports by regulators;
a facility manufacturing our drug candidates or any of their components being ordered by the FDA or comparable foreign regulatory authorities to temporarily or permanently shut down due to violations of current good manufacturing practice, or cGMP, regulations or other applicable requirements, or infections or cross-contaminations of drug candidates in the manufacturing process;
any changes to the manufacturing process that may be necessary or desired;
third-party clinical investigators losing the licenses or permits necessary to perform the clinical trials, not performing clinical trials on anticipated schedule or consistent with the clinical trial protocol, good clinical practice, or GCP, or other regulatory requirements; or
third-party contractors not performing data collection or analysis in a timely or accurate manner; or third-party contractors providing poor quality data that requires extensive cleansing; or third-party contractors becoming debarred or suspended or otherwise penalized by the FDA or other government or regulatory authorities for violations of regulatory requirements or of the US Foreign Corrupt Practices Act while conducting non-US trials, in which case we or our collaborators may need to find a substitute contractor, and we or our collaborators may not be able to use some or all of the data produced by such contractors in support of our marketing applications.

In addition, disruptions caused by the COVID-19 pandemic or other public health crises may increase the likelihood that our collaborators encounter such difficulties or delays in initiating, enrolling, conducting or completing clinical trials or research and development. Our collaborators could encounter delays if a clinical trial is suspended or terminated by them, by the IRBs (or IECs) of the institutions in which such trials are being conducted, by the Data Safety Monitoring Board, or DSMB, for such trial or by the FDA or other regulatory authorities. Such authorities may impose such a suspension or termination due to a number of factors, including failure to conduct the clinical trial in accordance with regulatory requirements or clinical protocols, inspection of the clinical trial operations or trial site by the FDA or other regulatory authorities resulting in the imposition of a clinical hold, unforeseen safety issues or adverse side effects, failure to demonstrate a benefit from using a drug, changes in governmental regulations or administrative actions or lack of adequate funding to continue the clinical trial. Furthermore, our collaborators may rely on CROs and clinical trial sites to ensure the proper and timely conduct of clinical trials and, while there may be agreements governing these activities, our collaborators would have limited influence over their actual performance.

Further, conducting clinical trials in foreign countries, as our collaborators may do for our current and future drug candidates, presents additional risks that may delay completion of clinical trials. These risks include the failure of enrolled patients in foreign countries to adhere to clinical protocol as a result of differences in healthcare services or cultural customs, managing additional administrative burdens associated with foreign regulatory schemes, failure to account for foreign currency exchange rates in budgeting and financial considerations, customs and trade practices in the shipment of drug substances, as well as political and economic risks relevant to such foreign countries.

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

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novel treatments

We and our collaborators will depend on enrollment of patients in their clinical trials in order to continue development of our drug candidates. If they are unable to enroll patients in those clinical trials, our and their research and development efforts could be adversely affected.

The timely completion of clinical trials in accordance with their protocols depends, among other things, on our collaborators’ ability to enroll a sufficient number of patients who remain in the study until its conclusion. Our collaborators may experience difficulties in patient enrollment in their clinical trials for a variety of reasons. Patient enrollment is affected by many factors including the size and nature of the patient population, the proximity of patients to clinical sites, the eligibility criteria for the trial, the design of the clinical trial, the size of the patient population required for analysis of the trial’s primary endpoints, the proximity of patients to study sites, our collaborators’ ability to recruit clinical trial investigators with the appropriate competencies and experience, our collaborators’ ability to obtain and maintain patient consents, the risk that patients enrolled in clinical trials will drop out of the trials before completion, and competing clinical trials and clinicians’ and patients’ perceptions as to the potential advantages of the drug being studied in relation to other available therapies, including any new drugs that may be approved for the indications we are investigating. Our collaborators’ ability to enroll patients in clinical trials may be impacted by governmental restrictions and diversion of healthcare resources resulting from the COVID-19 pandemic. Many pharmaceutical companies may conduct clinical trials in patients with the disease indications that our potential drug products may target. As a result, we and our collaborators may need to compete with them for clinical sites, physicians and the limited number of patients who fulfill the stringent requirements for participation in clinical trials. Also, due to the confidential nature of clinical trials, it is unknown how many of the eligible patients may be enrolled in competing studies and who are consequently not available for our collaborators’ clinical trials. Our Phase 1 clinical trials or our collaborators’ clinical trials may be delayed or terminated due to the inability to enroll enough patients. The delay or inability to meet planned patient enrollment may result in increased costs and delay or termination of the trials, which could have a harmful effect on our and our collaborators’ ability to develop products.

The regulatory approval processes of the FDA and comparable foreign authorities are lengthy, time consuming, expensive and inherently challenging, and if we or our collaborators are ultimately unable to obtain regulatory approval for our drug candidates, our business could be significantly limited.

The time required to obtain approval by the FDA and comparable foreign authorities is unpredictable but typically takes many years following the commencement of clinical trials and depends upon numerous factors, including the substantial discretion of the regulatory authorities. The results of preclinical studies and early predictionclinical trials of our drug candidates may not be predictive of the results of later-stage clinical trials. Drug candidates in later stages of clinical outcometrials may fail to show the desired safety and efficacy traits despite having progressed through preclinical studies and initial clinical trials. It is supported bycommon for companies in the biopharmaceutical industry to suffer significant setbacks in advanced clinical trials due to nonclinical findings made while clinical studies were underway and safety or efficacy observations made in clinical studies, including previously unreported adverse events. Our collaborators’ future clinical trial results may not be successful, and notwithstanding any potential promising results in earlier studies, we cannot be certain that we and our extended portfoliocollaborators’ will not face similar setbacks. The historical failure rate for drug candidates in our industry is high. In addition, approval policies, regulations, or the type and amount of orthotopic, xenograftsclinical data necessary to gain approval may change during the course of a drug candidate’s clinical development, is subject to individual or review panel interpretation, and syngeneic tumor test systems. Since this acquisition if relatively new,may vary among jurisdictions. We have not obtained regulatory approval for any drug candidate and it is unclearpossible that none of our existing drug candidates or any drug candidates we may seek to develop in the future will ever obtain regulatory approval.

Our drug candidates could fail to receive regulatory approval for many reasons, including the following:

the FDA or comparable foreign regulatory authorities may disagree with the design or implementation of our collaborators’ clinical trials;
we or our collaborators’ may be unable to demonstrate to the satisfaction of the FDA or comparable foreign regulatory authorities that a drug candidate is safe and effective for its proposed indication;
the results of clinical trials may not meet the level of statistical significance required by the FDA or comparable foreign regulatory authorities for approval;
the FDA or comparable foreign regulatory authorities may disagree with our or our collaborators’ interpretation of data from preclinical studies or clinical trials;
the data collected from clinical trials of our drug candidates may not be sufficient to support the submission of an New Drug Application (NDA), or Biologics License Application (BLA), or other submission or to obtain regulatory approval in the United States or elsewhere; the FDA or comparable foreign regulatory authorities may disagree that changes to branded reference drugs meet the criteria for the 505(b)(2) regulatory pathway or foreign regulatory pathways such as the hybrid medicinal product pathway;
the FDA or comparable foreign regulatory authorities may fail to approve the manufacturing processes or facilities of third-party manufacturers with which we or our collaborators contract for clinical and commercial supplies; and
the approval policies or regulations of the FDA or comparable foreign regulatory authorities may significantly change in a manner rendering clinical data insufficient for approval.

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The lengthy approval process as well as the unpredictability of future clinical trial results may result in our or our collaborators failing to obtain regulatory approval to market our drug candidates, which would significantly harm our business, results of operations and prospects.

In addition, even if we were to obtain approval, regulatory authorities may approve any of our potential drug candidates for fewer or more limited indications than we request, may not approve the price we intend to charge for our products, may grant approval contingent on the performance of costly post-marketing clinical trials, may approve a drug candidate with a label that does not include the labeling claims necessary or desirable for the successful commercialization of that drug candidate, may classify our drug candidates in a way that hinders market acceptance, and/or may restrict distribution of our approved drugs. Any of the foregoing scenarios could materially harm the commercial prospects for our potential drug candidates.

We have not previously submitted an NDA or BLA to the FDA or similar drug approval filings to comparable foreign authorities, for any drug candidate, and we cannot be certain that any of our drug candidates will be successful in clinical trials or receive regulatory approval. Further, our drug candidates may not receive regulatory approval even if they are successful in clinical trials. If we do not receive regulatory approvals for our drug candidates, we may not be able to continue our operations. Even if we successfully obtain regulatory approvals to market one or more of our drug candidates, our revenue will be dependent, in part, upon the size of the markets in the territories for which we gain regulatory approval and have commercial rights. If the markets for patients that we or our collaborators are targeting for our drug candidates are not as significant as we estimate, we may not generate significant revenue from sales of such products, if approved.

We may plan to seek regulatory approval to commercialize our drug candidates in the United States, the European Union, and in additional foreign countries. While the scope of regulatory approval is similar in other countries, to obtain separate regulatory approval in many other countries we must comply with numerous and varying regulatory requirements of such countries regarding safety and efficacy and governing, among other things, clinical trials and commercial sales, pricing and distribution of our drug candidates, and we cannot predict success in these jurisdictions.

Our success depends upon achieving a critical mass of customers and strategic relationships.

Our success is dependent upon achieving significant market acceptance and strategic relationships. To date, we have achieved only limited market acceptance and formed only limited strategic relationships. We do not know whether we will be able to maintaincreate all the customer and grow the numberstrategic relationships necessary to make our business model function.

The degree of pharmaceuticalmarket acceptance and biotech companies and clinical research organizations who will avail themselvesadoption of our services, or how regular a flow of drug development projects weproducts will be able to obtain from existing customers.


If we are unable to increase sales of our tests and services or to successfully develop, validate and commercialize other diagnostic tests, we will not produce sufficient revenues to become profitable.

If pathologists and oncologists decide not to order our diagnostic tests and/or pharmaceutical and biotech companies and clinical research organizations decide not to use our diagnostic tests and services and our CRO services in connection with their clinical trials, we may be unable to generate sufficient revenue to sustain our business.

To generate demand for our Clinical Services, we will need to educate oncologists and pathologists on the clinical utility, benefits and value of each type of test we provide through published papers, presentations at scientific conferences and one-on-one education sessions by members of our sales force. In addition, we will need to assure oncologists and pathologists of our ability to obtain and maintain coverage and adequate reimbursement from third-party payors. To generate demand for our Biopharma Services and Discovery Services, we need to educate pharmaceutical and biotech companies and clinical research organizations on the utility of our tests and services to improve the outcomes of clinical trials for new oncology drugs and more rapidly advance targeted therapies through the clinical development process through published papers, presentations at scientific conferences and one-on-one education sessions by members of our sales force. We may need to hire additional commercial, scientific, technical and other personnel to support this process. If we cannot convince medical practitioners, pharmaceutical and biotech companies or clinical research organizations to order our diagnostic tests or other future tests we develop, we will likely be unable to create demand for our tests in sufficient volume for us to achieve sustained profitability.

The potential loss or delay of our large contracts or of multiple contracts could adversely affect our results.

Most of our Discovery Services customers can terminate our contracts upon 30 to 90 days’ notice. These customers may delay, terminate or reduce the scope of our contracts for a variety of reasons beyond our control, including but not limited to:

decisions to forego or terminate a particular clinical trial;
lack of available financing, budgetary limits or changing priorities;
failure of products being tested to satisfy safety requirements or efficacy criteria;
unexpected or undesired clinical results for products; or
shift of business to a competitor or internal resources.

As a result, contract terminations, delays and alterations are a possible outcome in our Discovery Services business. In the event of termination, our contracts often provide for fees for winding down the project, but these fees may not be sufficient for us to maintain our margins, and termination may result in lower resource utilization rates. In addition, we may not realize the full benefits of our backlog of contractually committed services if our customers cancel, delay or reduce their commitments under our contracts with them, which may occur if, among other things, a customer decides to shift its business to a competitor or revoke our status as a preferred provider. Thus, the loss or delay of a large contract or the loss or delay of multiple contracts could adversely affect our revenues and profitability. We believe the risk of loss or delay of multiple contracts potentially has greater effect where we are party to broader partnering arrangements with global biopharmaceutical companies.

The commercial success of our Clinical Services business could be compromised if third-party payors, including insurance companies, managed care organizations and Medicare, do not provide coverage and reimbursement, breach, rescind or modify their contracts or reimbursement policies or delay payments for our molecular diagnostic tests.

Pathologists and oncologists may not order our molecular diagnostic tests unless third-party payors, such as insurance companies, managed care organizations and government payors, such as Medicare and Medicaid, pay a substantial portion of the test price. If reimbursement is not available, or is available only to limited levels, we may not be able to successfully commercialize our molecular diagnostic tests. Even if coverage is provided, the approved reimbursement amount may not be high enough to allow us to establish or maintain pricing sufficient to realize a sufficient return on our investment. Coverage and reimbursement by a third-party payor may depend on a number of factors, including a payor’s determination that tests usingcost, potential efficacy and potential advantages over alternatives, ease of use and quality, the strength of marketing and distribution support and timing of market introduction of competitive products and services, publicity concerning our technologies are:

not experimentalproducts and services or investigational;
medically necessary;
appropriate forcompeting products and services or the specific patient;

cost-effective;
supportedstandards of our competitors who are trying to improve on their own stem cell development technologies. Another risk of adoption is changes in the allocated spending by peer-reviewed publications;these companies as our products come online, which is unpredictable and
included could hurt our business. Other changes in clinical practice guidelines.

Uncertainty surrounds third-party payor coveragethe healthcare landscape, including current treatments and reimbursement of any test incorporating new technology, including tests developed usingreimbursements, will impact interest in adopting our NGS panels. Technology assessments of new medical tests and devices conducted by research centers and other entities may be disseminated to interested parties for informational purposes. technology.

Even if we obtain marketing clearancea product or approval to market molecular diagnostic tests, or where we have acquired the rights to already cleared or approved products, our future revenues will depend upon the size of any marketsservice displays a favorable efficacy in which our product candidates and acquired products have received clearance or approval, and our ability to achieve sufficientdevelopment, market acceptance reimbursement from third-party payors and adequate market share for our product candidates and acquired products in those markets.


Third-party payors and health care providers may use such technology assessments as grounds to deny coverage for a test or procedure. For example, on March 16, 2018, the Centers for Medicare and Medicaid Services (“CMS”) finalized a National Coverage Determination (“NCD”) that covers diagnostic laboratory tests using Next Generation Sequencing (“NGS”) for patients with advanced cancer (i.e., recurrent, metastatic, relapsed, refractory, or stages III or IV cancer). Under the NCD, CMS will cover FDA-approved or cleared companion in vitro diagnostics when the test has an FDA-approved or cleared indication for use in that patient’s cancer and results are provided to the treating physician for management of the patient using a report template to specify treatment options. Tests that gain FDA approvalproduct or clearance as an in vitro companion diagnostic will automatically receive full coverage under this final NCD, provided other coverage criteria are also met. However, coverage determinations for other diagnostic laboratory tests (i.e. not companion diagnostics) using NGS for Medicare patients with advanced cancer will be made by local Medicare Administrative Contractors (“MACs”). Local coverage determinations will vary, and may affect reimbursement rates, if any, that may be offered for tests developed using our NGS panels.

Because each payor generally determines for its own enrollees or insured patients whether to cover or otherwise establish a policy to reimburse our diagnostic tests, seeking payor approvals is a time-consuming and costly process. For our FDA-approved Tissue of Origin ® test, we are currently working with CMS to negotiate an increased CFLS rate for our FDA-approved test, and are exploring additional reimbursement arrangement with third-party payors. We cannot be certain that coverage for our tests (FDA-cleared/approved or LDT) will be provided in the future by additional third-party payors or that existing contracts, agreements or policy decisions or reimbursement levels will remain in place or be fulfilled under existing terms and provisions. If we cannot obtain coverage and reimbursement from private and governmental payors such as Medicare and Medicaid for our current tests, or new tests or test enhancements that we may develop in the future, our ability to generate revenues from our clinical services could be limited, which may have a material adverse effect on our financial condition, results of operations and cash flow. Further, we have experienced in the past, and will likely experience in the future, delays and temporary interruptions in the receipt of payments from third-party payors due to missing documentation and other issues, which could cause delay in collecting our revenue.

Our quarterly operating results may be subject to significant fluctuations and may be difficult to forecast.

In recent years, we have been expanding our Biopharma Services business. The nature of these services is that they tend to come in relatively large projects but episodically, rather than providing steady sources of revenues. The timing, size and duration of our contracts with pharmaceutical and biotech companies and clinical research organizations depend on the size, pace and duration of such customer’s clinical trial, over which we have no control and sometimes limited visibility. In addition, our expense levels are based, in part, on expectation of future revenue levels. A shortfall in expected revenue could, therefore, result in a disproportionate decrease in our net income. As a result, our quarterly operating results may be subject to significant fluctuations and may be difficult to forecast.

If we are unable to successfully validate our laboratory tests and services, weservice will not be ableknown until after it is launched. Our efforts to increase revenues.

Pathologists and oncologists may not order our proprietary tests, and third-party payors may not reimburse for our tests, unless we are able to provide compelling evidence thateducate the tests are useful to patient treatment and produce actionable information with respect to the diagnosis, prognosis and theranosis of the various cancersmedical community on which our work is focused. In addition, pharmaceutical and biotech companies and clinical research organizations may not order our proprietary tests unless we are able to provide compelling evidence that such tests improve the outcomes of clinical trials for new oncology drugs and allow pharmaceutical and biotech companies to more rapidly advance targeted therapeutics. While we have successfully validated all of the tests that we currently offer through: the FDA for our FDA-cleared TOO® test, and CAP, CLIA, the New York Clinical Lab Evaluation Program (CLEP) Validation Unit, through our pharmaceutical clients and partners for our lab-developed tests,

we believe that we will need to finance and successfully complete additional and more powerful studies, and then effectively disseminate the results of those studies, to drive widespread adoption of our tests and thereby increase our revenues.
If the market for our tests and services does not experience significant growth or if our tests and services do not achieve broad acceptance, our operations will suffer.

We cannot accurately predict the future growth rate or the size of the market for our tests and services. The expansion of this market depends on a number of factors, such as:

the results of clinical trials;
the cost, performance and reliability of our tests and services, and the tests and services offered by competitors;
customers' perceptions regarding the benefits of our testsproducts and services;
customers' satisfaction withservices may require significant resources and may never be successful. Such efforts to educate the marketplace may require more resources than are required by the conventional technologies marketed by our tests and services; and
marketing efforts and publicity regarding our tests and services.

Our financial results may be adversely affected if we underprice our contracts, overrun our cost estimates or failcompetitors, particularly due to receive approval for or experience delays in documenting change orders.

Mostthe novelty of our Discovery Services contracts are either fee for service contracts or fixed-fee contracts. Our past financial results have been,approach. If these products do not achieve an adequate level of acceptance, we may not generate significant product revenue and our future financial results may be, adversely impacted if we initially underprice our contracts or otherwise overrun our cost estimates and are unable to successfully negotiate a change order. Change orders typically occur when the scope of work we perform needs to be modified from that originally contemplated by our contract with the customer. Modifications can occur, for example, when there is a change in a key clinical trial assumption or parameter or a significant change in timing. Where we are not successful in converting out-of-scope work into change orders under our current contracts, we bear the cost of the additional work. Such underpricing, significant cost overruns or delay in documentation of change orders could have a material adverse effect on our business, results of operations, financial condition or cash flows.become profitable.

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If we fail to perform our services in accordance with contractual requirements, regulatory standards and ethical considerations, we could be subject to significant costs or liability and our reputation could be harmed.

In connection with our Discovery Services business, we contract with biopharmaceutical companies to provide specialized services to assist them in planning and conducting unique, specialized studies to guide drug discovery and development programs with a concentration in oncology and immuno-oncology. Our services include monitoring clinical trials, data and laboratory analysis, electronic data capture and other related services. Such services are complex and subject to contractual requirements, regulatory standards and ethical considerations. If we fail to perform our services in accordance with these requirements, regulatory agencies may take action against us for failure to comply with applicable regulations governing clinical trials. Customers may also bring claims against us for breach

Any investigation of our contractual obligations. Any such actioncustomers could have a material adverse effect on our results of operations, financial condition and reputation.


Such consequences could arise if, among other things, the following occur:

Improper performance of our services. The performance of clinical development services is complex and time-consuming. For example, we may make mistakes in conducting a clinical trial that could negatively impact or obviate the usefulness of the clinical trial or cause the results of the clinical trial to be reported improperly. If the clinical trial results are compromised, we could be subject to significant costs or liability, which could have an adverse impact on our ability to perform our services. As examples:

non-compliance generally could result in the termination of ongoing clinical trials or sales and marketing projects or the disqualification of data for submission to regulatory authorities;
compromise of data from a particular clinical trial, such as failure to verify that informed consent was obtained from patients, could require us to repeat the clinical trial under the terms of our contract at no further cost to our customer, but at a substantial cost to us; and
breach of a contractual term could result in liability for damages or termination of the contract.

While we endeavor to contractually limit our exposure to such risks, improper performance of our services could have an adverse effect on our financial condition, damage our reputation and result in the cancellation of current contracts by or failure to obtain future contracts from the affected customer or other customers.


Investigation of customers.business.

From time to time, one or more of our customers aremay be audited or investigated by regulatory authorities or enforcement agencies with respect to regulatory compliance of their clinical trials, programs or the marketing and sale of their drugs. There is a risk that either our customers or regulatory authorities could claim that we performed our services improperly or that we are responsible for clinical trial or program compliance. If our customers or regulatory authorities make such claims against us and prove them, we could be subject to damages, fines or penalties. In addition, negative publicity regarding regulatory compliance of our customers’ clinical trials, programs or drugs could have an adverse effect on our business and reputation.


If we fail to perform our Biopharma Services in accordance with contractual and regulatory requirements, and ethical considerations, we could be subject to significant costs or liability.

Through our Biopharma Services offering, we contract with pharmaceutical and biotech companies to perform a wide range of services to assist them in bringing new therapeutics to market. Our services include data and laboratory analysis, clinical trial design consulting, data capture and other related services. Such services are complex and subject to contractual requirements, regulatory standards and ethical considerations. If we fail to perform our services in accordance with these requirements, regulatory authorities may take action against us or our customers. Such actions may include failure of such regulatory authority to grant marketing approval of our customers’ products, imposition of holds or delays, suspension or withdrawal of clearances or approvals, rejection of data collected, laboratory license revocation, product recalls, operational restrictions, civil or criminal penalties or prosecutions, damages or fines. Any such action could have a material adverse effect on our business.

If we are unable to manage growth in our business, our prospects may be limited and our future results of operations may be adversely affected.

We intend to continue with our research and development activities, our sales and marketing programs and other activities as needed to meet future demand. Any significant expansion may strain our managerial, financial and other resources. If we are unable to manage such growth, our business, operating results and financial condition could be adversely affected. We will need to improve continually our operations, financial and other internal systems to manage its growth effectively, and any failure to do so may lead to inefficiencies and redundancies, and result in reduced growth prospects and diminished operational results.

Our business depends on our ability to successfully commercialize novel cancer diagnostic tests and services, which is time consuming and complex, and our development efforts may fail.

Part of our business strategy focuses on discovering, developing and commercializing molecular, genomic and genetic diagnostic tests and services. We believe the long-term success of our business depends on our ability to fully validate and commercialize our existing diagnostic tests and services and to develop and commercialize new diagnostic tests. We have multiple tests we are currently offering or may develop, but research, development and commercialization of diagnostic tests is time-consuming, uncertain and complex.

Tests we currently offer in our laboratory, or any additional technologies that we may develop, may not succeed in reliably diagnosing or predicting the recurrence of cancers with the sensitivity and specificity necessary to be clinically useful, and thus may not succeed commercially. In addition, prior to or an in continuing in conjunction with commercializing our diagnostic tests, we must undertake time-consuming and costly development activities, including clinical studies, and obtain regulatory clearance or approval, which may be denied. This development process involves a high degree of risk, substantial expenditures and will occur over several years. Our development efforts may fail for many reasons, including:
failure of the tests at the research or development stage;
difficulty in accessing archival tissue samples, especially tissue samples with known clinical results; or
lack of sufficient clinical validation data to support the effectiveness of the test.

Tests that appear promising in early development may fail to be validated in subsequent studies, and even if we achieve positive results, we may ultimately fail to obtain the necessary regulatory clearances or approvals. There is substantial risk that our research and development projects will not result in commercial tests, and that success in early clinical trials will not be replicated in later studies. At any point, we may abandon development of a test or be required to expend considerable resources repeating clinical trials, which would adversely impact the timing for generating potential revenues from that test. In addition, as we develop tests, we will have to make significant investments in research, development and marketing resources. If a clinical validation study of a particular test then fails to demonstrate the outlined goals of the study, we might choose to abandon the development of that test. Further, our ability to develop and launch diagnostic tests will likely depend on our receipt of additional funding. If our discovery and development programs yield fewer commercial tests than we expect, we may

be unable to execute our business plan, which may adversely affect our business, financial condition and results of operations. Additionally, if the supply of reagents or equipment on which our tests in development or commercial tests rely becomes unavailable and we have to source replacement reagents or equipment for our tests, additional validation activities will be required and we may need to obtain regulatory clearances or approvals for the modified tests.

We may acquire other businesses or form joint ventures or make investments in other companies or technologies that could harm our operating results, dilute ourits stockholders’ ownership, increase our debt or cause us to incur significant expense.


As part of our business strategy, we may pursue other mergers or acquisitions of businesses and assets. We also may pursue strategic alliances and joint ventures that leverage our core technology and industry experience to expand our offerings or distribution. For example, we acquired vivoPharm in 2017, Response Genetics, Inc. in 2015 and Gentris Corporation in 2014, and we entered into a joint venture in May 2013 with Mayo Foundation for Education and Research. We subsequently shut down Response Genetics operations in California and moved them to New Jersey and North Carolina and we are in the process of completing our commitments thereby ending the need for our joint venture with Mayo. We also purchased a business in India in August 2014 which we sold in April 2018. We have developed experience with acquiring other companies and forming strategic alliances and joint ventures. We may not be able to find suitable partners or acquisition candidates, and we may not be able to complete such transactions on favorable terms, if at all. If we make any acquisitions, we may not be able to integrate these acquisitions successfully into our existing business, and we could assume unknown or contingent liabilities. Any future acquisitions also could result in significant write-offs or the incurrence of debt and contingent liabilities, any of which could have a material adverse effect on our financial condition, results of operations and cash flows. Integration of an acquired company also may disrupt ongoing operations and require management resources that would otherwise focus on developing our existing business. We may experience losses related to investments in other companies, which could have a material negative effect on ourthe results of operations. We may not identify or complete these transactions in a timely manner, on a cost-effective basis, or at all, and we may not realize the anticipated benefits of any acquisition, technology license, strategic alliance or joint venture.


To finance any acquisitionsmergers or joint ventures,acquisitions, we may choose to issue shares of our common stock as consideration, which would dilute the ownership of ourits stockholders. If the price of our common stock is low or volatile, we may not be able to acquire other companies or fund a joint venture project using our stock as consideration. Alternatively, it may be necessary for us to raise additional funds for acquisitions through public or private financings. Additional funds may not be available on terms that are favorable to us, or at all.


We conduct business in a heavily regulated industry, and if we are unable to obtain regulatory clearance or approvals in the United States, if we experience delays in receiving clearance or approvals, or if we do not gain acceptance from other laboratories of any cleared or approved diagnostic tests at their facilities, our growth strategy may not be successful.

We currently offer our proprietary tests in conjunction with our comprehensive panel of laboratory services in our CLIA-certified and CAP-accredited laboratory. Because we currently offer these tests and services solely for use within our laboratory, we believe we may market the tests as laboratory developed tests (LDTs) under the U.S. Food and Drug Administration’s (“FDA’s”) enforcement framework. Although the FDA has statutory authority to assure that medical devices, including LDTs, are safe and effective for their intended uses, the FDA has generally exercised its enforcement discretion and not enforced applicable regulations with respect to LDTs. Specifically, under current FDA enforcement policies and more recent draft guidance, LDTs generally do not require FDA premarket clearance or approval before commercialization, and we have marketed our LDTs on that basis. While we believe that we are currently in material compliance with applicable laws and regulations as historically enforced by the FDA, we cannot assure you that the FDA will agree with our determination or that its application and enforcement of its authorities will not change, and a determination that we have violated these laws and regulations, or a public announcement that we are being investigated for possible violations, could adversely affect our business, prospects, results of operations or financial condition. Further, our LDT may be subject to approval by the New York State Clinical Lab Evaluation Program (“CLEP”). New York state’s clinical laboratory regulatory program is exempt from CLIA, and maintains its own policies and procedures for evaluating and approving commercial LDTs for use in New York or on individuals residing in New York. New York LDT approval can be lengthy processes, which could delay our ability to market our tests to doctors and patients in this state.

If we were to offer our tests through third-party laboratories, these tests would most likely not be subject to the FDA’s current exercise of enforcement discretion over LDTs, and would be subject to the applicable medical device regulations. For example, these tests could become subject to the FDA’s requirements for premarket review. Unless an exemption applies, generally, before a new medical device or a new use for a medical device may be sold or distributed in the United States, the medical device must receive premarket marketing authorization from the FDA, which is generally either FDA clearance of a 510(k) premarket notification or premarket approval of a PMA application. As a result, before we can market or distribute our tests in

the United States for use by other clinical testing laboratories, we must first obtain premarket marketing authorization (generally referred to as premarket clearance or premarket approval throughout this document) from the FDA. We have not yet applied for clearance or approval from the FDA, and would need to complete additional validations before we are ready to apply. We believe it would likely take two years or more to conduct the studies and trials necessary to obtain approval from the FDA to commercially launch any of our proprietary products outside of our clinical laboratory. Once we do apply, we may not receive FDA clearance or approval for the commercial use of our tests on a timely basis, or at all. If we are unable to obtain clearance or approval or if clinical diagnostic laboratories do not accept our tests, our ability to grow our business by deploying our tests could be compromised.

Our laboratory may also require an out-of-state laboratory operations permit to accept and perform diagnostic tests on specimens from residents of California, Florida, Maryland, Massachusetts, Pennsylvania, Rhode Island, New Jersey and New York. Failure to obtain a permit to operate as an out-of-state laboratory in any of these or other locations could result in fines, refusal by the relevant state regulatory authority to issue a permit in the future, and adversely affect our ability to market our products in the future. The laboratory permitting application and approval process can be lengthy, which may further delay our ability to market our lab services and products in these states.

We do not have immediate plans to market our tests for commercial use in the European Union and as a result, at this time we do not believe we are subject to EU or EU member state post-market regulations related to our tests.

The FDA may impose additional regulatory obligations and costs upon our business.

On October 3, 2014 the FDA issued two draft guidance documents regarding its intent to modify its policy of enforcement discretion and increase oversight over LDTs. The two draft guidance documents are entitled “Framework for Regulatory Oversight of Laboratory Developed Tests (LDTs)” (the “Framework Draft Guidance”) and “FDA Notification and Medical Device Reporting for Laboratory Developed Test (LDTs)” (the “Notification Draft Guidance”). In the Framework Draft Guidance, FDA stated that after the Guidances are finalized, it no longer would exercise enforcement discretion with respect to most LDTs and instead would regulate them in a risk-based manner consistent with the existing classification of medical devices. The Framework Draft Guidance stated that within six months after the Guidances were finalized, all laboratories would be required to give notice to the FDA and provide basic information concerning the nature of the LDTs offered. The FDA then would begin a phased-in review of the LDTs available, based on the risk associated with the tests. For the highest risk LDTs, which the FDA classifies as Class III devices, the Framework Draft Guidance stated that the FDA would begin to require premarket review within 12 months after the Guidance was finalized. Other high risk LDTs would be reviewed over the next four years and then lower risk tests (Class II tests) would be reviewed in the following four to nine years. The Framework Draft Guidance stated that FDA expected to issue a separate Guidance describing the criteria for its risk-based classification 18-24 months after the Guidances were finalized.

On November 18, 2016, the FDA stated that it would not be issuing final guidance on regulation of LDTs and, instead, it would outline its view of an appropriate risk-based approach to LDTs. On January 13, 2017, the FDA released a “Discussion Paper on Laboratory Developed Tests” that synthesizes the feedback that the agency received from various stakeholders on FDA regulation of LDTs “with the hope that it advances public discussion on LDT oversight.” The FDA stated in the introduction to the discussion paper: “The synthesis does not represent the formal thinking of the FDA, nor is it enforceable…This document does not represent a final version of the LDT draft guidance documents that were published in 2014.” Rather, its purpose is to allow for further public discussion and to give Congress a chance to develop a legislative solution. FDA Commissioner Scott Gottlieb has stated publicly that it would be preferable for Congress to develop a clear legislative framework for the FDA to implement, rather than for the FDA to regulate LDTs through guidance documents. A number of Congressional committees of the 115th Congress reportedly are working with various stakeholders to consider different approaches to regulation of LDTs. On August 3, 2018, FDA provided Congressional committee staff technical assistance on the discussion draft entitled the Diagnostic Accuracy and Innovation Act (DAIA). In FDA’s technical assistance, FDA reiterated that it supported the goal of legislation to create pathways to market for all in vitro clinical tests (IVCTs). It is unclear at this time whether those committees and stakeholders can reach consensus around an approach and develop legislation and whether Congress would pass any such legislation.

If we and our tests become subject to FDA’s enforcement of its medical device regulations with respect to LDTs, we may be subject to significant and onerous regulatory obligations. See section entitled “Risk Factors-Regulatory Risks Relating to CGI’s Business-If the FDA regulates LDTs as proposed, then it would classify LDTs according to the current system used to regulate medical devices. Under that system, there are three different classes of medical devices, with the requirements becoming more stringent depending on the Class.”


If we are unable to execute our marketing strategy for our tests and our tests are unable to gain acceptance in the market, we may be unable to generate sufficient revenue to sustain our business.

Although we believe that our tests represent promising commercial opportunities, our tests may never gain significant acceptance in the marketplace and therefore may never generate substantial revenue or profits for us. We need to continue to develop a market for our tests through physician education and awareness programs. Gaining acceptance in medical communities requires that we perform additional studies after validating the efficacy of our tests and services for the diagnosis, prognosis and treatment of cancer, and that we obtain acceptance of the results of those studies using our tests for publication in leading peer-reviewed medical journals. The results of any studies are always uncertain and even if we believe such studies demonstrate the value of our tests, they process of publication in leading medical journals is subject to a peer review process and peer reviewers may not consider the results of our studies sufficiently novel or worthy of publication. Failure to have our studies published in peer-reviewed journals would limit the adoption of our tests. Our ability to successfully market the tests that we may develop will depend on numerous factors, including:

whether health care providers believe our diagnostic tests provide clinical utility;
whether the medical community accepts that our diagnostic tests are sufficiently sensitive and specific to be meaningful in-patient care and treatment decisions; and
whether health insurers, government health programs and other third-party payors will cover and pay for our diagnostic tests and, if so, whether they will adequately reimburse us.

Failure to achieve widespread market acceptance of our diagnostic tests would materially harm our business, financial condition and results of operations.

If we cannot develop tests to keep pace with rapid advances in technology, medicine and science, our operating results and competitive position could be harmed.

In recent years, there have been numerous advances in technologies relating to the diagnosis and treatment of cancer. There are several new cancer drugs under development that may increase patient survival time. There have also been advances in methods used to analyze very large amounts of genomic information. We must continuously develop new tests and enhance our existing tests to keep pace with evolving standards of care. Our existing tests could become obsolete unless we continually innovate and expand them to demonstrate benefit in patients treated with new therapies. New cancer therapies typically have only a few years of clinical data associated with them, which limits our ability to perform clinical studies and correlate sets of genes to a new treatment’s effectiveness. If we cannot adequately demonstrate the applicability of our tests to new treatments, sales of our tests and services could decline, which would have a material adverse effect on our business, financial condition and results of operations.

If our tests do not continue to perform as expected, our operating results, reputation and business will suffer.

Our success depends on the market’s confidence that we can continue to provide reliable, high-quality diagnostic tests. We believe that our customers are likely to be particularly sensitive to test defects and errors. As a result, the failure of our tests or services to perform as expected would significantly impair our reputation and the public image of our tests and services, and we may be subject to legal claims arising from any defects or errors.

There is a scarcity of experienced professionals in our industry. If we are not able to retain and recruit personnel with the requisite technical skills, we may be unable to successfully execute our business strategy.

The specialized nature of our industry results in an inherent scarcity of experienced personnel in the field. Our future success depends upon our ability to attract and retain highly skilled personnel (including medical, scientific, technical, commercial, business, regulatory and administrative personnel) necessary to support our anticipated growth, develop our business and perform certain contractual obligations. Given the scarcity of professionals with the scientific knowledge that we require and the competition for qualified personnel among life science businesses, we may not succeed in attracting or retaining the personnel we require to continue and grow our operations. The loss of a key employee, the failure of a key employee to perform in his or her current position or our inability to attract and retain skilled employees could result in our inability to continue to grow our business or to implement our business strategy.

The loss or transition of any member of our senior management team or our inability to attract and retain highly skilled scientists, clinicians, and salespeople could adversely affect our business.


Our success depends on the skills, experience, and performance of key members of our senior management team. The individual and collective efforts of these employees will be important as we continue to develop our tests and services, and as we expand our commercial activities. The loss or incapacity of existing members of our senior management team could adversely affect our operations if we experience difficulties in hiring qualified successors.

In February 2018, Panna Sharma resigned as our chief executive officer and John A. Roberts, then our Chief Operating Officer and Executive Vice President, Finance, succeeded him as our interim chief executive officer and was subsequently appointed our President and Chief Executive Officer. The complexity inherent in integrating a new key member of the senior management team with existing senior management may limit the effectiveness of any such successor or otherwise adversely affect our business. Leadership transitions can be inherently difficult to manage and may cause uncertainty or a disruption to our business or may increase the likelihood of turnover of other key officers and employees. Specifically, a leadership transition in the commercial team may cause uncertainty about or a disruption to our commercial organization, which may impact our ability to achieve sales and revenue targets.

Our inability to attract, hire and retain a sufficient number of qualified sales professionals would hamper our ability to increase demand for our tests, to expand geographically and to successfully commercialize any other diagnostic tests or products we may develop.

Our success in selling our clinical laboratory services, Biopharma Services, Discovery Services, diagnostic tests and any other tests or products that we are able to develop will require us to expand our sales force in the United States and internationally by recruiting additional sales representatives with extensive experience in oncology and close relationships with medical oncologists, surgeons, pathologists and other hospital personnel, as well as pharmaceutical and biotech companies and clinical research organizations. To achieve our marketing and sales goals, we will need to continue to expand our sales and commercial infrastructure. Sales professionals with the necessary technical and business qualifications are in high demand, and there is a risk that we may be unable to attract, hire and retain the number of sales professionals with the right qualifications, scientific backgrounds and relationships with decision-makers at potential customers needed to achieve our sales goals. We may face competition from other companies in our industry, some of whom are much larger than us and who can pay greater compensation and benefits than we can, in seeking to attract and retain qualified sales and marketing employees. If we are unable to hire and retain qualified sales and marketing personnel, our business will suffer.

We have indebtedness with restrictive covenants that limit our ability to obtain additional debt financing and that requires us to comply with certain financial covenants, which could have a material adverse effect on our financial condition, our ability to fund operations, and react to changes in our business.

As of March 27, 2019, we had approximately $2.4 million of indebtedness for borrowed money under our credit facility with Silicon Valley Bank, due April 15, 2019 and $6.0 million under our term loan with Partners for Growth due on March 22, 2020. Repayments of amounts borrowed under the credit facility may be accelerated if an event of default occurs, which includes, among other things, a violation of financial covenants and negative covenants. We are currently in default with respect to certain financial covenants with such lenders, and while we have obtained amendments, waivers and most recently forbearance, the forbearance is only through April 15, 2019, and no assurances can be given that such lenders will agree to waive or amend such covenants and continue to forbear from calling our loan, which would have a material adverse effect on our ability to continue as a going concern. Further, no assurances can be given than the ABL will be extended beyond its maturity date of April 15, 2019.

The agreements restrict us from, among other things, paying cash dividends, incurring debt and entering into certain transactions without the prior consent of the lenders. Our debt and related covenants could limit our ability to satisfy our obligations, limit our ability to operate our business and impair our competitive position. For example, it could:

require us to dedicate a substantial portion of our cash flow from operations to payments on our debt, reducing the availability of our cash flow from operations to fund working capital, capital expenditures or other general corporate purposes;
limit our flexibility in planning for, or reacting to, changes in our business and industry;
place us at a disadvantage compared to competitors that may have proportionately less debt; and
increase our cost of borrowing.

If our laboratory facilities become damaged or inoperable, or we are required to vacate any facility, ourthe ability to provide services and pursue our research and development efforts may be jeopardized.



We currently derive substantially all of our revenuesrevenue from our laboratory testingpreclinical services. We do not have any clinical reference laboratory facilities outside of our facilities in Rutherford, New Jersey, and Morrisville, North Carolina. Our facilities and equipment could be harmed or rendered inoperable by natural or man-made disasters, including fire, flooding and power outages, which may render it difficult or impossible for us to perform our tests or provide laboratory services for some period of time. The inability to perform our testsservices or the backlog of testsprojects that could develop if any of our facilities is inoperable for even a short period of time may result in the loss of customers or harm to our reputation or relationships with key researchers, collaborators, and customers, and we may be unable to regain those customers or repair our reputation in the future. Furthermore, our facilities and the equipment we useused to perform our research and development work could be costly and time-consuming to repair or replace.


Additionally, a key component of our research and development process involves using biological samples and the resulting data sets and medical histories, as the basis for our diagnostic test development. In some cases, these samples are difficult to obtain. If the parts of our laboratory facilities where we store these biological samples are damaged or compromised, our ability to pursue our research and development projects, as well as our reputation, could be jeopardized. We carry insurance for damage to our property and the disruption of our business, but this insurance may not be sufficient to cover all of our potential losses and may not continue to be available to us on acceptable terms, if at all.

Further, if any of our laboratories became inoperable we may not be able to license or transfer our proprietary technology to a third-party, with established state licensure and CLIA certification under the scope of which our diagnostic tests could be performed following validation and other required procedures, to perform the tests. Even if we find a third-party with such qualifications to perform our tests, such party may not be willing to perform the tests for us on commercially reasonable terms. Moreover, we believe our tests are currently subject to an exercise of enforcement discretion by the FDA because the tests currently qualify as LDTs. If we are required to find a third-party laboratory to conduct our testing services, we believe the FDA would consider such tests to be medical devices that are no longer subject to its exercise of enforcement discretion for LDTs. In that case, we may be required to obtain premarket clearance or approval prior to offering our tests, which would be time-consuming and costly and could result in delays in our ability to sell or offer our tests.

If we cannot compete successfully with our competitors, we may be unable to increase or sustain our revenues or achieve and sustain profitability.

We face competition from mainstream diagnostic methods that pathologists and oncologists use and have used for many years. It may be difficult to change the methods or behavior of the referring pathologists and oncologists to incorporate our molecular diagnostic testing in their practices. We believe that we can introduce our diagnostic tests successfully due to their clinical utility and the desire of pathologists and oncologists to find solutions for more accurate diagnosis, prognosis and personalized treatment options for cancer patients.

We also face competition from companies that currently offer or are developing products to profile genes, gene expression or protein biomarkers in various cancers. Precision medicine is a new area of science, and we cannot predict what tests others will develop that may compete with or provide results superior to the results we are able to achieve with the tests we develop. Our competitors include public companies such as Abbott Laboratories, Inc., bioTheranostics, Inc., Foundation Medicine, Inc., Genomic Health, Inc., Invitae Corp., Johnson & Johnson, Myriad Genetics Inc., Nant Health, NeoGenomics, Inc., Quest Diagnostics, Interpace Diagnostics, BioCept, Roche Molecular Systems, Inc., and many private companies. We expect that pharmaceutical and biotech companies will increasingly focus attention and resources on the personalized diagnostic sector as the potential and prevalence increases for molecularly targeted oncology therapies approved by FDA along with companion diagnostics.

With respect to our clinical laboratory business we face competition from companies such as Bio-Reference Laboratories, Inc. (a division of Opko), Invitae Corp., LabCorp, NeoGenomics, Inc., Quest Diagnostics, BioCept and Interpace Diagnostics. With respect to our Discovery Services, including our CRO services, we face competition from companies that offer or are developing animal models for tumors and that have capabilities in toxicology and pharmacology testing. Our competitors in our Discovery Services business include Champions Oncology, Crown BioScience (recently acquired by JSR Life Sciences), Eurofins Scientific and Explora Biolabs.

Many of our present and potential competitors have widespread brand recognition and substantially greater financial and technical resources and development, production and marketing capabilities than we do. Others may develop lower-priced, less complex tests that payors, pathologists and oncologists could view as functionally equivalent to our tests, which could force us to lower the list price of our tests and impact our operating margins and our ability to achieve profitability. In addition, technological innovations that result in the creation of enhanced diagnostic tools may enable other clinical laboratories, hospitals, physicians or medical providers to provide specialized diagnostic services similar to ours in a more patient-friendly,

efficient or cost-effective manner than is currently possible. If we cannot compete successfully against current or future competitors, we may be unable to increase market acceptance and sales of our tests, which could prevent us from increasing or sustaining our revenues or achieving or sustaining profitability.

A small number of test ordering sites account for most of the sales of our tests and services. If any of these sites orders fewer tests from us for any reason, our revenues could decline.

Due to the early stage nature of our business and our limited sales and marketing activities to date, we have historically derived a significant portion of our revenue from a limited number of test ordering sites, although the test ordering sites that generate a significant portion of our revenue may change from period to period. Our test ordering sites are largely hospitals, cancer centers, reference laboratories and physician offices, as well as pharmaceutical and biotech companies as part of a clinical trial. Oncologists and pathologists at these sites order the tests on behalf of the needs of their oncology patients or as part of a clinical trial sponsored by a pharmaceutical and biotech company in which the patient is being enrolled. During the year ended December 31, 2018, no Biopharma client accounted for more than 10% of our revenue. During the year ended December 31, 2017 one Biopharma client accounted for approximately 11% of our revenue.

If we fail to perform our Biopharma Services in accordance with contractual and regulatory requirements, and ethical considerations, we could be subject to significant costs or liability.

Through our Biopharma Services offering, we contract with pharmaceutical and biotech companies to perform a wide range of services to assist them in bringing new therapeutics to market. Our services include monitoring clinical trials, data and laboratory analysis, clinical trial design consulting, data capture and other related services. Such services are complex and subject to contractual requirements, regulatory standards and ethical considerations. If we fail to perform our services in accordance with these requirements, regulatory authorities may take action against us or our customers. Such actions may include failure of such regulatory authority to grant marketing approval of our customers’ products, imposition of holds or delays, suspension or withdrawal of approvals, rejection of data collected, laboratory license revocation, product recalls, operational restrictions, civil or criminal penalties or prosecutions, damages or fines. Any such action could have a material adverse effect on our business.

We expect to continue to incur significant expenses to develop and market our diagnostic tests, which could make it difficult for us to achieve and sustain profitability.

In recent years, we have incurred significant costs in connection with the development of our diagnostic tests. For the year ended December 31, 2018, our research and development expenses were $2.5 million, which was 9% of our revenue and our sales and marketing expenses were $5.3 million, which was 19% of revenue. For the year ended December 31, 2017, our research and development expenses were $4.8 million, which was 16% of our net revenue and our sales and marketing expenses were $5.0 million, which was 17% of revenue. We expect our research and development expenses to continue to decrease, in absolute dollars, for the foreseeable future as we focus our business strategy on expanding our biopharma business.  This change in focus however, does not change our need to validate the clinical utility of our diagnostic tests to obtain adoption or to secure reimbursement for our diagnostic tests from third party payers. We continue to require generating significant revenues in order to achieve sustained profitability.

We depend on certain third parties for the supply of certain tissue samples and biological materials that we use in our research and development services and efforts. If the costs of such collaborations increase or the third parties terminate their relationships with us, our business may be materially harmed.

Under standard clinical practice in the United States, tumor biopsies removed from patients are chemically preserved, embedded in paraffin wax and stored. Our clinical development relies on our ability to access these archived tumor biopsy samples, as well as information pertaining to their associated clinical outcomes. Other companies often compete with us for access. Additionally, the process of negotiating access to archived samples is lengthy, because it typically involves numerous parties and approvals to resolve complex issues such as usage rights, institutional review board approval, privacy rights, publication rights, intellectual property ownership and research parameters.

We have collaboration arrangements with Mayo Clinic, North Shore-Long Island Jewish Health System, the National Cancer Institute, and other institutions who provide us with tissue samples and other biological materials that we use in developing and validating our tests. We do not have any written arrangement with certain third parties, and in many of the cases in which the arrangements are in writing, our relationships are terminable on 30 days’ notice or less. If one or more third parties terminate their relationship with us, we will need to identify other third parties to supply us with tissue samples and biological materials, which could result in a delay in our research and development activities and negatively affect our business.

We currently rely on a limited number of suppliers for the reagents and chemistry related to our NGS panels. Any problems, such as disruption of the supply chain or lack of visibility, experienced by these suppliers could result in a delay or interruption in the supply of our NGS panels to us until the problem is cured or until we locate and qualify an alternative source of supply.

The design of our NGS panels is currently optimized using certain reagents and chemistry, which we have incorporated into our processes, equipment and protocols. We currently purchase these components from a limited number of suppliers. If one or more of these suppliers were to delay or stop producing the required reagents, or if the prices charged us were to increase significantly, we would need to identify another supplier and optimize our NGS panels using new reagents. We could experience delays in performing the NGS panels while finding other acceptable suppliers, which could impact our results of operations.

If we were sued for product liability or professional liability, we could face substantial liabilities that exceed our resources.

The marketing, sale and use of our tests could lead to the filing of product liability claims were someone to allege that our tests failed to perform as designed. We may also be subject to liability for errors in the test results we provide to pathologists and oncologists or for a misunderstanding of, or inappropriate reliance upon, the information we provide. A product liability or professional liability claim could result in substantial damages and be costly and time-consuming for us to defend.

Although we believe that our existing product and professional liability insurance is adequate, our insurance may not fully protect us from the financial impact of defending against product liability or professional liability claims. Any product liability or professional liability claim brought against us, with or without merit, could increase our insurance rates or prevent us from securing insurance coverage in the future. Additionally, any product liability lawsuit could damage our reputation, result in the recall of our tests, or cause current clinical partners to terminate existing agreements and potential clinical partners to seek other partners, any of which could impact our results of operations.

If we use biological and hazardous materials in a manner that causes injury, we could be liable for damages.


Our activities currently require the controlled use of potentially harmful biological materials and hazardous materials and chemicals. We cannot eliminate the risk of accidental contamination or injury to employees or third parties from the use, storage, handling or disposal of these materials. In the event of contamination or injury, we could be held liable for any resulting damages, and any liability could exceed our resources or any applicable insurance coverage we may have. Additionally, we are subject to, on an ongoing basis, federal, state and local laws and regulations governing the use, storage, handling and disposal of these materials and specified waste products. The cost of compliance with these laws and regulations may become significant and could have a material adverse effect on ourthe financial condition, results of operations and cash flows. In the event of an accident or if we otherwise fail to comply with applicable regulations, we could lose our permits or approvals or be held liable for damages or penalized with fines.

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Cyber-attacks or other failures in telecommunications or information technology systems could result in information theft, data corruption and significant disruption of our business operations.

We depend on information technology and telecommunications systems for significant aspects of operations. These information technology and telecommunications systems support a variety of functions, including test processing, sample tracking, quality control, customer service and support, billing, and general and administrative activities. Information technology and telecommunications systems are vulnerable to damage from a variety of sources, including telecommunications or network failures, malicious human acts and natural disasters. In May of 2019, an unknown individual gained unauthorized access to the then StemoniX chief executive officer’s email account and fraudulently sent an email instructing an employee to wire company funds to a bank account. As a result of this breach, we suffered financial loss of $109,000. In response, StemoniX implemented additional information technology security precautions, including enhanced e-mail security software, employee training, verbal acknowledgement of requests for payment and dual authorization payment controls at a new bank, as well as hired our current Chief Financial Officer. However, we can provide no assurances that a cyber-attack or security breach will not occur again. If we are subjected to one or more cyber-attacks or security breaches, we would suffer additional financial loss. Furthermore, as use of digital technologies has increased, cyber incidents, including deliberate attacks and attempts to gain unauthorized access to computer systems and networks, have increased in frequency and sophistication and make us even more at risk. These threats pose a risk to the security of our systems and networks, the confidentiality and the availability and integrity of our data. Any disruption or loss of information technology or telecommunications systems on which critical aspects of our operations depend could have an adverse effect on business.

Our results of operations may be adversely affected if we fail to realize the full value of our assets.

We assess the realizable condition of goodwill annually and conducts an interim evaluation of these assets as well as amortizing indefinite-lived intangible assets whenever events or changes in circumstances, such as operating losses or a significant decline in earnings associated with the acquired business or asset, indicate that these assets may be impaired. In connection with the Merger and in accordance with US GAAP, we recorded $9.5 million of amortizing intangible assets and $22.0 million of goodwill based on the fair value of the Cancer Genetic’s outstanding common stock, stock options and warrants on the day of the Merger. All of the amortizing intangible assets and goodwill were allocated to the vivoPharm business. During the fourth quarter of 2021, we commenced a process to sell our vivoPharm business and reclassified its operations as discontinuing operations. Upon this change in classification, we recorded an impairment charge of $20.2 million to reflect the estimated net proceeds from the sale of this business. Our ability to realize the carrying value of the vivoPharm business recorded as of December 31, 2021 will depend on the future cash flows from the sale of the vivoPharm business. If we are not able to realize the value of the goodwill and indefinite-lived intangible assets, we may be required to incur additional material charges relating to the impairment of those assets. Such impairment charges could materially and adversely affect our operating results and financial condition.

Our business model and technology are evolving and unproven.

Our historic StemoniX business model is relatively new, unproven, and likely to continue to evolve. Accordingly, our business model may not be successful, and it may need to be changed. Our ability to generate significant revenue will depend, in large part, on its ability to successfully market its products. We intend to continue to develop our business model as the market for our products and services continues to evolve.

In addition, the technology our business model depends on is rapidly changing. Our current model is based on current knowledge and technologies in stem cell sciences, which change frequently. These changes may soon cause our current model to be less relevant, decreasing potential business revenue.

If we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incur costs that could have a material adverse effect on the success of 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 as well as known and novel therapeutic drug candidates. Our operations also produce hazardous waste products. We generally contract with third parties for the disposal of these materials and wastes. We cannot eliminate the risk of contamination or injury from these materials. In the event of contamination or injury resulting from our use of hazardous materials, we could be held liable for any resulting damages, and any liability could exceed our resources.

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We also could incur significant costs associated with civil or criminal fines and penalties. Furthermore, environmental laws and regulations are complex, change frequently and have tended to become more stringent. We cannot predict the impact of such changes and cannot be certain of our future compliance. 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. Failure to comply with these laws and regulations also may result in substantial fines, penalties or other sanctions.

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 or other work-related injuries, this insurance may not provide adequate coverage against potential liabilities. 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. Failure to comply with these laws and regulations also may result in substantial fines, penalties or other sanctions or liabilities, which could materially adversely affect our business, financial condition, results of operations and prospects.

Future governmental regulation or lack of regulatory approvals of the industry could affect our business.

Legislative and regulatory proposals are continuously under consideration by federal, state, local, and foreign governmental organizations, and it is possible that laws or regulations may exist or may be adopted with respect to our industry. The adoption of any such laws or regulations may decrease the growth in the use of our products, our ability to attract and retain personnel, increase our cost of doing business, or otherwise have a material adverse effect on our business. Regulatory changes or failure to comply with existing regulations could adversely affect our business and financial condition and results of operations. We may need to obtain regulatory approvals in the use of stem cells and our other technologies and may not receive these approvals. We also may not receive approvals for our potential therapeutic applications. We would be unable to act without approval, as that would be a regulatory violation and expose the business to significant liability.

We are exposed to the risks of natural and man-made catastrophes, pandemics and malicious and terrorist acts that could materially adversely affect our business, financial condition and results of operations.

Natural and man-made catastrophes, pandemics, and malicious and terrorist acts present risks that could materially adversely affect our results of operations. While we have taken steps to identify and mitigate these risks, such risks cannot be predicted, nor fully protected against even if anticipated. In addition, such events could result in overall macroeconomic volatility or specifically a decrease or halt in economic activity in large geographic areas, adversely affecting the marketing or operation of our business within such geographic areas or the general economic climate, which in turn could have an adverse effect on our business, operations and financial condition.

In particular, the COVID-19 outbreak, which has been declared a global pandemic by the World Health Organization, has significantly and negatively impacted financial markets and economic conditions in the United States and globally. As a result, our operations have been, and may be further, negatively impacted. Consequently, our business, financial condition and results of operations has been, and could be further, significantly and adversely affected.

Our Discovery Servicesability to obtain compounds used for drug discovery and development could be affected as a result of the tensions between Ukraine and Russia.

Certain of our collaborators purchase a significant portion of their supply of systemized compounds used for drug discovery and development from a supplier headquartered in Ukraine. Tensions between Ukraine and Russia have escalated in recent months, culminating in Russia’s recent invasion of Ukraine. Continued escalation of political tensions, economic instability, military activity or civil hostilities in Ukraine could disrupt our ability to obtain these compounds on a timely basis or at all. If we and our collaborators are unable to continue to obtain supplies from Ukraine or secure one or more replacement suppliers capable of production at a substantially equivalent cost, our developmental efforts could be delayed and our costs increased, and our business, financial condition and results of operation could be adversely affected.

Risks Related to vivoPharm

We may not be able to sell the vivoPharm business and/or any sales we consummate may not produce the desired results.

During the year ended December 31, 2021, we committed to a plan to sell the vivoPharm business as we believe it is in the best interest of our stockholders. As a result, the vivoPharm business been classified as discontinuing operations in the consolidated financial statements in this Annual Report on Form 10-K. As of December 31, 2021, our net assets held for sale totaled $9.4 million, excluding cash. See Note 3 – Discontinuing Operations to the consolidated financial statements in this Annual Report on Form 10-K for more information.

We can provide no assurances that we will successfully sell the vivoPharm business, that we will do so in accordance with our expected timeline or that we will recover the carrying value of the assets. Additionally, any decisions made regarding our deployment or use of any sales proceeds we receive in any sale involves risks and uncertainties. As a result, our decisions with respect to such proceeds may not lead to increased long-term stockholder value, or may result in a material charge to our statement of operations.

A number of factors will impact the sales price of the vivoPharm business which are outside our control, therefore, there can be no assurance that the vivoPharm business can be sold for a price that in our opinion reflects its fair value. If a sale of the vivoPharm business at what we consider to be a reasonable price is not available, we may decide to cease efforts to sell the vivoPharm business and would be required to again reflect the vivoPharm business as part of our continuing operations for financial accounting and reporting purposes. Such a change would also require us to restate our financial statements retroactively for all reportable periods, which would change the information being reported herein. Because vivoPharm incurred an operating loss for fiscal 2021, such a change would negatively affect our fiscal 2021 results from continuing operations.

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Our discovery services customers face intense competition from lower cost generic products, which may lower the amount that they spend on our services.


Our Discovery Servicesdiscovery service customers face increasing competition from lower cost generic products, which in turn may affect their ability to pursue research and development activities with us. In the United States, EU and Japan, political pressure to reduce spending on prescription drugs has led to legislation and other measures which encourages the use of generic products. In addition, proposals emerge from time to time in the United States and other countries for legislation to further encourage the early and rapid approval of generic drugs. Loss of patent protection for a product typically is followed promptly by generic substitutes, reducing our customers’ sales of that product and their overall profitability. Availability of generic substitutes for our customers’ drugs may adversely affect their results of operations and cash flow, which in turn may mean that they would not have surplus capital to invest in research and development and drug commercialization, including in our services. If competition from generic products impacts our customers’ finances such that they decide to curtail our services, our revenuesrevenue may decline and this could have a material adverse effect on our business.


If we cannot support demand for our tests, including successfully managing the evolution

The potential loss or delay of our technologylarge contracts or of multiple contracts could adversely affect results.

Most of our discovery services customers can terminate the contracts upon 30 to 90 days’ notice. These customers may delay, terminate or reduce the scope of the contracts for a variety of reasons beyond our control, including but not limited to:

decisions to forego or terminate a particular clinical trial;
lack of available financing, budgetary limits or changing priorities;
failure of products being tested to satisfy safety requirements or efficacy criteria;
unexpected or undesired clinical results for products; or
shift of business to a competitor or internal resources.

As a result, contract terminations, delays and manufacturing platforms,alterations are a possible outcome in our business could suffer.


As our test volume grows, we will need to increase our testing capacity, implement increases in scale and related processing, customer service, billing, collection and systems process improvements and expand our internal quality assurance program and technology to support testing on a larger scale. We will also need additional certified laboratory scientists and other scientific

and technical personnel to processdiscovery services business. In the event of termination, the contracts often provide for fees for winding down the project, but these additional tests. Any increases in scale, related improvements and quality assurancefees may not be successfully implementedsufficient for us to maintain margins, and appropriate personneltermination may result in lower resource utilization rates. In addition, we may not realize the full benefits of the backlog of contractually committed services if customers cancel, delay or reduce their commitments under our contracts with them, which may occur if, among other things, a customer decides to shift its business to a competitor or revoke our status as a preferred provider. Thus, the loss or delay of a large contract or the loss or delay of multiple contracts could adversely affect our revenue and profitability. We believe the risk of loss or delay of multiple contracts potentially has greater effect where we are party to broader partnering arrangements with global biopharmaceutical companies.

Our financial results may be available. As additional testsadversely affected if we underprice contracts, overruns cost estimates or fails to receive approval for or experience delays in documenting change orders.

Most of the discovery services contracts are commercialized,either fee for service contracts or fixed-fee contracts. Our past financial results have been, and future financial results may be, adversely impacted if we willinitially underprice contracts or otherwise overrun cost estimates and is unable to successfully negotiate a change order. Change orders can occur when the scope of work we perform need to bringbe modified from that originally contemplated by the contract with the customer and are typically treated as new equipment on line, implement new systems, technology, controls and procedures and hire personnel with different qualifications. Failure to implement necessary procedures or to hire the necessary personnel could resultprojects. Modifications can occur, for example, when there is a change in a higherkey clinical trial assumption or parameter or a significant change in timing. Where we are not successful in converting out-of-scope work into change orders under current contracts, we bear the cost of processingthe additional work. Such underpricing, significant cost overruns or an inability to meet market demand. We cannot assure you thatdelay in documentation of change orders could have a material adverse effect on our business, results of operations, financial condition or cash flows.

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If we will be ablefail to perform tests on a timely basis at a level consistentthe services in accordance with demand, that our effortscontractual requirements, regulatory standards and ethical considerations, we could be subject to scale our commercial operations will not negatively affect the quality of our test resultssignificant costs or that we will respond successfully to the growing complexity of our testing operations. If we encounter difficulty meeting market demand or quality standards for our tests,liability and our reputation could be harmedharmed.

In connection with the discovery services business, we contract with biopharmaceutical companies to provide specialized services to assist them in planning and conducting unique, specialized studies to guide drug discovery and development programs with a concentration in oncology and immuno-oncology. Our services include managing pre-clinical trials, data and laboratory analysis, electronic data capture and other related services. Such services are complex and subject to contractual requirements, regulatory standards and ethical considerations. If we fail to perform the services in accordance with these requirements, regulatory agencies may take action against us for failure to comply with applicable regulations governing clinical trials. Customers may also bring claims against us for breach of contractual obligations. Any such action could have a material adverse effect on results of operations, financial condition and reputation.

The performance of clinical development services is complex and time-consuming. For example, we may make mistakes in conducting a clinical trial that could negatively impact or obviate the usefulness of the clinical trial or cause the results of the clinical trial to be reported improperly. If the clinical trial results are compromised, we could be subject to significant costs or liability, which could have an adverse impact on the ability to perform services. As examples:

non-compliance generally could result in the termination of ongoing clinical trials or sales and marketing projects or the disqualification of data for submission to regulatory authorities;
compromise of data from a particular clinical trial, such as failure to verify that informed consent was obtained from patients, could require us to repeat the clinical trial under the terms of the contract at no further cost to the customer, but at a substantial cost to us; and
breach of a contractual term could result in liability for damages or termination of the contract.

While we endeavor to contractually limit exposure to such risks, improper performance of our services could have an adverse effect on our financial condition, damage reputation and result in the cancellation of current contracts by or failure to obtain future prospectscontracts from the affected customer or other customers.

In our preclinical CRO business unit doing early-stage discovery work we conduct testing on animals, which could subject us to disruptions by animal rights activists, and we are subject to laws and standards dealing with animal testing, each of which could affect our business negatively.

Our Pennsylvania and Australia research laboratory facilities comply with Good Laboratory Practices (“GLP”) to the extent required by the FDA, Environmental Protection Agency, USDA, Organization for Economic Co-operation and Development (“OECD”), as well as other international regulatory agencies. Furthermore, our early-stage discovery work, which is not subject to GLP standards, is typically carried out under a quality management system or internally developed quality systems. Our facilities are regularly inspected by U.S. and other regulatory compliance monitoring authorities, its clients’ quality assurance departments, and its own internal quality assessment program. We are also accredited by American Association for Accreditation of Laboratory Animal Care (“AAALAC”) International, a private, nonprofit organization that promotes the humane treatment of animals in science through voluntary accreditation and assessment programs. We volunteer to participate in the AAALAC’s program to demonstrate its commitment to responsible animal care and use, in addition to its compliance with local, state and federal laws that regulate animal research.

Animal rights group, such as People for the Ethical Treatment of Animals (“PETA”) have in the past targeted scientific research, which, if targeted at us or our customers, could suffer,affect our business.

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International expansion of our business exposes us to business, regulatory, political, operational, financial and economic risks associated with doing business outside of the United States.

Our business strategy incorporates international expansion, including recent acquisitions which mayhave provided facilities in Australia, and the possibility of establishing and maintaining other locations outside of the United States and expanding relationships with biopharmaceutical, academic and governmental research organizations. Doing business internationally involves a number of risks, including:

multiple, conflicting and changing laws and regulations such as tax and transfer pricing laws, export and import restrictions, employment laws, regulatory requirements and other governmental approvals, permits and licenses;
being subject to additional privacy and cybersecurity laws, including the Australian Privacy Act of 1988;
failure by us or our distributors to obtain regulatory approvals for the sale or use of tests in various countries, including failure to achieve “CE Marking”, a conformity mark which is required to market in vitro diagnostic medical devices in the European Economic Area and which is broadly accepted in other international markets;
difficulties in managing foreign operations;
financial risks, such as longer payment cycles, difficulty enforcing contracts and collecting accounts receivable and exposure to foreign currency exchange rate fluctuations;
reduced protection for intellectual property rights;
natural disasters, political and economic instability, including wars, terrorism and political unrest, outbreak of disease, boycotts, curtailment of trade and other business restrictions; and
failure to comply with the Foreign Corrupt Practices Act (“FCPA”), including its books and records provisions and its anti-bribery provisions, by maintaining accurate information and control over sales and distributors’ activities.

Any of these risks, if encountered, could significantly harm future international expansion and operations and, consequently, have a material adverse effect on our financial condition, results of operations and cash flows.


We depend on our information technology and telecommunications systems, and any failure of these systems could harm our business.

We depend on information technology and telecommunications systems for significant aspects of our operations. In addition, our third-party billing and collections provider depends upon telecommunications and data systems provided by outside vendors and information we provide on a regular basis. These information technology and telecommunications systems support a variety of functions, including test processing, sample tracking, quality control, customer service and support, billing and reimbursement, research and development activities and our general and administrative activities. Information technology and telecommunications systems are vulnerable to damage from a variety of sources, including telecommunications or network failures, malicious human acts and natural disasters. Moreover, despite network security and back-up measures, some of our servers are potentially vulnerable to physical or electronic break-ins, computer viruses and similar disruptive problems. Despite the precautionary measures we have taken to prevent unanticipated problems that could affect our information technology and telecommunications systems, failures or significant downtime of our information technology or telecommunications systems or those used by our third-party service providers could prevent us from processing tests, providing test

Our operating results to pathologists, oncologists, billing payors, processing reimbursement appeals, handling patient or physician inquiries, conducting research and development activities and managing the administrative aspects of our business. Any disruption or loss of information technology or telecommunications systems on which critical aspects of our operations depend could have an adverse effect on our business.


Security breaches, loss of data, and other disruptions could compromise sensitive information related to our business or prevent us from accessing critical information and expose us to fines, penalties, liability, and adverse effects to our business and our reputation.

In the ordinary course of our business, we and our third-party billing and collections provider collect and store sensitive data, including legally Protected Health Information (as that term is defined at 45 C.F.R. §160.103), personally identifiable information, intellectual property, and proprietary business information owned or controlled by ourselves or our customers, payors, and pharmaceutical and biotech partners. The secure processing, storage, maintenance, and transmission of this critical information is vital to our operations and business strategy, and we devote significant resources to protecting such information. Although we take measures to protect sensitive information from unauthorized access or disclosure, our information technology and infrastructure, and that of our third-party billing and collections provider, may be vulnerable to attacks by hackers or viruses or breached due to employee error, malfeasance, or other disruptions. Any such breach or interruption could compromise our networks, and the information stored there could be accessed by unauthorized parties, publicly disclosed, lost, or stolen. Any such improper access or disclosure, or loss of information could require us to provide notice to the affected individuals, the press, and regulatory bodies, result in legal claims or proceedings, liability, fines and penalties under laws that protect the privacy of personal information, such as the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Health Information Technology for Economic and Clinical Health Act (“HITECH Act”), their implementing regulations, and similar state laws. Unauthorized access, loss, or dissemination could also disrupt our operations, including our ability to conduct our analyses, provide test results, bill payors or patients, process claims and appeals, provide customer assistance services, conduct research and development activities, collect, process, and prepare company financial information, provide information about our products and other patient and physician education and outreach efforts through our website, manage the administrative aspects of our business, and damage our reputation, any of which could adversely affect our business.

The U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) may impose penalties on a covered entity, such as us, for a failure to comply with a requirement of HIPAA. Penalties will vary significantly depending on factors such as the date of the violation, whether the covered entity knew or should have known of the failure to comply, or whether the covered entity’s failure to comply was due to willful neglect. As of October 2018, these penalties include civil monetary penalties of $155 to $57,051per violation, up to an annual, per violation cap of $1,711,533. A single breach incident can result

in violations of multiple standards, resulting in possible penalties potentially in excess of $1,711,533. A person who knowingly obtains or discloses individually identifiable health information in violation of HIPAA may face a criminal penalty of up to $50,000 and up to one year imprisonment. The criminal penalties increase to $100,000 and up to five years imprisonment if the wrongful conduct involves false pretenses, and to $250,000 and up to 10 years imprisonment if the wrongful conduct involves the intent to sell, transfer, or use identifiable health information for commercial advantage, personal gain, or malicious harm. The U.S. Department of Justice is responsible for criminal prosecutions under HIPAA.

HIPAA authorizes state attorneys general to file suit under HIPAA on behalf of state residents. Courts can award damages, costs and attorneys’ fees related to violations of HIPAA in such cases. While HIPAA does not create a private right of action allowing individuals to sue us in civil court for HIPAA violations, its standards have been used as the basis for a duty of care in state civil suits such as those for negligence or recklessness in the misuse or breach of Protected Health Information.

In addition, HIPAA mandates that the Secretary of HHS conduct periodic compliance audits of HIPAA covered entities for compliance with the HIPAA privacy and security regulations. It also tasks HHS with establishing a methodology whereby harmed individuals who were the victims of breaches of unsecured Protected Health Information may receive a percentage of the Civil Monetary Penalty fine paid by the violator.
HIPAA further requires covered entities to notify affected individuals “without unreasonable delay and in no case later than 60 calendar days after discovery of the breach” if their unsecured Protected Health Information is subject to an unauthorized access, use or disclosure. If a breach affects 500 patients or more, it must be reported to HHS and local media without unreasonable delay, and HHS will post the name of the breaching entity on its public website. If a breach affects fewer than 500 individuals, the covered entity must log it and notify HHS at least annually.

In addition, the interpretation and application of consumer, health-related, and data protection laws in the United States, Europe, and elsewhere are often uncertain, contradictory, and in flux. California recently passed the California Consumer Privacy Act (“CCPA”), which will become effective on January 1, 2020. We may need to alter our security and privacy practices in order to comply with CCPA, but we have not yet fully evaluated CCPA’s impact on our business. It is possible that this law, and other laws may be interpreted and applied in a manner that is inconsistent with our practices. If so, this could result in government-imposed fines or orders requiring that we change our practices, which could adversely affect our business. In addition, these privacy regulations may differ from state to state and country to country, and may vary based on whether testing is performed in the United States or in the local country. Complying with these various laws could cause us to incur substantial costs or require us to change our business practices and compliance procedures in a manner adverse to our business.

The collection and use of personal data in the European Union is governed by the General Data Protection Regulation (“GRPR”) which became effective on May 25, 2018. The GDPR applies to any business, regardless of its location, that provides goods or services to residents in the EU. This expansion may incorporate our future clinical trial activities in EU members states. The GDPR imposes strict requirements on controllers and processors of personal data, including special protections for “sensitive information” which includes health and genetic information of data subjects residing in the EU. GDPR grants individuals the opportunity to object to the processing of their personal information, allows them to request deletion of personal information in certain circumstances, and provides the individual with an express right to seek legal remedies in the event the individual believes his or her rights have been violated. Further, the GDPR imposes strict rules on the transfer of personal data out of the European Union to the United States or other regions that have not been deemed to offer “adequate” privacy protections.
Our research activities in the EU are currently limited to non-human preclinical studies, and as such, we do not collect, store, maintain, process, or transmit any Personal Data (as that term is defined under the GDPR) of trial subjects. However, since we currently have three employees located in the EU, our processing and transfer for employee Personal Data is subject to GDPR requirements. We have implemented a privacy and security program that is designed to adhere to the requirements of the GDPR in order to protect employee Personal Data, and in the event we progress to research or clinical trials involving humans, to protect participant Personal Data. However, there is significant uncertainty related to the manner in which data protection authorities will seek to enforce compliance with GDPR. For example, it is not clear if the authorities will conduct random audits of companies doing business in the EU, or if the authorities will wait for complaints to be filed by individuals who claim their rights have been violated. Enforcement uncertainty and the costs associated with ensuring GDPR compliance be onerous and adversely affect our business, financial condition, results of operations and prospects. As a result, we cannot predict the impact of the GDPR regulations on our current or future business, either in the US or the EU. However, failure to comply with the requirements of the GDPR (when applicable to our business) and the related national data protection laws of the European Union Member States, which may deviate slightly from the GDPR, may result in fines of up to 4% of global revenues, or € 20,000,000, whichever is greater. As a result of the implementation of the GDPR, we may be required to put in place additional mechanisms ensuring compliance with the new data protection rules.


Our results of operations may be adversely affected ifby fluctuations in foreign currency exchange rates and restrictions on the deployment of cash across global operations.

Although we fail to realize the full valuereport operating results in U.S. dollars, a portion of our goodwillrevenue and intangible assets.


We assessexpenses are or will be denominated in currencies other than the realizable conditionU.S. dollar, particularly in Australia and Europe. Fluctuations in foreign currency exchange rates can have a number of adverse effects on the Company. Because our indefinite-lived intangibleconsolidated financial statements are presented in U.S. dollars, we must translate revenue, expenses and income, as well as assets and goodwill annually and conduct an interim evaluation whenever eventsliabilities, into U.S. dollars at exchange rates in effect during or at the end of each reporting period. Therefore, changes in circumstances, such as operating losses or a significant decline in earnings associated with the acquired business or asset, indicate that these assets may be impaired. Our ability to realize the value of the goodwillU.S. dollar against other currencies will affect revenue, income from operations, other income (expense), net and indefinite-lived intangible assets will depend on the future cash flows of the businesses we have acquired, which in turn depend in part on how well we have integrated these businesses into our own business. If we are not able to realize the value of the goodwill and indefinite-lived intangible assets, we may be required to incur material charges relating to the impairment of those assets. Such impairment charges could materially and adversely affect our operating results and financial condition.

Regulatory Risks Relating to Our Business

Changesconsolidated balance sheet items originally denominated in health care law, regulations and policy may have a material adverse effect onother currencies. There is no guarantee that our financial condition, results will not be adversely affected by currency exchange rate fluctuations. In addition, in some countries we could be subject to strict restrictions on the movement of operationscash and cash flows.

In the United States and someexchange of foreign jurisdictions, there have been a number of legislative and regulatory changes and proposed changes regarding the healthcare system thatcurrencies, which could prevent or delay marketing clearance or approval of our clinical laboratory services and NGS products, restrict or regulate commercial activities and affectlimit our ability to profitably sell anyuse these funds across its global operations.

We could be adversely affected by violations of the FCPA and other worldwide anti-bribery laws.

The FCPA and anti-bribery laws in other jurisdictions generally prohibit companies and their intermediaries from making improper payments for the purpose of obtaining or retaining business or other commercial advantage. Our policies mandate compliance with these anti-bribery laws, which often carry substantial penalties, including criminal and civil fines, potential loss of export licenses, possible suspension of the ability to do business with the federal government, denial of government reimbursement for products for which we obtain marketing clearance or approval. We expect that current laws, as well as other healthcare reform measures that may be adoptedand exclusion from participation in the future, may result in more rigorous coverage criteria and in additional downward pressure on the price that we, or our third party collaborators, suppliers or customers may receive for any approved products.


In March 2010, U.S. President Barack Obama signed the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act (collectively, “PPACA”), which made a number of substantial changes in the waygovernment health care is financed by bothprograms. We may operate in jurisdictions that have experienced governmental and private insurers. Among other things, the PPACA required each medical device manufacturer to pay a sales tax equal to 2.3% of the price for which such manufacturer sells its medical devices, beginning in 2013. This tax may applysector corruption to some degree, and, in certain circumstances, strict compliance with anti-bribery laws may conflict with certain local customs and practices. We cannot assure that the internal control policies and procedures always will protect us from reckless or all of our current products and products which are in development.

Since the implementation of the PPACA, legislative and regulatory changes have been proposed and adopted, including aggregate reductions to Medicare Part B payments to providers of up to 2% per fiscal year, which became effective on April 1, 2013 and will remain in effect through 2027 unless additional congressional action is taken. The American Taxpayer Relief Act of 2012, among other things, further reduced Medicare payments to several providers and increased the statute of limitations period for the government to recover overpayments to providers from three to five years. At the state level, legislatures are increasingly passing legislation and implementing regulations designed to control product pricing, including priceinappropriate acts committed by affiliates, employees or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency measures. The full impactagents. Violations of these laws, as well as other new laws and reform measures that may be proposed and adopted in the future remains uncertain, but may result in additional reductions in Medicare and other health care funding, or higher production costs which could have a material adverse effect on our customers and, accordingly, our financial operations.

Members of the U.S. Congress and the Trump administration have expressed an intent to pass legislation or adopt executive orders to fundamentally change or repeal parts of the Affordable Care Act or to seek its invalidation through judicial action. While Congress has not passed repeal legislation to date, the 2017 Tax Cuts and Jobs Act includes a provision repealing the individual insurance coverage mandate included in the Affordable Care Act, effective January 1, 2019. On January 20, 2017, President Trump signed an Executive Order directing federal agencies with authorities and responsibilities under the ACA to waive, defer, grant exemptions from, or delay the implementation of any provision of the ACA that would impose a fiscal burden on states or a cost, fee, tax, penalty or regulatory burden on individuals, healthcare providers, health insurers, or manufacturers of pharmaceuticals or medical devices. On October 13, 2017, President Trump signed an Executive Order terminating the cost-sharing subsidies that reimburse insurers under the Affordable Care Act. Several state Attorneys General filed suit to stop the administration from terminating the subsidies, but their request for a restraining order was denied by a federal judge in California on October 25, 2017. Further, on June 14, 2018, U.S. Court of Appeals for the Federal Circuit ruled that the federal government was not required to pay more than $12 billion in ACA risk corridor payments to third-party payors who argued were owed to them. The effects of this gap in reimbursement on third-party payors, the viability of the ACA marketplace, providers, and our business, are not yet known. In addition, CMS has recently proposed regulations that would give states greater flexibility in setting benchmarks for insurers in the individual and small group marketplaces, which may have the effect of relaxing the essential health benefits required under the ACA for plans sold through such marketplaces.

Legislative and regulatory proposals may also impact our regulatory and commercial prospects, expand marketing requirements, and restrict sales and promotional activities. We cannot be sure whether additional legislative changes will be enacted, or whether regulations, guidance or interpretations will be changed, or what the impactallegations of such changes on the

marketing clearance or approval of our product candidates, if any, may be. For instance, the President also signed an Executive Order directing federal agencies to waive, defer, grant exemptions from or delay the implementation of provisions of the ACA that would impose a fiscal or regulatory burden on states, individuals, health care providers, health insurers, and manufacturers of drugs and devices, among others, and Congress may again attempt to repeal and possibly replace parts of the ACA. We do not know whether the ACA reform efforts will be successful or what they will ultimately look like. Accordingly, at this time it is difficult to determine the full impact of these efforts on our business. In addition, increased scrutiny by the U.S. Congress of the FDA’s clearance or approval process may significantly delay or prevent marketing clearance or approval, as well as subject us to more stringent product labeling and post-marketing testing and other requirements. Compliance with new requirements may increase our operational expenses and impose significant administrative burdens. As a result of these and other new proposals, we may need to change our current manner of operation, whichviolations, could have a material adverse effect on our business, financial condition,position and results of operations.

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Risks Related to Our Dependence on Third Parties

We expect federal and state healthcare reform measures that may be adopted in the future, may result in more rigorous coverage criteria, increased regulatory burdens and operating costs, decreased net revenue from our testing products and clinical services, decreased potential returns from our development efforts, and in additional downward pressure on the price that we receive for any product for which we may we may gain clearance or approval. Any reductionwill rely on third parties to assist us and our collaborators in reimbursement from Medicare or other government healthcare 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 testing products.


Further, in April 2014, Congress passed the Protecting Access to Medicare Act (PAMA) overhauling the Medicare Part B Clinical Laboratory Fee Schedule (CLFS). CLFS is the nationally set reimbursement rate forconducting clinical diagnostic tests established by Section 1833(h) of the Social Security Act. In the first massive overhaul of the CLFS since it was established in 1984, PAMA mandates the Centers for Medicare and Medicaid (CMS) to update the CLFS to reflect true market rates. Under PAMA and its implementing regulations, certain laboratories are required to report the amount that they are paid by third party payors for each test beginning in January 2017. CMS will use this data to calculate a weighted median for each test. For any rates that are reduced, a phase-in of the reduction will occur through 2022. Between calendar years 2018-2020 the reduction for any given test cannot exceed 10% per year, and between calendar years 2021-2022, the reduction cannot be greater than 15% per year. This data reporting process will be repeated every three years for most tests, although laboratories offering Advanced Diagnostic Laboratory Tests (ADLTs) will have to report private payor data on those tests annually. It is possible that some of our tests may qualify as Advanced Diagnostic Laboratory Tests, which will require us to submit pricing annually for those tests. In addition, under PAMA, we also may be required to obtain new unique codes from CMS or any entity it designates,trials for our tests thatdrug candidates. If these third parties do not currently have unique codes. If PAMA results in a significant reduction in the prices for our tests, it could have a significant impact on our revenues and it is not known at this time how the implementation of PAMA will affect our reimbursement. We are currently working with CMS to negotiate an increased CFLS rate for our FDA-cleared test, and are exploring additional reimbursement arrangements with third-party payors.

Certain of our laboratory services are paid under the Medicare Physician Fee Schedule and, under the current statutory formula, the rates for these services are updated annually. For the past several years, the application of the statutory formula would have resulted in substantial payment reductions if Congress failed to intervene. In the past, Congress passed interim legislation to prevent the decreases. On April 16, 2015, President Obama signed the Medicare and CHIP Reauthorization Act (“MACRA”), which had previously been passed by both houses of Congress. MACRA repealed the provisions related to the Medicare Sustainable Growth Rate (SGR) formula and implements a new physician payment system that is designed to reward the quality of care (“Quality Payment Program”). In addition, it extended the current Medicare Physician Fee Schedule rates through June 2015, and then increases them by 0.5% for the remainder of 2015. Beginning on January 1, 2016, the rates will increase annually by 0.5%, through 2019. For 2020 through 2025, payments will be frozen, although payment will be adjusted to account for performance on certain quality metrics under the Merit-Based Incentive Payment Systems (“MIPS”)successfully carry out their contractual duties or to reflect physician participation in alternative payment models (“APMs”). For 2026 and subsequent years, qualified APM participants receive an annual 0.75% update on Medicare physician payment rates, while those not participating receive a 0.25% annual payment update, plus any applicable MIPS-based payment adjustments. At this time, it is too early to determine how these changes may impact our business beyond 2015. It is unclear what impact, if any, MACRA will have on our business and operating results, but any resulting decrease in payment may result in reduced demand for our services, which could adversely impact our revenues and results of operations. CMS releases its Final Physician Fee Schedule Rule annually. The Schedule changes on a year-to-year basis, and it is difficult to predict what rates our services and tests will receive. For example, the Final Fee Schedule Rule for 2017 reduced payments for flow cytometry by approximately 19% from the 2016 rate, and increases the professional component of the immunohistochemistry by approximately 9% over the 2016 rate. In 2018, there was another reduction in rates for flow cytometry codes 88185-TC and 88189-26, with the technical side cut by 23.1% to $30.60 and the professional interpretation cut by 4.1% to $88.92. Rates for the professional component of immunohistochemistry increased again but only slightly (0.3%) to $29.87 up from $29.79 in 2017.


On July 12, 2018, CMS issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019. CMS has proposed a change to the way Medicare Advantage payments are treated in the definition of “applicable laboratory.” If CMS were to finalize the proposed change, additional laboratories of all types serving a significant population of beneficiaries enrolled in Medicare Part C could meet the majority of Medicare revenues threshold and potentially qualify as an applicable laboratory and report data to CMS. It is not clear at this time what affect this change to the definition of “applicable laboratory” would have, if any, on our reporting obligations or reimbursement.

In addition, many of the Current Procedure Terminology (“CPT”) procedure codes that we use to bill our tests were revised by the AMA, effective January 1, 2013. In the Final Physician Fee Schedule Rule for 2013, CMS announced that it has decided to keep the new molecular codes on the CLFS, rather than move them to the Medicare Physician Fee Schedule as some stakeholders had urged. CMS also announced that for 2013 it would price the new codes using a “gapfilling” process by which it will refer the codes to the Medicare contractors to allow them to determine an appropriate price. Those prices were determined and became effective January 1, 2014. In addition, CMS also stated that it would not recognize certain of the new codes for Multi-Analyte Assays with Algorithmic Assays (“MAAAs”) because it does not believe they qualify as clinical laboratory tests. However, more recently, it has determined that the individual contractors may determine whether to pay for MAAA tests on a case by case basis. On September 25, 2015, CMS released its Preliminary Determinations for new CPT codes effective in 2016, including several new MAAA CPT codes. CMS had proposed “crosswalking” these codes to an unrelated test, resulting in a significant cut in their reimbursement. However, on November 17, 2015, CMS reversed its policy and directed that the tests be gap-filled by the local contracts until 2018. For a new CDLT that is assigned a new or substantially revised HCPCS code on or after January 1, 2018, CMS determines the payment amount based on crosswalking if it is determined that a new CDLT is comparable to an existing test, multiple existing test codes, or a portion of an existing test code, or uses gap-filling if no comparable existing CDLT is available. It is expected that when PAMA is fully implemented, many of the MAAA codes could qualify to be reimbursed as Advanced Diagnostic Laboratory Tests (“ADLTs”), although it is unclear whether laboratories offering such tests voluntarily will apply for the ADLT designation for those tests. There can be no guarantees that Medicare and other payors will establish positive or adequate coverage policies or reimbursement rates.

We cannot predict whether future health care initiatives will be implemented at the federal or state level, or how any future legislation or regulation may affect us. The taxes imposed by the new federal legislation and the expansion of government’s role in the U.S. health care industry as well as changes to the reimbursement amounts paid by payors for our products or our medical procedure volumes may reduce our profits and have a materially adverse effect on our business, financial condition, results of operations and cash flows. Moreover, Congress has proposed on several occasions to impose a 20% coinsurance on patients for clinical laboratory tests reimbursed under the CLFS, which would require us to bill patients for these amounts. Because of the relatively low reimbursement for many clinical laboratory tests, in the event that Congress were to ever enact such legislation, the cost of billing and collecting for these services would often exceed the amount actually received from the patient and effectively increase our costs of billing and collecting.

We depend on Medicare and a limited number of private payors for a significant portion of our revenues and if these or other payors do not provide or stop providing reimbursement or decrease the amount of reimbursement for our tests, our revenues could decline.

In 2018, we derived approximately 19% of our total revenue from other third party payors, including managed care organizations and other health care insurance providers and 8% from Medicare. Medicare and other third-party payors may withdraw their coverage policies or cancel their contracts with us at any time, review and adjust the rate of reimbursement or stop paying for our tests altogether, which would reduce our total revenues.

Payors have increased their efforts to control the cost, utilization and delivery of health care services. In the past, measures have been undertaken to reduce payment rates for and decrease utilization of the clinical laboratory industry generally. Because of the cost-trimming trends, third-party payors that currently cover and provide reimbursement for our tests may suspend, revoke or discontinue coverage at any time, or may reduce the reimbursement rates payable to us. Any such action could have a negative impact on our revenues, which may have a material adverse effect on our financial condition, results of operations and cash flows.

In addition, we are currently considered a “non-contracting provider” by a number of private third-party payors because we have not entered into a specific contract to provide our specialized diagnostic services to their insured patients at specified rates of reimbursement. If we were to become a contracting provider in the future, the amount of overall reimbursement we receive is likely to decrease because we will be reimbursed less money per test performed at a contracted rate than at a non-contracted rate, which could have a negative impact on our revenues. Further, we typically are unable to collect payments from patients beyond that which is paid by their insurance and will continue to experience lost revenue as a result.

Because of certain Medicare billing rules, we may not receive reimbursement for all tests provided to Medicare patients.

Under current Medicare billing rules, claims for our tests performed on Medicare beneficiaries who were hospital inpatients when the tumor tissue samples were obtained and whose tests were ordered less than 14 days from discharge must be incorporated in the payment that the hospital receives for the inpatient services provided. Accordingly, we must bill individual hospitals for tests performed on Medicare beneficiaries during these timeframes in order to receive payment for our tests. Because we generally do not have a written agreement in place with these hospitals that purchase these tests,deadlines, we may not be paidable to obtain regulatory approval for or commercialize our drug candidates and our business would be substantially harmed.

We expect that we and our collaborators will enter into agreements with third-party CROs to assist our collaborators in conducting and managing their clinical programs, including contracting with clinical sites to perform clinical studies. We and our collaborators may rely on these parties for execution of clinical studies for our tests or may have to pursue payment fromdrug candidates, and they would control only certain aspects of conducting the hospitalclinical studies. Nevertheless, our collaborators will be responsible for ensuring that each of their studies is conducted in accordance with the applicable protocol, legal, regulatory and scientific standards, and their reliance on a case-by-case basis. In addition, until 2012, we were permitted to bill globally for certain anatomic pathology services we furnished to certain hospitals, i.e. we billed both the technical componentCROs and the professional component to Medicare. As partclinical sites will not relieve them of the Middle Class Tax Relief and Job Creation Act of 2012, Congress terminated the special provision for “grandfathered” hospitals as of July 1, 2012. Therefore, as of that date we were required to bill all hospitals for the technical component of all anatomic pathology services we furnish to their patients, which may be difficult and/or costly for us.


Further, the Medicare Administrative Contractors who process claims for Medicare also can impose their own rules related to coverage and payment for laboratory services provided in their jurisdiction. In 2013, Palmetto GBA, the Medicare Administrative Contractor for North Carolina, South Carolina, Virginia and West Virginia, announced a comprehensive new billing policy and a coverage policy applicable to molecular diagnostic tests, such as ours. Under coverage policy, Palmettoregulatory responsibilities. Such CROs will deny payment for molecular diagnostic tests, unless it has issued a positive coverage determination for the test. Other Medicare contractors are also adopting policies similar to Palmetto’s. If any of our tests are subject to the Palmetto policy and/or the Palmetto policy is adopted by other contractors that process claims with hospitals or laboratories that purchase and bill for our tests, our business could be adversely impacted.

Complying with numerous regulations pertaining to our business is an expensive and time-consuming process, and any failure to comply could result in substantial penalties.

We are subject to CLIA, a federal law regulating clinical laboratories that perform testing on specimens derived from humans for the purpose of providing information for the diagnosis, prevention or treatment of disease. Our clinical laboratory must be certified under CLIA in order for us to perform testing on human specimens. In addition, our proprietary tests must also be recognized as part of our accredited programs under CLIA so that we can offer them in our laboratory. CLIA is intended to ensure the quality and reliability of clinical laboratories in the United States by mandating specific standards in the areas of personnel qualifications, administration, and participation in proficiency testing, patient test management, quality control, quality assurance and inspections. We have a current certificate under CLIA to perform high complexity testing and our laboratory is accredited by CAP, one of six CLIA-approved accreditation organizations. To renew this certificate, we are subject to survey and inspection every two years. Moreover, CLIA inspectors may make periodic inspections of our clinical reference laboratory outside of the renewal process.

The law also requires us to maintain a state laboratory license to conduct testing in that state. Our laboratory is located in New Jersey and must have a New Jersey state license; as we expand our geographic focus, we may need to obtain laboratory licenses from additional states. New Jersey laws establish standards for day-to-day operation of our clinical reference laboratory, including the training and skills required of personnel and quality control. In addition, several other states require that we hold licenses to test specimens from patients in those states. For example, California is just one of several states that require out-of-state laboratories to have a state laboratory license to perform diagnostic tests on samples originating from California residents. Other states may have similar requirements or may adopt similar requirements in the future. Additionally, both New York and Washington State are exempt from CLIA and have their own stricter clinical laboratory regulatory programs. We could be required to comply with those states’ programscurrent Good Clinical Practices regulations, or cGCPs, which are regulations and guidelines enforced by the FDA, the Competent Authorities of the Member States of the European Economic Area and comparable foreign regulatory authorities for any products in clinical development. The FDA enforces these cGCP regulations through periodic inspections of trial sponsors, principal investigators and trial sites. If our collaborators or their CROs fail to comply with applicable cGCPs, the event we accept specimens from New York or Washington. Finally, weclinical data generated in clinical trials may be deemed unreliable and the FDA or comparable foreign regulatory authorities may require our collaborators to perform additional clinical trials before approving their marketing applications. We cannot assure you that, upon inspection, the FDA will determine that any of the clinical trials comply with cGCPs. In addition, clinical trials must be conducted with products produced under current Good Manufacturing Practices, or cGMP regulations and will require a large number of test subjects. The failure of us, our collaborators, CROs or clinical sites to comply with these regulations may require them to repeat clinical trials, which would delay the regulatory approval process and could also subject them to regulationenforcement action up to and including civil and criminal penalties.

Although we expect our collaborators to design the clinical trials for our drug candidates in foreign jurisdictions asconsultation with CROs, we seek to expand international distributionexpect that the CROs will manage and assist our collaborators with the clinical trials conducted at contracted clinical sites. As a result, many important aspects of our tests.


drug development programs would be outside of our collaborators’ direct control. In addition, the CROs and clinical sites may not perform all of their obligations under arrangements with us or our collaborators or in compliance with regulatory requirements. If we werethe CROs or clinical sites do not perform clinical trials in a satisfactory manner, or if they breach their obligations to lose our CLIA certification, CAP accreditationcollaborators or New Jersey laboratory license, whether as a resultfail to comply with regulatory requirements, the development and commercialization of a revocation, suspensionour drug candidates for the subject indications may be delayed or limitation, we would no longerour development program materially and irreversibly harmed. We cannot control the amount and timing of resources these CROs and clinical sites will devote to our program or our drug candidates. If our collaborators are unable to rely on clinical data collected by CROs through the clinical research sites, our collaborators could be able to offer our tests, which would limit our revenues and harm our business. If we were to lose our license in other states where we are required to hold licenses, we wouldrepeat, extend the duration of, or increase the size of clinical trials, which could significantly delay commercialization and require significantly greater expenditures.

If any of our collaborators’ relationships with these third-party CROs or clinical sites terminate, our collaborators may not be able to test specimens from those states.enter into arrangements with alternative CROs or clinical sites. If we perform testing on samples originating in a state where we require a license, but do not currently have one, we could be subject to fines, sanctions, and may be denied permits or licenses in the future.


If the FDA were to begin requiring approval or clearance of our tests, we could incur substantial costs and time delays associated with meeting requirements for premarket clearance or approval or we could experience decreased demand for, or reimbursement of, our tests.


Although FDA maintains that it has authority to regulate the development and use of LDTs, such as ours, as medical devices, it has not exercised its authority with respect to most LDTs as a matter of enforcement discretion. FDA does not generally extend its enforcement discretion to reagents or software provided by third parties and used to perform LDTs, and therefore these products must typically comply with FDA medical device regulations, which are wide-ranging and govern, among other things: product design and development, product testing, product labeling, product storage, premarket clearance or approval, advertising and promotion and product sales and distribution.

We believe that our proprietary tests, as utilized in our laboratory testing, are LDTs. As a result, we believe that pursuant to FDA’s current policies and guidance that FDA does not require that we obtain regulatory clearances or approvals for our LDTs. The container we provide for collection and transport of tumor samples from a pathology laboratory to our clinical reference laboratory may be a medical device subject to FDA’s enforcement of its medical device regulations but we believe it is currently exempt from premarket review by FDA. However, our LDTs may be subject to approval by the New York State Clinical Lab Evaluation Program (“CLEP”). New York state’s clinical laboratory regulatory program is exempt from CLIA, and maintains its own policies and procedures for evaluating and approving commercial LDTs for use in New York or on individuals residing in New York. New York LDT approval can be lengthy processes, which could delay our ability to market our tests to doctors and patients in this state. While we believe that we are currently in material compliance with applicable laws and regulations, we cannot assure you that FDA or other regulatory agencies would agree with our determination, and a determination that we have violated these laws, or a public announcement that we are being investigated for possible violations of these laws, could adversely affect our business, prospects, results of operations or financial condition.

Moreover, FDA guidance and policy pertaining to diagnostic testing is continuing to evolve and is subject to ongoing review and revision. A significant change in any of the laws, regulations or policies may require us to change our business model in order to maintain regulatory compliance. At various times since 2006, FDA has issued guidance documents or announced draft guidance regarding initiatives that may require varying levels of FDA oversight of our tests. For example, in June 2010, FDA announced a public meeting to discuss the agency’s oversight of LDTs prompted by the increased complexity of LDTs and their increasingly important role in clinical decision-making and disease management, particularly in the context of personalized medicine. FDA indicated that it was considering a risk-based application of oversight to LDTs and that, following public input and discussion, it might issue separate draft guidance on the regulation of LDTs, which ultimately could require that we seek and obtain, generally, either premarket clearance or approval of LDTs, depending upon the risk-based approach FDA adopts. The public meeting was held in July 2010 and further public comments were submitted to FDA through September 2010. Section 1143 of the Food and Drug Administration Safety and Innovation Act, signed by the U.S. President on July 9, 2012, required FDA to notify U.S. Congress at least 60 days prior to issuing a draft or final guidance regulating LDTs and provide details of the anticipated action.

On July 31, 2014, FDA notified Congress pursuant to the FDASIA that it intended to issue draft Guidances that would modify its policy of enforcement discretion with respect to LDTs and begin to enforce the applicable medical device regulations with respect to such products and tests. On October 3, 2014, the FDA issued two separate draft guidances: “Framework for Regulatory Oversight of Laboratory Developed Tests (LDTs)” (“The Framework Draft Guidance”) and “FDA Notification and Medical Device Reporting for Laboratory Developed Tests” (the “Notification Draft Guidance”). In the Framework Draft Guidance, FDA stated that after the Guidances are finalized, it no longer would exercise enforcement discretion with respect to most LDTs and instead would regulate them in a risk-based manner consistent with the existing classification of medical devices. The Framework Draft Guidance stated that within six months after the Guidances were finalized, all laboratories would be required to give notice to the FDA and provide basic information concerning the nature of the LDTs offered. The FDA then would begin a phased-in review of the LDTs available, based on the risk associated with the tests. For the highest risk LDTs, which the FDA classifies as Class III devices, the Framework Draft Guidance stated that the FDA would begin to require premarket review within 12 months after the Guidance was finalized. Other high risk LDTs would be reviewed over the next four years and then lower risk tests (Class II tests) would be reviewed in the following four to nine years. The Framework Draft Guidance stated that FDA expected to issue a separate Guidance describing the criteria for its risk-based classification 18-24 months after the Guidances were finalized.

On November 18, 2016, the FDA stated that it would not be issuing final guidance on regulation of LDTs and, instead, it would outline its view of an appropriate risk-based approach to LDTs. On January 13, 2017, the FDA released a “Discussion Paper on Laboratory Developed Tests” that synthesizes the feedback that the agency received from various stakeholders on FDA regulation of LDTs “with the hope that it advances public discussion on LDT oversight.” The FDA stated in the introduction to the discussion paper: “The synthesis does not represent the formal thinking of the FDA, nor is it enforceable…This document does not represent a final version of the LDT draft guidance documents that were published in 2014.” Rather, its purpose is to allow for further public discussion and to give Congress a chance to develop a legislative solution. FDA Commissioner Scott Gottlieb has stated publicly that it would be preferable for Congress to develop a clear legislative framework for the FDA to implement, rather than for the FDA to regulate LDTs through guidance documents. A number of Congressional committees of

the 115th Congress reportedly are working with various stakeholders to consider different approaches to regulation of LDTs. On August 3, 2018, FDA provided Congressional committee staff technical assistance on the discussion draft entitled the Diagnostic Accuracy and Innovation Act (DAIA). In FDA’s technical assistance, FDA reiterated that it supported the goal of legislation to create pathways to market for all in vitro clinical tests (IVCTs). It is unclear at this time whether those committees and stakeholders can reach consensus around an approach and develop legislation and whether Congress would pass any such legislation.

If the FDA regulates LDTs as proposed, then it would likely classify LDTs according to the current system used to regulate medical devices. Under that system, there are three different classes of medical devices, with the requirements becoming more stringent depending on the Class.
We cannot provide any assurance that FDA regulation, including premarket review, will not be required in the future for our tests, whether through guidance issued by FDA, new enforcement policies adopted by FDA or new legislation enacted by Congress. We believe it is possible that legislation will be enacted into law or guidance could be issued by FDA, which may result in increased regulatory burdens for us to continue to offer our tests or to develop and introduce new tests. Given the attention Congress continues to give to these issues, legislation affecting this area may be enacted into law and may result in increased regulatory burdens on us as we continue to offer our tests and to develop and introduce new tests.
In addition, the former Secretary of the Department of Health and Human Services requested that its Advisory Committee on Genetics, Health and Society make recommendations about the oversight of genetic testing. A final report was published in April 2008. If the report’s recommendations for increased oversight of genetic testing were to result in further regulatory burdens, they could negatively affect our business and delay the commercialization of tests in development.

An FDA requirement that LDTs undergo premarket review could negatively affect our business until such review is completed and clearance or approval to market is obtained. FDA could require that we stop selling our tests pending premarket clearance or approval. If FDA allows our tests to remain on the market but there is uncertainty about our tests, if they are labeled investigational by FDA or if labeling claims FDA allows us to make are very limited, orders or reimbursement may decline. The regulatory approval process may involve, among other things, successfully completing additional clinical trials and making a 510(k) submission, or filing a PMA application with FDA. If FDA requires premarket review, our tests may not be cleared or approved on a timely basis, if at all. We may also decide voluntarily to pursue FDA premarket review of our tests if we determine that doing so would be appropriate.

Additionally, should future regulatory actions affect any of the reagents we obtain from vendors and use in conducting our tests, our business could be adversely affected in the form of increased costs of testing or delays, limits or prohibitions on the purchase of reagents necessary to perform our testing.

If we were required to conduct additional clinical trials prior to continuing to offer our proprietary tests or any other tests that we may develop as LDTs, those trials could lead to delays or failure to obtain necessary regulatory approval, which could cause significant delays in commercializing any future products and harm our ability to achieve sustained profitability.

If the FDA decides to require that we obtain clearance or approvals to commercialize our proprietary tests, we may be required to conduct additional clinical testing prior to submitting a marketing application (e.g., 510(k) premarket notification or PMA application) for commercial sales. In addition, as part of our long-term strategy we plan to seek FDA clearance or approval so we can sell our proprietary tests outside our laboratory; however, we need to conduct additional clinical validation activities on our proprietary tests, including reproducibility between labs, before we can submit an application for FDA approval or clearance. If the supply of reagents or equipment on which our tests in development or commercial tests rely becomes unavailable and we have to source replacement reagents or equipment for our tests, additional validation activities will be required and we may need to obtain regulatory clearances or approvals for the modified tests.

Additionally, if we commercialize any of our lab developed tests, we may also be required to submit such tests for approval by the New York State Clinical Laboratory Evaluation Program. Clinical trials must be conducted in compliance with FDA regulations or FDA may take enforcement action or reject the data. The data collected from these clinical trials may ultimately be used to support clearance or approval for our tests. Once commenced, we believe it would likely take two years or more to conduct the studies and trials necessary to obtain clearance or approval from FDA to commercially launch any of our proprietary tests outside of our clinical laboratory. Even if our clinical trials are completed as planned, we cannot be certain that their results will support our test claims or that FDA or foreign authorities will agree with our conclusions regarding our test results. Success in early clinical trials does not ensure that later clinical trials will be successful, and we cannot be sure that the later trials will replicate the results of prior trials and studies. If we are required to conduct clinical trials, whether using

prospectively acquired samples or archival samples, delays in the commencement or completion of clinical testing could significantly increase our test development costs, delay commercialization, and interrupt sales of our current products and tests. Many of the factors that may cause or lead to a delay in the commencement or completion of clinical trials may also ultimately lead to delay or denial of regulatory clearance or approval. The commencement of clinical trials may be delayed due to insufficient patient enrollment, which is a function of many factors, including the size of the patient population, the nature of the protocol, the proximity of patients to clinical sites and the eligibility criteria for the clinical trial. Moreover, the clinical trial process may fail to demonstrate that our tests are effective for the proposed indicated uses, which could cause us to abandon a test candidate and may delay development of other tests.

We may find it necessary to engage contract research organizations to perform data collection and analysis and other aspects of our clinical trials, which might increase the cost and complexity of our trials. We may also depend on clinical investigators, medical institutions and contract research organizations to perform the trials properly. If these partiesCROs do not successfully carry out their contractual duties or obligations or meet expected deadlines, if they need to be replaced or if the quality completeness or accuracy of the clinical data they obtain is compromised due to the failure to adhere to our clinical protocols, regulatory requirements or for other reasons, ourany such clinical trials may have to be extended, delayed or terminated. Many of these factors would be beyond our control. We may not be able to enter into replacement arrangements without undue delays or considerable expenditures. If there are delays in testing or approvals as a result of the failure to perform by third parties, our research and development costs would increase,terminated, and we may not be able to obtain regulatory clearanceapproval for or successfully commercialize our drug candidates. As a result, our financial results and the commercial prospects for our drug candidates would be harmed, our costs could increase and our ability to generate revenue could be delayed.

We expect that we will rely on third parties to assist us and our collaborators in formulation and manufacture of our drug candidates and approved drugs. If these third parties do not successfully carry out their contractual duties or meet expected deadlines, we may not be able to obtain regulatory approval for our tests.drug candidates or commercialize approved drugs and our business would be substantially harmed.

We do not currently, nor do we expect in the future to, have expertise in the formulation and manufacturing of drug candidates for use in clinical trials or commercial drug products. As such, we expect to engage a contract manufacturing organization (CMO) for the formulation, production, packaging, and distribution of high-quality drug products in sufficient quantities for clinical trials and market entry. These products must meet FDA and other regulatory authority standards for quality, strength, and potency. Regulatory authorities require submission of manufacturing specification in the investigational new drug application (IND), which must adhere to quality standards and be manufactured according to guidance on cGMP.

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The CMO is reliant on the availability of the active pharmaceutical ingredient (API) in sufficient quantities to meet the requirements for the production of the specified dosage form for the clinical trial as well as subsequent manufacturing requirements for the marketed drug. The CMO may manufacture the API in-house or contract with a third-party chemical manufacturer to supply the API in sufficient quantity. If the CMO or the third-party API supplier are not able to produce the API or drug product because of scarcity of raw materials, manufacturing equipment malfunction, manufacturing facility inoperability or damage, disruption of shipping or transport logistics, or other unplanned for complications the approval of the IND will be delayed until a replacement CMO can be secured. Likewise, disruptions to the production of the dosage form for marketed drug manufacture will delay the final approval of the NDA or BLA or will affect our ability to enter the market. If the CMO fails to meet quality standards in the manufacture of the drug product for any reason, significant delays in the availability of the product will adversely affect the availability of the marketed product.

We require third-party relationships that may not provide needed services. If such collaborators or partners fail to perform as expected the potential for us to generate future revenue from our technologies and products and services would be significantly reduced and our business would be harmed.

Many aspects of our business require third-party relationships, including but not limited to equipment, materials, technology, knowledge, sales, business development and distribution. We also utilize a number of banking, payroll, enterprise software and computer applications, and data storage that relay upon third-party vendors and cloud-based applications.

Specific and unique material needs are human cells and co-factors to support the growth and development of those cells. These partners may not allocate the resources, including time and capital, necessary to supply whatever is needed for our business. This and other issues may require termination or conflict with partners that our business model depends upon. We have been sourcing a number of our lab supplies from alternative suppliers due to product availability from our normal suppliers. For our StemoniX business, 384 well plates used to grow microOrgans are in scarce supply to due to product availability and a lack of alternative suppliers.

Our current and any future partnerships are subject to numerous risks, including:

partners have significant discretion in determining the efforts and resources that they will apply to the partnerships;
partners may not perform their obligations as expected or fail to fulfill their responsibilities in a timely manner, or at all;
we may not have access to, or may be restricted from disclosing, certain information regarding products or services being developed or commercialized under a partnership and, consequently, may have limited ability to inform our shareholders about the status of such developments;
partners could independently develop, or develop with third parties, products that compete directly or indirectly with ours if the collaborators believe that competitive products are more likely to be successfully developed or can be commercialized under terms that are more economically attractive than ours;
products or services developed with partners may be viewed by our partners as competitive with their own products or services, which may cause partners to stop work on our behalf; or
partners may not properly maintain or defend our intellectual property rights or may use our proprietary information in such a way as to invite litigation that could jeopardize or invalidate our intellectual property or proprietary information or expose us to potential litigation.

In addition, certain partnership agreements provide our partners with rights to terminate such agreements, which rights may or may not be subject to conditions, and which rights, if exercised, could adversely affect our product development efforts and could make it difficult for us to attract new partners. In that event: we would likely be required to limit the size and scope of efforts for the development and commercialization; we would likely be required to seek additional financing to fund further development or identify alternative strategic collaborations; our potential to generate future revenue from royalties and milestone payments would be significantly reduced, delayed or eliminated; and it could have an adverse effect on our business and future growth prospects.

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If conflicts arise with our partners, collaborators or licensors, they may act in their own self-interest, which may be adverse to the interests of our Company.

We may in the future experience disagreements with our partners, collaborators or licensors. Conflicts may arise in our collaboration and license arrangements with third parties due to one or more of the following:

disputes with respect to milestone or payments that are believed due under the applicable agreements;
disagreements with respect to the ownership of intellectual property rights or scope of licenses;
disagreements with respect to the scope of any obligations;
unwillingness on the part of a partner or collaborator to keep us informed regarding the progress of its activities; and
disputes with respect to our efforts with respect to the agreement with a partner or collaborator.

Conflicts with our partners, collaborators or licensors could materially adversely affect our business, financial condition or results of operations and future growth prospects.

A partner may choose to violate confidentiality agreements or use knowledge of our business operations to compete, decreasing our potential collaborators and increasing competition, which could lead to a loss of business revenue.

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

Because we collaborate with various organizations and academic institutions, we must, at times, share trade secrets with them. We seek to protect our proprietary technology in part by entering into confidentiality agreements and, if applicable, material transfer agreements, collaborative research agreements, consulting agreements or other similar agreements with our collaborators, advisors, employees and consultants prior to beginning research or disclosing proprietary information. These agreements typically limit the rights of the third parties to use or disclose our confidential information, such as trade secrets.

Despite the contractual provisions employed when working with third parties, the need to share trade secrets and other confidential information increases the risk that such trade secrets become known by our competitors, are inadvertently incorporated into the technology of others, or are disclosed or used in violation of these agreements. Given that our proprietary position is based, in part, on our know-how and trade secrets, a competitor’s discovery of our trade secrets or other unauthorized use or disclosure would impair our competitive position and may have a material adverse effect on our business. A competitor’s discovery of our trade secrets would impair our competitive position and have an adverse impact on our business.

Intellectual Property Risks Relating to Our Business

If we are unable to obtain and maintain patent and other intellectual property protection for our products and processes, or if the scope of the patent and other intellectual property protection obtained is not sufficiently broad, our competitors could develop and commercialize products similar or identical to ours, and our ability to successfully commercialize our technology and products may be adversely affected.

Our ability to compete effectively will depend, in part, on our ability to maintain the proprietary nature of our technology and processes. We rely on know-how, patents, trade secrets, license agreements and contractual provisions to establish our intellectual property rights and protect our products. These legal means, however, afford only limited protection and may not adequately protect our rights.

Through our StemoniX subsidiary, we currently have twenty patent applications pending in the United States. The main risks related to these patent applications is that the underlying patents will not be issued, or if they are issued, that the technology will still be used or challenged by competitors. If the patents are issued and need to be defended from lawsuits, such defense would require significant time and financial costs, and there is the risk of losing the challenge. In addition, we may not be issued similar patent rights throughout the world. These risks apply to any of our trademarks as well. Furthermore, competitors may allege that our business infringes on their intellectual property. If challenged, there will be legal costs and the risk of loss, even if such allegations are false.

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Moreover, the patent application and approval process is expensive and time-consuming. We may not be able to file and prosecute all necessary or desirable patent applications at a reasonable cost or in a timely manner. Furthermore, we, or any future partners, collaborators, or licensees, may fail to identify patentable aspects of inventions made in the course of development and commercialization activities before it is too late to obtain patent protection on them. Therefore, we may miss potential opportunities to seek additional patent protection. If we fail to establish, maintain or maintain relationshipsprotect such patents and other intellectual property rights, such rights may be reduced or eliminated. If there are material defects in the form, preparation, prosecution or enforcement of our patents or patent applications, such patents may be invalid and/or unenforceable, and such applications may never result in valid, enforceable patents.

Even if they are unchallenged, our patents and patent applications, if issued, may not provide us with these parties on favorable terms, if at all. Eachany meaningful protection or prevent competitors from designing around our patent claims by developing similar or alternative technologies in a non-infringing manner. For example, a third party may develop a competitive technology that is similar to ours, but that falls outside the scope of these outcomes would harmour patent protection. If the patent protection provided by the patents and patent applications we hold or pursue is not sufficiently broad to impede such competition, our ability to marketsuccessfully commercialize our tests or to achieve sustained profitability.


We are subject to federal and state health care fraud and abuse laws and regulations andtechnology could face substantial penalties if we are unable to fully comply with such laws.

Healthcare providers, physicians, and others will play a primary role in the ordering of our testing products and clinical services. Our arrangements with such persons and third-party payors, including price reporting obligations imposed by federal health care programs, will expose us to broadly applicable fraud and abuse and other healthcare laws and regulations that may constrain the business or financial arrangements and relationships through which we research, market, sell, and distribute our tests, if we require or obtain marketing approval. Even though we do not and will not control referrals of healthcare services or directly bill to Medicare, Medicaid, or other third party payors, certain federal and state healthcare laws, and regulations pertaining to fraud and abuse and to patients’ rights are and will be applicable to our business. We are subject to health care fraud and abuse regulation and enforcement by both the federal government and the states in which we conduct our business. These health care laws and regulations include, for example:

the federal Anti-kickback Statute, which prohibits, among other things, persons or entities from knowingly and willfully soliciting, receiving, offering or providing remuneration, directly or indirectly, in cash or in kind, to induce or to reward inducement either the referral of an individual for, or the purchase or lease, order or recommendation of, any item, good, facility or service, for which payment may be made under federal healthcare programs such as Medicare and Medicaid. The term ‘‘remuneration’’ has been interpreted broadly to include anything of value;
the federal physician self-referral prohibition, commonly known as the Stark Law, which prohibits physicians from referring Medicare or Medicaid patients to providers of “designated health services” (including clinical laboratory services) with whom the physician or a member of the physician’s immediate family has an ownership interest or compensation arrangement, unless a statutory or regulatory exception applies;
HIPAA, which established federal crimes for knowingly and willfully executing a scheme to defraud any health care benefit program or making false statements in connection with the delivery of or payment for health care benefits, items or services;
the beneficiary inducement provision of the federal civil monetary penalties law, which prohibits, among other things, offering or transferring remuneration, including waivers of co-payments and deductible amounts (or any part thereof), to a federal healthcare beneficiary that a person knows or should know is likely to influence the beneficiary’s decision to order or receive items or services reimbursable by the government from a particular provider or supplier;
the civil monetary penalties statute also imposes fines against any person who is determined to have knowingly presented, or caused to be presented, claims to a federal healthcare program that the person knows, or should know, is for an item or service that was not provided as claimed or is false or fraudulent;
federal civil False Claims Act imposes civil penalties, including through civil whistleblower or qui tam actions, against individuals or entities for knowingly presenting, or causing to be presented, false or fraudulent claims for payment by a federal healthcare program; knowingly making, using, or causing to be made or used a false record or statement material to a false or fraudulent claim or an obligation to pay money to the federal government; and knowingly concealing or knowingly and improperly avoiding or decreasing an obligation to pay money to the federal

government. Any demand for payment, such as an invoice, that includes items or services resulting from a violation of the Anti-Kickback Statute constitutes a false or fraudulent claim under the False Claims Act;
the criminal False Claims Act prohibits the making or presenting of a claim to the government knowing such claim to be false, fictitious, or fraudulent and, unlike the civil False Claims Act, requires proof of intent to submit a false claim; and
state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws, which may apply to items or services reimbursed by any third-party payor, including commercial insurers.

Further, the PPACA, among other things, amends the intent requirement of the federal anti-kickback and criminal health care fraud statutes. A person or entity no longer needs to have actual knowledge of this statute or specific intent to violate it. negatively affected.

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 false claims statutes.


The PPACA, among other things, also imposed new reporting requirements on manufacturers of certain devices, drugs and biologics for certain payments and transfers of value by them and in some cases their distributors to physicians and teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members. The Physician Payment Sunshine Act (Section 6002 of the PPACA) states that failure to submit required information timely, completely and accurately for all payments, transfers of value and ownership or investment interests may result in civil monetary penalties of up to an aggregate of $150,000 per year (or up to an aggregate of $1.0 million per year for “knowing failures”). Manufacturers must submit reports by the 90th day of each calendar year. Any failure to comply with these reporting requirements could result in significant fines and penalties. Because we manufacture our own LDTs solely for use by or within our own laboratory, we believe that we are exempt from these reporting requirements. We cannot assure you, however, that the government will agree with our determination, and a determination that we have violated these laws and regulations, or a public announcement that we are being investigated for possible violations, could adversely affect our business, prospects, results of operations or financial condition.

Ensuring that our business arrangements with third parties comply with applicable healthcare laws and regulations could be costly. It is possible that governmental authorities will conclude that our business practices do 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 were found to be in violation of any of these laws or any other governmental regulations that may apply to us, we may be subject to significant civil, criminal and administrative penalties, damages, fines, disgorgement, individual imprisonment, debarment from governmental contracting and refusal of orders under existing contracts, and exclusion from government funded healthcare programs, such as Medicare and Medicaid, any of which could substantially disrupt our operations. If the physicians or other providers or entities with whompatent protection, we expect to do businessrely heavily on trade secrets, know-how and other unpatented technology, which are founddifficult to protect. Although we seek such protection in part by entering into confidentiality agreements with our vendors, employees, consultants and others who may have access to proprietary information, we cannot be certain that these agreements will not be breached, adequate remedies for any breach would be available, or our trade secrets, know-how and other unpatented proprietary technology will not otherwise become known to or be independently developed by our competitors. If we are unsuccessful in compliance with applicable laws, they may be subject to criminal, civil or administrative sanctions, including exclusions from government funded healthcare programs.

We have adopted policies and procedures designed to comply with these laws, including policies and procedures relating to financial arrangements between us and physicians who refer patients to us. In the ordinary courseprotecting our intellectual property rights, sales of our business, we conduct internal reviews of our compliance with these laws. Our compliance is also subject to governmental review. The government alleged that we engaged in improper billing practices in the pastproducts may suffer and we may be the subject of such allegations in the future as the growth of our business and sales organization may increase the potential of violating these laws or our internal policies and procedures. The risk of our being found in violation of these laws and regulations is further 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 brought against us for violation of these laws or regulations, 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. If our operations are found to be in violation of any of these laws and regulations, we may be subject to any applicable penalty associated with the violation, including civil and criminal penalties, damages and fines, and/or exclusion from participation in Medicare, Medi-Cal or other state or federal health care programs, we could be required to refund payments received by us, and we could be required to curtail or cease our operations. Any of the foregoing consequences could seriously harm our business and our financial results.

We are required to comply with laws governing the transmission, security and privacy of health information that require significant compliance costs, and any failure to comply with these laws could result in material criminal and civil penalties.

Under the administrative simplification provisions of HIPAA, the U.S. Department of Health and Human Services has issued regulations which establish uniform standards governing the conduct of certain electronic health care transactions and

protecting the privacy and security of Protected Health Information used or disclosed by health care providers and other covered entities. Three principal regulations with which we are currently required to comply have been issued in final form under HIPAA: privacy regulations, security regulations and standards for electronic transactions.

The privacy regulations cover the use and disclosure of Protected Health Information (“PHI”) by “covered entities,” which includes health plans, healthcare clearinghouses, and health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards. It also sets forth certain rights that an individual has with respect to his or her PPHI maintained by a covered entity, including the right to access or amend certain records containing PHI or to request restrictions on the use or disclosure of PHI. We have implemented policies, procedures and standards in an effort to comply appropriately with the final HIPAA security regulations, which establish requirements for safeguarding the confidentiality, integrity and availability PHI, which is electronically transmitted or electronically stored. The HIPAA privacy and security regulations establish a uniform federal “floor” and do not supersede state laws that are more stringent or provide individuals with greater rights with respect to the privacy or security of, and access to, their records containing Protected Health Information. As a result, we are required to comply with both HIPAA privacy regulations and varying state privacy and security laws, which may be more stringent than HIPAA. Moreover, HITECH, among other things, established certain health information security breach notification requirements. Under HIPAA, a covered entity must notify any individual “without unreasonable delay and in no case later than 60 calendar days after discovery of the breach” if their unsecured Protected Health Information is subject to an unauthorized access, use or disclosure. If a breach affects 500 patients or more, it must be reported to HHS and local media without unreasonable delay, and HHS will post the name of the breaching entity on its public website. If a breach affects fewer than 500 individuals, the covered entity must log it and notify HHS at least annually.

Certain state laws may also affect our other privacy and security practices. For example, California recently passed the California Consumer Privacy Act (“CCPA”), which will become effective on January 1, 2020. Although HIPAA-protected information is exempt from CCPA, additional information we may maintain on our customers and employees may be subject to additional security and privacy protections. Other states have specific protections for certain types of information. We may need to alter our security and privacy practices in order to comply with CCPA, but we have not yet fully evaluated CCPA’s impact on our business.

HIPAA contains significant fines and other penalties for wrongful use or disclosure of Protected Health Information. We have implemented practices and procedures to meet the requirements of the HIPAA privacy regulations and state privacy laws. In addition, we have taken commercially reasonable and industry standard steps to comply with HIPAA’s standards for electronic transactions, which establish standards for common health care transactions. Given the complexity of the HIPAA, HITECH and state privacy restrictions, the possibility that the regulations may change, and the fact that the regulations are subject to changing and potentially conflicting interpretation, our ability to comply with the HIPAA, HITECH and state privacy requirements is uncertain and the costs of compliance are significant. To the extent that we submit electronic health care claims and payment transactions that do not comply with the electronic data transmission standards established under HIPAA and HITECH, payments to us may be delayed or denied. Additionally, the costs of complying with any changes to the HIPAA, HITECH and state privacy restrictions may have a negative impact on our operations. Wegenerate revenue could be subject to criminal penalties and civil sanctions for failing to comply with the HIPAA, HITECH and state privacy restrictions, which could result in the incurrence of significant monetary penalties. For further discussion of HIPAA and the impact on our business, see the section entitled “Risk Factors-Risks Related to Our Business and Strategy-Security breaches, loss of data, and other disruptions could compromise sensitive information related to our business or prevent us from accessing critical information and expose us to fines, penalties, liability, and adverse effects to our business and our reputation.

Our operations are subject to environmental, health and safety laws and regulations, with which compliance may be costly.

Our business is subject to federal, state, and local laws and regulations relating to the protection of the environment, worker health and safety and the use, management, storage, and disposal of hazardous substances and wastes. Failure to comply with these laws and regulations may result in substantial fines, penalties or other sanctions. In addition, environmental laws and regulations could require us to pay for environmental remediation and response costs, or subject us to third party claims for personal injury, natural resource or property damage, relating to environmental contamination. Liability may be imposed whether or not we knew of, or were responsible for, such environmental contamination. The cost of defending against environmental claims, of compliance with environmental, health and safety regulatory requirements or of remediating contamination could materially adversely affect our business, assets or results of operations.

Intellectual Property Risks Relating to Our Business

severely impacted.

Our rights to use technologies licensed from third parties are not within our control and may we lose existing rights or may not be able to obtain new rights on reasonable terms.

We are heavily dependent on licensed in technology in order to operate our business. We license multiple patents and protocols from the University of California, San Diego, as well as from (1) Academia Japan for technology that we need in order to create and sell induced pluripotent stem cells, (2) ID Pharma for the Sendai virus vector technology, and (3) the Max Plank Innovation GmbH for mid-brain organoid production. None of these licenses are exclusive. In addition, we may need to obtain additional licenses that are also non-exclusive. The lack of exclusivity could decrease the barriers of entry for potential competitors. Additionally, if one or more of our license agreements terminates, we may not be able to sellenter into new license agreements for comparable technology or on comparable terms.

If our products if we lose our existing rights or cannot obtain new rights on reasonable terms.


Our ability to market certain of our teststrademarks and services, domestically and/or internationally, is in part derived from licenses to intellectual property which is owned by third parties. As such,trade names are not adequately protected, then we may not be able to continue selling our tests and services if we lose our existing licensed rights or sell new tests and services if we cannot obtain such licensed rights on reasonable terms. In particular, we currently in-license a biomarker from the National Cancer Institute usedbuild name recognition in our FHACT probe. Further, we may also need to license other technologies to commercialize future products. As may be expected,marks of interest and our business may suffer if (i) these licenses terminate; (ii) if the licensors fail to abide by the terms of the license, properly maintain the licensed intellectual propertybe adversely affected.

Our trademarks or fail to prevent infringement of such intellectual property by third parties; (iii) if the licensed patentstrade names may be challenged, infringed, circumvented or other intellectual property rights are founddeclared generic or determined to be invalid or (iv) if we are unable to enter into necessary licensesinfringing on reasonable terms or at all. In return for the use of a third-party’s technology, we may agree to pay the licensor royalties based on sales of our products as well as other fees. Such royalties and fees are a component of cost of product revenues and will impact the margins on our tests.


Third parties may assert ownership or commercial rights to inventions we develop from our use of the biological materials they provide to us.

marks. We rely on certain third partiesboth registration and common law protection for our trademarks. We may not be able to provide us with tissue samplesprotect our rights to these trademarks and biological materials thattrade names or may be forced to stop using these names, which we use to developneed for name recognition by potential partners or customers in our tests. In some cases we have written agreements with third parties that may require us to negotiate ownership and commercial rights with the third party if our usemarkets of such third party’s materials results in an invention. Other agreements may limit our use of those materials to research/not for profit use. In other cases,interest. During trademark registration proceedings, we may not have written agreements, or the written agreementsreceive rejections. Although we have may not clearly deal with intellectual property rights. If we cannot successfully negotiate sufficient ownership and commercial rightswould be given an opportunity to the inventions that result from our use of a third party supplier’s materials where required, or if disputes otherwise arise with respectrespond to the intellectual property developed with the use of a third party’s samples,those rejections, we may be limitedunable to overcome such rejections. In addition, in the USPTO and in comparable agencies in many foreign jurisdictions, third parties are given an opportunity to oppose pending trademark applications and to seek to cancel registered trademarks. Opposition or cancellation proceedings may be filed against our ability to capitalize on the market potential of these inventions.

The U.S. governmenttrademarks, and our trademarks may have “march-in rights” to certain of our probe related intellectual property.

Because federal grant monies were used in support of the research and development activities that resulted in our two issued U.S. patents, the federal government retains what are referred to as “march-in rights” to these patents. In particular, the National Cancer Institute and the National Institutes of Health, each of which administered grant monies to us, technically retain the right to require us, under certain specific circumstances, to grant the U.S. government either a nonexclusive, partially exclusive, or exclusive license to the patented invention in any field of use, upon terms that are reasonable for a particular situation. Circumstances that trigger march-in rights include, for example, failure to take, within a reasonable time, effective steps to achieve practical application of the invention in a field of use, failure to satisfy the health and safety needs of the public, and failure to meet requirements of public use specified by federal regulations. The National Cancer Institute and the National Institutes of Health can elect to exercise these march-in rights on their own initiative or at the request of a third-party.

not survive such proceedings. If we are unable to maintain intellectual property protection,establish name recognition based on our competitive position couldtrademarks and trade names, we may not be harmed.
Our ability to protect our proprietary discoveries and technologies affects our abilityable to compete effectively and to achieve sustained profitability. Currently, we rely on a combination of U.S. and foreign patents and patent applications, copyrights, trademarks and trademark applications, confidentiality or non-disclosure agreements, material transfer agreements, licenses, work-for-hire agreements and invention assignment agreements to protect our intellectual property rights. We also maintain as trade secrets certain company know-how and technological innovations designed to provide us with a competitive advantage in the marketplace. Currently, including both U.S. and foreign patent applications, we have only two issued U.S. patents and twelve pending patent applications relating to various aspects of our technology. While we intend to pursue additional patent applications, it is possible that our pending patent applications and any future applications may not result in issued patents. Even if patents are issued, third parties may independently develop similar or competing technology that avoids our patents. Further, we cannot be certain that the steps we have taken will prevent the misappropriation of our trade secrets and other confidential information and technology, particularly in foreign countries where we do not have intellectual property rights.

From time to time the U.S. Supreme Court, other federal courts, the U.S. Congress or the U.S. Patent and Trademark Office (“USPTO”) may change the standards of patentability. Any such changes could have a negative impact on our business. For instance, on October 30, 2008, the Court of Appeals for the Federal Circuit issued a decision that methods or processes cannot be patented unless they are tied to a machine or involve a physical transformation. The U.S. Supreme Court later reversed that decision in Bilski v. Kappos, finding that the “machine-or-transformation” test is not the only test for determining patent eligibility. The Court, however, declined to specify how and when processes are patentable. Most recently, on March 20, 2012, in the case Mayo v. Prometheus, the U.S. Supreme Court reversed the Federal Circuit’s application of Bilski and invalidated a patent focused on a diagnostic process because the patent claim embodied a law of nature. On July 3, 2012, the USPTO issued

its Interim Guidelines for Subject Matter Eligibility Analysis of Process Claims Involving Laws of Nature in view of the Prometheus decision. It remains to be seen how these guidelines play out in the actual prosecution of diagnostic claims. Similarly, it remains to be seen lower courts will interpret the Prometheus decision. Some aspects of our technology involve processes thatbusiness may be subject to this evolving standard, and we cannot guarantee that any of our pending process claims will be patentable as a result of such evolving standards.adversely affected.

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The U.S. Supreme Court’s June 14, 2013 decision in Association for Molecular Pathology v. Myriad will likely have an impact on the entire biotechnology industry. Specifically, the case involved certain of Myriad Genetics, Inc.’s U.S. patents related to the breast cancer susceptibility genes BRCA1 and BRCA2. Plaintiffs asserted that the breast cancer genes were not patentable subject matter. The Supreme Court unanimously held that the isolated form of naturally occurring DNA molecules does not rise to the level of patent-eligible subject matter. But the Court also held that claims directed to complementary DNA (cDNA) molecules were patent-eligible because cDNA is not naturally occurring. The Supreme Court focused on the informational content of the isolated DNA and determined that the information contained in the isolated DNA molecule was not markedly different from that naturally found in the human chromosome. Yet, in holding isolated cDNA molecules patent-eligible, the Court recognized the differences between human chromosomal DNA and the corresponding cDNA. Because the non-coding regions of naturally occurring chromosomal DNA have been removed in cDNA, the Court accepted that cDNA is not a product of nature and, therefore, is patent-eligible subject matter.

It does not appear that the Supreme Court’s ruling in Myriad will adversely affect our current patent portfolio which, unlike the claims at issue in Myriad, centers on algorithmic methods associating chromosomal markers to specific clinical end-points. Nevertheless, we of course need to remain mindful that this is an evolving area of law.

In addition, on February 5, 2010, the Secretary’s Advisory Committee on Genetics, Health and Society voted to approve a report entitled “Gene Patents and Licensing Practices and Their Impact on Patient Access to Genetic Tests.” That report defines “patent claims on genes” broadly to include claims to isolated nucleic acid molecules as well as methods of detecting particular sequences or mutations. The report also contains six recommendations, including the creation of an exemption from liability for infringement of patent claims on genes for anyone making, using, ordering, offering for sale or selling a test developed under the patent for patient care purposes, or for anyone using the patent-protected genes in the pursuit of research. The report also recommended that the Secretary should explore, identify and implement mechanisms that will encourage more voluntary adherence to current guidelines that promote nonexclusive in-licensing of diagnostic genetic and genomic technologies. It is unclear whether the U.S. Department of Health and Human Services will act upon these recommendations, or if the recommendations would result in a change in law or process that could negatively impact our patent portfolio or future research and development efforts.

We may become involved in lawsuits or other proceedings to protect or enforce our patents or other intellectual property rights, which could be time-consuming and costly to defend, and could result in our loss of significant rights and the assessment of treble damages.


From time to time we may face intellectual property infringement (or misappropriation) claims from third parties. Some of these claims may lead to litigation. The outcome of any such litigation can never be guaranteed, and an adverse outcome could affect us negatively. For example, were a third-party to succeed on an infringement claim against the us, we may be required to pay substantial damages (including up to treble damages if such infringement were found to be willful). In addition, we could face an injunction, barring us from conducting the allegedly infringing activity. The outcome of the litigation could require us to enter into a license agreement which may not be pursuant to acceptable or commercially reasonable or practical terms or which may not be available at all. It is also possible that an adverse finding of infringement against us may require us to dedicate substantial resources and time in developing non-infringing alternatives, which may or may not be possible. In the case of diagnostic tests, we would also need to include non-infringing technologies which would require us to re-validate our tests. Any such re-validation, in addition to being costly and time consuming, may be unsuccessful.


Furthermore, we may initiate claims to assert or defend our own intellectual property against third parties. Any intellectual property litigation, irrespective of whether we are the plaintiff or the defendant, and regardless of the outcome, is expensive and time-consuming, and could divert our management’s attention from our business and negatively affect our operating results or financial condition. We may not be able to prevent, alone or with our third partythird-party collaborators or suppliers, misappropriation of our proprietary rights, particularly in countries where the laws may not protect those rights as fully as in the United States. In addition, interference proceedings brought by the USPTO may be necessary to determine the priority of inventions with respect to our patents and patent applications or those of our current or future collaborators, suppliers or customers.


Finally, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of our confidential and proprietary information could be compromised by disclosure during this type of


litigation. In addition, there could be public announcements of the results of hearings, motions or other interim proceedings or developments. If securities analysts or investors perceive these results to be negative, it could have a substantial adverse effect on our financial condition.

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 current and former employees, including our senior management, were previously employed at universities or at other biotechnology or pharmaceutical companies, including some which may be competitors or potential competitors. Some of these employees may be subject to proprietary rights, non-disclosure and non- competition agreements, or similar agreements, in connection with such previous employment. Although we try to ensure that our employees do not use the proprietary information or know-how of others in their work for us, we may be subject to claims that we or these employees have used or disclosed intellectual property, including trade secrets or other proprietary information, of any such third party. Litigation may be necessary to defend against such claims. If we fail in defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or personnel or sustain damages. Such intellectual property rights could be awarded to a third party, and we could be required to obtain a license from such third party to commercialize our technology or products. Such a license may not be available on commercially reasonable terms or at all. Even if we are successful in defending against such claims, litigation could result in substantial costs and be a distraction to management.

In addition, while we typically require our employees, consultants 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, which may result in claims by or against us related to the ownership of such intellectual property. If we fail in prosecuting or defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights. Even if we are successful in prosecuting or defending against such claims, litigation could result in substantial costs and be a distraction to our senior management and scientific personnel.

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Issued patents covering our technology or products could be found invalid or unenforceable if challenged in court or in administrative proceedings. We may not be able to protect our trade secrets in court.

If we initiate legal proceedings against a third-party to enforce a patent, should such a patent issue, the defendant could counterclaim that the patent covering is invalid or unenforceable. In patent litigation in the United States, defendant counterclaims alleging invalidity or unenforceability are commonplace. Grounds for a validity challenge could be an alleged failure to meet any of several statutory requirements, including lack of novelty, obviousness, written description or non- enablement. Grounds for an unenforceability assertion could be an allegation that someone connected with prosecution of the patent withheld information material to patentability from the USPTO, or made a misleading statement, during prosecution. Third parties also may raise similar claims before administrative bodies in the United States or abroad, even outside the context of litigation. An adverse determination could result in the revocation or cancellation of, or amendment to, our patents. Such a loss of patent protection could have a material adverse impact on our business.

In addition, our trade secrets may otherwise become known or be independently discovered by competitors. Competitors and other third parties could attempt to replicate some or all of the competitive advantages we derive from our development efforts, willfully infringe, misappropriate or otherwise violate our intellectual property rights, design around our protected technology or develop their own competitive technologies that fall outside of our intellectual property rights. If any of our trade secrets were to be lawfully obtained or independently developed by a competitor or other third party, 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 our trade secrets are not adequately protected or sufficient to provide an advantage over our competitors, our competitive position could be adversely affected, as could our business. Additionally, if the steps taken to maintain our trade secrets are deemed inadequate, we may have insufficient recourse against third parties for misappropriating our trade secrets.

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

We may be subject to claims that former employees, collaborators or other third parties have an ownership interest in the patents and intellectual property that we own or that we may own or license in the future. While it is our policy to require our employees 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 or such assignments may not be self-executing or may be breached. We could be subject to ownership disputes arising, for example, from conflicting obligations of employees or consultants. Litigation may be necessary to defend against any claims challenging inventorship or ownership. If we or fail in defending any such claims, we may have to pay monetary damages and may lose valuable intellectual property rights, such as exclusive ownership of, or right to use, intellectual property, which could adversely impact our business, results of operations and financial condition.

If we fail to comply with our obligations under any future intellectual property licenses with third parties, we could lose license rights that are important to our business.

We may enter into license agreements in the future. We expect that such license agreements will impose, various diligence, milestone payment, royalty, insurance and other obligations on us. If we fail to comply with our obligations under these licenses, our licensors may have the right to terminate these license agreements. Termination of these license agreements or reduction or elimination of our licensed rights may also result in our having to negotiate new or reinstated licenses with less favorable terms.

If we do not obtain patent term extension and exclusivity, our business may be materially harmed.

Patents have a limited lifespan. In the United States, if all maintenance fees are timely paid, the natural expiration of a patent is generally 20 years from its earliest U.S. non-provisional filing date. Various extensions may be available, but the life of a patent, and the protection it affords, is limited. Even if patents covering our proprietary technology are obtained, once the patent life has expired, we may be open to competition from competitive products. As a result, our patent portfolio may not provide us with sufficient rights to exclude others from commercializing products similar or identical to ours.

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


Filing, prosecuting, maintaining, defending and defendingenforcing patents on our technologies in all countries throughout the world would be prohibitively expensive, and our intellectual property rights in some countries outside the United States cancould be less extensive than those in the United States. The requirements for patentability may differ in certain countries, particularly in developing countries; thus, even in countries where we do pursue patent protection, there can be no assurance that any patents will issue. There can be no assurance that we will obtain or maintain patent rights in or outside the United States under any future license agreements. In addition, the laws of some foreign countries do not protect intellectual property rights to the same extent as federal and state laws in the United States. For example, many foreign countries have compulsory licensing laws under which a patent owner must grant licenses to third parties. Consequently, we may not be able to prevent third parties from practicing our inventions in all countries outside the United States.States, even in jurisdictions where we pursue patent protection, or from selling or importing technologies or products made using our inventions in and into the United States or other jurisdictions. Competitors may use our technologies in jurisdictions where we have not pursued and obtained patent protection to develop their own products and, further, may export otherwise infringing products to territories where we have patent protection, but enforcement rights areis not as strong as thosethat in the United States. These productscompetitors may compete with our technologies in jurisdictions where we do not have any issued patentsus, and our patent claimspatents or other intellectual property rights may not be effective or sufficient to prevent them from so competing.


Many companies

Risks Related to Employee Matters and Managing Growth

We only have encountered significant problemsa limited number of employees to manage and operate our business.

As of March 15, we had 34 employees in protectingour continuing operations and defending intellectual property rights38 employees in foreign jurisdictions. The legal systemsour vivoPharm business. Our focus on the development of certain countries do not favor the enforcement of patentsour drug candidates and other intellectual property protection, which could make it difficult fordisease models requires us to stopoptimize cash utilization and to manage and operate our business in a highly efficient manner. We cannot assure you that we will be able to hire or retain adequate staffing levels to develop our technology or run our operations or to accomplish all of the infringementobjectives that we otherwise would seek to accomplish.

There is a scarcity of experienced professionals in our industry. If we are not able to retain and recruit personnel with the requisite technical skills, we may be unable to successfully execute the business strategy.

The specialized nature of our patents generally. Proceedingsindustry results in an inherent scarcity of experienced personnel in the field. Our future success depends upon the ability to enforceattract and retain highly skilled personnel (including medical, scientific, technical, commercial, business, regulatory and administrative personnel) necessary to support anticipated growth, develop business and perform certain contractual obligations. Given the scarcity of professionals with the scientific knowledge that we require and the competition for qualified personnel among life science businesses, we may not succeed in attracting or retaining the personnel required to continue and grow operations. The loss of a key employee, the failure of a key employee to perform in his or her current position or our patent rights in foreign jurisdictionsinability to attract and retain skilled employees could result in substantial costs and divertthe inability to continue to grow our efforts and attention from other aspectsbusiness or to implement business strategy.

The loss or transition of any member of our business,senior management team or the inability to attract and retain highly skilled scientists, clinicians and salespeople could putadversely affect our patents at riskbusiness.

Our success depends on the skills, experience, and performance of being invalidated or interpreted narrowlykey members of the senior management team. The individual and our patent applications at riskcollective efforts of not issuingthese employees will be important as we continue to develop tests and could provoke third parties to assert claims against us.services, and as we expand commercial activities. We may not prevailhave experienced increased turnover in any lawsuits that we initiatethe past year and the damagesloss or incapacity of existing members of the senior management team could adversely affect operations if we experience difficulties in hiring qualified successors.

The complexity inherent in integrating a new key member of the senior management team with existing senior management may limit the effectiveness of any such successor or otherwise adversely affect our business. Leadership transitions can be inherently difficult to manage and may cause uncertainty or a disruption to business or may increase the likelihood of turnover of other key officers and employees. Specifically, a leadership transition in the commercial team may cause uncertainty about or a disruption to our commercial organization, which may impact the ability to achieve sales and revenue targets.

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Our officers and directors have significant influence over critical decisions.

Our officers and directors have a significant stake in the Company and are likely to have influence over any critical decisions relating to the Company. Our officers and directors beneficially own, directly or indirectly, approximately 10.9% of our outstanding common stock as of March 15, 2022. As a result, such individuals are likely to continue to have a significant influence in determining the outcome of any matter submitted to the shareholders for approval (including the election of directors and any merger, consolidation or sale of all or substantially all of the Company’s assets) and to have significant influence in the management and affairs of the Company. The interests of the officers and directors may differ from the interests of other shareholders due to various factors, which may include the differing price at which they acquired their ownership in the Company as compared to other shareholders, the significant investment of personal time and effort by the officers and directors into the Company, and differing views on the effect of sunk costs with regard to potential future liquidity events.

Our employees, independent contractors, consultants, collaborators and contract research organizations may engage in misconduct or other remedies awarded, if any,improper activities, including non-compliance with regulatory standards and requirements, which could cause significant liability for us and harm our reputation.

We are exposed to the risk that our employees, independent contractors, consultants, collaborators and contract research organizations may engage in fraudulent conduct or other illegal activity. Misconduct by those parties could include intentional, reckless and/or negligent conduct or disclosure of unauthorized activities to us that violates: (1) FDA regulations or similar regulations of comparable non-U.S. regulatory authorities, including those laws requiring the reporting of true, complete and accurate information to such authorities, (2) manufacturing standards, (3) federal and state healthcare fraud and abuse laws and regulations and similar laws and regulations established and enforced by comparable non-U.S. regulatory authorities, and (4) laws that require the reporting of financial information or data accurately. In particular, sales, marketing and business arrangements in the healthcare industry are subject to extensive laws and regulations intended to prevent fraud, misconduct, kickbacks, self- dealing, bribery and other abusive practices. These laws and regulations restrict or prohibit a wide range of pricing, discounting, marketing and promotion, sales commission, customer incentive programs and other business arrangements. Employee or collaborator misconduct could also involve the improper use of, including trading on, information obtained in the course of clinical trials, which could result in regulatory sanctions and serious harm to our reputation. We have adopted and maintained a code of conduct and in connection with the merger, we intend to maintain our code of conduct and business ethics, but it is not always possible to identify and deter misconduct, and the precautions we take to detect and prevent this activity may not be commercially meaningful. Accordingly,effective in controlling unknown or unmanaged risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws, standards or regulations. If any such actions are instituted against us, and we are not successful in defending ourselves or asserting our efforts to enforce our intellectual property rights, around the world may be inadequate to obtainthose actions could have a significant commercial advantage from the intellectual property that we develop or license.


Risks Relating to Our International Operations

International expansion ofimpact on our business exposes us to business, regulatory, political, operational, financial and economic risks associated with doing business outside of the United States.

Our business strategy incorporates international expansion, including our recent acquisitions which have provided us with facilities in Australia, and the possibility of establishing and maintaining clinician marketing and education capabilities in other locations outside of the United States and expanding our relationships with distributors and manufacturers. Doing business internationally involves a number of risks, including:

multiple, conflicting and changing laws and regulations such as tax and transfer pricing laws, export and import restrictions, employment laws, regulatory requirements and other governmental approvals, permits and licenses;
being subject to additional privacy and cybersecurity laws, including the Australian Privacy Act of 1988;
failure by us or our distributors to obtain regulatory approvals for the sale or use of our tests in various countries, including failure to achieve “CE Marking”, a conformity mark which is required to market in vitro diagnostic medical devices in the European Economic Area and which is broadly accepted in other international markets;
difficulties in managing foreign operations;
complexities associated with managing multiple payor-reimbursement regimes or self-pay systems;
logistics and regulations associated with shipping tissue samples, including infrastructure conditions and transportation delays;
limits on our ability to penetrate international markets if our diagnostic tests cannot be processed by an appropriately qualified local laboratory;
financial risks, such as longer payment cycles, difficulty enforcing contracts and collecting accounts receivable and exposure to foreign currency exchange rate fluctuations;
reduced protection for intellectual property rights;
natural disasters, political and economic instability, including wars, terrorism and political unrest, outbreak of disease, boycotts, curtailment of trade and other business restrictions; and
failure to comply with the Foreign Corrupt Practices Act, including its books and records provisions and its anti-bribery provisions, by maintaining accurate information and control over sales and distributors’ activities.

Any of these risks, if encountered, could significantly harm our future international expansion and operations and, consequently, have a material adverse effect on our financial condition, results of operations, including the imposition of civil, criminal and cash flows.

Our operating results may be adversely affected by fluctuations in foreign currency exchange ratesadministrative penalties, damages, monetary fines, imprisonment, contractual damages, reputational harm, diminished profits and restrictions on the deployment of cash across our global operations.

Although we report our operating results in U.S. dollars, a portionfuture earnings, and curtailment of our revenues and expenses are or will be denominated in currencies other than the U.S. dollar. Fluctuations in foreign currency exchange rates can have a numberoperations, any of adverse effects on us. Because our consolidated financial statements are presented in U.S. dollars, we must translate revenues, expenses and income, as well as assets and liabilities, into U.S. dollars at exchange rates in effect during or at the end of each reporting period. Therefore, changes in the value of the U.S. dollar against other currencies will affect our revenues, income from operations, other income (expense), net and the value of balance sheet items originally denominated in other currencies. There is no guarantee that our financial results will not be adversely affected by currency exchange rate fluctuations. In addition, in some countries we could be subject to strict restrictions on the movement of cash and the exchange of foreign currencies, which could limit our ability to use these funds across our global operations.

We could be adversely affected by violations of the U.S. Foreign Corrupt Practices Act and other worldwide anti-bribery laws.

The FCPA and anti-bribery laws in other jurisdictions generally prohibit companies and their intermediaries from making improper payments for the purpose of obtaining or retaining business or other commercial advantage. Our policies mandate compliance with these anti-bribery laws, which often carry substantial penalties, including criminal and civil fines, potential loss of export licenses, possible suspension of the ability to do business with the federal government, denial of government reimbursement for products and exclusion from participation in government health care programs. We may operate in jurisdictions that have experienced governmental and private sector corruption to some degree, and, in certain circumstances, strict compliance with anti-bribery laws may conflict with certain local customs and practices. We cannot assure that our internal control policies and procedures always will protect us from reckless or other inappropriate acts committed by our affiliates, employees or agents. Violations of these laws, or allegations of such violations, could have a material adverse effect on our ability to operate our business financial position and our results of operations.

If we are unable to manage growth, our prospects may be limited and our future results of operations may be adversely affected.

We intend to continue to attempt to expand our business with sales and marketing programs and other activities as needed to meet future demand. Any significant expansion may strain managerial, financial and other resources. If we are unable to manage such growth, business, operating results and financial condition could be adversely affected. We will need to improve continually the operations, financial and other internal systems to manage growth effectively, and any failure to do so may lead to inefficiencies and redundancies, and result in reduced growth prospects and diminished operational results.

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Risks Relating to Our Common Stock


The price of our common stock has been and could remain volatile, and the market price of our common stock may decrease.


The market price of our common stock has historically experienced and may continue to experience significant volatility. From January 2015consummation of the merger of Cancer Genetics and StemoniX on March 30, 2021 through December 31, 2018,March 15, 2022, the market price of our common stock has fluctuated from a high of $12.75$4.81 per share in the thirdsecond quarter of 2015,2021 to a low of $0.20 per share$0.99 in the fourthfirst quarter of 2018.2022. Market prices for securities of development-stage life sciences companies have historically been particularly volatile. The factors that may cause the market price of our common stock to fluctuate include, but are not limited to:

progress, or lack of progress, in developing and commercializing our proprietary tests;
favorable or unfavorable decisions about our tests or services from government regulators, insurance companies or other third-party payors;
our ability to recruit and retain qualified regulatory and research and development personnel;
changes in our relationship with key collaborators, suppliers, customers and third parties;
changes in the market valuation or earnings of our competitors or companies viewed as similar to us;
changes in key personnel;
depth of the trading market in our common stock;
changes in our capital structure, such as future issuances of securities or the incurrence of additional debt;
the granting or exercise of employee stock options or other equity awards;
realization of any of the risks described under this section titled “Risk Factors”; and
general market and economic conditions.

progress, or lack of progress, in developing and commercializing our drug discovery candidates;
our ability to recruit and retain qualified regulatory and research and development personnel;
changes in the relationship with key collaborators, suppliers, customers and third parties;
changes in the market valuation or earnings of competitors or companies viewed as similar to us;
changes in key personnel;
depth of the trading market in our common stock;
changes in our capital structure, such as future issuances of securities or the incurrence of additional debt;
the granting or exercise of employee stock options or other equity awards;
realization of any of the risks described under this section titled “Risk Factors;” and
general market and economic conditions.

In addition, the equity markets have experienced significant price and volume fluctuations that have affected the market prices for the securities of newly public companies for a number of reasons, including reasons that may be unrelated to our business or operating performance. These broad market fluctuations may result in a material decline in the market price of our common stock and you may not be able to sell your shares at prices you deem acceptable. In the past, following periods of volatility in the equity markets, securities class action lawsuits have been instituted against public companies. Such litigation, if instituted against us, could result in substantial cost and the diversion of management attention.



Reports published by securities or industry analysts, including projections in those reports that exceed our actual results, could adversely affect our common stock price and trading volume.


Securities research analysts establish and publish their own periodic projections for our business. These projections may vary widely from one another and may not accurately predict the results we actually achieve. Our stock price may decline if ourthe actual results do not match securities research analysts’ projections. Similarly, if one or more of the analysts who writesauthors reports on us downgrades our stock or publishes inaccurate or unfavorable research about our business, our stock price could decline. If one or more of these analysts ceases coverage of our companyus or fails to publish reports on us regularly, our stock price or trading volume could decline. While we expect securities research analyst coverage, if no securities or industry analysts begin to cover us, the trading price for our stock and the trading volume could be adversely affected.


Our directors and executive officers have substantial influence over us and could delay or prevent a change in corporate control.

Our directors and executive officers, together with their affiliates, in the aggregate beneficially own approximately 15.2% of our outstanding common stock, based on the number of shares outstanding on March 27, 2019. These stockholders, acting together, have significant influence over the outcome of matters submitted to our stockholders for approval, including the election of directors and any merger, consolidation or sale of all or substantially all of our assets. In addition, these stockholders, acting together, have significant influence over our management and affairs. Accordingly, this concentration of ownership might harm the market price of our common stock by:
delaying, deferring or preventing a change in control;
impeding a merger, consolidation, takeover or other business combination involving us; or
discouraging a potential acquirer from making a tender offer or otherwise attempting to obtain control of us.

We are incurring significantly increasedsignificant costs and devotedevotes substantial management time as a result of operating as a public company.


As a public company, we are incurring significant legal, accounting and other expenses that we did not incur as a private company.expenses. For example, in addition to being required to comply with certain requirements of the Sarbanes-Oxley Act of 2002, we are required to comply with certain requirements of the Dodd Frank Wall Street Reform and Consumer Protection Act, as well as rules and regulations subsequently implemented by the SEC, including the establishment and maintenance of effective disclosure and financial controls and changes in corporate governance practices. We expect that compliance with these requirements will continue to increase our legal and financial compliance costs and will make some activities more time consuming and costly. In addition, we expect that our management and other personnel will continue to need to divert attention from operational and other business matters to devote substantial time to these public company requirements.

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The Sarbanes-Oxley Act requires, among other things, that we maintain effective internal control over financial reporting and disclosure controls and procedures. In particular, we must perform system and process evaluation and testing of our internal control over financial reporting to allow management to report on the effectiveness of our internal control over financial reporting, as required by Section 404 of the Sarbanes-Oxley Act. In addition, if we lose our status as a “smaller reporting company,“non-accelerated filer,” we will be required to have our independent registered public accounting firm attest to the effectiveness of our internal control over financial reporting. Our compliance with Section 404 of the Sarbanes-Oxley Act, as applicable, requires us to incur substantial accounting expense and expend significant management efforts. We currently do not have an internal audit group, and we will need to continue to hire additional accounting and financial staff with appropriate public company experience and technical accounting knowledge. If we or ourthe independent registered public accounting firm identify deficiencies in our internal control over financial reporting that are deemed to be material weaknesses, the market price of our stock could decline and we could be subject to sanctions or investigations by the NASDAQ, the SEC or other regulatory authorities, which would require additional financial and management resources.


Our ability to successfully implement our business plan and maintain compliance with Section 404, as applicable, requires us to be able to prepare timely and accurate financial statements. We expect that we will need to continue to improve existing, and implement new operational and financial systems, procedures and controls to manage our business effectively. Any delay in the implementation of, or disruption in the transition to, new or enhanced systems, procedures or controls, may cause our operations to suffer and we may be unable to conclude that our internal control over financial reporting is effective and to obtain an unqualified report on internal controls from our auditors as required under Section 404 of the Sarbanes-Oxley Act.effective. 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, and current and potential stockholders may lose confidence in our financial reporting. This, in turn, could have an adverse impact on trading prices for our common stock, and could adversely affect our ability to access the capital markets.


Anti-takeover provisions of our certificate of incorporation, our bylaws and Delaware law could make an acquisition of us,the Company, which may be beneficial to our stockholders, more difficult and may prevent attempts by our stockholders to replace or remove the current members of ourthe board and management.


Certain provisions of our amended and restated certificate of incorporation and bylaws could discourage, delay or prevent a merger, acquisition or other change of control that stockholders may consider favorable, including transactions in which you might otherwise receive a premium for your shares. Furthermore, these provisions could prevent or frustrate attempts by our stockholders to replace or remove members of ourthe board of directors. These provisions also could limit the price that investors might be willing to pay in the future for our common stock, thereby depressing the market price of our common stock. Stockholders who wish to participate in these transactions may not have the opportunity to do so. These provisions, among other things:

authorize our board of directors to issue, without stockholder approoval, preferred stock, the rights of which will be determined at the discretion of the board of directors and that, if issued, could operate as a “poison pill” to dilute the stock ownership of a potential hostile acquirer to prevent an acquisition that our board of directors does not approve;
establish advance notice requirements for stockholder nominations to our board of directors or for stockholder proposals that can be acted on at stockholder meetings; and
limit who may call a stockholder meeting.

authorize the board of directors to issue, without stockholder approval, preferred stock, the rights of which will be determined at the discretion of the board of directors and that, if issued, could operate as a “poison pill” to dilute the stock ownership of a potential hostile acquirer to prevent an acquisition that the board of directors does not approve;
establish advance notice requirements for stockholder nominations to the board of directors or for stockholder proposals that can be acted on at stockholder meetings; and
limit who may call a stockholder meeting.

In addition, we are governed by the provisions of Section 203 of the Delaware General Corporation Law, or DGCL, which may, unless certain criteria are met, prohibit large stockholders, in particular those owning 15% or more of the voting rights on our common stock, from merging or combining with usthe Company for a prescribed period of time.


Because we do not expect to pay cash dividends for the foreseeable future, you must rely on appreciation of our common stock price for any return on your investment. Even if we change that policy, we may be restricted from paying dividends on our common stock.


We do not intend to pay cash dividends on shares of our common stock for the foreseeable future. Any determination to pay dividends in the future will be at the discretion of ourthe board of directors and will depend upon results of operations, financial performance, contractual restrictions, restrictions imposed by applicable law and other factors ourthe board of directors deems relevant. Accordingly, you will have to rely on capital appreciation, if any, to earn a return on your investment in our common stock. Investors seeking cash dividends in the foreseeable future should not purchase our common stock.


Our ability to use our net operating loss carryforwards and certain other tax attributes may be limited.

Our ability to utilize our federal net operating loss, carryforwards and federal tax credits are limited under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended. The limitations apply since we have experienced an “ownership change,” as defined by Section 382, as a result of the Company’s securities offerings. Generally, an ownership change occurs if the percentage of the value of the stock that is owned by one or more direct or indirect “five percent shareholders” changes by more than 50 percentage points over their lowest ownership percentage at any time during the applicable testing period (typically three years). Since we have experienced an “ownership change”, our NOL carryforwards and federal tax credits are subject to limitations as to our ability to utilize them to offset taxable income and related income taxes. In addition, future changes in our stock ownership, which may be outside of our control, may trigger further “ownership changes” which would further limit their utilization. As a result, if we earn net taxable income, our ability to use our pre-change net operating loss carryforwards and other tax attributes to offset United States federal taxable income and related income taxes are subject to limitations, which could potentially result in increased future tax liability to us.

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Item 1B.Unresolved Staff Comments

None.


Item 2.Properties

As of December 31, 2018, we had2021, the Company has lease agreements for our three locations for continuing operations, including a lease for approximately 17,9005,837 square feet offoot research and development space, as well as shared office and laboratorysuite space, in Rutherford,La Jolla, California, a 14,932 square foot lab, manufacturing and office space in Maple Grove, Minnesota, and a 1,625 square foot corporate headquarters office space in Cherry Hill, New Jersey, 24,900Jersey. All leases have escalating payment schedules. The La Jolla lease expires in March, 2022, at which time the La Jolla operations will move to a 4,995 square feet of laboratoryfoot facility in La Jolla. The new La Jolla and Maple Grove leases expire in 2027 and the Cherry Hill lease expires on March 31, 2024. We believe that these facilities are adequate for our current needs and that suitable additional space locatedwill be available as needed.

vivoPharm operates in Research Triangle Park (RTP) in Morrisville, North Carolina, 5,800 square feetleased facilities in Hershey, Pennsylvania, Berlin, Germany and 1,959 square feettwo locations in Bundoora, Australia. These lease agreements have


escalating lease payments and expire in February 2023, May 2020, November 2020 and July 2021, respectively. During 2018, we had a lease agreement for approximately 19,100 square feet of laboratory space in Los Angeles, California which expired on December 31, 2018. At December 31, 2018, we owed approximately $164,000 in overdue rent and related expenses to the Los Angeles landlord, and are in active negotiations to finalize our financial obligations related to his property.

Item 3.Legal Proceedings

On April 5, 2018 and April 12, 2018, purported stockholders of the Company filed nearly identical putative class action lawsuits

We are not currently subject to any material legal proceedings. However, we may from time to time become a party to various legal proceedings arising in the U.S. District Court for the District of New Jersey, against the Company, Panna L. Sharma, John A. Roberts, and Igor Gitelman, captioned Ben Phetteplace v. Cancer Genetics, Inc. et al., No. 2:18-cv-05612 and Ruo Fen Zhang v. Cancer Genetics, Inc. et al., No. 2:18-06353, respectively. The complaints alleged violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and SEC Rule 10b-5 based on allegedly false and misleading statements and omissions regarding our business, operational, and financial results. The lawsuits sought, among other things, unspecified compensatory damages in connection with purchasesordinary course of our stock between March 23, 2017 and April 2, 2018, as well as interest, attorneys’ fees, and costs. On August 28, 2018, the Court consolidated the two actions in one action captioned In re Cancer Genetics, Inc. Securities Litigation (the “Securities Litigation”) and appointed shareholder Randy Clark as the lead plaintiff. On October 30, 2018, the lead plaintiff filed an amended complaint, adding Edward Sitar as a defendant and seeking, among other things, compensatory damages in connection with purchases of CGI stock between March 10, 2016 and April 2, 2018. On December 31, 2018, Defendants filed a motion to dismiss the amended complaint for failure to state a claim. The Company is unable to predict the ultimate outcome of the Securities Litigation and therefore cannot estimate possible losses or ranges of losses, if any.


In addition, on June 1, 2018, September 20, 2018, and September 25, 2018, purported stockholders of the Company filed nearly identical derivative lawsuits on behalf of the Company in the U.S. District Court for the District of New Jersey against the Company (as a nominal defendant) and current and former members of the Company’s Board of Directors and current and former officers of the Company. The three cases are captioned: Bell v. Sharma et al., No. 2:18-cv-10009-CCC-MF, McNeece v. Pappajohn et al., No. 2:18-cv-14093, and Workman v. Pappajohn, et al., No. 2:18-cv-14259 (the “Derivative Litigation”). The complaints allege claims for breach of fiduciary duty, violations of Section 14(a) of the Securities Exchange Act of 1934 (premised upon alleged omissions in the Company’s 2017 proxy statement), and unjust enrichment, and allege that the individual defendants failed to implement and maintain adequate controls, which resulted in ineffective disclosure controls and procedures, and conspired to conceal this alleged failure. The lawsuits seek, among other things, damages and/or restitution to the Company, appropriate equitable relief to remedy the alleged breaches of fiduciary duty, and attorneys’ fees and costs. On November 9, 2018, the Court in the Bell v. Sharma action entered a stipulation filed by the parties staying the Bell action until the Securities Litigation is dismissed, with prejudice, and all appeals have been exhausted; or the defendants’ motion to dismiss in the Securities Litigation is denied in whole or in part; or either of the parties in the Bell action gives 30 days’ notice that they no longer consent to the stay. On December 10, 2018, the parties in the McNeece action filed a stipulation that is substantially identical to the Bell stipulation. On February 1, 2019, the Court in the Workman action granted a stipulation that is substantially identical to the Bell stipulation. The Company is unable to predict the ultimate outcome of the Derivative Litigation and therefore cannot estimate possible losses or ranges of losses, if any.

business.

Item 4.Mine Safety Disclosures

Not applicable.



PART II

Item 5.Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

Market Information

The following table sets forth, for the periods indicated, the reported high and low sales prices of ourCompany’s common stock trades on The NASDAQ Capital Market.Stock Market LLC under the symbol “VYNT.”

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  High Low
4th Quarter 2018
 $1.05
 $0.20
3rd Quarter 2018
 $1.30
 $0.85
2nd Quarter 2018
 $1.75
 $0.82
1st Quarter 2018
 $2.20
 $1.55
     
4th Quarter 2017
 $3.50
 $1.75
3rd Quarter 2017
 $4.25
 $2.60
2nd Quarter 2017
 $4.78
 $3.00
1st Quarter 2017
 $5.30
 $1.35

Holders


As of December 31, 2018, we2021, the Company had approximately 10083 holders of record of ourthe Company’s common stock. The number of record holders was determined from the records of ourthe transfer agent and does not include beneficial owners of common stock whose shares are held in the names of various security brokers, dealers, and registered clearing agencies. The transfer agent of ourthe Company’s common stock is Continental Stock Transfer & Trust, 17 Battery Place, 8th1 State Street, 30th Floor, New York, New York, 10004.


Dividends


We have

The Company has never declared dividends on ourthe Company’s equity securities, and currently dodoes not plan to declare dividends on shares of ourthe Company’s common stock in the foreseeable future. We expectThe Company expects to retain our future earnings, if any, for use in the operation and expansion of ourthe Company’s business. Our loan agreements prohibit us from paying cash dividends on our common stock and the terms of any future loan agreement we enter into or any debt securities we may issue are likely to contain similar restrictions on the payment of dividends. Subject to the foregoing, theThe payment of cash dividends in the future, if any, will be at the discretion of ourthe board of directors and will depend upon such factors as earnings levels, capital requirements, our overall financial condition and any other factors deemed relevant by ourthe board of directors.


Item 6.Selected Financial Data.

The selected financial data set forth below as of December 31, 2018 and 2017, and for the years then ended has been derived from the audited consolidated financial statements of the Company, which are included elsewhere in this Annual Report on Form 10-K. We derived the consolidated financial data as of and for the years ended December 31, 2016, 2015 and 2014 from our audited consolidated financial statements that are not included elsewhere in this Annual Report on Form 10-K.

The information set forth below should be read in conjunction with "Management's

Item 6. Reserved.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations" and the audited consolidated financial statements, and the notes thereto, and other financial information included herein. Our historical results are not necessarily indicative of our future results.



  Year Ended December 31,
  2018 2017 2016 2015 2014
  (in thousands, expect per share data)
Consolidated Statements of Operations Data:          
Revenue $27,470
 $29,121
 $27,049
 $18,040
 $10,199
Cost of revenues 18,724
 18,070
 17,104
 14,098
 8,453
Gross profit (loss) 8,746
 11,051
 9,945
 3,942
 1,746
Operating expenses:          
Research and development 2,488
 4,789
 5,967
 5,483
 4,622
General and administrative 19,184
 19,894
 16,034
 14,567
 12,369
Sales and marketing 5,268
 4,990
 4,668
 5,269
 3,964
Restructuring costs 2,320
 
 
 
 
Merger costs 1,464
 
 
 
 
Total operating expenses 30,724
 29,673
 26,669
 25,319
 20,955
Loss from operations (21,978) (18,622) (16,724) (21,377) (19,209)
Other income (expense):          
Interest expense (2,120) (2,128) (454) (344) (473)
Interest income 21
 63
 23
 49
 74
Change in fair value of warrant liability 3,732
 (1,964) 1,525
 35
 417
Change in fair value of acquisition note payable 136
 (42) 152
 269
 198
Other expense (78) (266) (325) 
 
Total other income (expense) 1,605
 (4,337) 921
 9
 216
Loss before income taxes (20,373) (22,959) (15,803) (21,368) (18,993)
Income tax (benefit) 
 (2,079) 
 (1,184) (2,350)
Net (loss) $(20,373) $(20,880) $(15,803) $(20,184) $(16,643)
Basic net (loss) per share $(0.75) $(1.01) $(1.00) $(1.96) $(1.76)
Diluted net (loss) per share $(0.75) $(1.01) $(1.00) $(1.96) $(1.80)
Basic weighted average shares outstanding 27,291
 20,663
 15,861
 10,298
 9,449
Diluted weighted average shares outstanding 27,291
 20,663
 15,861
 10,299
 9,462
           
  Year Ended December 31,
  2018 2017 2016 2015 2014
Consolidated Balance Sheet Data: (in thousands)
Cash and cash equivalents $161
 $9,541
 $9,502
 $19,459
 $25,554
Working capital (deficit) (17,946) 3,566
 12,378
 18,333
 27,389
Total assets 35,406
 52,221
 42,434
 48,884
 47,105
Debt, excluding current portion 
 
 2,654
 4,642
 6,000
Accumulated deficit (157,716) (134,834) (113,954) (98,151) (77,967)
Total stockholders' equity $6,802
 $26,765
 $25,624
 $33,017
 $34,554

Item 7.Management’s Discussion and Analysis of Financial Condition and Results of Operations

Operations

As used herein, the “Company,” “we,” “us,” “our” or similar terms, refer“Company” refers to Cancer Genetics,Vyant Bio, Inc. and its wholly owned subsidiaries: Cancer Genetics Italia, S.r.l., Gentris, LLC, BioServe Biotechnologies (India) Private LimitedStemoniX, Inc. (“StemoniX”) and vivoPharmvivoPharm Pty Ltd.Ltd (“vivoPharm”), except as expressly indicated or unless the context otherwise requires. The following Management’s Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”) is intended to help facilitate an understanding of ourthe Company’s financial condition and ourits historical results of operations for the periods presented. This MD&A should be read in conjunction with the audited consolidated financial statements and notes thereto included in this annual report on Form10-K.Form 10-K. This MD&A may contain forward-looking statements that involve risks and uncertainties. For a discussion on forward-looking statements, see the information set forth in the Introductory Note to this Annual Report under the caption “Forward Looking Statements”, which information is incorporated herein by reference.


Overview


Vyant Bio, Inc. (the “Company”, “Vyant Bio”, “VYNT” or “we”), is an innovative biotechnology company reinventing drug discovery for complex neurodevelopmental and neurodegenerative disorders. Our central nervous system (“CNS”) drug discovery platform combines human-derived organoid models of brain disease, scaled biology, and machine learning. Our platform is designed to: 1) elucidate disease pathophysiology; 2) formulate key therapeutic hypotheses; 3) identify and validate drug targets, cellular assays, and biomarkers to guide candidate molecule selection; and 4) guide clinical trial patient selection and trial design. Our current programs are focused on identifying repurposed and novel small molecule clinical candidates for rare CNS genetic disorders including Rett Syndrome (“Rett”), CDKL5 Deficiency Disorders (“CDD”) and familial Parkinson’s Disease (“PD”). The Company’s management believes that drug discovery needs to progressively shift as the widely used preclinical models for predicting safe and effective drugs have under-performed, as evidenced by the time and cost of bringing novel drugs to market. As a result, Vyant Bio is focused on combining sophisticated data science capabilities with highly functional human cell derived disease models. We are an emerging leaderleverage our ability to identify validated targets and molecular-based biomarkers to screen and test thousands of small molecule compounds in enabling precision medicinehuman diseased 3D brain organoids in oncology by providing multi-disciplinary diagnosticorder to create a unique approach to assimilating biological data that supports decision making iteratively throughout the discovery phase of drug development to identify both novel and data solutions, facilitating individualized therapies through our diagnostic tests, services and molecular markers. We develop, commercialize and provide molecular- and biomarker-based tests and services, including proprietary preclinical oncology and immuno-oncology services, that enable biotech and pharmaceutical companies engaged in oncology trialsrepurposed drug candidates.

In December 2021, the Company’s Board of Directors approved a plan to better select candidate populations and reduce adverse drug reactions by providing information regarding genomic factors influencing subject responses to therapeutics. Through our clinical services, we enable physicians to personalizesell the clinical management of each individual patient by providing genomic information to better diagnose, monitor and inform cancer treatment. We have a comprehensive, disease-focused oncology testing portfolio, and an extensive set of anti-tumor referenced data based on predictive xenograft and syngeneic tumor models. Our tests and techniques target a wide range of indications, covering all ten of the top cancers in prevalence in the United States, with additional unique capabilities offered by our FDA-cleared Tissue of Origin® test for identifying difficult to diagnose tumor types or poorly differentiated metastatic disease. Following the acquisition of vivoPharmvivoPharm Pty Ltd (“vivoPharm”vivoPharm”) we provide contract research services, focused primarilybusiness to allow the Company to focus on unique specialized studies to guide drug discovery and development programs in the oncology and immuno-oncology fields.


We are currently executing a strategy of partnering with pharmaceutical and biotech companies and clinicians as oncology diagnostic specialists by supporting therapeutic discovery, development and patient care. Pharmaceutical and biotech companies are increasingly attracted to work with us to provide molecular profiles on clinical trial participants. Similarly, we believe the oncology industry is undergoing a rapid evolution in its approach to diagnostic, prognostic and treatment outcomes (theranostic) testing, embracing precision medicine and individualized testing as a means to drive higher standards of patient treatment and disease management. These profiles may help identify biomarker and genomic variations that may be responsible for differing responses to oncology therapies, thereby increasing the efficiency of trials while lowering costs. We believe tailored and combination therapies can revolutionize oncology care through molecular- and biomarker-based testing services, enabling physicians and researchers to target the factors that make each patient and disease unique.

We believe the next shift in cancer management will bring together testing capabilities for germline, or inherited mutations, and somatic mutations that arise in tissues over the course of a lifetime. We have created a unique position in the industry by providing both targeted somatic analysis of tumor sample cells alongside germline analysis of an individual's non-cancerous cells' molecular profile as we attempt to continue achieving milestones in precision medicine.

Our clinical offerings include our portfolio of proprietary tests targeting hematological, urogenital and HPV-associated cancers, in conjunction with ancillary non-proprietary tests. Our proprietary tests target cancers that are difficult to prognose and predict treatment outcomes through currently available mainstream techniques. We provide our proprietary tests and services, along with a comprehensive range of non-proprietary oncology-focused tests and laboratory services, to oncologists and pathologists at hospitals, cancer centers, and physician offices, as well as biotech and pharmaceutical companies to support their clinical trials. Our proprietary tests are based principally on our expertise in specific cancer types, test development methodologies and proprietary algorithms correlating genetic events with disease specific information. Our portfolio primarily includes comparative genomic hybridization (CGH) microarrays and next generation sequencing (NGS) panels, gene expression tests, and DNA fluorescent in situ hybridization (FISH) probes.

The non-proprietary testing services we offer are focused in part on specific oncology categories where we are developing our proprietary tests. We believe that there is significant synergy in developing and marketing a complete set of tests and services that are disease focused and delivering those tests and services in a comprehensive manner to help with treatment decisions. The insight that we develop in delivering the non-proprietary services are often leveraged in the development of neurological developmental and degenerative disease therapeutics. We engaged an investment banker in December 2021 to sell the vivoPharm business during 2022.

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Cancer Genetics, Inc. Merger

On March 30, 2021, Vyant Bio, Inc. (the “Company”, “Vyant Bio”, “VYNT” or “we”), formerly known as Cancer Genetics, Inc. (“CGI”), completed its business combination (the “Merger”) with StemoniX, Inc., a Minnesota corporation (“StemoniX”), in accordance with the Agreement and Plan of Merger and Reorganization, dated as of August 21, 2020 (the “Initial Merger Agreement”) by and among the Company, StemoniX and CGI Acquisition, Inc., a Minnesota corporation and wholly-owned subsidiary of the Company (“Merger Sub”), as amended by Amendment No. 1 thereto made and entered into as of February 8, 2021 (the “First Amendment”) and Amendment No. 2 thereto made and entered into as of February 26, 2021 (the “Second Amendment”) (the Initial Merger Agreement, as amended by the First Amendment and Second Amendment, the “Merger Agreement”), pursuant to which Merger Sub merged with and into StemoniX, with StemoniX surviving the Merger as a wholly-owned subsidiary of the Company.

The Merger was accounted for as a reverse acquisition with StemoniX being the accounting acquirer of CGI using the acquisition method of accounting. Under acquisition accounting, the assets and liabilities (including executory contracts, commitments and other obligations) of CGI, as of March 30, 2021, the closing date of the Merger, were recorded at their respective fair values and added to those of StemoniX. Any excess of purchase price consideration over the fair values of the identifiable net assets is recorded as goodwill. The total consideration paid by StemoniX in the Merger amounted to $59.9 million, which represents the fair value of CGI’s 11,007,186 shares of Common Stock or $50.74 million, 2,157,686 Common Stock warrants or $9.04 million and 55,907 Common Stock options outstanding on the closing date of the Merger with a fair value of $139 thousand. In addition, at the effective time of the Merger, existing StemoniX shareholders received an additional 804,711 incremental shares in accordance with the conversion ratio set forth in the Merger Agreement.

Business Disposals - Discontinuing Operations

In December 2021, vivoPharm, met the criteria to be reported as discontinuing operations. Therefore, the related assets, liabilities, operating results and cash flows of the vivoPharm business are reported as discontinuing operations as of December 31, and for period from the Merger date of March 30, 2021 through December 31, 2021. See Note 3 Discontinuing operations, to the Consolidated Financial Statements included in Part II, Item 8 below for additional information.

Revenue from Continuing Operations

The Company’s primary revenue sources are microOrgan plate product sales and the performance of preclinical drug testing services using our proprietarymicroOrgan technology, referred to as Discovery as a Service, or DaaS. The Company plans to focus its resources on internal drug discovery development programs and now increasinglywill wind down substantially all customer revenue generation in the validationfirst half of our proprietary programs, such as MatBA and Focus::NGS.


Net cash used in operating activities was $12.6 million and $13.6 million for2022. For the years ended December 31, 20182021 and 2017, respectively, and2020, 21% of revenue in each year was generated from customers located outside of the Company had unrestricted cash and cash equivalents of $0.2 million at December 31, 2018, a reduction from $9.5 million at December 31, 2017. The Company has negative working capital at December 31, 2018 of $17.9 million.

The Company currently requires a significant amount of additional capital to fund operations and pay its accounts payable, and its ability to continue as a going concern is dependent upon its ability to raise such additional capital and achieve profitability. IfUnited States. During the Company is not able to raise such additional capital on a timely basis or on favorable terms, the Company may need to scale back or, in extreme cases, discontinue its operations or liquidate its assets.

While we have implemented an aggressive consolidation strategy to reduce our operating costs in 2018, including the closure of our California laboratory and facility, we expect to continue to incur material losses for the near future. We incurred losses of $20.4 million and $20.9 million for fiscal years ended December 31, 20182021 and 2017, respectively. As of December 31, 2018, we had an accumulated deficit of $157.7 million. We need to raise additional capital or execute on our plans to execute a strategic transaction. The report of our independent registered public accounting firm with respect to our financial statements appearing in Part II Item 8 of this annual report on Form 10-K contains an explanatory paragraph stating that our operating losses and negative cash flows from operations, raise substantial doubt about our ability to continue as a going concern. There can be no assurance that additional capital will be available to us on acceptable terms, if at all, or that we will complete a strategic transaction. In addition, we are in default of certain financial covenants in our credit agreements with our senior lenders and our ABL matures on April 15, 2019. While we have negotiated forbearance agreements with both lenders through April 15, 2019, we will not be able to close on a strategic transaction on or before April 15, 2019, and there is no assurance that will be able to extend the forbearance periods or the term of the ABL.

Sale of India Subsidiary

On April 26, 2018, we sold our India subsidiary, BioServe Biotechnologies (India) Private Limited (“BioServe”) to Reprocell, Inc., for $1.9 million, including $1.6 million in cash at closing and up to an additional $0.3 million, which was contingent upon the India subsidiary meeting a specified revenue target through August 31, 2018. The contingent consideration was reduced to $0.2 million and received in November 2018. As a result of this transaction, we recognized a loss of approximately $0.1 million on the disposal of BioServe, which is included in other income (expense) in our Consolidated Statements of Operations and Other Comprehensive Loss.

Restructuring

In 2018, the Company adopted a plan to migrate its California operations to its New Jersey and North Carolina locations and to permanently close its California laboratory. The Company incurred approximately $2.3 million of restructuring costs during the year ended December 31, 2018 as the result of this consolidation of our operations.

Merger Agreement

On September 18, 2018, we entered into an agreement and plan of merger (the “Merger Agreement”) with NovellusDx, Ltd., a privately-held company formed under the law of the State of Israel (“NDX”), in regards to Wogolos Ltd., our wholly-owned subsidiary company formed under the laws of the State of Israel. Subject to satisfaction or waiver of the conditions set forth in the Merger Agreement, Wogolos Ltd. would have merged with and into NDX, with NDX becoming a wholly-owned subsidiary of us and the surviving company. In connection with the signing of the Merger Agreement, we entered into a credit agreement with NDX, pursuant to which NDX loaned us $1.5 million (“Advance from NDX”).

On December 15, 2018, we terminated the Merger Agreement. As a result, the Advance from NDX, plus interest thereon, became due and payable on March 15, 2019. In addition, the interest rate was increased beginning on December 15, 2018 to 21% due to an event of default. The default also gives NDX the right to convert all, but not less than all, of the outstanding balance into shares of the Company’s common stock at a conversion price of $0.606 per share.

Acquisition

On August 15, 2017, we purchased all of the outstanding stock of vivoPharm, with its principal place of business in Victoria, Australia, in a transaction valued at approximately $1.6 million in cash and shares of the Company’s common stock, valued at $8.1 million based on the closing price of the stock on August 15, 2017.

Key Factors Affecting our Results of Operations and Financial Condition

Our overall long-term growth plan is predicated on our ability to develop or acquire technology solutions to accelerate the penetration into the Biopharma community to achieve more revenue supporting clinical trials and develop and commercialize unique or proprietary services and tests to achieve sustainable organic growth. Our unique and proprietary tests include CGH microarrays, NGS panels, and DNA FISH probes. We continue to develop additional unique and proprietary tests. To facilitate market adoption of our proprietary tests, we anticipate having to successfully complete additional studies with clinical samples and publish our results in peer-reviewed scientific journals. Our ability to complete such studies is dependent upon our ability to leverage our collaborative relationships with leading institutions to facilitate our research and obtain data for our quality assurance and test validation efforts.

We believe that the factors discussed in the following paragraphs have had and are expected to continue to have a material impact on our results of operations and financial condition.

Revenues

Our revenue is generated through our Biopharma Services, Discovery Services and Clinical Services. Biopharma Services are billed to the customer directly. While we have agreements with our Biopharma clients, volumes from these clients are subject to the progression and continuation of the clinical trials which can impact testing volume. We also derive revenue from Discovery Services, which are services provided in the development of new testing assays and methods and include pre-clinical toxicology and efficacy studies. Discovery Services are billed directly to the customer. Our Clinical Services can be billed to Medicare, another third party insurer or the referring community hospital or other healthcare facility, or patients in accordance with state and federal law.

We have historically derived a significant portion of our revenue from a limited number of test ordering sites, although the test ordering sites that generate a significant portion of our revenue have changed from period to period. Test ordering sites account for all of our Clinical Services revenue along with a portion of the Biopharma Services revenue. Our test ordering sites are hospitals, cancer centers, reference laboratories, physician offices, and pharmaceutical and biotechnology companies. Oncologists and pathologists at these sites order the tests on behalf of their oncology patients or as part of a clinical trial sponsored by a pharmaceutical or biotechnology company in which the patient is being enrolled.
During the year ended December 31, 2018, no Biopharma clients accounted for more than 10% of our revenue. During the year ended December 31, 2017, one Biopharma client2020, three customers accounted for approximately 11% of our revenue.

We receive revenue for our Clinical Services from Medicare, other insurance carriers47% and other healthcare facilities. Some of ourtwo customers choose, generally at the beginning of our relationship, to pay for laboratory services directly as opposed to having patients (or their insurers) pay for those services and providing us with the patients’ insurance information. A hospital may elect to be a direct bill customer and pay our bills directly, or may provide us with patient information so that their patients pay our bills, in which case we generally expect payment from their private insurance carrier or Medicare. In a few instances, we have arrangements where a hospital may have two accounts with us, so that certain tests are billed directly to the hospital, and certain tests are billed to and paid by a patient’s insurer. The billing arrangements generally are dictated by our customers and in accordance with state and federal law. For the year ended December 31, 2018, Medicare and other third party payors accounted for approximately 8% and 19%39%, respectively, of our totalthe consolidated revenue respectively.

from continuing operations.

Cost of Revenues


OurGoods from Continuing Operations

The Company separately reports cost of revenues consists principally of internal personnelgoods for product sales and service revenue. Product revenue costs including non-cash stock-based compensation, laboratory consumables, shippinginclude labor and product costs overhead and other direct expenses, such as specimen procurementlabware, plates and third party validation studies. We are pursuing various strategiesreagents required to reducedevelop iPSC’s into microOrgans as well as overhead, facility and control our costequipment costs at the Company’s Maple Grove, Minnesota facility. As the facility was designed to accommodate the Company’s long-term growth, it has historically operated at less than 25% of revenues, including automating our processes through more efficient technologycapacity. The Company is converting the Maple Grove facility to a research and attemptingdevelopment facility in the first half of 2022 to negotiate improved terms with our suppliers. In 2017, we purchased allfocus its resources on internal drug discovery development programs. Cost of the outstanding stock of vivoPharm. Overall, we have made significant progress with integrating our resourcesgoods for service revenue includes internal labor, materials and allocated overhead costs to perform services and leveraging enterprise wide purchasing power to gain supplier discounts, in an effort to reduce costs. We will continue to assess other possible advantages to help us improve our cost structure, including other consolidations of operations and further reductions in headcount.for DaaS projects.

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Operating Expenses


We classify our from Continuing Operations

The Company classifies its operating expenses into fivethree categories: research and development, sales and marketing,selling, general and administrative; restructuring costs andadministrative as well as merger related costs. Our operatingOperating expenses principally consist of personnel costs, including


non-cash stock-based compensation, outside services, laboratory consumables, andrent, overhead, development costs, and marketing program costs, and legal and accounting fees.

Research and Development Expenses. We incur research Research and development expenses principally in connection with our effortsreflect the personnel related expenses, overhead and lab consumable costs to develop our proprietary tests. Our primary researchits microOrgan technology at its La Jolla, California facility as well as development activities undertaken at the Maple Grove, Minnesota facility. The Company intends to accelerate its drug discovery development activities in 2022 and development expenses consist of direct personnel costs, laboratory equipment and consumables and overhead expenses. All research and development expenses are charged to operations in the periods they are incurred.


beyond.

Selling, General and Administrative Expenses. GeneralSelling, general and administrative expenses consist principally of personnel-related expenses, professional fees, such as legal, accounting, and business consultants, occupancy costs bad debt and other general expenses. We have incurred increases in our general and administrative expenses and anticipate only modest increases as we expand our business operations.


Sales and Marketing Expenses. Our sales and marketing expenses consist principally ofwell as personnel and related overhead costs for our salesits business development team and theirrelated support personnel, travel and entertainment expenses, and other selling costs, including sales collaterals and trade shows. We expect

Merger Related Costs. Merger related costs are direct professional service and investor banker costs incurred by the Company in connection with the Merger.

Coronavirus (COVID-19) Pandemic. On March 11, 2020, the World Health Organization declared the novel strain of coronavirus (“COVID-19”) a global pandemic and recommended containment and mitigation measures worldwide. Many of the Company’s customers worldwide were impacted by COVID-19 and temporarily closed their facilities which impacted revenue in the first half of 2020. While the impact of the pandemic on our salesbusiness has lessened in 2021, the global outbreak of COVID-19 continued in late 2021 with new variants and marketing expenseshas impacted the way we operate our business, including remote working, including its impact on technology security risks and employee retention. The extent to decreasewhich the COVID-19 pandemic may impact the Company’s future business will depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as, we expand into existing geographiesthe duration of the outbreak, travel restrictions and customize clinical testssocial distancing in the U.S. and services.


Restructuring Costs. In alignmentother countries, business closures or business disruptions, and the effectiveness of actions taken in the U.S. and other countries to contain and treat the disease.

The Company is actively monitoring the impact of the COVID-19 pandemic on its business, results of operations and financial condition. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition in the future is unknown at this time and will depend on future developments that are highly unpredictable.

As the Merger was consummated at the close of business on March 30, 2021, the Company’s consolidated statement of operations for the year ended December 31, 2021 includes nine months and one day of operations associated with our strategic plan to migrate our Californiathe historical CGI business. Further, as noted in Note 3 Discontinuing operations, to our New Jersey and North Carolina locations and to permanently close our California laboratory, we experienced various expenses associated with exiting a facility, transitionthe Consolidated Financial Statements included in Part II, Item 8 below for additional information, the vivoPharm business has been classified as discontinuing operations as of lab equipment and supplies, disposal of assets and termination benefits associated with displaced employees. We consider this expense to be one time in nature and subject to board approved strategic initiatives.December 31, 2021.

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Merger Costs. In the pursuit of various strategic options for the Company, legal and other professional costs are incurred while evaluating, negotiating, executing and implementing merger and acquisition alternatives. While this expense is a non-recurring cost, until such time as we complete a strategic transaction, we expect to incur these expenses in the near term.

Seasonality

Our business experiences decreased demand during spring vacation season, summer months and the December holiday season when patients are less likely to visit their health care providers. We expect this trend in seasonality to continue for the foreseeable future.

Results of Operations


Years Ended December 31, 20182021 and 2017


2020

The following table sets forth certain information concerning ourthe Company’s results offrom continuing operations for the periods shown:shown (in thousands):

  For the year ended December 31,  Change 
  2021  2020  $  % 
          
Revenue:                
Service $665  $588  $77   13%
Product  483   279   204   73%
Total revenue  1,148   867   281   32%
Operating costs and expenses:                
Cost of goods sold - service  408   384   24   6%
Cost of goods sold - product  1,439   717   722   101%
Research and development  4,273   3,232   1,041   32%
Selling, general and administrative  8,424   2,717   5,707   210%
Merger related costs  2,310   1,440   870   60%
Total operating costs and expenses  16,854   8,490   8,364   99%
Loss from operations  (15,706)  (7,623)  (8,083)  106%
                
Other expense:                
Change in fair value of warrant liability  214   -   214   N/A 
Change in fair value of share settlement obligation derivative  (250)  (503)  253   (50)%
Loss on debt conversions  (2,518)  -   (2,518)  N/A 
Other income, net  57   11   46   418%
Interest expense, net  (372)  (535)  163   (30)%
Total other expense, net  (2,869)  (1,027)  (1,842)  179%
Loss from continuing operations before income taxes  (18,575)  (8,650)  (9,926)  115%
Income tax expense (benefit)  

-

   -   -   - 
Net loss from continuing operations $(18,575) $(8,650) $(9,926)  115%

53

  Year Ended December 31, Change
  2018 2017 $ %
(dollars in thousands)        
Revenue $27,470
 $29,121
 $(1,651) -6 %
Cost of revenues 18,724
 18,070
 654
 4 %
Research and development expenses 2,488
 4,789
 (2,301) -48 %
General and administrative expenses 19,184
 19,894
 (710) -4 %
Sales and marketing expenses 5,268
 4,990
 278
 6 %
Restructuring costs 2,320
 
 2,320
 N/A
Merger costs 1,464
 
 1,464
 N/A
Total operating loss (21,978) (18,622) (3,356) 18 %
Interest (expense), net (2,099) (2,065) (34) 2 %
Change in fair value of warrant liability 3,732
 (1,964) 5,696
 -290 %
Change in fair value of other derivatives (86) 
 (86) N/A
Change in fair value of acquisition note payable 136
 (42) 178
 -424 %
Other expense (78) (266) 188
 -71 %
Loss before income taxes (20,373) (22,959) 2,586
 -11 %
Income tax (benefit) 
 (2,079) 2,079
 N/A
Net loss $(20,373) $(20,880) $507
 -2 %

Non-GAAP Financial Information

In addition to disclosing financial results in accordance with United States generally accepted accounting principles (“GAAP”), the table below contains non-GAAP financial measures that we believe are helpful in understanding and comparing our past financial performance and our future results. The non-GAAP financial measures disclosed by the Company exclude the non- operating changes in the fair value of derivative instruments. These non-GAAP financial measures should not be considered a substitute for, or superior to, financial measures calculated in accordance with GAAP, and the financial results calculated in accordance with GAAP and reconciliations

Revenue from these results should be carefully evaluated. Management believes that these non-GAAP measures provide useful information about the Company’s core operating results and thus are appropriate to enhance the overall understanding of the Company’s past financial performance and its prospects for the future. The non-GAAP financial measures in the table below include adjusted net (loss) and the related adjusted basic and diluted net (loss) per share amounts.


ReconciliationContinuing Operations

Total revenue from GAAP to Non-GAAP Results (in thousands, except per share amounts):

  Year Ended December 31,
  2018 2017
Reconciliation of net (loss):    
Net (loss) $(20,373) $(20,880)
Adjustments:    
Change in fair value of acquisition note payable (136) 42
Change in fair value of other derivatives 86
 
Change in fair value of warrant liability (3,732) 1,964
Adjusted net (loss) $(24,155) $(18,874)
Reconciliation of basic and diluted net (loss) per share:    
Basic and diluted net (loss) per share $(0.75) $(1.01)
Adjustments to net (loss) (0.14) 0.10
Adjusted basic and diluted net (loss) per share $(0.89) $(0.91)
Basic and diluted weighted-average shares outstanding 27,291
 20,663


Adjusted net (loss)continuing operations increased 28% to $24.2 million during the year ended December 31, 2018, from an adjusted net (loss) of $18.9 million during the year ended December 31, 2017. Adjusted basic and diluted net (loss) per share decreased 2% to $0.89 during the year ended December 31, 2018, down from $0.91 during the year ended December 31, 2017.

Revenue

The breakdown of our revenue is as follows:
 Year Ended December 31, Change
 2018 2017    
(dollars in thousands)$ % $ % $ %
Biopharma Services14,828
 54% 14,629
 50% 199
 1 %
Clinical Services7,429
 27% 10,774
 37% (3,345) (31)%
Discovery Services5,213
 19% 3,718
 13% 1,495
 40 %
Total Revenue27,470
 100% 29,121
 100% (1,651) (6)%

Revenue decreased 6%32%, or $1.7 million,$281 thousand, to $27.5 million for the year ended December 31, 2018, from $29.1 million for the year ended December 31, 2017, principally due to lower realization on third party and direct billings in our Clinical Services and the effects of the adoption of the new revenue recognition standard, which is directly the result of actual cash collection trends, offset in part by an increase in our Discovery Services.

Revenue from Biopharma Services increased 1%, or $0.2 million, to $14.8 million for the year ended December 31, 2018, from $14.6 million for the year ended December 31, 2017, principally due to the variability of timing related to project start dates and patient recruitment into clinical trials by our customers. Revenue from Clinical Services customers decreased 31%, or $3.3 million, to $7.4 million for the year ended December 31, 2018, from $10.8 million for the year ended December 31, 2017, principally due to lower realization on third party and direct billings and the effects of the adoption of the new revenue recognition standard. Revenue from Discovery Services increased $1.5 million, to $5.2 million for the year ended December 31, 2018, from $3.7 million for the year ended December 31, 2017 due to a full year of operations at vivoPharm, which was acquired in August 2017.

Cost of Revenues

Cost of revenues increased 4%, or $0.7 million, to $18.7 million for the year ended December 31, 2018, from $18.1 million for the year ended December 31, 2017, principally due to increased shipping and payroll costs of $1.0 million and $1.1 million, respectively, as a result of a full year of operations at vivoPharm, offset, in part, by a decrease in lab supplies of $1.2 million and a decrease of $0.4 million in depreciation and amortization. Gross margin declined from 38% to 32% during the year ended December 31, 2018. The decline in gross margin was caused by the challenges of cash collections in our clinical services business, which reduced our recorded revenue in the period. In addition, we recognized an out of measurement period adjustment associated with the vivoPharm acquisition and a corresponding change in estimate of the contract obligations for the remaining portfolio of contracts.

Operating Expenses

Research and Development Expenses. Research and development expenses decreased 48%, or $2.3 million, to $2.5 million for the year ended December 31, 2018, from $4.8 million for the year ended December 31, 2017. The decrease relates primarily to reduced payroll and benefits costs of $1.7 million and decreased lab supplies of $0.6 million.

General and Administrative Expenses. General and administrative expenses decreased 4%, or $0.7 million to $19.2 million for the year ended December 31, 2018, from $19.9 million for the year ended December 31, 2017. The decrease primarily relates to a decline in our bad debt expense of $2.8 million due to the adoption of the new revenue recognition standard, which requires implicit price concessions to be recorded as a reduction of revenue, and large write-offs of Clinical Services revenue in 2017 related to challenges faced at our California location during the period October 2015 through December 2017. We also reduced our legal and accounting costs by $0.5 million, travel costs by $0.2 million and office supplies by $0.1 million due to expense control measures and optimizing use of legal counsel. These reductions were partially offset by an increase in professional services of $0.7 million, an increase in medical billings expense of $0.5 million, an increase in payroll and other benefits of $0.6 million, an increase in depreciation and amortization of $0.2 million due to a full year of operations at

vivoPharm, an increase in business licenses of $0.2 million, an increase in taxes of $0.3 million and an increase in software and maintenance of $0.2 million.

Sales and Marketing Expenses. Sales and marketing expenses increased 6%, or $0.3 million, to $5.3 million for the year ended December 31, 2018, from $5.0 million for the year ended December 31, 2017, principally due to increased compensation and related benefits of $0.2 million due to the effect of a full year of operating expenses related to the vivoPharm acquisition and increased rent expense of $0.1 million.

Restructuring Costs: Restructuring costs of $2.3 million were incurred during the year ended December 31, 2018, primarily associated with the closure of the California laboratory and operations.

Merger Costs. Merger costs of $1.5 million were incurred during the year ended December 31, 2018, principally due to the evaluation and pursuit of strategic options, including the terminated merger with NDX.

Interest Expense, Net

Interest expense, net remained consistent during the year ended December 31, 2018 as compared to the year ended December 31, 2017.

Change in Fair Value of Warrant Liability

Changes in fair value of some of our common stock warrants may impact our results.  Accounting rules require us to record certain of our warrants as a liability, measure the fair value of these warrants each quarter and record changes in that value in earnings. We recognized non-cash income of $3.7 million for the year ended December 31, 2018, as compared to non-cash expense of $2.0 million for the year ended December 31, 2017, as a result of fluctuations in our stock price. In the future, if our stock price increases, we would record a non-cash charge as a result of changes in the fair value of our common stock warrants. Consequently, we may be exposed to non-cash charges, or we may record non-cash income, as a result of this warrant exposure in future periods.

Change in Fair Value of Other Derivatives

The change in fair value of other derivatives resulted in $0.1 million of non-cash expense due to provisions in our convertible note and Advance from NDX agreements that qualify as derivatives. We considered the probabilities of the occurrence or non-occurrence of various scenarios, as well as any potential changes in interest rates, in determining the valuation of these derivatives.

Change in Fair Value of Acquisition Note Payable

The change in fair value of the acquisition note payable resulted in $0.1 million in non-cash income for the year ended December 31, 2018, as compared to non-cash expense $42,000 for the year ended December 31, 2017 as a result of fluctuations in our stock price.

Other Expense

During the year ended December 31, 2018, we recognized a loss on the sale of our India subsidiary of approximately $0.1 million. During the year ended December 31, 2017, we incurred $0.3 million of aggregate expense resulting from the issuance of derivative warrants as part of a debt refinancing and the 2017 Offering (as defined below).

Income Taxes

During 2017, we received approximately $2.1 million of net proceeds from the sale of state NOL’s and state research and development credits. No NOL’s or research and development tax credits were sold during the year ended December 31, 2018. However, we received $0.5 million of net proceeds from the sale of state NOL’s and state research and development credits on April 12, 2019.

Liquidity and Capital Resources

Sources of Liquidity


Our primary sources of liquidity have been funds generated from our debt financings and equity financings. In addition, we have generated funds from the following sources: (i) cash collections from customers and (ii) cash received from sale of state NOL’s. On April 26, 2018, we sold our India subsidiary for $1.9 million, including $1.6 million in cash at closing and up to an additional $0.3 million, which was contingent upon the India subsidiary meeting a specified revenue target through August 31, 2018. The contingent consideration was reduced to $0.2 million and received in November 2018. In general, our primary uses of cash are providing for operating expenses, working capital purposes and servicing debt.

Line of Credit and Term Note

On March 22, 2017, we entered into a two year asset-based revolving line of credit agreement with Silicon Valley Bank (“SVB”). The SVB credit facility provided for an asset-based line of credit (“ABL”) for an amount not to exceed the lesser of (a) $6.0 million or (b) an amount equal to 80% of eligible accounts receivable plus the lesser of 50% of the net collectible value of third party accounts receivable or three times the average monthly collection amount of third party accounts receivable over the previous quarter. The ABL required monthly interest payments at the Wall Street Journal prime rate plus 1.5% (7.0% at December 31, 2018) and was scheduled to mature on March 22, 2019. We pay a fee of 0.25% per year on the average unused portion of the ABL. In August 2018, the maximum borrowings were reduced from $6.0 million to $3.0 million. Subsequent to year-end, the interest rate was adjusted to the Wall Street Journal prime rate plus 2.25% and the maturity date was extended through April 15, 2019, subject to the Company satisfying certain milestones of the forbearance agreement discussed below. At December 31, 2018, we had borrowed $2.6 million on the ABL, which was the maximum amount allowed based on eligible accounts receivable at the time and timing related to cash collections of accounts receivable.

On March 22, 2017, we concurrently entered into a three year $6.0 million term loan agreement (“PFG Term Note”) with Partners for Growth IV, L.P. (“PFG”). The PFG Term Note is an interest only loan with the full principal and any outstanding interest due at maturity on March 22, 2020. Interest is payable monthly at a rate of 11.5% per annum. At December 31, 2018, the PFG Term Note had a principal balance of $6.0 million.

Both loan agreements require us to comply with certain financial covenants, including minimum adjusted EBITDA, revenue and liquidity covenants, and restrict us from, among other things, paying cash dividends, incurring debt and entering into certain transactions without the prior consent of the lenders. Repayment of amounts borrowed under the loan agreements may be accelerated if an event of default occurs, which includes, among other things, a violation of such financial covenants and negative covenants. As of December 31, 2018, January 31, 2019, February 28, 2019 and March 31, 2019, we were in violation of certain financial covenants in the loan agreements. In January 2019, we entered into forbearance agreements with both lenders that, among other things, (i) require us to comply with certain milestones in connection with a potential strategic transaction satisfactory to PFG and SVB with an anticipated closing date of on or before April 15, 2019 (the “Milestones”), (ii) provide for PFG and SVB’s forbearance of their respective rights and remedies resulting from existing and stated potential events of default under the PFG Term Note and ABL until the earlier of (a) the occurrence of an additional event of default or (b) February 15, 2019; provided such date shall be automatically extended to (1) February 28, 2019 and then to (2) April 15, 2019 so long as we are in compliance with the Milestones required as of such dates and (iii) extend the maturity date of the ABL until April 15, 2019. The Company will not be able to close on a strategic transaction on or before April 15, 2019. No assurance can be given that the Company will be able to extend the maturity of the ABL beyond April 15, 2019 or extend the forbearances with SVB and PFG beyond April 15, 2019.

Convertible Debt

On July 17, 2018, the Company entered into a convertible note with Iliad Research and Trading, L.P. (“Iliad”), with an initial principal amount of $2.6 million (“Convertible Note”). The Convertible Note has an 18 month term and carries interest at 10% per annum. The note is convertible into shares of the Company’s common stock at a conversion price of $0.80 per share upon 5 trading days’ notice, subject to certain adjustments (standard dilution) and ownership limitations specified in the Convertible Note.

Advance from NDX

On September 18, 2018, NDX loaned us $1.5 million. The Advance from NDX bears interest at 10.75% and is payable on March 15, 2019. The interest rate was increased to 21% on December 15, 2018 due to the termination of the Merger Agreement, which was an event of default. The default also gives NDX the right to convert all, but not less than all, of the outstanding balance into shares of the Company’s common stock at a conversion price of $0.606 per share.

2019 Offerings


On January 9, 2019, we entered into an underwriting agreement with H.C. Wainwright & Co., LLC (“H.C. Wainwright”), relating to an underwritten public offering of 13,333,334 shares of our common stock for $0.225 per share. We received proceeds from the offering of approximately $2.4 million, net of expenses and discounts of approximately $0.6 million. We also issued warrants to purchase 933,334 shares of common stock to H.C. Wainwright in connection with this offering. The warrants are exercisable for five years from the date of issuance at a per share price of $0.2475.

On January 26, 2019, we issued 15,217,392 shares of common stock at a public offering price of $0.23 per share. We received proceeds from the offering of approximately $3.0 million, net of expenses and discounts of approximately $0.5 million. We also issued warrants to purchase 1,065,217 shares of common stock to the underwriter, H.C. Wainwright, in connection with this offering. The warrants are exercisable for five years from the date of issuance at a per share price of $0.253.

2017 Offering

On December 8, 2017, we sold 3,500,000 shares of our common stock and warrants to purchase 3,500,000 shares of common stock in a public offering (“2017 Offering”). The offering resulted in gross proceeds of $7.0 million. The 2017 Offering warrants have an exercise price of $2.35 per share of common stock. In addition, we issued warrants to purchase an aggregate of 175,000 shares of common stock at $2.50 per share to the placement agent. Subject to certain ownership limitations, these warrants were initially exercisable 6 months from the issuance date and are exercisable for 12 months from the initial exercise date.

Common Stock Purchase Agreement with Aspire Capital

On August 14, 2017, we entered into a Common Stock Purchase Agreement (the “Purchase Agreement”) with Aspire Capital Fund, LLC, an Illinois limited liability company (“Aspire Capital”), which provides that Aspire Capital is committed to purchase up to an aggregate of $16 million of our common stock (the “Purchase Shares”) from time to time over the 24-month term of the Purchase Agreement. Aspire Capital made an initial purchase of 1,000,000 Purchase Shares (the “Initial Purchase”) at a purchase price of $3.00 per share on the commencement date of the agreement.

As of December 31, 2018, the Company has sold 1,000,000 shares under this agreement at $3.00 per share, resulting in proceeds of approximately $3.0 million, net of offering costs of approximately $35,000. The Company has also issued 320,000 shares as consideration for entering into the Purchase Agreement. The Company has not deferred any offering costs associated with this agreement. Due to the price of the Company’s stock being lower than the $3.00 per share, the Company does not expect to sell more shares under the Purchase Agreement in the foreseeable future.

Cash Flows

Our net cash flow from operating, investing and financing activities for the periods below were as follows:
  Year Ended December 31,
  2018 2017
(in thousands)    
Cash provided by (used in):    
Operating activities $(12,552) $(13,564)
Investing activities 1,084
 (2,701)
Financing activities 2,147
 16,338
Effect of foreign exchange rates on cash and cash equivalents and restricted cash (59) 16
Net increase (decrease) in cash and cash equivalents and restricted cash $(9,380) $89

We had cash and cash equivalents and restricted cash of $0.5 million and $9.9 million at December 31, 2018 and 2017, respectively.

The $9.4 million decrease in cash and cash equivalents and restricted cash was principally the result of $12.6 million of net cash used to fund operations and $1.5 million used to repay debt. These uses were offset by net proceeds of $2.5 million and $1.5 million received from Iliad and NDX, respectively, and net proceeds of $1.8 million received from the sale of our India subsidiary.


The primary uses of cash during 2017 include $13.6 million of net cash used to fund operations, $1.3 million of net cash used to invest in fixed assets, $1.1 million of net cash used to acquire vivoPharm and $4.7 million used to repay debt. These uses were offset by $6.6 million of net proceeds from the 2017 Offering, $3.0 million of net proceeds from Aspire Capital stock purchases, $1.8 million of proceeds from warrant exercises and $10.1 million in aggregate borrowings from our PFG Term Note and the ABL.

Cash Used in Operating Activities

Net cash used in operating activities was $12.6 million for the year ended December 31, 2018. We used $17.6 million in net cash to run our core operations, including losses from operations and $1.3 million in cash paid for interest. These uses were partially offset by a net decrease in accounts receivable of $1.0 million, a net increase in accounts payable, accrued expenses and deferred revenue of $3.8 million and a net decrease in other current assets of $0.3 million.

Net cash used in operating activities was $13.6 million for the year ended December 31, 2017. We used $8.1 million in net cash to run our core operations, including losses from operations and $0.9 million in cash paid for interest. We incurred additional uses of cash when adjusting for working capital items as follows: a net increase in accounts receivable of $3.6 million, a net increase in other current assets of $0.2 million, a net decrease in accounts payable, accrued expenses and deferred revenue of $1.5 million and a net decrease in deferred rent and other of $0.2 million.

Cash Used in Investing Activities

Net cash provided by investing activities was $1.1 million for the year ended December 31, 2018. During 2018, we received net proceeds2021, from $867 thousand for the year ended December 31, 2020. The increase in service revenue was primarily due to increased sales after COVID slowdown in 2020. Product revenue increased by $204 thousand in 2021 as compared with 2020 as the result of $1.8increased sales volume of $147 thousand and average selling prices of $57 thousand.

Cost of Goods from Continuing Operations

Cost of goods sold – service aggregated $408 thousand and $384 thousand, respectively, for the years ended December 31, 2021 and 2020, resulting in a cost of goods sold of 61.4% and 65.3%, respectively, of service revenue. The 2020 period was impacted by two negative margin service contracts.

Cost of goods sold – product aggregated $1.4 million and $717 thousand for the years ended December 31, 2021 and 2020, respectively, resulting in a gross margin deficit of $956 thousand and $438 thousand, respectively, resulting from StemoniX’s excess manufacturing capacity at its Maple Grove facility. The increase in the cost of goods sold and margin deficit in the 2021 period as compared with the 2020 period was the result of increased employee related costs due to increased headcount, as the 2020 period reflecting lower costs from the salebenefit of our India subsidiary. These proceeds were partially offsetthe Paycheck Protection Program (“PPP”) loan forgiveness, which is reflected as a reimbursement of manufacturing and quality salaries, and additional production costs in 2021 due to increased sales volume.

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Operating Expenses from Continuing Operations

Research and Development Expenses. Research and development expenses from continuing operations increased 32%, or $1.0 million, to $4.3 million for the year ended December 31, 2021, from $3.2 million for the year ended December 31, 2020 principally due to a $750 thousand increase in personnel costs resulting from additional headcount, including the hiring of a Chief Scientific Officer in October 2021 as well as a $315 thousand reduction in the 2020 research and development expense reimbursement from the Company’s PPP loan. In addition, the Company increased collaboration developmental expenses by $0.7$224 thousand as well as other lab and legal expenses by $401 thousand in 2021 as compared with 2020.

Selling, General and Administrative Expenses. Selling, general and administrative expenses from continuing operations increased over 200%, or $5.7 million, of fixed asset additions.


Net cash used in investing activities wasto $8.4 million for the year ended December 31, 2021, from $2.7 million for the year ended December 31, 20172020 primarily due to post-Merger public company costs including increased headcount costs of $1.4 million, stock-based compensation of $855 thousand, professional fees of $1.7 million, insurance costs of $1.2 million and principally resulted fromother Board of Director, software, franchise tax and investor relations costs aggregating $487 thousand.

Merger Related Costs. Merger related costs for the purchase of fixed assets for $1.3years ended December 31, 2021 and 2020, were $2.3 million net cash usedand $1.4 million, respectively. The increase in the acquisition2021 merger related costs was primarily from investment banker fees related to the closing of vivoPharmthe Merger.

Change in Fair Value of $1.1 million, patent costsWarrant Liability

The Company issued a warrant with multiple settlement terms in the first quarter of $0.1 million,2021 and $0.2 million usedas a result, this warrant was classified as liability. Upon the close of the Merger, the warrant’s settlement terms were finalized resulting in a cost method investment.


Cash Used/Provided by Financing Activities

Net cash provided by financing activities was $2.1 million forfinal mark-to-market adjustment resulting in a non-cash gain of $214 thousand during the year ended December 31, 20182021.

Change in Fair Value of Share Settlement Obligation Derivative

The Company recorded $250 thousand and principally resulted from net proceeds received$503 thousand mark-to-market losses during the years ended December 31, 2021 and 2020, respectively, for an embedded compound derivative from the 2020 Convertible NoteNotes. Upon the close of the Merger the 2020 Convertible Notes were converted to equity.

Loss on Debt Conversion

The year ended December 31, 2021 included a $2.5 million and proceeds receivedloss on the conversion of the 2020 Convertible Notes to equity upon the closing of the Merger.

Interest Expense, Net

Net interest expense from NDX of $1.5 million, offset, in part,continuing operations decreased by net repayments on our ABL of $1.5 million and capital lease payments of $0.3 million.


Net cash provided by financing activities was $16.3 million for$163 thousand, or 30%, to $372 thousand during the year ended December 31, 20172021, from $535 thousand during the year ended December 31, 2020, primarily related to the conversion of the 2020 Convertible Notes to equity upon the closing of the Merger.

Discontinuing Operations

In connection with the Merger, the Company was deemed to be the accounting acquiror of the vivoPharm business on March 30, 2021. Therefore, the vivoPharm business is not reflected in the Company’s 2020 operating results. After the Merger, the vivoPharm business generated $4.0 million in revenue in 2021 and principally resultedincurred a $22.3 million net loss. This net loss includes a goodwill impairment charge of $20.2 million, $713 thousand of amortization of intangible assets arising from the 2017 Offering,merger, $112 thousand of professional service costs related to accounting for the vivoPharm business and a $1.25 million operating loss. The 2021 operating loss was significantly impacted by lower than expected revenue resulting from turnover in the vivoPharm business development team and the delay in the commencement of two large customer contracts which resultedwere signed in $6.6 million in net proceeds, aggregate borrowings on our PFG Term Notethe second and ABLthird quarter.

Liquidity and Capital Resources

Sources and Uses of $10.1 million,Liquidity

The Company’s operating activities have been primarily funded with proceeds from warrant exercisesthe sale of $1.8convertible notes and preferred stock securities. Prior to the Merger, CGI’s primary sources of liquidity had been cash collections from its customers and funds generated from debt and equity financings. The Company is expected to generate minimal revenue from the StemoniX business during the first half of 2022 as it winds down its revenue producing operations to support its internal drug discovery programs. The Company had cash and cash equivalents of $20.6 million andas of December 31, 2021. The Company’s management has projected that the Company’s cash on hand, together with the net proceeds from Aspirethe planned sale of the vivoPharm business during 2022 and proceeds from sales of common stock pursuant to the Purchase Agreement with Lincoln Park Capital, stock proceedsLLC, will be adequate to fund the Company’s currently planned operations into the second quarter of $3.0 million, offset by2023. Such estimate may prove to be wrong, and we could use our available capital resources sooner than we currently expect, and/or the repayment of $4.7 million in indebtedness, debt issuances costs of $0.3 million and capital lease payments of $0.2 million.resources that we are assuming will be present could fail to materialize at the amounts we project or at all.

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Capital Resources, Acquisitions and Expenditure Requirements

We expect

The Company expects to continue to incur material operating losses in the future. Itfuture, unless and until the Company’s drug discovery efforts or other revenue from collaborators are able to demonstrate a level of success that would lead to licensing potential. In addition, the Company will continue to incur the costs of being public, including legal and audit fees and director’s and officer’s liability insurance. These losses have had, and will continue to have, an adverse effect on the Company’s working capital, total assets and stockholders’ equity. Because of the numerous risks and uncertainties associated with drug discovery and development efforts and costs associated with being a public company, the Company is unable to predict when it will become profitable, and it may never become profitable. Even if the Company does achieve profitability, it may not be able to sustain or increase profitability on a quarterly or annual basis. The Company’s inability to achieve and then maintain profitability would negatively affect its business, financial condition, results of operations and cash flows.

On March 28, 2022, the Company entered into a purchase agreement, or Purchase Agreement, with Lincoln Park Capital Fund, LLC (“Lincoln Park”), which, subject to the terms and conditions, provides that the Company has the right to sell to Lincoln Park and Lincoln Park is obligated to purchase up to $15.0 million of its common shares. Additionally, on March 28, 2022, the Company entered into a registration rights agreement (the “Registration Rights Agreement”) with Lincoln Park, pursuant to which the Company agreed to file a registration statement with the Securities and Exchange Commission (the “SEC”), covering the resale of shares of common stock issued to Lincoln Park under the Purchase Agreement. In addition, under the Purchase Agreement, the Company agreed to issue a commitment fee of 405,953 common shares, or the Commitment Shares, as consideration for Lincoln Park entering into the Purchase Agreement. The Company cannot sell any shares to Lincoln Park until the date that a registration statement covering the resale of shares of common stock that have been, and may in the future be, issued to Lincoln Park under the Purchase Agreement is declared effective by the SEC and a final prospectus in connection therewith is filed and all of the other conditions set forth in the Purchase Agreement are satisfied (such date, the “Commencement Date”). Under the Purchase Agreement, the Company may from time to time for 30 months following the Commencement Date, at its discretion, direct Lincoln Park to purchase on any single business day, or a Regular Purchase, up to (i) 50,000 common shares, (ii) 75,000 common shares if the closing sale price of its common shares is not below $1.50 per share on Nasdaq or (iii) 100,000 common shares if the closing sale price of its common shares is not below $2.50 per share on Nasdaq. In addition to Regular Purchases, the Company may also direct Lincoln Park to purchase other amounts as accelerated purchases or as additional accelerated purchases on the terms and subject to the conditions set forth in the Purchase Agreement. In any case, Lincoln Park’s commitment in any single Regular Purchase may not exceed $1.0 million absent a mutual agreement to increase such amount. The purchase price per share for each Regular Purchase will be based on prevailing market prices of the Common Stock immediately preceding the time of sale as computed in accordance with the terms set forth in the Purchase Agreement. There are no upper limits on the price per share that Lincoln Park must pay for shares of Common Stock under the Purchase Agreement. The Purchase Agreement may be terminated by the Company at any time after the Commencement Date, at its sole discretion, without any cost or penalty, by giving one business day notice to Lincoln Park to terminate the Purchase Agreement.

During the next twelve months, the Company may take several years, if ever, to achieve positive operational cash flow. We may needfurther steps to raise additional capital to fund our current operations, to repay certain outstanding indebtedness and to fund expansion of our business to meet our long-term liquidity needs including, but not limited to, one or more of the following: the licensing of drug candidates with existing or new collaborative partners, possible business objectives through publiccombinations, issuance of debt, or private equity offerings, debt financings, borrowings or strategic partnerships coupled with an investment in our company or a combination thereof. If we raise additional funds through the issuance of convertible debt securities,common stock or other debt securities these securities could be secured and could have rights senior to those of our common stock. In addition, any new debt incurred byvia private placements or public offerings. Although the Company could impose covenantshas been successful in raising capital in the past, there can be no assurance that restrict our operations and increase our interest expense. The issuance of any new equity securitiesadditional financing will also dilute the interest of our current stockholders. Given the risks associated with our business, including our unprofitable operating history and our ability to develop additional proprietary tests, additional capital may not be available when needed on acceptable terms, orif at all. If adequate fundsall, and its negotiating position in capital raising efforts may worsen as existing resources are not available, we will need to curb our expansion plans or limit our research and development activities, which may have a material adverse impact on our business prospects and results of operations. Due to the terms of the ABL, we have reached the borrowing limit based on eligible accounts receivable at December 31, 2018. In addition, we were in violation of certain financial covenants with SVB and PFG as of December 31, 2018, January 31, 2019, February 28, 2019 and March 31, 2019. We have negotiated forbearance agreements with both lenders, as discussed above. However, we will not be able to close on a strategic transaction on or before April 15, 2019, andused. There is also no assurance can be given that wethe Company will be able to extendenter into collaborative relationships that will provide sources of liquidity. Additional equity financings may be dilutive to our stockholders. Debt financing, if available, may involve significant cash payment obligations and covenants that restrict the maturity of the ABL beyond April 15, 2019 or extend the forbearances


beyond April 15, 2019. If our lenders were to seek repayment of the loans we would likely not have adequate capital to make such payment and continueCompany’s ability to operate as a business. Licensing or strategic collaborations may result in royalties or other terms which reduce our business.

We do not believe that our current cash will support operations for at leasteconomic potential from products under development. If the next 12 months from the date of this report unless we raise additional equity or debt capital or spin-off non-core assetsCompany is unable to raise additional cash. We have hired Raymond James & Associates Inc. as our financial advisorthe funds necessary to assist with evaluating strategic alternatives. Such alternatives could include raising more capital, the acquisition of another company and / or complementary assets, the sale ofmeet its long-term liquidity needs, the Company may have to delay or another typediscontinue the development of strategic partnership. There is no assurance that the review of strategic alternatives will result in the Company changing its business plan, pursuing any particular transaction, if any,one or if it pursues any such transaction, that it will be completed.

Meanwhile we are taking steps to improve our operating cash flow. We can provide no assurances that our current actions will be successfulmore discovery programs, license out programs earlier than expected, raise funds at a significant discount or that any additional sources of financing will be available to us on favorableother unfavorable terms, if at all, when needed. Our cash position, recurring losses from operations and negative cash flows from operations raise substantial doubt about our ability to continue asor sell all or a going concern, and as a result, our independent registered public accounting firm included an explanatory paragraph in its report on our financial statements aspart of and for the year ended December 31, 2018 with respect to this uncertainty. This going concern opinion, and any future going concern opinion, could materially limit our ability to raise additional capital. business.

The perception that we may not be able to continue as a going concern may cause potential partners or investors to choose not to deal with us due to concerns about our ability to meet our contractual and financial obligations. If we cannot continue as a going concern, our stockholders may lose their entire investment in our common stock.


OurCompany’s forecast of the period of time through which ourits current financial resources will be adequate to support ourits operations and ourits expected operating expenses are forward-looking statements and involve risks and uncertainties. Actual results could vary materially and negatively as a result of a number of factors, including:

the expected benefits of, and potential value, including synergies, created by, the Merger for the stockholders of the Company;
the Company’s ability to adapt its business for future developments in light of the global outbreak of COVID-19, which continues to rapidly evolve;
the Company’s ability to internally identify and develop new iPSC disease models, drug candidates and intellectual property;
the Company’s ability to negotiate strategic partnerships, where appropriate, for technology and research data, iPSC and human primary cell-based disease models or drug candidates;
the Company’s ability to secure clinical co-development partnerships with pharmaceutical and biotechnology companies;
the Company’s need for significant additional capital and the Company’s ability to satisfy its capital needs;
the Company’s ability to complete required clinical trials of its products and obtain approval from the FDA or other regulatory agencies in different jurisdictions;
the Company’s ability to execute on its marketing and sales strategy for its preclinical research services and gain acceptance of its services in the market;
the Company’s ability to keep pace with rapidly advancing market and scientific developments;
the Company’s ability to satisfy U.S. (including the FDA) and international regulatory requirements with respect to its services;
the Company’s ability to maintain its present customer base and obtain new customers;
the Company’s ability to maintain the Company’s clinical and research collaborations and enter into new collaboration agreements with highly regarded organizations so that, among other things, the Company has access to thought leaders in advanced preclinical and translational science;
the Company’s potential product liability or intellectual property infringement claims;
the Company’s ability to maintain or protect the validity of its patents and other intellectual property;

56

our ability to extend our forbearance agreements

the Company’s dependency on third-party manufacturers to supply it with instruments and specialized supplies;
the Company’s ability to attract and retain a sufficient number of scientists, clinicians, sales personnel and other key personnel with extensive relevant experience, who are in short supply;
the Company’s ability to effectively manage its international businesses in Australia and Europe, including the expansion of its customer base and volume of new contracts in these markets;
the Company’s dependency on the intellectual property licensed to the Company or possessed by third parties; and
the Company’s ability to adequately support future growth.

Cash Flows from Continuing Operations

The Company’s net cash flow from operating, investing and financing activities from continuing operations for the ABL;

our ability to achieve revenue growth and profitability;
our ability to secure financing and the amount thereof;
the costs for funding the operations we recently acquired and our ability to realize anticipated benefits from the vivoPharm acquisition;
our ability to improve efficiency of billing and collection processes;
our ability to obtain approvals for our new diagnostic tests;
our ability to execute on our marketing and sales strategy for our tests and gain acceptance of our tests in the market;
our ability to obtain adequate reimbursement from governmental and other third-party payors for our tests and services;
our ability to maintain our present customer base and obtain new customers;
our ability to clinically validate our pipeline of tests currently in development;
the costs of operating and enhancing our laboratory facilities;
our ability to succeed with our cost control initiative;
our ability to satisfy US (FDA) and international regulatory regiments with respect to our tests and services, many of which are new and still evolving;
the costs of maintaining, expanding and protecting our intellectual property portfolio, including potential litigation costs and liabilities;
our ability to manage the costs of manufacturing our tests;
our rate of progress in, and cost of research and development activities associated with, products in research and early development;
the effect of competing technological and market developments;
costs related to expansion; and
other risks discussed in the section entitled “Risk Factors.”


Subject to the availability of future financing, we may use significant cash to fund acquisitions. On August 15, 2017, we purchased all of the outstanding stock of vivoPharm, with its principal place of business in Victoria, Australia, in a transaction valued at approximately $1.6 million inperiods below were as follows (in thousands):

  

Year Ended

December 31,

 
  2021  2020 
       
Cash provided by (used in) continuing operations:        
Operating activities $(16,488) $(5,812)
Investing activities  29,678   (43)
Financing activities  7,222   6,332 
Net increase in cash and cash equivalents from continuing operations $20,412  $477 

The Company had cash and $8.1cash equivalents of $20.6 million and $792 thousand as of December 31, 2021 and 2020, respectively.

Cash Used in the Companys common stock based on the closing price of the stock on August 15, 2017.


The consolidated financial statementsOperating Activities from Continuing Operations

Net cash used in operating activities from continuing operations was $16.5 million for the year ended December 31, 2018 were prepared on the basis2021, consisting of a going concern, which contemplates thatnet loss from continuing operations of $18.6 million, decreased for net non-cash adjustments of $4.8 million. The non-cash adjustments include (i) stock-based compensation of $1.0 million, (ii) depreciation and amortization expense of $1.1 million, and (iii) a net loss related to the Company will be able to realizepre-merger StemoniX capital structure and related debt conversions of $2.7 million. Operating assets and discharge liabilities used net cash of $2.7 million including Merger related costs in 2021. The net loss for the normal course year ended December 31, 2021, also includes $2.3 million of business. Accordingly, they do not give effect toMerger related costs.

Net cash used in operating activities from continuing operations was $5.8 million for the year ended December 31, 2020, consisting of a loss of $8.7 million, increased for net non-cash adjustments that would be necessary shouldof $1.5 million, which includes a reduction of $740 thousand in operating expenses from the Company be required to liquidate its assets.  The abilityPPP loan. Operating assets and liabilities provided $1.3 million of cash from the $740 thousand funding of the CompanyCompany’s PPP loan, an increase of $878 thousand in accounts payable principally resulting from accrued merger related professional service costs, offset by $485 thousand in cash utilized for operating lease payments.

Cash Provided by Investing Activities from Continuing Operations

Net cash provided by investing activities from continuing operations was $29.7 million for the year ended December 31, 2021, principally from CGI cash balances at the close of the Merger of $30.2 million, offset by $535 thousand of equipment purchases. Investing activity cash flows from continuing operations were not significant for the year ended December 31, 2020.

57

Cash Provided by Financing Activities from Continuing Operations

Net cash provided by financing activities from continuing operations was $7.2 million for the year ended December 31, 2021 due to meet its obligations, and to continue as a going concern is dependent upon the


availability of future funding and the continued growth in revenues.  The consolidated financial statements do not include any adjustments that might result$5.0 million from the outcomeissuance of these uncertainties.

Future Contractual Obligations

2020 Convertible Notes and $1.8 million from the issuance of Series Preferred C shares. The following table reflects a summarynet cash provided by financing activities from continuing operations of our estimates of future contractual obligations as of$6.3 million for the year ended December 31, 2018. The information in2020 was principally from the table reflects future unconditional paymentsissuance of $4.9 million of 2020 Convertible Notes and is based on the terms$1.3 million of the relevant agreements, appropriate classification of items under U.S. GAAP as currently in effect and certain assumptions, such as the interest rate on our variable debt that was in effect as of December 31, 2018. Future events could cause actual payments to differ from these amounts.
  Payments Due by Period
Contractual Obligations Total Less than 1 Year 1-3 Years 3-5 Years More than 5 years
(dollars in thousands)          
Principal and interest under notes payable and lines of credit $13,054
 $13,054
 $
 $
 $
Capital lease obligations, including interest, for equipment 777
 394
 370
 13
 
Operating lease obligations relating to corporate headquarters and clinical laboratories 3,612
 1,388
 1,567
 657
 
Total $17,443
 $14,836
 $1,937
 $670
 $

Series Preferred B shares.

Income Taxes


Over the past several years we havethe Company has generated operating losses in all jurisdictions in which weit may be subject to income taxes. As a result, we havethe Company has accumulated significant net operating losses and other deferred tax assets. Because of ourthe Company’s history of losses and the uncertainty as to the realization of those deferred tax assets, a full valuation allowance has been recognized. We doThe Company does not expect to report a benefit related to the deferred tax assets until we haveit has a history of earnings, if ever, that would support the realization of ourits deferred tax assets.


Off-Balance Sheet Arrangements

Since inception, we have not engaged in any off-balance sheet activities as defined in Item 303(a)(4) of Regulation S-K.

Critical Accounting Policies and Significant Judgment and Estimates


Our

The Company’s management’s discussion and analysis of financial condition and results of operations is based on ourits financial statements and condensed consolidated financial statements, which have been prepared in accordance with U.S. GAAP. The preparation of our consolidatedthe financial statements requires usmanagement to make estimates and judgments that affect the reported amounts of assets, liabilities, revenue and expenses and related disclosure of contingent assets and liabilities. On an ongoing basis, we evaluate ourthe Company evaluates its estimates based on historical experience and makemakes various assumptions, which management believes to be reasonable under the circumstances, and which form the basis for judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.


The notes

While our significant accounting policies are described in more detail in Note 4 to our auditedDecember 31, 2021 and 2020 consolidated financial statements contain a summary of our significant accounting policies. We considerappearing elsewhere herein, we believe that the following accounting policies are those most critical to the understandingjudgments and estimates used in the preparation of our financial statements.

Revenue recognition. Prior to the Merger, the Company’s primary sources of revenue were product sales from the sale of microOrgan plates and the performance of preclinical drug testing services using the microOrgan technology. Subsequent to the Merger, the Company’s revenue includesvivoPharm’s discovery services, consisting primarily of contract research services focused primarily on unique specialized studies to guide drug discovery. As noted herein, the vivoPharm business has been classified as discontinuing operations as of December 31, 2021 and revenue earned from that business are included therein.

The Company recognizes revenue when it satisfies performance obligations under the terms of its contracts, and transfers control of the resultsproduct to its customers in an amount that reflects the consideration the Company expects to receive from its customers in exchange for those products. This process involves identifying the customer contract, determining the performance obligations in the contract, determining the contract price, allocating the contract price to the distinct performance obligations in the contract, and recognizing revenue when the performance obligations have been satisfied. A performance obligation is considered distinct from other obligations in a contract when it (a) provides a benefit to the customer either on its own or together with other resources that are readily available to the customer and (b) is separately identified in the contract. The Company considers a performance obligation satisfied once it has transferred control of our operations:a product to a customer, which is generally upon shipment as the customer has the ability to direct the use and obtain the benefit of the product.

For product contracts, revenue is recognized at a point-in-time upon delivery to the customer. Product contracts with customers generally state the terms of the sale, including the quantity and price of each product purchased. Payment terms and conditions may vary by contract, although terms generally include a requirement of payment within a range of 30 to 90 days after the performance obligation has been satisfied. As a result, the contracts do not include a significant financing component. In addition, contacts typically do not contain variable consideration as the contracts include stated prices. The Company provides assurance-type warranties on all of its products, which are not separate performance obligations.

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For service contracts, revenue is recognized over time and is generally defined pursuant to an enforceable right to payment for performance completed on service projects for which the Company’s has no alternative use as customer furnished compounds are added to Company plates for testing. The Company does not obtain control of the customer furnished compounds as the Company does not have the ability to direct the use. Revenue is measured by the costs incurred to date relative to the estimated total direct costs to fulfill each contract (cost-to-cost method). Incurred costs represent work performed, which corresponds with, and thereby best depicts, the transfer of control to the customer. Contract costs include labor, materials and overhead.

Some contracts offer price discounts after a specified volume has been purchased. The Company evaluates these options to determine whether they provide a material right to the customer, representing a separate performance obligation. If the option provides a material right to the customer, revenue is allocated to these rights and deferred; subsequently the revenue is recognized when those future goods or services are transferred, or when the option expires.

Contract assets primarily represent revenue earnings over time that are not yet billable based on the terms of the contracts. Contract liabilities consist of fees invoiced or paid by Vyant Bio’s customers for which the associated performance obligations have not been satisfied and revenue has not been recognized based on Vyant Bio’s revenue recognition criteria described above.

Derivative Instruments. Prior to the closing of the Merger on March 30, 2021 the Company had a number of the financial instruments that were classified as derivatives. Upon the closing of the Merger, these instruments were converted to Company common stock at which time final mark-to-market adjustments were recorded by the Company.

The Company recognized all derivative instruments as either assets or liabilities in the consolidated balance sheets at their respective fair values. The Company evaluated its debt and equity issuances to determine if those contracts or embedded components of those contracts qualify as derivatives requiring separate recognition in its financial statements. The result of this accounting treatment is that the fair value of embedded derivatives was revalued as of each reporting date and recorded as a liability, and the change in fair value during the reporting period is recorded in other income (expense) in the statements of operations. In circumstances where the embedded conversion option in a convertible instrument was required to be bifurcated and there are also other embedded derivative instruments in the convertible instrument that are required to be bifurcated, the bifurcated derivative instruments were accounted for as a single, compound derivative instrument. The classification of derivative instruments, including whether such instruments should be recorded as liabilities or as equity, was reassessed at the end of each reporting period. Derivative instrument liabilities are classified in the consolidated balance sheets as current or non-current based on whether or not net-cash settlement of the derivative instrument is expected within twelve months of the balance sheet date.

The 2020 Convertible Notes contained a share settled redemption feature that required conversion to equity at the lesser of specified discounts from qualified financing price per share or the fair value of the common stock at the time of conversion. The discount changed based on the passage of time between issuance of the convertible note and the conversion event. This feature was considered a derivative that required bifurcation because it provide a specified premium to the holder of the note upon conversion. We measured the share-settlement derivative obligation at fair value based on significant inputs that are not observable in the market and require significant judgement. This instrument was settled upon the closing of the Merger.

The Company issued a warrant during the first quarter of 2021 that contained an indexation feature not indexed to the Company’s stock resulting in this warrant to be accounted for as a derivative. As a result, this warrant was accounted for as a liability and marked to market from its issuance date in February 2021 through the Merger date, at which time the warrant’s indexation features were finalized.

Business Combinations. Accounting for acquisitions requires extensive use of estimates and judgment to measure the fair value of the identifiable tangible and intangible assets acquired and liabilities assumed. Additionally, we must determine whether an acquired entity is considered a business or a set of net assets because the excess of the purchase price over the fair value of net assets acquired can only be recognized as goodwill in a business combination. We accounted for the Merger with CGI as a business combination under the acquisition method of accounting. Consideration transferred to acquire CGI was measured at fair value. The determination of the $59.9 million purchase price consideration for the Merger was based on the closing stock price of the CGI common stock on the Merger date as well as the fair value of CGI common stock warrants and options outstanding on the Merger date using the Black Scholes Mertons option pricing model. We allocated the purchase price to the acquired tangible and intangible assets and assumed liabilities of CGI based on their estimated fair values as of the acquisition date. Significant judgement is required to value and allocate the purchase price, especially for identified intangible assets. The allocation of the purchase price resulted in recognition of intangible assets related to tradename, customer relationships aggregating $9.5 million and goodwill of $22.4 million.

59
Revenue recognition;

Accounts receivable

Valuation of Goodwill and bad debts;

Warrant liabilitiesIntangible Assets. Goodwill represents the excess of the purchase price over the fair value of net tangible and other derivatives;identified intangible assets acquired in a business combination. Goodwill is not amortized but is evaluated at least annually for impairment or when a change in facts and
Impairment circumstances indicate that the fair value of intangibles and long-lived assets.

Recent Accounting Pronouncements

the goodwill may be below the carrying value. The notesCompany did not record Goodwill prior to our audited consolidatedthe March 30, 2021 Merger. As a result of the Merger, the Company recorded $22.4 million of goodwill attributed to the vivoPharm business.

As a described in Note 3 to the Company’s financial statements, containthe Company changed the classification of the vivoPharm business to a summaryheld for sale asset in the fourth quarter of recent accounting pronouncements.


2021. Upon change in classification of this asset from held for use to held for sale, the Company was required to perform an analysis of the carrying value of the vivoPharm business as compared with its estimated fair market value assuming the business would be sold. The Company determined the carrying value of the vivoPharm business equally weighting public company revenue multiples and comparable transaction revenue multiples, which are classified as Level 3 measurements within the fair value hierarchy. As described in Note 11 to the Company’s financial statements, the Company valued the vivoPharm business at $11 million as of December 31, 2021. This value, less estimated transaction costs and the Company’s currency translation adjustment, which is solely related to the vivoPharm business, were compared with the carrying value of the vivoPharm business, and resulted in a $20.2 million goodwill impairment charge in the fourth quarter of 2021.

Intangible assets subject to amortization, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. If circumstances require a long-lived asset or asset group be tested for possible impairment, the Company first compares undiscounted cash flows expected to be generated by that asset or asset group to its carrying amount. If the carrying amount of the long-lived asset or asset group is not recoverable on an undiscounted cash flow basis, an impairment is recognized to the extent that the carrying amount exceeds its fair value. As of December 31, 2021 and 2020, the Company determined that there were no indicators of impairment and did not recognize any fixed asset impairment. Fair value is determined through various valuation techniques including discounted cash flow models, quoted market values and appraisals, as considered necessary.

Item 7A.Qualitative and Quantitative Disclosures about Market Risk

We have

The Company has exposure to financial market risks, including changes in foreign currency exchange rates, and interest rates, and risk associated with how we invest ourit invests its cash.


Foreign Exchange Risk


We conduct

The Company conducts business in foreign markets through ourits subsidiary in Australia (vivoPharm(vivoPharm Pty Ltd.) and through our subsidiary in Italy (Cancer Genetics Italia, S.r.l.). The Company plans to sell the vivoPharm business during 2022. For the years ended December 31, 20182021 and 2017,2020, approximately 7%21% and 6%21%, respectively, of our revenuesthe Company’s continuing revenue were earned outside the United States and collected in local currency. We areThe Company is subject to risk for exchange rate fluctuations between such local currencies and the United States dollar and the subsequent translation of the Australia Dollar or Euro to United States dollars. WeThe Company currently dodoes not hedge currency risk. The translation adjustments for the years ended December 31, 20182021 and 20172020 were not significant.


Interest Rate Risk

At December 31, 2018, we had interest rate risk primarily related to borrowings of $2.6 million on the asset-based line of credit with Silicon Valley Bank (“ABL”). The ABL requires monthly interest payments at the Wall Street Journal prime rate plus 1.5% (7.0% at December 31, 2018). If interest rates increased by 1.0%, interest expense on our current borrowings would increase by approximately $7,500, calculated based on the current maturity date of April 15, 2019.

Investment of Cash


We invest our

The Company invests its cash primarily in cash and US government money market funds. Because of the short-term nature of these investments, we dothe Company does not believe we haveit has material exposure due to market risk. The impact to ourthe Company’s financial position and results of operations from likely changes in interest rates is not material.



60

Item 8.Financial Statements and Supplementary Data

INDEX TO FINANCIAL STATEMENTS

Cancer Genetics,

Vyant Bio, Inc. and Subsidiaries

Consolidated Financial Report December 31, 2018

2021

(PCAOB ID No. 34)62
64
Consolidated Statements of Operations and Other Comprehensive Loss
65
66
67
68

61

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM



To the stockholders and the Board of Directors and Stockholders

Cancer Genetics,of Vyant Bio, Inc. and Subsidiaries


Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of Cancer Genetics,Vyant Bio, Inc. and its subsidiaries (the Company)“Company”) as of December 31, 20182021 and 2017, and2020, the related consolidated statements of operations and other comprehensive loss, changes in stockholders'temporary equity and common stockholders’ equity (deficit), and cash flows, for each of the two years thenin the period ended December 31, 2021, and the related notes (collectively referred to as the consolidated financial statements (collectively, the financial statements)“financial statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 20182021 and 2017,2020, and the results of its operations and its cash flows for each of the two years thenin the period ended December 31, 2021, in conformity with accounting principles generally accepted in the United States of America.


Substantial Doubt About the Company’s Ability to Continue as a Going Concern
The accompanying financial statements have been prepared assuming that the Company will continue as a going concern. As discussed in Note 2 to the financial statements, the Company has suffered recurring losses, and has an accumulated deficit and negative cash flows from operations. The Company is also in violation of certain debt covenants. This raises substantial doubt about the Company's ability to continue as a going concern. Management's plans in regard to these matters are also described in Note 2 to the financial statements. The financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Change in Accounting Principle
As discussed in Note 3 to the consolidated financial statements, the Company has changed its method of accounting for recognizing revenue effective January 1, 2018 due to the adoption of Accounting Standards Update No. 2014-09, “Revenue from Contracts with Customers”.

Basis for Opinion

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

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


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

Critical Audit Matter

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

62

Fair Value Measurements Included in Discontinuing Operations — Refer to Notes 3, 4 and 11 to the financial statements

Critical Audit Matter Description

In December 2021, the Company’s Board of Directors approved a plan to sell the vivoPharm Pty Ltd (“vivoPharm”) business and classified the business as held for sale and discontinuing operations. As a result, the Company performed a valuation of the vivoPharm disposal group, including goodwill and intangible assets, and compared its fair value less costs to sell to its carrying value. The Company’s valuation included an equally weighted analysis of similar company sales transactions over the past several years as well as guideline public company multiples of revenue as of December 31, 2021. This valuation requires management to make significant estimates and assumptions related to valuation multiples and forecasts of fiscal year 2022 revenue. Changes in these assumptions could have a significant impact on the fair value and the goodwill impairment charge taken during the year. As a result of this valuation, the Company recorded a goodwill impairment charge of $20.2 million.

We identified the valuation of the vivoPharm disposal group as a critical audit matter because of the significant judgments made by management to estimate the fair value vivoPharm and the resulting impairment charge. This required a high degree of auditor judgment and an increased extent of effort, including the need to involve our fair value specialists, when performing audit procedures to evaluate the reasonableness of management’s estimates and assumptions related to selection of the valuation multiples and forecasts of fiscal 2022 revenue.

How the Critical Audit Matter Was Addressed in the Audit

Our audit procedures related to the valuation of the vivoPharm disposal group included the following, among others:

Performed sensitivity analyses of the valuation multiples and revenue growth assumptions used in the model.
Perform substantive testing procedures over the forecasted 2022 revenue used within the valuation model, including inspecting signed contracts for a significant portion of the population. For the remainder of the population where signed contracts were not available, we inquired of management as to the stage of contract negotiations with the customer and obtained cost breakdowns and presentations to the customer to support the value and likelihood of the forecasted revenue.
With the assistance of our fair value specialists, we evaluated the reasonableness of the (1) valuation methodology and (2) valuation multiples by:

- Testing the source information underlying the determination of the multiples and the mathematical accuracy of the calculation.
– Developing an independent range of valuation multiples and comparing those to the multiples selected by management.
– Compared quantitative factors including size, profitability, and growth prospects of vivoPharm to that of the guideline public companies.

/s/ RSM USDELOITTE & TOUCHE LLP

Minneapolis, Minnesota

March 30, 2022

We have served as the Company’s auditor since 2010.2020.

63


New York, New York
April 15, 2019


CANCER GENETICS, INC. AND SUBSIDIARIES

Vyant Bio, Inc.

(Formerly Known as Cancer Genetics, Inc.)

Consolidated Balance Sheets

(Shares and USD in thousands, except par value)

  December 31,
  2018 2017
ASSETS    
CURRENT ASSETS    
Cash and cash equivalents $161
 $9,541
Accounts receivable, net of allowance for doubtful accounts of 2018 $3,462; 2017 $6,539 7,038
 10,958
Other current assets 2,148
 2,707
Total current assets 9,347
 23,206
FIXED ASSETS, net of accumulated depreciation 4,056
 5,550
OTHER ASSETS    
Restricted cash 350
 350
Patents and other intangible assets, net of accumulated amortization 4,004
 4,478
Investment in joint venture 92
 246
Goodwill 17,257
 17,992
Other 300
 399
Total other assets 22,003
 23,465
Total Assets $35,406
 $52,221
LIABILITIES AND STOCKHOLDERS’ EQUITY    
CURRENT LIABILITIES    
Accounts payable and accrued expenses $13,067
 $8,715
Obligations under capital leases, current portion 330
 272
Deferred revenue 2,173
 516
Line of credit 2,621
 4,137
Term note 6,000
 6,000
Convertible note, net 2,481
 
Advance from NovellusDx, Ltd., net 535
 
Other derivatives 86
 
Total current liabilities 27,293
 19,640
Obligations under capital leases 379
 624
Deferred rent payable and other 305
 360
Warrant liability 248
 4,403
Deferred revenue, long-term 379
 429
Total Liabilities 28,604
 25,456
STOCKHOLDERS’ EQUITY    
Preferred stock, authorized 9,764 shares $0.0001 par value, none issued 
 
Common stock, authorized 100,000 shares, $0.0001 par value, 27,726 and 27,754 shares issued and outstanding as of December 31, 2018 and 2017, respectively 3
 3
Additional paid-in capital 164,455
 161,527
Accumulated other comprehensive income 60
 69
Accumulated deficit (157,716) (134,834)
Total Stockholders’ Equity 6,802
 26,765
Total Liabilities and Stockholders’ Equity $35,406
 $52,221
Thousands)

       
  December 31, 
  2021  2020 
       
Assets        
Current assets:        
Cash and cash equivalents $20,608  $792 
Trade accounts and other receivables  434   357 
Inventory  475   415 
Prepaid expenses and other current assets  895   223 
Assets of discontinuing operations – current  802   - 
Total current assets 23,214  1,787 
Non-current assets:        
Fixed assets, net  1,020   1,031 
Operating lease right-of-use assets, net  673   1,095 
Long-term prepaid expenses and other assets  1,221   136 
Assets of discontinuing operations – non-current  11,508   - 
Total non-current assets 14,422  2,262 
Total Assets $37,636  $4,049 
         
Liabilities, Temporary Equity and Stockholders’ Equity (Deficit)        
Current liabilities:        
Accounts payable $740  $1,300 
Accrued expenses  764   162 
Deferred revenue  74   92 
Obligations under operating leases, current portion  174   486 
Obligation under finance lease, current portion  157   - 
Other current liabilities  -   9 
Liabilities of discontinuing operations – current  3,522   - 
Total current liabilities 5,431  2,049 
Obligations under operating leases, less current portion  516   627 
Obligations under finance leases, less current portion  293   - 
Share-settlement obligation derivative  -   1,690 
Accrued interest  -   277 
Long-term debt  57   6,839 
Liabilities of discontinuing operations – non-current  49   - 
Total Liabilities 6,346  11,482 
         
Commitments and Contingencies (Note 16)  -   - 
Temporary Equity        
Series A Convertible Preferred stock, $0.0001 par value; 4,700 shares authorized, 0 and 4,612 shares issued and outstanding as of December 31, 2021 and 2020, respectively (liquidation value of $0 and $11,732, respectively, as of December 31, 2021 and 2020)  -   12,356 
Series B Convertible Preferred stock, $0.0001 par value; 4,700 shares authorized, 0 and 3,489 shares issued and outstanding, as of December 31, 2021 and 2020, respectively (liquidation value of $0 and $15,707, respectively, as of December 31, 2021 and 2020)  -   16,651 
Series C Convertible Preferred stock, $0.0001 par value; 2,000 shares authorized, 0 shares issued and outstanding as of December 31, 2021 and 2020 (liquidation value of $0 as of December 31, 2021 and 2020)  -   - 
Total Temporary Equity -  29,007 
         
Stockholders’ Equity (Deficit)        
Preferred stock, authorized 9,764 shares $ 0.0001 par value, 0 shares issued and outstanding as of December 31, 2021 and 2020  -   - 
Common stock, authorized 100,000 shares, $0.0001 par value, 28,993 and 2,594 shares issued and outstanding as of December 31, 2021 and 2020, respectively  3   - 
Additional paid-in capital  110,174   1,514 
Accumulated comprehensive loss  (74)  - 
Accumulated deficit  (78,813)  (37,954)
Total Common Stockholders’ Equity (Deficit) 31,290  (36,440)
Total Liabilities and Stockholders’ Equity (Deficit) $37,636  $4,049 

See Notes to Consolidated Financial Statements.

64

CANCER GENETICS, INC. AND SUBSIDIARIES

Vyant Bio, Inc.

(Formerly Known as Cancer Genetics, Inc.)

Consolidated Statements of Operations and Other Comprehensive Loss

(Shares and USD in thousands, except per share amounts)

  Years Ended December 31,
  2018 2017
Revenue $27,470
 $29,121
Cost of revenues 18,724
 18,070
Gross profit 8,746
 11,051
Operating expenses:    
Research and development 2,488
 4,789
General and administrative 19,184
 19,894
Sales and marketing 5,268
 4,990
Restructuring costs 2,320
 
Merger costs 1,464
 
Total operating expenses 30,724
 29,673
Loss from operations (21,978) (18,622)
Other income (expense):    
Interest expense (2,120) (2,128)
Interest income 21
 63
Change in fair value of warrant liability 3,732
 (1,964)
Change in fair value of other derivatives (86) 
Change in fair value of acquisition note payable 136
 (42)
Other expense (78) (266)
Total other income (expense) 1,605
 (4,337)
Loss before income taxes (20,373) (22,959)
Income tax (benefit) 
 (2,079)
Net (loss) $(20,373) $(20,880)
Basic and diluted net (loss) per share $(0.75) $(1.01)
Basic and diluted weighted average shares outstanding 27,291
 20,663
     
Net (loss) (20,373) (20,880)
Unrealized gain (loss) on foreign currency translation (9) 69
Total comprehensive (loss) $(20,382) $(20,811)
Thousands)

       
  Years Ended December 31, 
  2021  2020 
Revenue:        
Service $665  $588 
Product  483   279 
Total revenue 1,148  867 
Operating costs and expenses:        
Cost of goods sold – service  408   384 
Cost of goods sold – product  1,439   717 
Cost of goods sold        
Research and development  4,273   3,232 
Selling, general and administrative  8,424   2,717 
Merger related costs  2,310   1,440 
Total operating costs and expenses 16,854  8,490 
Loss from operations  (15,706)  (7,623)
Other income (expense):        
Change in fair value of warrant liability  214   - 
Change in fair value of share-settlement obligation derivative  (250)  (503)
Loss on debt conversions  (2,518)  - 
Other income  57   11 
Interest expense, net  (372)  (535)
Total other income (expense) (2,869) (1,027)
Loss from continuing operations before income taxes  (18,575)  (8,650)
Income tax expense (benefit)  -   - 
Loss from continuing operations  (18,575)  (8,650)
Discontinuing operations (net of $0 tax benefit in 2021) (22,284) - 
Net loss  

(40,859

)  

(8,650

)
Cumulative translation adjustment  

(74

)  

-

 
Comprehensive loss $

(40,933

) $

(8,650

)
         
Net loss per share attributed to common stock – basic and diluted:        
Net loss per share from continuing operations $(0.82) $(3.48)
Net loss per share from discontinuing operations  (0.99)  - 
Net loss per share $(1.81) $(3.48)
Weighted average shares outstanding:        
Weighted average common shares outstanding – basic and diluted  22,614   2,486 

See Notes to Consolidated Financial Statements.

65

CANCER GENETICS, INC. AND SUBSIDIARIES

Vyant Bio, Inc.

(Formerly Known as Cancer Genetics, Inc.)

Consolidated Statements of Changes inTemporary Equity and Common Stockholders’ Equity

(Deficit)

Years Ended December 31, 20182021 and 2017

2020

(in thousands)

  Common Stock Additional
Paid-in
Capital
 Accumulated Other Comprehensive Income Accumulated
Deficit
 Total
  Shares Amount 
Balance, December 31, 2016 18,936
 $2
 $139,576
 $
 $(113,954) $25,624
Stock based compensation - employees 68
 
 1,826
 
 
 1,826
Stock based compensation - non-employees 
 
 69
 
 
 69
Exercise of warrants 857
 
 4,609
 
 
 4,609
Exercise of options 3
 
 7
 
 
 7
Issuance of stock - consultant 2
 
 5
 
 
 5
Issuance of stock - acquisition of vivoPharm, Pty Ltd. 3,068
 
 8,084
 
 
 8,084
Issuance of stock - Aspire Capital 1,320
 
 2,965
 
 
 2,965
Issuance of stock - 2017 Offering 3,500
 1
 4,386
 
 
 4,387
Unrealized gain on foreign currency translation 
 
 
 69
 
 69
Net loss 
 
 
 
 (20,880) (20,880)
Balance, December 31, 2017 27,754
 3
 161,527
 69
 (134,834) 26,765
Stock based compensation—employees (28) 
 921
 
   921
Fair value of warrants reclassified from liabilities to equity 
 
 423
 
 
 423
Warrant modification costs 
 
 83
 
 
 83
Beneficial conversion feature on Convertible Note 
 
 328
 
 
 328
Beneficial conversion feature on Advance from NovellusDx, Ltd. 
 
 1,173
 
 
 1,173
Transition adjustment for adoption of Accounting Standards Codification Topic 606 
 
 
 
 (2,509) (2,509)
Unrealized loss on foreign currency translation 
 
 
 (9) 
 (9)
Net loss 
 
 
 
 (20,373) (20,373)
Balance, December 31, 2018 27,726
 $3
 $164,455
 $60
 $(157,716) $6,802

                                         
  

Series A

Preferred Stock

  

Series B

Preferred Stock

  

Series C

Preferred Stock

  

Total

Temporary

   Common Stock  

Additional

Paid In

  Accumulated  

Accumulated

Comprehensive

  

Total Common

Stockholders’

Equity

 
  Shares  Amount  Shares  Amount  Shares  Amount  Equity   Shares  Amount  Capital  Deficit  Loss  (Deficit) 
Balance as of December 31, 2019  4,612  $12,356   3,735  $18,045   -  $-  $30,401    2,456  $-  $1,047  $(29,304) $-  $(28,257)
Stock-based compensation  -   -   -   -   -   -   -    -   -   216   -   -   216 
Exercise of stock options                                                     
Exercise of stock options, shares                                                     
Issuance of Series C Convertible Preferred shares, net of issuance costs of $214                                                     
Issuance of Series C Convertible Preferred shares, net of issuance costs of $214, shares                                                     
Issuance of Common Stock for acquisition consideration                                                     
Issuance of Common Stock for acquisition consideration                                                     
Issuance of shares for services  -   -   5   30   -   -   30    20   -   40   -   -   40 
Exercise of stock options in exchange for a note payable  -   -   -   -   -   -   -    12   -   26   -   -   26 
Issuance of shares upon exercise of common stock options  -   -   -   -   -   -   -    63   -   99   -   -   99 
Executives restricted common stock grants  -   -   -   -   -   -   -    43   -   86   -   -   86 
Issuance of Series B Convertible Preferred shares, net of issuance costs of $41  -   -   236   1,250   -   -   1,250    -   -   -   -   -   - 
Exchange of Series B Preferred Stock for 2020 Convertible Notes  -   -   (487)  (2,674)  -   -   (2,674)   -   -   -   -   -   - 
Warrant liability reclassified to equity upon Merger                                                     
Foreign currency translation adjustment                                                     
Net loss  -   -   -   -   -   -   -    -   -   -   (8,650)  -   (8,650)
Balance as of December 31, 2020  4,612  $12,356   3,489  $16,651   -  $-  $29,007    2,594  $-  $1,514  $(37,954) $-  $(36,440)
Balance  4,612  $12,356   3,489  $16,651   -  $-  $29,007    2,594  $-  $1,514  $(37,954) $-  $(36,440)
Stock-based compensation  -  ��-   -   -   -   -   -    -   -   1,298   -   -   1,298 
Exercise of stock options  -   -   -   -   -   -   -    8   -   41   -   -   41 
Issuance of Series C Convertible Preferred shares, net of issuance costs of $214  -   -   -   -   567   1,786   1,786    -   -   -   -   -   - 
Issuance of Common Stock for acquisition consideration  -   -   -   -   -   -   -    11,007   2   59,918   -   -   59,920 
Issuance of incremental shares to StemoniX shareholders upon Merger  -   -   -   -   -   -   -    805   -   -   -   -   - 
Conversion of Preferred Stock to Common Stock upon Merger  (4,612)  (12,356)  (3,489)  (16,651)  (567)  (1,786)  (30,793)   11,197   1   30,792   -   -   30,793 
Conversion of 2020 Convertible Notes to Common Stock upon Merger  -   -   -   -   -   -   -    3,339   -   16,190   -   -   16,190 
Preferred stock warrant settled for Common Stock upon Merger  -   -   -   -   -   -   -    43   -   -   -   -   - 
Warrant liability reclassified to equity upon Merger  -   -   -   -   -   -   -    -   -   421   -   -   421 
Foreign currency translation adjustment  -   -   -   -   -   -   -    -   -   -   -   (74)  (74)
Net loss  -   -   -   -   -   -   -    -   -   -   (40,859)  -   (40,859)
Balance as of December 31, 2021  -  $-   -  $-   -  $-  $-    28,993  $3  $110,174  $(78,813) $(74) $31,290 
Balance  -  $-   -  $-   -  $-  $-    28,993  $3  $110,174  $(78,813) $(74) $31,290 

See Notes to Consolidated Financial Statements.

66

CANCER GENETICS, INC. AND SUBSIDIARIES

Vyant Bio, Inc.

(Formerly Known as Cancer Genetics, Inc.)

Consolidated Statements of Cash Flows

(USD in thousands)

  Years Ended December 31,
  2018 2017
CASH FLOWS FROM OPERATING ACTIVITIES    
Net loss $(20,373) $(20,880)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation 1,602
 1,799
Amortization 512
 366
Provision for bad debts 2,514
 5,278
Stock-based compensation 921
 1,895
Stock issued for consulting services 
 5
Change in fair value of warrant liability, acquisition note payable and other derivatives (3,782) 2,006
Amortization of discount of debt and debt issuance costs 517
 1,299
Loss on disposal of fixed assets and sale of India subsidiary 204
 
Modification of 2017 Debt warrants 83
 
Loss in equity-method investment 154
 22
Loss on extinguishment of debt 
 78
Change in working capital components:    
Accounts receivable 1,041
 (3,583)
Other current assets 330
 (159)
Other non-current assets 1
 
Accounts payable, accrued expenses and deferred revenue 3,766
 (1,538)
Deferred rent and other (42) (152)
Net cash (used in) operating activities (12,552) (13,564)
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of fixed assets (649) (1,284)
Patent costs (31) (126)
Purchase of cost method investment 
 (200)
Cash received in the sale of India subsidiary, net of cash transferred 1,764
 
Cash used in acquisition of vivoPharm, Pty Ltd., net of cash received 
 (1,091)
Net cash provided by (used in) investing activities 1,084
 (2,701)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on capital lease obligations (337) (230)
Proceeds from warrant and option exercises 
 1,834
Proceeds from offerings of equity and derivative warrants, net of certain offering costs 
 6,586
Proceeds from borrowings on Silicon Valley Bank line of credit 12,055
 4,137
Repayments of borrowings on Silicon Valley Bank line of credit (13,571) 
Proceeds from Convertible Note 2,500
 
Advance from NovellusDx, Ltd. 1,500
 
Proceeds from Partners for Growth IV, L.P. term note 
 6,000
Proceeds from Aspire Capital common stock purchase, net of certain offering costs 
 2,965
Payment of debt issuance costs 
 (287)
Principal payments on Silicon Valley Bank term note 
 (4,667)
Net cash provided by financing activities 2,147
 16,338
Effect of foreign currency exchange rates on cash and cash equivalents (59) 16
Net increase (decrease) in cash and cash equivalents
 (9,380) 89
CASH AND CASH EQUIVALENTS AND RESTRICTED CASH    
Beginning 9,891
 9,802
Ending $511
 $9,891

SUPPLEMENTAL CASH FLOW DISCLOSURE    
Cash paid for interest $1,271
 $871
SUPPLEMENTAL DISCLOSURE OF NONCASH    
INVESTING AND FINANCING ACTIVITIES    
Fixed assets acquired through capital lease arrangements $150
 $567
Derivative warrants issued with debt 
 1,004
Value of shares issued as partial consideration to purchase vivoPharm, Pty Ltd. 
 8,084
Derivative warrants issued with common stock 
 2,199
Fair value of warrants reclassified from liabilities to equity 423
 
Beneficial conversion feature on Convertible Note 328
 
Beneficial conversion feature on Advance from NovelluxDx, Ltd. 1,173
 
Sale of India subsidiary:    
Accounts receivable, net $365
 $
Other current assets 229
 
Fixed assets, net 608
 
Goodwill 735
 
Other noncurrent assets 98
 
Accounts payable, accrued expenses and deferred revenue (180) 
Deferred rent and other (13) 
Loss on sale of India subsidiary (78) 
Cash received in the sale of India subsidiary, net of cash transferred $1,764
 $

       
  Years Ended December 31, 
  2021  2020 
Cash Flows from Operating Activities:        
Net loss $(40,859) $(8,650)
Net loss from discontinuing operations  22,284   - 
Reconciliation of net loss to net cash used in operating activities, continuing operations:        
Stock-based compensation  1,003   372 
Amortization of operating lease right-of-use assets  504   538 
Depreciation and amortization expense  550   572 
Change in fair value of share-settlement obligation derivative  250   503 
Change in fair value of financial instruments  (210)  - 
Accretion of debt discount  173   235 
Loss on conversion of debt  2,518   - 
PPL loan and EIDL grant forgiveness  -   (740)
Other  (14)  29 
Changes in operating assets and liabilities, net of impacts of business combination:        
Trade accounts and other receivables  (77)  (127)
Inventory  (60)  (43)
Prepaid expense and other assets  (165)  68 
Accounts payable  (1,146)  878 
PPL loan and EIDL grant proceeds  -   740 
Obligations under operating leases  (499)  (485)
Accrued expenses and other liabilities  (740)  298 
Net cash used in operating activities, continuing operations  (16,488)  (5,812)
Net cash provided by operating activities, discontinuing operations  (505)  - 
Net cash used in operating activities  (16,993)  (5,812)
Cash Flows from Investing Activities:        
Purchase of equipment  (535)  (60)
Proceeds from patent held for sale and equipment sales  50   17 
Cash acquired from acquisition  30,163   - 
Net cash provided by (used in) investing activities, continuing operations  29,678   (43)
Net cash used in investing activities, discontinuing operations  

(59

)  - 
Net cash provided by (used in) investing activities  

29,619

   

(43

)
Cash Flows from Financing Activities:        
EIDL loan proceeds  -   57 
Issuance of common stock, net of issuance costs  41   98 
Issuance of Series B Convertible Preferred Stock, net of issuance costs  -   1,250 
Issuance of Series C Convertible Preferred Stock, net of issuance costs  1,786   - 
2020 Convertible Note proceeds, net of issuance costs  5,022   4,923 
Related party notes payable  -   80 
Principal payments on long-term debt  (82)  - 
Proceeds from lease financing  

492

   - 
Principal payments on obligations under financing leases  (37)  (76)
Net cash provided by financing activities, continuing operations  7,222   6,332 
Net cash used in financing activities, discontinuing operations  

(32

)  

-

 
Net cash provided by financing activities  

7,190

   

6,332

 
Net increase in cash and cash equivalents  19,816   477 
Cash and cash equivalents, beginning of year  792   315 
Cash and cash equivalents, end of year $20,608  $792 
         
Supplemental disclosure of cash flow information:        
Cash paid for interest $8  $5 
Cash paid for income taxes  -   1 
Non-cash investing activities:        
Fair value of non-cash merger consideration $59,920  $- 
Right-of-use assets obtained in exchange for new operating lease liabilities  83   373 
Non-cash financing activities:        
Conversion of Convertible Preferred Stock to Common Stock upon Merger  30,793   - 
Conversion of 2020 Convertible Notes and accrued interest to Common Stock upon Merger  16,190   - 
Exchange of Series B Convertible Preferred Stock for 2020 Convertible Notes  -   2,674 
Related party note payable converted to 2020 Convertible Notes  

-

   55 
Related party note payable exchanged for stock option exercise  

-

   26 
Reclass warrant liability to equity upon Merger  421   - 

See Notes to Consolidated Financial Statements.

67

CANCER GENETICS, INC. AND SUBSIDIARIES

Vyant Bio, Inc.

(Formerly Known as Cancer Genetics, Inc.)

Notes to Consolidated Financial Statements

Note 1. Organization, Description of Business, SaleBusiness Disposals, Offerings and Merger

Vyant Bio, Inc. (the “Company”, “Vyant Bio”, “VYNT” or “we”), is an innovative biotechnology company reinventing drug discovery for complex neurodevelopmental and neurodegenerative disorders. Our central nervous system (“CNS”) drug discovery platform combines human-derived organoid models of India Subsidiary, Restructuring, Financing,brain disease, scaled biology, and machine learning. Our platform is designed to: 1) elucidate disease pathophysiology; 2) formulate key therapeutic hypotheses; 3) identify and validate drug targets, cellular assays, and biomarkers to guide candidate molecule selection; and 4) guide clinical trial patient selection and trial design. Our current programs are focused on identifying repurposed and novel small molecule clinical candidates for rare CNS genetic disorders including Rett Syndrome (“Rett”), CDKL5 Deficiency Disorders (“CDD”) and familial Parkinson’s Disease (“PD”). The Company’s management believes that drug discovery needs to progressively shift as the widely used preclinical models for predicting safe and effective drugs have under-performed, as evidenced by the time and cost of bringing novel drugs to market. As a result, Vyant Bio is focused on combining sophisticated data science capabilities with highly functional human cell derived disease models. We leverage our ability to identify validated targets and molecular-based biomarkers to screen and test thousands of small molecule compounds in human diseased 3D brain organoids in order to create a unique approach to assimilating biological data that supports decision making iteratively throughout the discovery phase of drug development to identify both novel and repurposed drug candidates.

As further described in Note 3, in December 2021, the Company’s Board of Directors approved a plan to sell the vivoPharm Pty Ltd (“vivoPharm”) business to focus the Company on the development of neurological developmental and degenerative disease therapeutics. The Company engaged an investment banker in December 2021 to sell the vivoPharm business during 2022.

On March 11, 2020, the World Health Organization declared the novel strain of coronavirus (“COVID-19”) a global pandemic and recommended containment and mitigation measures worldwide. Many of the Company’s customers worldwide were impacted by COVID-19 and temporarily closed their facilities which impacted revenue in the first half of 2020 for StemoniX. While the impact of the pandemic on our business has lessened in 2021, the global outbreak of COVID-19 continued in late 2021 with new variants and has impacted the way we operate our business including remote working, including its impact on technology security risks and employee retention. The extent to which the COVID-19 pandemic may impact the Company’s future business will depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as, the duration of the outbreak, travel restrictions and social distancing in the U.S. and other countries, business closures or business disruptions, and the effectiveness of actions taken in the U.S. and other countries to contain and treat the disease.

The Company is actively monitoring the impact of the COVID-19 pandemic on its business, results of operations and financial condition. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition in the future is unknown at this time and will depend on future developments that are highly unpredictable.

Dollar amounts in tables are stated in thousands of U.S. dollars.

Note 2. Cancer Genetics, Inc. Merger

The Company formerly known as Cancer Genetics, Inc. (“CGI”), StemoniX and OfferingsCGI Acquisition, Inc. (“Merger Sub”) entered into a merger agreement on August 21, 2020, which was amended on February 8, 2021 and February 26, 2021 (as amended, the “Merger Agreement”). Pursuant to the terms of the Merger Agreement, Merger Sub was merged (the “Merger”) with and into StemoniX on March 30, 2021, with StemoniX surviving the Merger as a wholly owned subsidiary of the Company. For U.S. federal income tax purposes, the Merger qualified as a tax-free “reorganization”. Concurrent with the Merger closing, the Company changed its name to Vyant Bio, Inc. Under the terms of the Merger Agreement, upon consummation of the Merger, the Company issued (i) an aggregate of 17,977,544 shares of VYNT common stock, par value $0.0001 per share (the “Common Stock”) to the holders of StemoniX capital stock (after giving effect to the conversion of all StemoniX preferred shares and StemoniX 2020 Convertible Notes) and StemoniX warrants (which does not include a certain warrant (the “Investor Warrant”) issued to a certain StemoniX convertible note holder (the “Major Investor”)), (ii) options to purchase an aggregate of 891,780 shares of Common Stock to the holders of StemoniX options with exercise prices ranging from $0.66 to $4.61 per share and a weighted average exercise price of $1.46 per share, and (iii) a warrant (the “Major Investor Warrant”) to the Major Investor, expiring February 23, 2026 to purchase 143,890 shares of Common Stock at a price of $5.9059 per share in exchange for the Investor Warrant.

68

We are

The Merger was accounted for as a reverse acquisition with StemoniX being the accounting acquirer of CGI using the acquisition method of accounting. Under acquisition accounting, the assets and liabilities (including executory contracts, commitments and other obligations) of CGI, as of March 30, 2021, the closing date of the Merger, were recorded at their respective fair values and added to those of StemoniX. Any excess of purchase price consideration over the fair values of the identifiable net assets is recorded as goodwill. The total consideration paid by StemoniX in the Merger amounted to $59.9 million, which represents the fair value of CGI’s 11,007,186 shares of Common Stock or $50.74 million, 2,157,686 Common Stock warrants or $9.04 million and 55,907 Common Stock options outstanding on the closing date of the Merger with a fair value of $139 thousand. In addition, at the effective time of the Merger, existing StemoniX shareholders received an emerging leaderadditional 804,711 incremental shares in enabling precision medicineaccordance with the conversion ratio set forth in oncology by providing multi-disciplinary diagnostic the Merger Agreement.

The Company incurred $2.3 million and data solutions, facilitating individualized therapies through our diagnostic tests, services$1.4 million of costs associated with the Merger that have been reported on the consolidated statements of operations as Merger related costs for the years ended December 31, 2021 and molecular markers. We develop, commercialize2020, respectively. As of December 31, 2021 and provide molecular-2020, accounts payable includes $0 thousand and biomarker-based tests$1.0 million of Merger related costs.

The following details the allocation of the preliminary purchase price consideration recorded on March 30, 2021, the acquisition date, with adjustments recorded in the remainder of 2021, and services, including proprietary preclinical oncologypurchase price allocation.

Schedule of Preliminary Allocation of the Purchase Price Consideration

  Preliminary  Adjustments  Final 
Assets acquired:            
Cash and equivalents $30,163  $-  $30,163 
Accounts receivable  705   -   705 
Other current assets  806   227   1,033 
Intangible assets  9,500   -   9,500 
Fixed assets  416   (256)  160 
Goodwill  22,164   

216

  22,380 
Long-term prepaid expenses and other assets  1,381   -   1,381 
Total assets acquired $65,135  $187 $65,322 
             
Liabilities assumed:            
Accounts payable and accrued expenses $2,670  $437  $3,107 
Current liabilities of discontinuing operations  588   (141)  447 
Obligations under operating leases  198   -   198 
Obligations under finance leases  106   -   106 
Deferred revenue  1,293   (114)  1,179 
Payroll and income taxes payable  360   5  365 
Total liabilities assumed $5,215  $187 $5,402 
             
Net assets acquired: $59,920  $-  $59,920 

The Company substantially completed valuation analyses necessary to assess the fair values of the tangible and immuno-oncology services, that enable biotechintangible assets acquired and pharmaceutical companies engaged in oncologyliabilities assumed and immuno-oncology trialsthe amount of goodwill to better select candidate populationsbe recognized as of the acquisition date. As of December 31, 2021, the Company has recorded provisional payroll and reduce adverse drug reactions by providing information regarding genomic and molecular factors influencing subject responses to therapeutics. Through our clinical services, we enable physicians to personalize the clinical management of each individual patient by providing genomic information to better diagnose, monitor and inform cancer treatment. We have a comprehensive, disease-focused oncology testing portfolio, and extensive set of anti-tumor referenced dataincome taxes payable liabilities. Fair values were based on predictive xenograftmanagement’s estimates and syngeneic tumor models. Our tests and techniques target a wide range of indications, covering all tenassumptions. The Company recognized intangible assets related to the Merger, which consist of the top cancerstradename valued at $1.5 million with an estimated useful life of ten years and customer relationships valued at $8.0 million with an estimated useful life of ten years. The value of the vivoPharm tradename was determined using the relief from royalty method based on analysis of profitability and review of market royalty rates. The Company determined that a 1.0% royalty rate was appropriate given the business-to-business nature of the vivoPharm operations. The value of the vivoPharm customer relationships was determined using an excess earnings method based on projected discounted cash flows and historic customer data. Key assumptions in prevalence in the United States, with additional unique capabilities offered by our FDA-cleared Tissuethis analysis included an estimated 10% annual customer attrition rate based on historical vivoPharm operations, a blended U.S. federal, state and Australian income tax rate of Origin® test for identifying difficult to diagnose tumor types or poorly differentiated metastatic disease. Following the acquisition27.1%, a present value factor of vivoPharm, Pty Ltd. (“vivoPharm”) we provide contract research services, focused primarily on unique specialized studies to guide drug discovery and development programs in the oncology and immuno-oncology fields.


We were incorporated in the State of Delaware on April 8, 1999 and currently have offices and state-of-the-art laboratories located in New Jersey, North Carolina, Pennsylvania, and Australia. Our laboratories comply with the highest regulatory standards as appropriate for the services they deliver including CLIA, CAP, and NY State. Our services are built on a foundation of world-class scientific knowledge and intellectual property in solid and blood-borne cancers,8.5% as well as strong academic relationships with major cancer centers suchrevenue, cost of revenue and operating expense assumptions regarding the future growth, operating expenses, including corporate overhead charges, and required capital investments.

69

These intangible assets are classified as Memorial Sloan-Kettering, Mayo Clinic, andLevel 3 measurements within the National Cancer Institute. We offer preclinical services suchfair value hierarchy.

The following presents the unaudited pro forma combined financial information as predictive tumor models, human orthotopic xenografts and syngeneic immuno-oncology relevant tumor models in our Hershey PA facility, and a leader inif the fieldMerger had occurred as of immuno-oncology preclinical services inJanuary 1, 2020:

Schedule of Proforma Financial Information

         
  Years ended December 31, 
  2021  2020 
Total revenue $6,726  $6,618 
Net loss  (35,623)  (13,138)
Pro forma loss per common share, basic and diluted  (1.23)  (0.45)
Pro forma weighted average number of common shares basic and diluted  28,977,491   28,875,162 

The pro forma combined results of operations are not necessarily indicative of the United States. This service is supplemented with GLP toxicology and extended bioanalytical services in our Australian based facility in Bundoora VIC.


Saleresults of India Subsidiary

On April 26, 2018, we sold our India subsidiary, BioServe Biotechnologies (India) Private Limited (“BioServe”) to Reprocell, Inc., for $1.9 million, including $1.6 million in cash at closing and up to an additional $300,000, which was contingent uponoperations that actually would have occurred had the India subsidiary meeting a specified revenue target through August 31, 2018. The contingent consideration was reduced to $213,000 and received in November 2018. As a resultMerger been completed as of this transaction, we recognized a lossJanuary 1, 2020, nor are they necessarily indicative of approximately $78,000 onfuture consolidated results.

Note 3. Discontinuing Operations

In December 2021, the disposalCompany’s Board of BioServe, which is included in other income (expense) in our Consolidated Statements of Operations and Other Comprehensive Loss.


Restructuring

In 2018, the Company adoptedDirectors approved a plan to migrate its Californiasell the vivoPharm Pty Ltd (“vivoPharm”) business to focus the Company on the development of neurological developmental and degenerative disease therapeutics. In December 2021, the Company engaged an investment bank to sell the vivoPharm business which is expected to be completed 2022. No amounts in 2020 were classified as discontinuing operations to its New Jersey and North Carolina locations and to permanently close its California laboratory. as the vivoPharm business was acquired as part of the Merger on March 30, 2021.

The Company incurredclassified the vivoPharm business as held for sale as of December 31, 2021, and, paid approximately $2,320,000given the significance of restructuring costs during the change in the Company’s strategy, classified this business as discontinuing operations in these 2021 consolidated financial statements. In connection with the reclassification of the vivoPharm business as held for sale, the Company completed a valuation of the net carrying value of this business and recorded a goodwill impairment charge of $20.2 million. The Company valued the vivoPharm business as of December 31, 2021 equally weighting public company revenue multiples and comparable transaction revenue multiples, which are classified as Level 3 measurements within the fair value hierarchy.

Also included in discontinuing operations are pre-Merger-related payables related to Cancer Genetic’s sale of its BioPharma and Clinical businesses (“Pre-Merger discontinuing operations”). As of December 31, 2021, $409 thousand of liabilities relating to these businesses are classified as other current liabilities – discontinuing operations on the Company’s consolidated balance sheets.

The following tables reflect the Pre-Merger discontinuing operations and the vivoPharm business operations from March 30, 2021, the Merger date, through December 31, 2021, and related assets and liabilities as of December 31, 2021.

Results of discontinuing operations were as follows:

Schedule of Disposal Groups Including Discontinuing Operations from Income Statement

     
Revenue $3,978 
Cost of goods sold  2,524 
General and administrative  3,531 
Impairment of goodwill  20,216 
Total operating costs and expenses $26,271 
Loss from discontinuing operations $(22,293)
Total other income $9
Loss from discontinuing operations before income taxes $(22,284)
Income tax benefit  - 
Net loss from discontinuing operations $(22,284)

Asset and liabilities of discontinuing operations were as follows:

Schedule of Disposal Groups Including Discontinuing Operations from Balance Sheet

     
Accounts receivable $457 
Other current assets  345 
Assets of discontinuing operations - current $802 
     
Fixed assets, net of accumulated depreciation $163 
Operating lease right-of-use assets  30 
Patents and other intangible assets, net  8,787 
Goodwill  2,164 
Other assets  364 
Assets of discontinuing operations - non-current $11,508 
     
Accounts payable $358 
Accrued expense  418 
Obligation under operating lease, current  29 
Obligation under finance lease, current  32 
Deferred revenue  1,911 
Taxes payable  

365

 
Other current liabilities  409 
Liabilities of discontinued operations - current $3,522 
     
Obligations under operating leases, less current $2 
Obligations under finance leases, less current  47 
Liabilities of discontinued operations -non- current $49 

Intangible assets consisted of the following as of December 31, 2021:

Schedule of Intangible Assets

  2021 
Intangible Assets:    
Customer relationships $8,000 
Trade name  1,500 
Intangible assets gross  9,500 
Less accumulated amortization  (713)
Intangible assets, net $8,787 

Amortization expense for intangible assets aggregated $713 thousand for the year ended December 31, 2018, which are summarized in2021.

Goodwill arising from the table below (in thousands).


Disposal activity costs$705
Costs to consolidate facilities766
Contract termination costs371
Employee termination costs478
 $2,320

Convertible Debt

On July 17, 2018, the Company issued a convertible promissory note to an institutional accredited investor in the initial principal amount of $2,625,000 (“Convertible Note”), as described in Note 7. The Convertible Note has an 18 month term and carries interest at 10% per annum. The note is convertible into shares of the Company’s common stock at a conversion price

of $0.80 per share upon 5 trading days’ notice, subject to certain adjustments (standard dilution) and ownership limitations specified in the Convertible Note. The note provides that in the event of default, the lender may, at its option, elect to increase the outstanding balance by applying the default effect (defined as outstanding balance at date of default multiplied by 15% plus outstanding amount) by providing written noticeMerger was solely attributed to the Company. Additionally,vivoPharm business. The following is a roll forward of goodwill as of and for the lender may elect to increase the interest rate to 22% in the eventyear ended December 31, 2021:

Schedule of default.Goodwill Rollforward

  2021 
    
Beginning balance, January 1 $- 
Initial balance upon consummation of the Merger  22,164 
Purchase price adjustments  216
Impairment charge  (20,216)
Ending balance, December 31 $2,164 

70

Merger with NovellusDx, Ltd.

On September 18, 2018, we entered into an agreement and plan

Note 4. Significant Accounting Policies

Basis of merger (the “Merger Agreement”) with NovellusDx, Ltd., a privately-held company formed under the law of the State of Israel (“NDX”), in regards to Wogolos Ltd., our wholly-owned subsidiary company formed under the laws of the State of Israel. Subject to satisfaction or waiver of the conditions set forth in the Merger Agreement, Wogolos Ltd. would have merged with and into NDX, with NDX becoming a wholly-owned subsidiary of us and the surviving company. In connection with the signing of the Merger Agreement, we entered into a credit agreement with NDX, pursuant to which NDX loaned us $1,500,000 (“Advance from NDX”), as described in Note 7.


On December 15, 2018, we terminated the Merger Agreement. As a result, the Advance from NDX, plus interest thereon, became due and payable on March 15, 2019. In addition, the interest rate was increased on December 15, 2018 to 21% due to an event of default. The default also gives NDX the right to convert all, but not less than all, of the outstanding balance into shares of the Company’s common stock at a conversion price of $0.606 per share.

2019 Offerings

In January 2019, we closed two public offerings and issued an aggregate of28,550,726 shares of common stock for approximately $5,412,000, net of expenses and discounts of approximately $1,088,000 (“2019 Offerings”).presentation: The Company also issued 1,998,551 warrants toprepares its underwriters in conjunction with these offerings. See Note 21 for additional information.

Note 2. Going Concern

At December 31, 2018, our cash position and history of losses required management to assess our ability to continue operating as a going concern, according to Financial Accounting Standards Board (“FASB”) Accounting Standards Update No. 2014-15, Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern (“ASU 2014-15”). The Company does not have sufficient cash at December 31, 2018 to fund normal operations for the next twelve months. In addition, the Company is in violation of certain financial covenants under its debt agreements at December 31, 2018, January 31, 2019, February 28, 2019 and March 31, 2019. In January 2019, the Company was able to secure forbearance agreements with both of its senior lenders and raise approximately $5,412,000, net of expenses and discounts of $1,088,000, through two public offerings. The Company's ability to continue as a going concern is dependent on the Company's ability to meet the milestones outlined in its forbearance agreements, extend the forbearance agreements and the term of the ABL beyond April 15, 2019, raise additional equity or debt capital or spin-off non-core assets to raise additional cash. These factors raise substantial doubt about the Company's ability to continue as a going concern.

We have hired Raymond James & Associates, Inc. as our financial advisor to assist with evaluating strategic alternatives. Such alternatives could include raising more capital, the acquisition of another company and/or complementary assets, the sale of the Company or non-core assets, or another type of strategic partnership. We can provide no assurances that our current actions will be successful or that additional sources of financing with be available to us on favorable terms, if at all.

The consolidated financial statements do not include any adjustments that might be necessary should the Company be unable to continue as a going concern.

Note 3. Significant Accounting Policies

Basis of presentation: We prepare our financial statements on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America.
America (U.S. GAAP).

Segment reporting: Operating segments are definedidentified as components of an enterprise about which separate discrete financial information is usedavailable for evaluation by the chief operating decision maker, or decision-making group,decision-maker in deciding how to allocate resourcesmaking decisions regarding resource allocation and in assessing performance. We view ourAll of the Company’s assets from continuing operations are maintained in the U.S. The Company views and manage ourmanages its continuing operations as one segment. Per Note 2, the Merger on March 30, 2021, combined the StemoniX business with Vyant Bio and its vivoPharm business. The Company completed its review of the ongoing strategy and reporting structure of its operations in the fourth quarter of 2021 resulting in the Company’s Board of Directors approval to engage investment bankers to sell the vivoPharm business in one operating2022. As a result of this strategic decision, the Company completed its analysis of segment which isand reporting unit accounting arising from the businessMerger, identified vivoPharm as a reporting unit, and allocated all of developing and selling diagnostic tests and services.


the goodwill arising from the Merger to the vivoPharm business’ discontinuing operations. See Note 3 for further information regarding the vivoPharm discontinuing operations.

Principles of consolidation: The accompanying consolidated financial statements include the accounts of Cancer Genetics,Vyant Bio, Inc. and ourits wholly-owned subsidiaries.

All significant intercompany account balances and transactions have been eliminated in consolidation.

Reclassification: As a result of the Merger, the Company has reclassified $92 thousand of deferred revenue as of December 31, 2020 previously included in the balance sheet caption other current liabilities to deferred revenue to conform to the post-Merger presentation.

Foreign currency: We translateThe Company translates the financial statements of ourits foreign subsidiaries, which have a functional currency in the respective country’s local currency, to U.S. dollars using month-end exchange rates for assets and liabilities and average exchange rates for revenue, costs and expenses. Translation gains and losses are recorded in accumulated other comprehensive incomeloss as a component of stockholders’ equity. For the year ended December 31, 2021 there were foreign currency translation losses of $74 thousand, all related to the vivoPharm business. Gains and losses resulting from foreign currency transactions that are denominated in currencies other than the entity'sentity’s functional currency are included within discontinuing operations in the Consolidated Statementsconsolidated statements of Operations and Other Comprehensive Loss andoperations. There were not0foreign currency translation or transaction gains or losses for the year ended December 31, 2020 as the Merger, which includes significant during 2018 or 2017.

foreign operations, occurred on March 30, 2021.

Use of estimates and assumptions: The preparation of financial statements in conformity with accounting principlesU.S. generally accepted in the United States of Americaaccounting principles requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenuesrevenue and expenses during the reporting period. Significant estimates made by management include, among others, realization of amounts billed, realization of long-lived assets, realization of intangible assets, accruals for litigation and registration payments, assumptions used to value stock options, warrants and goodwill and the valuation of assets acquired and liabilities assumed from acquisitions. Actual results could differ from those estimates.

The Company’s significant estimates include estimated transaction price, including variable consideration, of the Company’s revenue contracts; the value of intangible assets arising from the Merger, the fair value of the net assets of the vivoPharm business classified as discontinuing operations, the useful lives of fixed assets; the valuation of derivatives and one 2020 Convertible Note accounted for under the fair-value election; deferred tax assets, inventory, right-of-use (ROU) assets and lease liabilities, stock-based compensation, income tax uncertainties, and other contingencies.

Risks and uncertainties: We operateThe Company operates in an industry that is subject to intense competition, government regulation and rapid technological change. OurThe Company’s operations are subject to significant risk and uncertainties including financial, operational, technological, regulatory, foreign operations, and other risks, including the potential risk of business failure.

Cash and cash equivalents: HighlyThe Company considers all highly liquid investments with original maturitiesa maturity of three months or less when purchased are considered to be cash equivalents. Included in cash and cash equivalents as of December 31, 2020 was $738thousand of restricted cash related to the Company’s PPP loan. The Company was required to escrow the PPP loan proceeds plus accrued interest as the Company’s PPP loan forgiveness application had not been processed by the U.S. Small Business Administration at the time of the Merger. This amount was returned to the Company in April 2021 when the PPP loan was fully forgiven. The cash and cash equivalents balance as of December 31, 2021 includes $12 million invested in a U.S. government money market fund.

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Revenue recognition: The Company recognizes revenue when it satisfies performance obligations under the terms of its contracts, and transfers control of the product to its customers in an amount that reflects the consideration the Company expects to receive from its customers in exchange for those products. This process involves identifying the customer contract, determining the performance obligations in the contract, determining the contract price, allocating the contract price to the distinct performance obligations in the contract, and recognizing revenue when the performance obligations have been satisfied. A performance obligation is considered distinct from other obligations in a contract when it (a) provides a benefit to the customer either on its own or together with other resources that are readily available to the customer and (b) is separately identified in the contract. The Company considers a performance obligation satisfied once it has transferred control of a product to a customer, which is generally upon shipment as the customer has the ability to direct the use and obtain the benefit of the product.

The Company’s primary sources of revenue are product sales from the sale of microOrgan® plates and the performance of preclinical drug testing services using the microOrgan technology. The Company does not act as an agent in any of its revenue arrangements.

For product contracts, revenue is recognized at a point-in-time upon delivery to the customer. Product contracts with customers generally state the terms of the sale, including the quantity and price of each product purchased. Payment terms and conditions may vary by contract, although terms generally include a requirement of payment within a range of 30 to 90 days after the performance obligation has been satisfied. As a result, the contracts do not include a significant financing component. In addition, contacts typically do not contain variable consideration as the contracts include stated prices. The Company provides assurance-type warranties on all of its products, which are not separate performance obligations.

For service contracts, revenue is recognized over time and is generally defined pursuant to an enforceable right to payment for performance completed on service projects for which the Company has no alternative use as customer furnished compounds are added to Company plates for testing. The Company does not obtain control of the customer furnished compounds as the Company does not have the ability to direct their use. Revenue is measured by the costs incurred to date relative to the estimated total direct costs to fulfill each contract (cost-to-cost method). Incurred costs represent work performed, which corresponds with, and thereby best depicts, the transfer of control to the customer. Contract costs include labor, materials and overhead.

Contracts are often modified to account for changes in contract specifications and requirements. Contract modifications exist when the modification either creates new, or changes existing, enforceable rights and obligations. Generally, when contract modifications create new performance obligations, the modification is considered to be a separate contract and revenue is recognized prospectively. When contract modifications change existing performance obligations, the impact on the existing transaction price and measure of progress for the performance obligation to which it relates is generally recognized as an adjustment to revenue (either as an increase in or a reduction of revenue) on a cumulative catch-up basis.

Contract assets primarily represent revenue earnings over time that are not yet billable based on the terms of the contracts. Contract liabilities (i.e., deferred revenue) consist of fees invoiced or paid by the Company’s customers for which the associated performance obligations have not been satisfied and revenue has not been recognized based on the Company’s revenue recognition criteria described above.

The Company records all amounts collected for shipping as revenue. Amounts collected from customers for sales tax are recorded in sales net of amounts paid to related taxing authorities.

The Company may include subcontractor or third-party vendors in certain integrated services arrangements. In these arrangements, revenue from sales of third-party vendor services is generally recorded gross as revenue and cost of goods sold – service, as the Company is the principal for the transaction. When the Company is acting as an agent between a customer and the vendor services, the Company does not record revenue and vendor costs are recorded net within cost of goods sold - service. To determine whether the Company is an agent or principal, the Company considers whether it obtains control of services before they are transferred to the customer. In making this evaluation, several factors are considered, most notably whether the Company has primary responsibility for fulfillment to the client, as well as fiscal risk and pricing discretion.

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Contract assets from continuing operations were $70 thousand and $32 thousand as of December 31, 2021 and 2020, respectively. Contract liabilities from continuing operations related to unfulfilled performance obligations were $74 thousandand $92 thousand as of December 31, 2021 and 2020, respectively, and are recorded in deferred revenue. Contract assets and liabilities classified within discontinuing operations aggregated $75 thousand and $1.9 million as of December 31, 2021. Remaining performance obligations as of December 31, 2021 are expected to be recognized as revenue in the next twelve months. 

Trade accounts receivable: Trade accounts receivable are recorded at the invoiced amount and do not bear interest. The Company records an allowance for doubtful accounts for estimated losses inherent in its accounts receivable portfolio. In establishing the required allowance, management considers historical losses adjusted to consider current market conditions and the Company’s customers’ financial condition, the amount of receivables in dispute, and the current receivables aging and current payment patterns. The Company reviews its allowance for doubtful accounts monthly. NaN allowances were recorded as of December 31, 2021 or 2020. Write-offs for the years ended December 31, 2021 and 2020 were not significant. The Company does not have any off-balance-sheet credit exposure related to its customers.

Other receivables: For the years ended December 31, 2021 and 2020, the Company elected to use federal research and development (R&D) tax credit carryforwards to offset federal payroll taxes paid. The Company recorded R&D tax credit receivables of $100 thousand and $133 thousandas of December 31, 2021 and 2020, respectively. For the years ended December 31, 2021 and 2020, the Company recognized $205 thousand and $190 thousand, respectively, of R&D tax credits as a reduction in payroll tax expenses.

Concentration of credit risk:Financial instruments whichthat potentially subject usthe Company to concentrations of credit risk consist primarily of cash and cash equivalents. We maintainequivalents and trade receivables. The Company places cash and cash equivalents in various financial institutions with high-credit quality financial institutions. At


times, such amounts may exceed insured limits. We have not experienced any losses in such accountshigh credit rating and believe we are not exposedlimits the amount of credit exposure to any significantone financial institution. Trade receivables are primarily from clients in the pharmaceutical and biotechnology industries, as well as academic and government institutions. Concentrations of credit risk on our cash and cash equivalents.

Restricted cash: Represents cash held at financial institutionswith respect to trade receivables, which we may not withdraw and which collateralizes certain of our financial commitments. All of our restricted cash is invested in interest bearing certificates of deposit. At December 31, 2018 and 2017, our restricted cash collateralizes a $350,000 letter of credit in favor of our landlord, pursuantare typically unsecured, are limited due to the termswide variety of the lease for our Rutherford facility. Effective January 1, 2018, we adopted ASU 2016-18, which requires companies to include restricted cash accounts with cash and cash equivalents when reconciling the beginning of period and end of period total amounts shown on the Consolidated Statements of Cash Flows.

Revenue recognition under ASC 606: Effective January 1, 2018, the Company recognizes revenue in accordance with FASB Accounting Standards Codification (“ASC”) 606. We adopted the new standardcustomers using the modified retrospective method. We recognized the cumulative effect of initially applying the new revenue standardCompany’s products and services as an adjustment to the opening balance of accumulated deficit. Financial information for the year ended December 31, 2017 has not been restated and continues to be reported under the accounting standards in effect for that period.

The transition adjustment resulted in a net reduction to the opening balance of accumulated deficit of $2.5 million on January 1, 2018 and increased deferred revenue associated with Biopharma Services and Discovery Services by $1.9 million and $0.6 million, respectively, due to a change in our policies for recognized revenue for performance obligations fulfilled over time. In our Clinical Services area, the majority of the amounts historically chargedwell as a provision for bad debts are now considered an implicit price concession in determining net revenue under ASC 606. Accordingly, we now report uncollectible balances as a reduction in the transaction price, and therefore, as a reduction in net revenues rather than a component of selling, general and administrative expenses.

The following tables present the amounts by which each financial statement line item was affected by adopting the new revenue recognition guidance (in thousands):
  Year Ended December 31, 2018
  As Reported ASC 606 Adjustments Balances Without Adoption
Consolidated Statements of Operations and Other Comprehensive Loss      
Revenue:      
Biopharma Services $14,828
 $(832) $13,996
Clinical Services 7,429
 3,954
 11,383
Discovery Services 5,213
 (650) 4,563
  $27,470
 $2,472
 $29,942

  December 31, 2018
  As Reported ASC 606 Adjustments Balances Without Adoption
Consolidated Balance Sheets      
CURRENT ASSETS      
Accounts receivable, net of allowance for doubtful accounts $7,038
 $3,954
 $10,992
       
CURRENT LIABILITIES      
Deferred revenue      
Biopharma Services $959
 $(899) $60
Clinical Services 
 
 
Discovery Services 1,214
 
 1,214
  $2,173
 $(899) $1,274
       
NON-CURRENT LIABILITIES      
Deferred revenue      
Biopharma Services $379
 $(128) $251
Clinical Services 
 
 
Discovery Services 
 
 
  $379
 $(128) $251
       
STOCKHOLDERS' EQUITY      
Accumulated (deficit) $(157,716) $4,981
 $(152,735)

The adoption of ASC 606 had no impact on our total cash flows from operations.

We record deferred revenues (contract liabilities) when cash payments are received or due in advance of our performance, including amounts which are refundable.

The allowance for doubtful accounts does not reflect any adjustments related to the ASC 606 adjustment for accounts receivable.

Performance Obligations:


Biopharma ServicesClinical ServicesDiscovery Services
Performance Obligation Satisfaction and Revenue Recognition:Performance obligations are satisfied at a point in time as the Company processes samples delivered by the customer. Project level activities, including study setup and project management, are satisfied over the life of the contract. Revenues are recognized at a point in time when the test results or other deliverables are reported to the customer. Project level fee revenue is recognized ratably over the life of the contract.Performance obligations are satisfied at a point in time when the tests are reported to the customer. Revenues are recognized at a point in time when the test results are reported to the ordering site.Performance obligations are satisfied over time and as study data is transmitted to the customer. Revenue is recognized using the time elapsed method and at a point in time as the Company delivers study results to the customers.
Significant Payment Terms:Monthly invoices at a contractual rate are generated as services are delivered for work completed during the prior month. Some contracts have prepayments prior to services being rendered that are recorded as deferred revenue.The Company invoices at its list price or contractually negotiated price. Payments realized vary from amounts invoiced. Accordingly, the Company estimates the variable consideration it expects to collect.As results are delivered, the invoices are generated based on contractual rates. Some contracts have prepayments prior to services being rendered that are recorded as deferred revenue.
Nature of Services:Biopharma testing services, study setup and study managementClinical testing servicesDiscovery services

Remaining Performance Obligations:

Services offered under the Biopharma and Discovery Services frequently take time to complete under their respective contacts. These times vary depending on specific contract arrangements including the length of the study and how samples are delivered to us for processing. In the case of Clinical Services and Discovery Services, the duration of performance obligation is less than one year.dispersion across many geographic areas. As of December 31, 2018,2021 and 2020, four and three customers, respectively, represented 10% or more of the Company had approximately $34.8 million in remaining performance obligationsCompany’s total trade accounts receivable, and in the Biopharma Services area. We expect to recognize the remaining performance obligations over the next two to three years.

Practical Expedients:

Our customer arrangements in Biopharma Servicesaggregate, these customers represented 78%, or $262 thousand, and Discovery Services do not contain any significant financing component (interest). We have not recognized the financing component in the case of Clinical Services, as the payment plans we may grant to our self-pay customers do not to exceed six months.
We incur incremental costs on our Biopharma clients but have elected the practical expedient afforded by the new revenue standard to expense such costs as incurred.

We exclude from the measurement73%, or $131 thousand, respectively, of the transaction price all taxes that we collect from customers that are assessed by governmental authorities and are both imposed on and concurrent with specific revenue-producing transactions.

Revenue recognition under ASC 605Company’s total trade accounts receivable. 

Inventory: Prior to 2018,Inventory is stated at the Company recognized revenue in accordance with FASB ASC 605, as well as SEC Staff Accounting Bulletin 104, for its Biopharma and Discovery Services, and ASC 954-605, Health Care Entities, Revenue Recognition for its Clinical Services. These standards generally required that four basic criteria be met before revenue could be recognized: (1) persuasive evidence that an arrangement exists; (2) delivery has occurred and title and the risks and rewardslower of ownership have been transferred to the customercost or services have been rendered; (3) the price is fixed or determinable; and (4) collectability is reasonably assured. In determining whether the price was fixed or determinable, we considered payment limits imposed by insurance carriers and Medicare, and the amount of revenue recorded took into account the historical percentage of revenue we had collected for each type of test for each payor category. Periodically, an adjustment was made to Clinical Services revenue to record differences between our anticipated cash receipts from third parties, such as insurance carriers and Medicare, and actual receipts from such payors. For the year ended December 31, 2017, the Company recorded an adjustment of approximately $1,640,000. For some Clinical Service and Biopharma customers billed directly, revenue was recorded based upon the contractually agreed upon fee schedule. When assessing collectability, we considered whether we had sufficient payment history to reliably estimate a payor’s individual payment patterns. We did not bill customers for shipping and handling fees, other than reimbursement of such expenses we incur on behalf of our Biopharma clients, and we did not collect any sales or other taxes from customers.


Accounts receivable: Accounts receivable are carried at net realizable value, which is the original invoice amount less an estimate for contractual adjustments, discountswith cost being determined on a first-in first-out basis. Cost includes materials, labor and doubtful receivables, the amounts of which are determined by an analysis of individual accounts. Our policy for assessing the collectability of receivables is dependent upon the major payor source of the underlying revenue. For Biopharma and Discovery clients, an assessment of credit worthiness is performed prior to initial engagement and is reassessed periodically. If deemed necessary, an allowance is established on receivables from direct bill clients. For Clinical Services clients, we record revenues andmanufacturing overhead related receivables when the testing process is complete and the results are reported. After the adoption of ASC 606 on January 1, 2018, revenue is recorded at the amount expected to be collected, which includes implicit price concessions. Under the new standard, the majority of the amounts historically charged as a provision for bad debts are now considered an implicit price concession.
Prior to the adoptionpurchase and production of ASC 606, revenue was recorded atinventory. Costs associated with the expected price, taking into accountunderutilization of capacity are expensed to Cost of goods sold - product as incurred. Inventory is adjusted for excess and obsolete amounts. Evaluation of excess inventory includes items such as inventory levels, anticipated usage, and customer demand, among others.

Prepaid expenses and other assets: In connection with the patient's ability to pay,Merger on March 30, 2021 a number of Director and Officer insurance contracts were in place, including tail policies accounted for as wellacquired assets in connection with the Merger. Aggregate premiums of $2.7 million are being expensed over the term of each respective policy. As of December 31, 2021, $1.0 million has been classified in the consolidated balance sheet as anticipated discounts, adjustments and/or contractual allowances, as applicable. After reasonable collection efforts are exhausted, amounts deemed to be uncollectible were written off against the allowance for doubtful accounts. Since the Company only recognized revenue to the extent it expected to collect such amounts, bad debt expensenon-current prepaid assets related to receivables from patient service revenue was recorded in general and administrative expense in the Consolidated Statements of Operations and Other Comprehensive Loss. Recoveries of accounts receivable previously written off were recorded when received. For the 2017 calendaramounts that will be expensed more than one year the Company, as part of its evaluation of outstanding accounts receivable, determined that a substantial amount of its receivables would not likely be collectible. Accordingly, the Company recorded approximately $5,278,000 of bad debt expense in its Consolidated Statements of Operations and Other Comprehensive Loss during the year endedafter December 31, 2017. While the Company continues with its collections efforts on all claims, the Company determined that an additional $2,514,000 of bad debt was required for the year ended December 31, 2018 and specifically an additional $647,000 in fourth quarter 2018 beyond the previous quarter levels associated with typical collection windows of third party claims due to continued challenges associated with collections.

2021.

Deferred revenue:revenue: Payments received in advance of services rendered are recorded as deferred revenue and are subsequently recognized as revenue in the period in which the services are performed.

Fixed assets:assets: The Company’s purchased fixed assets are stated at cost. Fixed assets consistunder finance leases are stated at the present value of diagnostic equipment, furniture and fixtures, software developed for internal use and leasehold improvements. Fixed assets are carried at cost and are depreciatedminimum lease payments. Depreciation is calculated using the straight-line method over the estimated useful lives of the assets, which generally range fromassets. The estimated useful life of equipment is five to seven years. Leasehold improvements are depreciated over the lessershorter of useful life or the lease term or the estimated useful lives of the improvements using the straight-line method. The cost of computer software developed for internal use, which consists of our lab information system that is still in its configuration and implementation stages, is capitalized and will be amortized on a straight-line basis over its estimated useful life of ten years when complete. Repairsterm. Repair and maintenance costs are charged to expenseexpensed as incurred while improvements are capitalized. Upon sale, retirement or disposal ofincurred.

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Long-lived assets, such as fixed assets the accounts are relieved of the cost and the related accumulatedsubject to depreciation, with any gain or loss recorded to the Consolidated Statements of Operations and Other Comprehensive Loss.

Fixed assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. These computations utilize judgments and assumptions inherent in our estimate of futureIf circumstances require a long-lived asset or asset group be tested for possible impairment, the Company first compares undiscounted cash flows expected to determine recoverabilitybe generated by that asset or asset group to its carrying amount. If the carrying amount of these assets. If our assumptions about thesethe long-lived asset or asset group is not recoverable on an undiscounted cash flow basis, an impairment is recognized to the extent that the carrying amount exceeds its fair value. As of December 31, 2021 and 2020 the Company determined that there were no indicators of impairment and did not recognize any fixed asset impairment use in continuing operations. Fair value is determined through various valuation techniques including discounted cash flow models, quoted market values and appraisals, as considered necessary.

Goodwill: Goodwill represents the excess of the purchase price over the fair value of net tangible and identified intangible assets wereacquired in a business combination. Goodwill is not amortized but is evaluated at least annually for impairment or when a change in facts and circumstances indicate that the fair value of the goodwill may be below the carrying value. The Company did not record Goodwill prior to change asthe March 30, 2021 Merger. As a result of events or circumstances, we may be requiredthe Merger, the Company recorded $22.4 million of goodwill attributed to record an impairment loss.


Goodwill: Goodwill resulted from the purchases of Gentris Corporation (“Gentris”) and BioServe in 2014, the purchase of certain assets of Response Genetics in 2015 and the purchase of vivoPharm, Pty Ltd. (“vivoPharm”) in 2017. In accordance with ASC 350, Intangibles - Goodwill and Other, we are required to test goodwill for impairment and adjust for impairment losses, if any, at least annually and on an interim basis if an event or circumstance indicates that it is likely impairment has occurred. Our annual goodwill impairment testing date is October 1 of each year. No such losses were incurred during the years ended December 31, 2018 and 2017.
Goodwill (in thousands)
Balance, January 1, 2017 $12,029
Purchased through acquisition of vivoPharm 5,960
Foreign currency translation adjustment 3
Balance, December 31, 2017 17,992
Reduced by sale of our India subsidiary, BioServe (735)
Balance, December 31, 2018 $17,257

Financing fees: Financing fees are amortized using the effective interest method over the term of the related debt. Debt is recorded net of unamortized debt issuance costs.
Warrant liability: We issued warrants during the 2016 Offerings and the 2017 Offering that containvivoPharm business. As a contingent net cash settlement feature, which are described herein as derivative warrants. We also issued warrants that were subject to a 20% reduction if we achieved certain financial milestones as part of our 2017 debt refinancing described in Note 7. At December 31, 2017, these3, the Company changed the classification of the vivoPharm business to a held for sale asset in the fourth quarter of 2021 resulting in the recording of a $20.2 million goodwill impairment charge.

Convertible notes: The Company accounts for convertible notes using an amortized cost model. Debt issuance costs and the initial fair value of bifurcated compound derivatives reduce the initial carrying amount of the convertible notes. The carrying value is accreted to the stated principal amount at contractual maturity using the effective-interest method with a corresponding charge to interest expense. Debt discounts are presented on the consolidated balance sheets as a direct deduction from the carrying amount of that related debt.

Fair value option: The Company has the irrevocable option to report most financial assets and financial liabilities at fair value on an instrument-by-instrument basis, with changes in fair value reported in earnings. The Company elected to account for the convertible note issued to the Major Investor in February 2021 under the fair value option. See Note 11 to the consolidated financial statements.

Warrants: Except as noted in the next paragraph, the Company accounts for its preferred stock warrants issued to non-employees in equity as issuance costs, as the warrants were also classifiedissued as derivative warrants but were reclassifiedvested share-based payment compensation to non-employees.

The Company issued a warrant during first quarter of 2021 that contained an indexation feature not indexed to the Company’s stock resulting in this warrant being accounted for as equity during 2018 when the number of shares issuable under the agreement became fixed.a derivative. Derivative warrants are recorded as liabilities in the accompanying Consolidated Balance Sheets.consolidated balance sheets. These common stock purchase warrants do not trade in an active securities market, and as such, we estimatethe Company estimated the fair value of these warrants using the binomial lattice, Black-Scholes and Monte Carlo valuation pricing modelsmodel with the assumptions as follows: Thethe risk-free interest rate for periods within the contractual life of the warrant is based on the U.S. Treasury yield curve. The expected life of the warrants is based upon the contractual life of the warrants. We useThe Company uses the historical volatility of ourits common stock and the closing price of ourits shares on the NASDAQ Capital Market. As further described in Note 10 to the consolidated financial statements, as a result of the Merger, the terms of this warrant were finalized through the conversion to a Vyant Bio warrant resulting in the Vyant Bio warrant being equity classified.

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We compute

Derivative instruments: The Company recognizes all derivative instruments as either assets or liabilities in the consolidated balance sheets at their respective fair values. The Company evaluates its debt and equity issuances to determine if those contracts or embedded components of those contracts qualify as derivatives requiring separate recognition in the Company’s financial statements. The result of this accounting treatment is that the fair value of the warrant liability atembedded derivative is revalued as of each reporting perioddate and recorded as a liability, and the change in the fair value during the reporting period is recorded as non-cash expense or non-cash income. The key component in the value of the warrant liability is our stock price, which is subject to significant fluctuation and is not under our control. The resulting effect on our net (loss) is therefore subject to significant fluctuation and will continue to be so until the warrants are exercised, amended or expire. Assuming all other fair value inputs remain constant, we will record non-cash expense when the stock price increases and non-cash income when the stock price decreases.

Income taxes: Income taxes are provided for the tax effects of transactions reported(expense) in the consolidated financial statements of operations. In circumstances where the embedded conversion option in a convertible instrument is required to be bifurcated and consist of taxes currently due plus deferred income taxes. Deferred income taxesthere are recognized for temporary differences between the financial statement and tax bases of assets and liabilities that will result in taxable or deductible amountsalso other embedded derivative instruments in the future. Deferred income taxes are also recognized for net operating loss (“NOLs”) carryforwardsconvertible instrument that are available to offset future taxable income and research and development credits.

On December 22, 2017, the U.S. federal government enacted legislation commonly referred to as the “Tax Cuts and Jobs Act” (the “TCJA”). The TCJA makes widespread changes to the Internal Revenue Code, including, among other items, the introduction of a new international “Global Intangible Low-Taxed Income” (“GILTI”) regime effective January 1, 2018. Companies may adopt one of two views in regards to establishing deferred taxes in accordance with the new GILTI regime under ASC 740. Companies may account for the effects of GILTI either (1) in the period the entity becomes subject to GILTI, or (2) establish deferred taxes (similar to the guidance that currently exists with respect to basis differences that will reverse under current Subpart F rules) for basis differences that upon reversal will be subject to GILTI. We have elected to account for GILTI in the period we become subject to GILTI.
Valuation allowances are established when necessary to reduce deferred tax assets to the amount expectedrequired to be realized. We have establishedbifurcated, the bifurcated derivative instruments are accounted for as a full valuation allowance on our deferred tax assetssingle, compound derivative instrument. The classification of derivative instruments, including whether such instruments should be recorded as of December 31, 2018 and 2017; therefore, we have not recognized any deferred tax benefitliabilities or expense in the periods presented.
ASC 740, Income Taxes, clarifies the accounting for uncertainty in income taxes recognized in the financial statements. ASC 740 provides that a tax benefit from uncertain tax positions may be recognized when itas equity, is more-likely-than-not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits of the position. Income tax positions must meet a more-likely-than-not recognition threshold to be recognized. ASC 740 also provides guidance on measurement, de-recognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. At December 31, 2018 and 2017 we had no uncertain tax positions.
Our policy is to recognize interest and/or penalties related to income tax matters in income tax expense. There is no accrual for interest or penalties on our Consolidated Balance Sheets at December 31, 2018 or 2017, and we have not recognized interest and/or penalties in the Consolidated Statements of Operations and Other Comprehensive Loss for the years ended December 31, 2018 or 2017.
Patents and other intangible assets: We account for intangible assets under ASC 350-30. Patents consisting of legal fees incurred are initially recorded at cost. We have also acquired patents that are initially recorded at fair value. Patents are amortized over the useful lives of the assets, using the straight-line method. Certain patents are in the legal application process and therefore are not currently being amortized. We review the carrying value of patentsreassessed at the end of each reporting period. Based upon our review, there were no patent impairmentsDerivative instrument liabilities are classified in 2018the consolidated balance sheets as current or 2017.non-current based on whether or not net-cash settlement of the derivative instrument is expected within twelve months of the consolidated balance sheet date.

Income taxes: Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. A valuation allowance is provided when it is more likely than not that some portion of the deferred tax asset will not be realized. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date.

The Company recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. The Company records interest related to unrecognized tax benefits in interest expense and penalties in selling, general, and administrative expenses.

The Company elects to present deferred taxes and the effect of unrecognized tax benefits associated with the held for sale assets and liabilities as part of the assets (or liabilities) held for sale. The deferred taxes primarily relate to net operating loss carryforwards in US and foreign jurisdictions that are classified as held for sale. Due to a valuation allowance recorded against the deferred tax assets, the net impact of deferred tax assets included in the held for sale assets and liabilities is $0.

Leases: The Company leases office space, laboratory facilities, and equipment. The Company determines if an arrangement is or contains a lease at contract inception and recognizes a right of use (“ROU”) asset and a lease liability at the lease commencement date.

For operating leases, the lease liability is initially and subsequently measured at the present value of the unpaid lease payments at the lease commencement date. For finance leases, the lease liability is initially measured in the same manner and date as for operating leases and is subsequently measured at amortized cost using the effective-interest method. The Company has elected the practical expedient to account for lease and non-lease components as a single lease component. Therefore, the lease payments used to measure the lease liability includes all of the fixed consideration in the contract.

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Other intangible

Key estimates and judgments include how the Company determines (1) the discount rate it uses to discount the unpaid lease payments to present value, (2) lease term and (3) lease payments. The Company discounts its unpaid lease payments using the interest rate implicit in the lease or, if that rate cannot be readily determined, its incremental borrowing rate. Generally, the Company cannot determine the interest rate implicit in the lease because it does not have access to the lessor’s estimated residual value or the amount of the lessor’s deferred initial direct costs. Therefore, the Company generally uses its incremental borrowing rate as the discount rate for the lease. The Company’s incremental borrowing rate for a lease is the rate of interest it would have to pay on a collateralized basis to borrow an amount equal to the lease payments under similar terms. Because the Company does not generally borrow on a collateralized basis, it uses the interest rate it pays on its non-collateralized borrowings as an input to deriving an appropriate incremental borrowing rate, adjusted for the lease payments, the lease term and the effect on that rate of designating specific collateral with a value equal to the unpaid lease payments for that lease.

The lease term for all the Company’s leases includes the noncancellable period of the lease plus any additional periods covered by either a Company option to extend (or not to terminate) the lease that the Company is reasonably certain to exercise, or an option to extend (or not to terminate) the lease controlled by the lessor.

Intangible assets: Intangible assets consist of softwarevivoPharm’s customer relationships and tradename that were acquired with Response Genetics and vivoPharm’s customer list and trade name,in the Merger, which are allwere being amortized using the straight-line method over the estimated useful lives of the assets which range from threeof ten years. These assets are included in long-term assets of discontinuing operations as of December 31, 2021. Amortization expense in discontinuing operations for these intangible assets aggregated $713 thousand for the year ended December 31, 2021. As a described in Note 3, the Company changed the classification of the vivoPharm business to ten years.

a held for sale asset in the fourth quarter of 2021 and, therefore, these assets are no longer amortized.

Research and development: Research and development costs associated with service and product development include direct costs of payroll, employee benefits, stock-based compensation and supplies and an allocation of indirect costs including rent, utilities, depreciation and repairs and maintenance. All research and development costs are expensed as they are incurred.

Stock-based compensation: Stock-based compensation is accounted for in accordance with the provisions Research and development costs primarily consist of ASC 718, Compensation-Stock Compensation, which requires the measurementpersonnel costs, including salaries and recognitionbenefits, lab materials and supplies, and overhead allocation consisting of compensation expense for all stock-based awards made to employeesvarious support and directors based on estimated fair values on the grant date. We estimate the fair value of stock-based awards on the date of grant using the Black-Scholes option pricing model. The value of the portion of the award that is ultimately expected to vest is recognized as expense over the requisite service periods using the straight-line method. See additional information in Note 13.
All issuances of stock options or other issuances of equity instruments to employees as the consideration for services received by us are accounted for based on the fair value of the equity instrument issued.
We account for stock-based compensation awards to non-employees in accordance with ASC 505-50, Equity Based Payments to Non-Employees. Under ASC 505-50, we determine the fair value of the warrants or stock-based compensation awards granted as either the fair value of the consideration received or the fair value of the equity instruments issued, whichever is more reliably measurable. Stock-based compensation awards issued to non-employees are recorded in expensefacility related costs. Research and additional paid-in capital in stockholders’ equity over the applicable service periods based on the fair value of the awards or consideration received at the vesting date.
Fair value of financial instruments: The carrying amount of cashdevelopment costs were $4.3 million and cash equivalents, restricted cash, accounts receivable, accounts payable and accrued expenses, approximate their estimated fair values due to the short term maturities of those financial instruments. The fair value of warrants recorded as derivative liabilities, the note payable to VenturEast and other derivatives are described in Notes 15 and 16.
Joint venture accounted for under the equity method: The Company records its joint venture investment following the equity method of accounting, reflecting its initial investment in the joint venture and its share of the joint venture’s net earnings or losses and distributions. The Company’s share of the joint venture’s net loss was approximately $154,000 and $22,000$3.2 million for the years ended December 31, 20182021 and 2017, respectively,2020, respectively.

Advertising costs: Advertising costs are expensed as incurred. Advertising costs were $34 thousand and $52thousand for the years ended December 31, 2021 and 2020, respectively. 

Stock-based compensation: The Company recognizes all employee stock-based compensation as a cost in the consolidated financial statements. Equity-classified awards are measured at the grant date fair value of the award. The Company estimates grant date fair value using the Black-Scholes-Merton option-pricing model and accounts for forfeitures as they occur. Excess tax benefits of awards related to stock option exercises are recognized as an income tax benefit in the consolidated statements of operations and reflected in operating activities in the consolidated statements of cash flows.

Commitments and contingencies: Liabilities for loss contingencies arising from claims, assessments, litigation, fines, and penalties and other sources are recorded when it is includedprobable that a liability has been incurred and the amount can be reasonably estimated. Legal costs incurred in researchconnection with loss contingencies are expensed as incurred.

Fair value measurements: The Company uses valuation approaches that maximize the use of observable inputs and development expenseminimize the use of unobservable inputs to the extent possible. The Company determines fair value based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels:

Level 1 inputs: Unadjusted quoted prices in active markets for identical assets or liabilities accessible to the reporting entity at the measurement date.
Level 2 inputs: Other than quoted prices included in Level 1 inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability.
Level 3 inputs: Unobservable inputs for the asset or liability used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at measurement date.

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The fair value hierarchy also requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. Assets and liabilities measured at fair value are classified in their entirety based on the Consolidated Statementslowest level of Operations and Other Comprehensive Loss.input that is significant to the fair value measurement.

Valuation of business combination: The Company hasallocates the consideration of a business acquisition to the assets acquired and liabilities assumed based on their fair values at the date of acquisition, including identifiable intangible assets which either arise from a contractual or legal right or are separable from Goodwill. The Company bases the fair value of identifiable intangible assets acquired in a business combination on detailed valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. The Company allocates to Goodwill any excess purchase price over the fair value of the net receivable due from the joint venture of approximately $10,000 at both December 31, 2018tangible and 2017, which is included in otheridentifiable intangible assets in the Consolidated Balance Sheets. See additional information in Note 19.

acquired. Transaction costs associated with a business combination are expensed as incurred and recorded as merger related costs.

Subsequent events: We haveThe Company has evaluated potential subsequent events through the date the financial statements were issued.


Recent Accounting Pronouncements: In February 2016, the FASB issued Accounting Standards Update (“ASU”) 2016-02, “Leases (Topic 842),”within our Annual Report on Form 10-K. See Note 17 to increase transparency and comparability among organizations by requiring recognition of right-of-use assets and lease liabilities on the balance sheet and disclosure of key information about leasing arrangements (with the exception of short-term leases). The standard will become effective for interim periods beginning after December 15, 2018, with early adoption permitted. In July 2018, the FASB issued ASU 2018-11, “Leases (Topic 842): Targeted Improvements” that allows entities to recognize a cumulative-effect adjustment to the opening balance of accumulated deficit in the period of adoption. We plan to adopt this guidance on January 1, 2019 using this new transition guidance. We currently expect to use the package of practical expedients which allows us to not (1) reassess whether any expired or existing contracts are considered a lease; (2) reassess the lease classification for any expired or existing leases; and (3) reassess the initial direct costs for any existing leases. We also expect to elect not to apply the recognition requirements for short-term leases and to include both the lease and non-lease components as a single component for all classes of assets. We are substantially complete with our implementation assessment and estimate the adoption will result in the addition of approximately $2,900,000 of assets and liabilities to ourthese Consolidated Balance Sheet, with no significant changes to our Consolidated Statements of Operations and Other Comprehensive Loss or Cash Flows.

In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other (Topic 350): “Simplifying the Accounting for Goodwill Impairment,” which removes the requirement to perform a hypothetical purchase price allocation to measure goodwill impairment. A goodwill impairment will now be the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. ASU 2017-04 is effective for annual periods beginning after December

15, 2019, and interim periods within those annual periods. Early adoption is permitted and applied prospectively. We do not expect ASU 2017-04 to have a material impact on our consolidated financial statements.

In July 2017, the FASB issued ASU 2017-11, Earnings Per Share (Topic 260); Distinguishing Liabilities from Equity (Topic 480); Derivatives and Hedging (Topic 815): “(Part 1) Accounting for Certain Financial Instruments with Down Round Features (Part 2) Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Noncontrolling Interests with a Scope Exception.” This guidance changes the methodology for determining the liability or equity classification of certain financial instruments with a down round feature and clarifies existing disclosure requirements for equity-classified instruments, among other things. The revised guidance is effective for annual reporting periods beginning after December 15, 2018. Early adoption is permitted and applied retrospectively. We plan to adopt the guidance on its effective date and do not expect it to have a material impact on our consolidated financial statements.

In June 2018, the FASB issued ASU 2018-07, Compensation - Stock Compensation (Topic 718): “Improvements to Nonemployee Share-Based Payment Accounting,” which simplifies the accounting for nonemployee share-based payment transactions. Under the new guidance, equity-classified share-based payment awards issued to nonemployees will now be measured on the grant date, instead of the previous requirement to remeasure the awards through the performance completion date. Awards that include performance conditions will recognize compensation cost when the achievement of the performance condition is probable, rather than upon achievement of the performance condition. Finally, the current requirement to reassess the classification (equity or liability) for nonemployee awards will be eliminated, except for awards in the form of convertible instruments. The ASU is effective for annual periods beginning after December 15, 2018, but no earlier than the adoption of ASC 606. We plan to adopt the guidance on January 1, 2019. The adoption of ASU 2018-07 is not expected to have a material impact on our consolidated financial statements.

In August 2018, the FASB issued ASU 2018-15, Intangibles - Goodwill and Other-Internal-Use Software (Subtopic 350-40): “Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement that is a Service Contract,” which clarifies the accounting for implementation costs in cloud computing arrangements. The update will become effective for interim and annual periods beginning after December 15, 2019 and may be adopted either retrospectively or prospectively. Early adoption is permitted. We plan to adopt the guidance on the effective date and are currently evaluating the impacts of the adoption of this ASU on our consolidated financial statements.
Earnings (loss)Statements.

Net loss per share: Basic earnings (loss)loss per share is computed by dividing net income (loss)loss available to common stockholdersshareholders by the weighted averageweighted-average number of shares of common shares assumed to bestock outstanding during the period of computation.period. Diluted earningsloss per share is computed similarby dividing loss available to basic earnings per share except thatcommon shareholders by the numerator is adjusted forweighted-average number of shares of common shares outstanding during the change in fair value of the warrant liability (only if dilutive) and the denominator isperiod increased to include the number of dilutive potentialadditional common shares that would have been outstanding duringif the periodpotentially dilutive securities had been issued, using the treasury stocktreasury-stock method.

Basic net loss and As the Company incurred losses for all periods presented, potentially dilutive securities have been excluded from fully diluted net loss per share data were computed as follows (in thousands, excepttheir impact is anti-dilutive and would reduce the loss per share amounts)share.

Recent accounting pronouncements:

  2018 2017
Numerator:    
Net (loss) for basic and dilutive earnings per share $(20,373) $(20,880)
Denominator:    
Weighted-average basic and dilutive common shares outstanding 27,291
 20,663
Basic and dilutive net loss per share $(0.75) $(1.01)
The following table summarizes potentially dilutive adjustments In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes, which eliminates certain exceptions related to the weighted average numberapproach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period, and the recognition of common sharesdeferred tax liabilities for outside basis differences. The amended guidance also clarifies and simplifies other aspects of the accounting for income taxes under ASC Topic 740, Income Taxes. The Company adopted this guidance effective January 1, 2021, prospectively, and the adoption of this standard did not have a material impact to the consolidated financial statements and related disclosures.

In January 2020, the FASB issued ASU No. 2020-01, Investments - Equity Securities (Topic 321), Investments - Equity Method and Joint Ventures (Topic 323), and Derivatives and Hedging (Topic 815), which were excludedclarified that before applying or upon discontinuing the equity method of accounting for an investment in equity securities, an entity should consider observable transactions that require it to apply or discontinue the equity method of accounting for the purposes of applying the fair value measurement alternative. The amended guidance will become effective for the Company on January 1, 2022. Early adoption is permitted. The Company does not expect this standard will have a material impact on its financial statements.

In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides temporary optional guidance to ease the potential burden of accounting for reference rate reform due to the cessation of the London Interbank Offered Rate, commonly referred to as “LIBOR.” The temporary guidance provides optional expedients and exceptions for applying U.S. GAAP to contracts, relationships, and transactions affected by reference rate reform if certain criteria are met. The provisions of the temporary optional guidance are only available until December 31, 2022, when the reference rate reform activity is expected to be substantially complete. When adopted, entities may apply the provisions as of the beginning of the reporting period when the election is made. The Company does not believe this standard will have a material impact on its financial statements and has yet to elect an adoption date. 

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Note 5. Inventory

The Company’s inventory consists of the following:

Schedule of Inventory

       
  

December 31,

2021

  

December 31,

2020

 
Finished goods $23  $40 
Work in process  138   121 
Raw materials  314   254 
Total inventory $475  $415 

Note 6. Fixed Assets

Presented in the table below are the major classes of fixed assets by category:

Schedule of Fixed Assets

  December 31, 2021  December 31, 2020 
Equipment $2,733  $2,212 
Furniture and fixtures  6   - 
Leasehold improvements  251   240 
Fixed assets, gross  2,990   2,452 
Less accumulated depreciation  (1,970)  (1,421)
Fixed assets, net $1,020  $1,031 

Depreciation expense from the calculation (in thousands):


  2018 2017
Common stock purchase warrants 10,055
 10,055
Stock options 3,004
 2,844
Restricted shares of common stock 29
 705
Convertible note 3,077
 
Advance from NovellusDx, Ltd. 2,562
 
  18,727
 13,604

Note 4. Revenue and Accounts Receivable

Revenue by service typecontinuing operations for each of the years ended December 31, is comprised of2021 and 2020 was $550 thousand and $572 thousand, respectively.

Note 7. Leases

The Company was obligated under finance leases related to certain equipment that were paid in full in 2020. During October 2021, the following (in thousands):

  2018 2017
Biopharma Services $14,828
 $14,629
Clinical Services 7,429
 10,774
Discovery Services 5,213
 3,718
  $27,470
 $29,121
Company entered into a new $491 thousand equipment financing lease. The table above includes approximately $4,932,000 and $2,717,000 of Discovery Services revenue from our acquisition of vivoPharm for the year ended December 31, 2018 and 2017, respectively.
Accounts receivable by service type at December 31, 2018 and 2017 consists of the following (in thousands):
  2018 2017
Biopharma Services $3,692
 $3,746
Clinical Services 6,031
 12,205
Discovery Services 777
 1,546
Allowance for doubtful accounts (3,462) (6,539)
  $7,038
 $10,958

Revenue for Biopharma Services are customized solutions for patient stratification and treatment selection through an extensive suite of DNA-based testing services. Biopharma Services are billed to pharmaceutical and biotechnology companies. Clinical Services are tests performed to provide information on diagnosis, prognosis and theranosis of cancers to guide patient management. Clinical Services tests can be billed to Medicare, another third party insurer or the referring community hospital or other healthcare facility. Discovery Services are services that provide the tools and testing methods for companies and researchers seeking to identify new DNA-based biomarkers for disease. The breakdown of our Clinical Services revenue (as a percent of total revenue) is as follows:

  2018 2017
Medicare 8% 12%
Other third party payors 19% 25%
Total Clinical Services 27% 37%
We have historically derived a significant portion of our revenue from a limited number of test ordering sites. Test ordering sites account for all of our Clinical Services revenue. Our test ordering sites are largely hospitals, cancer centers, reference laboratories, physician offices and biopharmaceutical companies. Oncologists and pathologists at these sites order the tests on behalf of the needs of their oncology patients or as part of a clinical trial sponsored by a biopharmaceutical company in which the patient is being enrolled. We generally do not have formal, long-term written agreements with such test ordering sites, and, as a result, we may lose a significant test ordering site at any time.
During the year ended December 31, 2018, no Biopharma clients accounted for more than 10% of our revenue. During the year ended December 31, 2017, one Biopharma client accounted for approximately 11% of our revenue.

Note 5. Other Current Assets

At December 31, 2018 and 2017, other current assets consisted of the following (in thousands):
  2018 2017
Inventory $144
 $144
Lab supplies 1,294
 1,690
Prepaid expenses 710
 873
  $2,148
 $2,707

Note 6. Lease Commitments

We lease ourCompany leases its laboratory, research facility and administrative office spacespaces under various operating leases. AtAs of December 31, 2018, we have approximately 17,900 square feet2020, the Company leased facilities in Maple Grove, Minnesota and in La Jolla, California under arrangements which expire(d) in July 2027 and February 2022, respectively. In 2020, the Company signed a five-year extension of officeits Maple Grove, Minnesota facility lease.The amendment reduces the Company’s rent to $10 thousand per month plus operating costs and laboratory spaceextends the lease to July 31, 2027. The monthly rentals are subject to a 2% annual rate increase. The Company recorded an increase to the ROU asset of $373 thousand in Rutherford, New Jersey, 24,900 square feet in Morrisville, North Carolina, 5,800 square feet in Hershey, Pennsylvania, and 1,959 square feet in Bundoora, Australia. During 2018, we had a2020 related to this lease agreement for approximately 19,100 square feet of laboratory space in Los Angeles, California which expired on December 31, 2018. At December 31, 2018, we owed the California landlord approximately $164,000. For a portion of 2018, we also had 10,000 square feet in Hyderabad, India, which was vacated in April 2018. We have escalating lease agreements for our New Jersey, North Carolina, Pennsylvania and Australia spaces, which expire February 2023, May 2020, November 2020 and June 2021, respectively.amendment. These leases require monthly rent with periodic rent increases that vary from $0.32increases. Under the agreements, the Company is also liable for certain insurance, property tax and common area maintenance costs. As of April 1, 2021 the Company commenced a new lease for its corporate headquarters. The Company recorded a ROU asset and operating lease obligation of $83 thousand related to $0.85 per square footthis lease.

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The components of the rented premises per year. The difference between minimum rentoperating and straight-line rent is recorded as deferred rent payable. The terms of our New Jerseyfinance lease require that a $350,000 security depositexpense in continuing operations for the facility be heldyear ended December 31, are as follows:

Components of Lease Expense and Supplemental Information

  2021  2020 
Operating lease cost $504  $466 
Finance lease cost:        
Depreciation of ROU assets $35  $72 
Interest on lease liabilities  8   4 
Total finance lease cost: $43  $76 
Variable lease costs $-  $- 
Short-term lease costs  -   - 
Total lease continuing operations expense $547  $542 

Amounts reported in a stand by letter of credit in favor of the landlord (see Note 8).


We acquired office and scientific equipment under long term leases which have been capitalized at the present value of the minimum lease payments. The equipment under these capital leases had a cost of $1,493,579 and accumulated depreciation of $623,867,consolidated balance sheet from continuing operations as of December 31, 2018.

Minimum future lease payments under all capital2021 and operating leases as of December 31, 20182020 are as follows:

Schedule of Amounts Reported in the Consolidated Balance Sheet

  2021  2020 
Operating leases:        
Operating lease ROU assets, net $673  $1,095 
Operating lease current liabilities $174  $486 
Operating lease long-term liabilities  516   627 
Total operating lease liabilities $690  $1,113 
Finance leases:        
Equipment $477  $289 
Accumulated depreciation  (63)  (289)
Finance leases, net $414  $- 
Current installment obligations under finance leases $157  $- 
Long-term portion of obligations under finance leases  293   - 
Total finance lease liabilities $450  $- 

Equipment subject to finance leases are classified within fixed assets, net, on the accompanying consolidated balance sheets.

Supplemental cash flow related to operating and finance leases of the Company’s continuing operations is as follows (in thousands):

  
Capital
Leases
 
Operating
Leases
 Total
December 31,      
2019 $394
 $1,388
 $1,782
2020 249
 969
 1,218
2021 121
 598
 719
2022 13
 563
 576
2023 
 94
 94
Total minimum lease payments $777
 $3,612
 $4,389
Less amount representing interest 68
    
Present value of net minimum obligations 709
    
Less current obligation under capital lease 330
    
Long-term obligation under capital lease $379
    

Rent expense for the years ended December 31, 20182021 and 2017 was approximately $1.76 million2020 (in thousands):

  2021  2020 
       
Cash paid amounts included in the measurement of lease liabilities from continuing operations:        
Operating cash flows used for operating leases $509  $594 
Financing cash flows used for finance leases $(37) $(80)
Financing cash flows provided by finance leases $492  $- 

Other supplemental information related to operating and $1.79 million, respectively.


Note 7. Financing

Line of Credit and Term Note

On March 22, 2017, we entered into a new two year asset-based revolving line of credit agreement with Silicon Valley Bank (“SVB”). The SVB credit facility provided for an asset-based line of credit (“ABL”) for an amount not to exceed the lesser of

(a) $6.0 million or (b) an amount equal to 80% of eligible accounts receivable plus the lesser of 50% of the net collectible value of third party accounts receivable or three times the average monthly collection amount of third party accounts receivable over the previous quarter. The ABL required monthly interest payments at the Wall Street Journal prime rate plus 1.5% (7.0% at December 31, 2018) and was scheduled to mature on March 22, 2019. We paid to SVB a $30,000 commitment fee at closing and pay a fee of 0.25% per year on the average unused portion of the ABL. In August 2018, the maximum borrowings were reduced from $6.0 million to $3.0 million. At December 31, 2018 and 2017, the ABL had a principal balance of $2,620,984 and $4,136,907, respectively, which is the maximum amount allowed based on eligible accounts receivable at the time and the timing of cash collections from accounts receivable. Subsequent to year-end, the interest rate was adjusted to the Wall Street Journal prime rate plus 2.25% and the maturity date was extended through April 15, 2019, subject to the Company satisfying certain milestones of the forbearance agreement discussed in Note 21.

On March 22, 2017, we concurrently entered into a three year $6.0 million term loan agreement (“PFG Term Note”) with Partners for Growth IV, L.P. (“PFG”). The PFG Term Note is an interest only loan with the full principal and any outstanding interest due at maturity on March 22, 2020. Interest is payable monthly at a rate of 11.5% per annum. We may prepay the PFG Term Note in whole or part at any time without penalty. We paid PFG a commitment fee of $120,000 at closing. At December 31, 2018 and 2017, the PFG Term Note had a principal balance of $6,000,000.

Both loan agreements require us to comply with certain financial covenants, including minimum adjusted EBITDA, revenue and liquidity covenants, and restrict us from, among other things, paying cash dividends, incurring debt and entering into certain transactions without the prior consent of the lenders. Repayment of amounts borrowed under the loan agreements may be accelerated if an event of default occurs, which includes, among other things, a violation of such financial covenants and negative covenants. As of December 31, 2018, January 31, 2019, February 28, 2019 and March 31, 2019, we were in violation of certain financial covenants. In January 2019, we entered into forbearance agreements with both lenders, as discussed in Note 21. However, we will not be able to close on a strategic transaction on or before April 15, 2019, and no assurance can be given that we will be able to extend the maturity of the ABL beyond April 15, 2019 or extend the forbearances beyond April 15, 2019, their current expiration date. We are in discussions with SVB and PFG about possible extensions of the forbearance agreements.

Our obligations to SVB under the ABL facility are secured by a first priority security interest on substantially all of our assets, and our obligations under the PFG Term Note are secured by a second priority security interest subordinated to the SVB lien.
In connection with the PFG Term Note, we issued seven year warrants to the lenders to purchase an aggregate of 443,262 shares of our common stock at an exercise price of $2.82 per share, initially valued at $1,004,000. These warrants were subject to a 20% reduction if we achieved certain financial milestones. These warrants were initially recorded as a warrant liability, and all subsequent changes in their fair value were recognized in earnings until April 2, 2018, when the number of shares of common stock issuable upon exercise of the warrants became fixed. See Notes 14 and 15. On June 30, 2018, the warrants were modified to adjust the exercise price from $2.82 per share to $0.92 per share.

At December 31, 2018, the principal amount of the PFG Term Note of $6,000,000 was due in 2020; however, due to the forbearance agreement, the debt is now considered due on demand and is presented as a current liability. As a result of financial covenant violations at December 31, 2017, we fully amortized debt issuance costs on the PFG Term Note and the ABL, resulting in additional interest expense of approximately $220,000, as well as approximately $796,000 of interest expense to accrete the remaining discount on debt on the PFG Term Note.

Convertible Note

On July 17, 2018, the Company entered into the Convertible Note with Iliad Research and Trading, L.P. (“Iliad”), with an initial principal amount of $2,625,000. The Company received consideration of $2,500,000, reflecting an original issue discount of $100,000 and expenses payable by the Company of $25,000. The Convertible Note has an 18 month term and carries interest at 10% per annum. The note is convertible into sharesfinance leases of the Company’s common stock at a conversion price of $0.80 per share upon 5 trading days’ notice, subject to certain adjustments (standard dilution) and ownership limitations specified in the Convertible Note and resulted in a beneficial conversion feature discount of approximately $328,000. At December 31, 2018, the principal amount of the Convertible Note was $2,625,000.

Iliad may redeem any portion of the Convertible Note, at any time after six months from the issue date upon 5 trading days’ notice, subject to a maximum monthly redemption amount of $650,000, with the Company having the option to pay such redemptions in cash, the Company’s common stock at the Conversion Price, or by a combination thereof, subject to certain conditions, including that the stock pricecontinuing operations is $1.00 per share or higher. Subsequent to year-end, the Company entered into a standstill agreement with Iliad to delay Iliad’s right to request monthly redemptions for an additional three months, as described in Note 21. The Company may prepay the outstanding balance of the Convertible Note, in part or in full, at a 10% premium to

par value if prior to the one year anniversary of the date of issuance and at par if prepaid thereafter. At maturity, the Company may pay the outstanding balance in cash, the Company’s common stock at the Conversion Price, or by a combination thereof, subject to certain conditions. The note provides that in the event of default, the lender may, at its option, elect to increase the outstanding balance applying the default effect (defined as outstanding balance at date of default multiplied by 15% plus outstanding amount) by providing written notice to the Company. In addition, the interest rate increases to 22% upon default. The default effect and default interest rate provisions qualify as embedded derivatives with an estimated fair value of $55,000 at December 31, 2018.

The Convertible Note is the general unsecured obligation of the Company and is subordinated in right of payment to the ABL and PFG Term Note. The following is a summary of the Convertible Note balance at December 31, 2018 (in thousands):

Convertible Note, net of discounts of $136$2,489
Less unamortized debt issuance costs8
Convertible Note, net$2,481

Advance from NDX

In connection with signing the Merger Agreement described in Note 1, NDX agreed to loan us $1,500,000. Interest originally accrued on the outstanding balance at 10.75% per annum, and the advance was to mature upon the earlier of March 31, 2019 or the date on which the Merger Agreement was terminated in accordance with its terms (or ninety days thereafter in the case of certain causes for termination). Upon certain events of default, NDX would be able to convert all, but not less than all, of the outstanding balance into shares of the Company’s common stock at a conversion price of $0.606 per share, which qualified as a contingent beneficial conversion feature that would only be recognized if a default occurs.

On December 15, 2018, we terminated the Merger Agreement. As a result, the Advance from NDX, plus interest thereon, became due and payable on March 15, 2019, and the interest rate was increased on December 15, 2018 to 21% due to an event of default. As a result of the default, the Company recognized the beneficial conversion feature discount of approximately $1,173,000. The default interest rate provision qualifies as an embedded derivative with an estimated fair value of $31,000 at December 31, 2018. At December 31, 2018, the principal balance of the Credit Agreement was $1,500,000, which is presented net of the unamortized beneficial conversion feature of approximately $965,000 in the Consolidated Balance Sheet.

The Advance from NDX is the general unsecured obligation of the Company and is subordinated in right of payment to the ABL and PFG Term Note, provided that NDX has asserted that its obligation to standstill under its subordination agreements will not be applicable at a time when the Company attains certain levels of unrestricted cash, as a result of the Company having improperly terminated the Merger Agreement. The Company does not believe it improperly terminated the Merger Agreement.

Note 8. Letter of Credit

We maintain a $350,000 letter of credit in favor of our landlord pursuant to the terms of the lease for our Rutherford facility. At December 31, 2018 and 2017, the letter of credit was fully secured by the restricted cash disclosed on our Consolidated Balance Sheets.

Note 9. Fixed Assets

Fixed assets are summarized by major classifications as follows (in thousands):
  2018 2017
Equipment $9,858
 $11,030
Furniture and fixtures 1,130
 1,076
Leasehold improvements 1,077
 924
Internal use software 1,172
 675
  13,237
 13,705
Less accumulated depreciation (9,181) (8,155)
Net fixed assets $4,056
 $5,550


Note 10. Patents and Other Intangible Assets

Patents and other intangible assets consist of the following at December 31, 2018 and 2017:
      Weighted-Average
      Remaining
  (in thousands) (in thousands) Amortization
  2018 2017 Period
Patents $1,800
 $1,769
 4 years
Software 446
 446
 0 years
Customer list - vivoPharm acquisition 2,738
 2,738
 9 years
Trade name - vivoPharm acquisition 477
 477
 9 years
  5,461
 5,430
  
Less accumulated amortization (1,457) (952)  
Net patent and other intangible assets $4,004
 $4,478
  
The customer list and trade name in the table above include foreign currency translation gains of approximately $38,000 and $17,000, respectively, at December 31, 2017. Foreign currency translation adjustments were de minimus during the year ended December 31, 2018.
Future amortization expense for legally approved patents (excluding patent applications in progress of approximately $601,000 as of December 31, 2018)2021 and other intangible assets, is estimated as follows (in thousands):2020:

  2021  2020 
Weighted average remaining lease term (in years):        
Operating leases  5.42   5.91 
Finance leases  2.75   - 
         
Weighted average discount rate:        
Operating leases  9.88%  10.0%
Finance leases ��6.54%  -

79

2019$488
2020482
2021479
2022411
2023347
Thereafter1,196
Total$3,403

Note 11. Income Taxes

On December 22, 2017, the U.S. federal government enacted legislation commonly referred to as the “Tax Cuts and Jobs Act” (the “TCJA”). The TCJA makes widespread changes to the Internal Revenue Code, including, among other things, a reduction in the federal corporate tax rate from 35% to 21%, effective January 1, 2018. The carrying value

Annual payments of deferred tax assets andlease liabilities is also determined by the enacted U.S. corporate income tax rate. Consequently, the U.S. corporate tax rate impacted the carrying value of our deferred tax assets and liabilities. Under the new corporate tax rate of 21%, deferred income tax assets, net of deferred tax liabilities have decreased by $15.2 millionunder noncancelable leases as of December 31, 2017. There was no net effect2021 are as follows:

Schedule of Annual Payments of Lease Liabilities Under Noncancelable Leases

  Operating leases  Finance leases 
2022 $228  $181 
2023  157   181 
2024  136   136 
2025  131   

-

 
2026  134   - 
Thereafter  84   

-

 
Total undiscounted lease payments  870   498 
Less: imputed interest  (180)  48 
Total lease liabilities $690  $450 

Note 8. Income Taxes

The components of loss before income taxes from continuing operations consist of the following.

Schedule Components of Loss Before Income Tax From Continuing Operations

  2021  2020 
       
United States $(18,575) $(8,650)
Foreign  -   - 
Total loss before income taxes  (18,575)  (8,650)

The Company did not record any current, deferred, or net income tax reform enactment on the consolidated financial statements as of December 31, 2017 due to full valuation allowance on the net deferredexpense (benefit) in 2021 or 2020. Total income tax assets.


The adoption of ASC 606 primarily resulted in a deceleration of revenue as of December 31, 2017, which in turn increased our existing deferred tax asset for amounts that had previously been included in revenue. As we have provided a full valuation allowance against our net deferred tax assets, the aggregate impact of adopting ASC 606 was offset by a corresponding increase to the valuation allowance.

The provisionexpense (benefit) for income taxes for the years ended December 31, 2018 and 2017 differsfrom continuing operations differed from the approximate amount of income tax benefit determinedamounts computed by applying the U.S. federal income tax rate of 21%to pre-tax loss, due to the following:

  For the Year Ended December 31, 2018 For the Year Ended December 31, 2017
  Amount
(in thousands)
 % of
Pretax
Loss
 Amount
(in thousands)
 % of
Pretax
Loss
Income tax benefit at federal statutory rate $(4,278) 21.0 % $(8,036) 35.0 %
State tax provision, net of federal tax benefit 226
 (1.1)% (707) 3.1 %
Tax credits (60) 0.3 % (545) 2.4 %
Stock based compensation 211
 (1.0)% 2,333
 (10.2)%
Derivative warrants (766) 3.7 % 687
 (3.0)%
Change in valuation allowance 4,048
 (19.9)% (11,551) 50.3 %
Foreign operations 508
 (2.5)% 15
 (0.1)%
Remeasurement of deferred taxes under TCJA 
  % 15,205
 (66.2)%
Other 111
 (0.5)% 520
 (2.3)%
Income tax (benefit) provision $
  % $(2,079) 9.0 %
In February 2017, we sold $18,177,059 of gross State of New Jersey NOL’s relating to the 2014 and 2015 tax yearspretax income as well as $167,572 of state research and development tax credits, resulting in the receipt of approximately $970,000, net of expenses. In December 2017, we sold $15,876,736 of gross State of New Jersey NOL’s relating to the 2011 and 2016 tax years as well as $523,385 of state research and development tax credits, resulting in the receipt of approximately $1,109,000, net of expenses. We transferred the NOL carryforwards through the Technology Business Tax Certificate Transfer Program sponsored by the New Jersey Economic Development Authority.

Approximate deferred taxes consista result of the following components asfor the years ended December 31:

Schedule of December 31, 2018 and 2017 (in thousands):

  2018 2017
Deferred tax assets:    
Net operating loss carryforwards $25,999
 $23,135
Accruals and reserves 4,328
 2,656
Stock based compensation 1,020
 1,052
Research and development tax credits 1,936
 1,876
Derivative warrant liability 17
 17
Investment in joint venture 162
 161
Other 6
 5
Total deferred tax assets 33,468
 28,902
Less valuation allowance (31,783) (27,083)
Net deferred tax assets 1,685
 1,819
Deferred tax liabilities    
Fixed assets (352) (379)
Goodwill and intangible assets (1,333) (1,440)
Net deferred taxes $
 $

DueComponents of Income Tax Expense Benefit

  2021  2020 
Computed “expected” tax expense $(3,901) $(1,816)
Deferred rate change  84   76 
State taxes, net of federal tax effect  (752)  (419)
Non-deductible transaction costs  222   290 
Non-deductible interest  664   218 
CARES Act PPP loan  0   (153)
R&D tax credit  (238)  - 
Other, net  (51)  78 
Change in valuation allowance  3,972   1,726 
Income tax expense (benefit) $-  $- 

The tax effects of temporary differences from continuing operations that give rise to a history of losses we have generated since inception, we believe it is more-likely-than-not that allsignificant portions of the deferred tax assets will not be realizedand deferred tax liabilities are presented below as of December 31:

Components of Approximate Deferred Tax

  2021  2020 
Deferred tax assets        
Accrued liabilities $47  $- 
Capitalized R&D costs 1,931  1,367 
Intangibles  

127

   - 
Stock compensation  160   82 
Lease liability  170   291 
Loss carryforward  18,144   7,672 
Tax credit carryforward  1,406   882 
Other temporary differences  4   - 
Total gross deferred tax assets  21,989   10,294 
Valuation allowance  (21,807)  (9,955)
Total deferred tax assets $182  $339 
         
Deferred tax liabilities        
Fixed assets $(17) $(53)
Lease assets  (165)  (286)
Total gross deferred tax liabilities $(182) $(339)
Net deferred tax asset $-  $- 

80

The Company assessed that the valuation allowance against its deferred tax assets is still appropriate as of December 31, 2021 and 2020, based on the consideration of all available positive and negative evidence using the “more likely than not” standard required when accounting for income taxes.

Under the Code, certain corporate stock transactions into which the Company has entered or may enter in the future could limit the amount of the net operating loss carryforwards that can be utilized in future periods. The Company has completed a review of historical stock transactions, as well as the current stock transactions completed in conjunction with the Merger and concluded our federal net operating loss and R&D credit carryforwards are subject to limitations under Section 382 and 383 of the Internal Revenue Code. As of December 31, 2021, the Company has federal net operating loss carryforwards of $68.8 million. Of this amount, $11.9 million relate to losses originating in tax years beginning prior to January 1, 2018 and 2017. Therefore, we have recorded a full valuation allowance on our deferred tax assets. As a result of the TCJA, theexpire between 2026 and 2037. The federal net operating losses incurredof $56.9 million generated in tax years beginning on or after 2017 will have an indefinite carryforward. At December 31, 2018, we have net operating loss carryforwards2017 do not expire.

The Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) was signed into law on March 27, 2020 and provides various tax relief measures to taxpayers impacted by the coronavirus. The Company has reflected the impact of the CARES Act within its financial statements for federalthe years ended December 31, 2021 and 2020, and such impact was not material to our consolidated financial statements.

As of December 31, 2021 and 2020, the Company had no liability for unrecognized tax benefits recorded in continued operations. The Company does not expect the liability for unrecognized tax benefits to change in the next twelve months.

The Company has elected to classify tax-related accrued interest and penalties as a component of income tax purposesexpense.

The Company files income tax returns in the U.S. federal jurisdiction and various state jurisdictions. As of December 31, 2021, the Company was no longer subject to income tax examinations for taxable years before 2018 in the case of U.S. federal taxing authorities, and taxable years generally before 2017 in the case of state and local taxing jurisdictions.

81

Note 9. Long-Term Debt

Long-term debt consists of the following:

Schedule of Long-term Debt

  December 31,
2021
  December 31,
2020
 
Department of Employment and Economic Development loan $-  $83 
Economic Injury Disaster Loan  57   57 
8% 2020 Convertible Notes, $7,651 face amount, due July 2022  -   7,651 
Total long-term debt before debt issuance costs and debt discount  57   7,791 
Less: current portion of long-term debt  -   - 
Less: debt discount (net of accretion of $0 and $235, respectively)  -   (952)
Total long-term debt $57  $6,839 

Future annual principal repayments due on the long-term debt as of December 31, 2021 are as follows:

Schedule of Future Annual Principal Repayments Due on Long-term Debt

  Amount 
2022 $- 
2023  1 
2024  1 
2025  1 
2026  1 
Thereafter  53 
Total $57 

Department of Employment and Economic Development (“DEED”) loan

On March 10, 2015, the Company received an interest free loan with a loan maturity date of March 10, 2022 from the Minnesota DEED under the State Small Business Credit Initiative Act of 2010. The funds were received under the Angel Loan Fund Program which are provided to early-stage small businesses for financial support through direct loans.

As of December 31, 2021 and 2020, the outstanding balance on this loan was $0 and $83 thousand, respectively, recorded within long-term notes payable in the consolidated balance sheets. If a change in control of the Company’s common stock were to occur the earlier of one year from the loan’s prepayment or the end of the seven-year loan term, the Company would be required to repay the outstanding principal balance with a 30% premium. Upon consummation of the merger with CGI on March 30, 2021, the Company triggered the 30% repayment premium and this loan was repaid.

2020 Convertible Notes

Effective February 8, 2021, the Company’s shareholders and 2020 Convertible Note holders approved amendments to the 2020 Convertible Notes to allow for the issuance of up to $10.0 million in 2020 Convertible Notes for cash (plus up to approximately $118 $3.9 million of which2020 Convertible Notes in exchange for the cancellation of Series B Preferred stock) as well as modifications to the financing’s terms for any 2020 Convertible Noteholder that invested at least $3.0 million of cash since May 4, 2020 in the offering (a “Major Investor”). As of March 12, 2021, the Company completed the $10.0 million 2020 Convertible Note offering. The Company raised approximately $99 $5.0 million could expire over time, beginning in 2027, if not used. Utilizationfrom the sale of these carryforwards is subject2020 Convertible Notes from January 1, 2021 through March 12, 2021. For any Major Investor, the modified terms provide for a fixed conversion discount on the 2020 Convertible Notes of 20% and a common stock warrant equal to limitation due to ownership changes that may delay the utilization of a portion20% of the carryforwards.


amount invested in all 2020 Convertible Notes by such Major Investor divided by the weighted average share price of the Common Stock over the five trading days prior to the closing of the Merger.One 2020 Convertible Note 12. Capital Stock

2017 Offering

On December 8, 2017, we sold 3,500,000 holder that had previously invested $1.25 million in the offering invested an additional $3.0 million on February 23, 2021 and upon the Merger received a warrant to purchase 143,890 shares of ourthe Company’s common stock and warrants to purchase 3,500,000 shares of common stock in a public offering (“2017 Offering”). The offering resulted in gross proceeds of $7.0 million. The 2017 Offering warrants haveat an exercise price of $2.35 $5.9059 per share (the “Major Investor Warrant”). At the time of the Merger, the outstanding principal of the 2020 Convertible Notes of approximately $12.7 million plus accrued interest of $468 thousand were exchanged for 3,338,944 shares of the Company’s common stock. In addition, we issued warrantsconnection with this exchange, the Company recorded a debt extinguishment loss of $2.5 million in the first quarter of 2021. The weighted average interest rate on the 2020 notes during the year-ended December 31, 2021 was 18.22%.

82

Paycheck Protection Program Loan

In April 2020, the Company applied for and received a $730 thousand loan under the Paycheck Protection Program (“PPP”) as part of the Coronavirus Aid, Relief, and Economic Security Act’s (“CARES Act”). Under the PPP, the Company was able to purchase an aggregatereceive funds for two and a half months of 175,000 sharespayroll, rent, utilities, and interest cost. The Company determined that the entire PPP loan would be forgiven resulting in no repayment, including the $10 thousand EIDL grant. The $730 thousand of PPP loan forgiveness was recorded as a reduction of operating costs during the second and fourth quarters of 2020. Therefore, the PPP loan is not reflected as a liability as of December 31, 2020. In April 2021, the SBA fully forgave the Company’s PPP loan.

Economic Injury Disaster Loan

In 2020 the Company received a $57 thousand Economic Injury Disaster Loan (“EIDL”) loan and a $10 thousand grant from the Small Business Administration in connection with the COVID-19 impact on the Company’s business. This loan bears interest at 3.75% and is repayable in monthly installments starting in June 2022 with a final balance due on June 21, 2050.As noted above, the grant was forgiven as has been recorded as other income.

Note 10. Stockholders’ Equity

Common Stock

Holders of common stock at $2.50are entitled to one vote per share, to receive dividends if and when declared, and, upon liquidation or dissolution, are entitled to receive all assets available for distribution to stockholders. The holders have no preemptive or other subscription rights and there are no redemption or sinking fund provisions with respect to such shares. Common stock is subordinate to the placement agent (“Wainwright Warrants”). Subjectpreferred stock with respect to certain ownership limitations, these warrants were initially exercisable 6 months from the issuance datedividend rights and are exercisable for 12 months from the initial exercise date. These warrants include a contingent net cash settlement feature, as described further in Note 14.


2019 Offerings

In January 2019, we closed two public offerings rights upon liquidation, winding up and issued an aggregate of28,550,726 shares of common stock for approximately $5,412,000, net of expenses and discounts of $1,088,000. See Note 21 for additional information.

Common Stock Purchase Agreement with Aspire Capital

On August 14, 2017, we entered into a Common Stock Purchase Agreement (the “Purchase Agreement”) with Aspire Capital Fund, LLC, an Illinois limited liability company (“Aspire Capital”), which provides that Aspire Capital is committed to purchase up to an aggregate of $16 million of our common stock (the “Purchase Shares”) from time to time over the 24-month termdissolution of the Purchase Agreement. Aspire Capital made an initial purchase of 1,000,000 Purchase Shares (the “Initial Purchase”) at a purchase price of $3.00 per share on the commencement date of the agreement.

Company.

Preferred Stock

Series A and B Preferred Stock

As of December 31, 2017,2020, the Company hashad 4,611,587 shares of Series A Preferred Stock (the “Series A Preferred”) 3,489,470 shares of Series B Preferred Stock (the “Series B Preferred”) issued and outstanding (collectively, the “Preferred Stock”). The Company had classified the Preferred Stock as temporary equity in the consolidated balance sheets as the Preferred Shareholders controlled a Deemed Liquidation Event, as defined below, under the terms of the Series A and Series B Preferred Stock as described below. Effective with the Merger, all the Series A Preferred and the Series B Preferred shares were exchanged for 5,973,509 and 4,524,171 shares of Vyant Bio common stock, respectively, and the related carrying value was reclassified to common stock and additional paid-in capital.

During the first quarter of 2020, the Company sold 1,000,000 235,877 shares under this agreement at $3.00 per share, resulting inof Series B Preferred stock for net proceeds of approximately $2,965,000, net$1.25 million.

Series C Preferred Stock

Effective March 15, 2021, StemoniX shareholders approved the Merger with Cancer Genetics and the authorization of offering costs$2.0 million of approximately $35,000. The Company has also issued 320,000 shares as consideration for entering intoSeries C Preferred Stock (“Series C Preferred”). Effective with the Purchase Agreement. The Company has not deferred any offering costs associated with this agreement. NoMerger on March 30, 2021, the Series C Preferred shares were sold during 2018 under the Purchase Agreement. Due to the price of the Company’s stock being lower than the $3.00 per share, the Company does not expect to sell more shares under the Purchase Agreement in the foreseeable future.


Stock Issued to Consultant

On October 3, 2017, we issued 2,000 exchanged for 699,395 shares of Vyant Bio common stock and the related carrying value was reclassified to a consultant at a value of $2.65 per common share.

stock and additional paid-in capital.

Effective with the Merger, all Series A, B and C Preferred Stock


We are currently authorizedshares were converted to issue up to 9,764,000 shares of preferredStemoniX common stock which were exchanged for Vyant Bio common stock. As of December 31, 2018 and 2017, no2021, the Company is authorized to issue 9.8 million shares of preferredPreferred stock of which none were outstanding.

83

Warrants

Common Stock Warrant

The Company issued the Investor Warrant on February 23, 2021. Effective with the Merger, the Investor Warrant was exchanged for a warrant to purchase 143,890 shares of the Company’s common stock at an exercise price of $5.9059 per share. Prior to this exchange, the Investor Warrant was classified as a liability and the Company recognized a $214 thousand gain in the first quarter of 2021 related to fair value adjustments. The fair value of the Investor Warrant was $421 thousand at the time of the Merger and reclassified to additional paid in capital.

In connection with the Merger, the Company assumed 2,157,686 common stock warrants issued in prior financings. A summary of the outstanding common stock warrants as of December 31, 2021 is as follows:

Summary of Common Stock Warrants Outstanding

Issuance Related to: Exercise Price  Outstanding Warrants  Expiration
Dates
 
2020 Convertible Note $5.91   143,890   Feb 23, 2026 
2021 offerings $3.50   1,624,140   Feb 10, 2026 - Aug 3, 2026 
Advisory fees $2.42 - $7.59   492,894   Jan 9, 2024 - Oct 28, 2025 
Debt $27.60   14,775   Mar 22, 2024 
Offering $67.50   3,917   Mar 14, 2022 
Debt $450.00   9,185   Oct 17, 2022 - Dec 7, 2022 
Debt $300.00   8,112   Oct 17, 2022 
Total      2,296,913     

Preferred Stock Warrants

In connection with the issuance of the Series A Convertible Preferred and Series B Convertible Preferred, the Company issued warrants (the “Series A Warrants” and “Series B Warrants”, respectively, and collectively, the “Preferred Warrants”) as compensation to non-employee placement agents. The Series A Warrants and Series B Warrants were issued on April 28, 2017 and May 18, 2019, respectively. The Company determined the Preferred Warrants should be classified as equity as they were issued as vested share-based payment compensation to nonemployees. The Preferred Warrants were recorded in stockholders’ equity at fair value upon issuance with no subsequent remeasurement. In accordance with the Preferred Warrants’ terms, upon the consummation of the Merger, the Preferred Warrants were converted and settled for a total of 43,107 shares of the Company’s common stock.

Note 11. Fair Value Measurements

During the first quarter of 2021, the Company elected to account for the $3.0 million investment in the 2020 Convertible Notes issued to the Major Investor using the fair value method. Further, the Major Investor Warrant was deemed to be a liability classified instrument due its variable settlement features. Both instruments were classified as Level 3 measurements within the fair value hierarchy.

The fair value of the Company’s 2020 Convertible Note issued to the Major Investor is measured as the sum of the instrument’s parts, being the underlying debt instrument and the conversion feature. The conversion feature was valued using the probability weighted conversion price discount. The instrument provided the holder the right to convert the instrument into shares of Series B Preferred Stock at a 20% discount. Given the timing of the issuance of the instrument near the Merger date, management determined that there was a 99.5% probability of the holders converting the instrument to Company shares at a 20% discount.

84

The Company valued the warrants issued with the 2020 Convertible Notes using a Black-Scholes-Merton model using the value of the underlying stock and exercise price of $2.01, along with a risk-free interest rate of 0.59% and volatility of 86%. The Company estimated the term of the warrant to be 5 years.

The Company’s 2020 Convertible Notes contain a share settled redemption feature (“Embedded Derivative”) that requires conversion at the lesser of specified discounts from qualified financing price per share or the fair value of the common stock at the time of conversion. The discount changes based on the passage of time between issuance of the convertible note and the conversion event. This feature is considered a derivative that requires bifurcation because it provides a specified premium to the holder of the note upon conversion. The Company measures the share-settlement obligation derivative at fair value based on significant inputs that are not observable in the market. This results in the liability classified as a Level 3 measurement within the fair value hierarchy.

Upon the Merger, all the above Level 3 instruments were exchanged for Vyant Bio equity classified instruments at which time they were no longer classified as Level 3 instruments. Prior to their exchange, all these instruments were marked to their fair market values with corresponding changes recorded in the statement of operations in the first quarter of 2021.

In the fourth quarter of 2021, the Company classified the vivoPharm as discontinuing operations and applied held for sale accounting. The Company valued the vivoPharm business equally weighting public company revenue multiples and comparable transaction revenue multiples, which are classified as Level 3 measurements within the fair value hierarchy.

The following tables present changes in fair value of level 3 valued instruments as of and for the years ended December 31, 2021 and 2020:

Schedule of Changes in Fair Value of Level 3 Valued Instruments

  2020 Convertible Note  Warrant  Embedded Derivative  vivoPharm Business 
Balance – January 1, 2021 $-  $-  $1,690  $- 
Additions  3,746   635   325   11,000 
Measurement adjustments  4   (214)  250   - 
Settlement  (3,750)  (421)  (2,265)  - 
Balance – December 31, 2021 $-  $-  $-  $11,000 

The following tables present changes in fair value of level 3 valued instruments for the year ended December 31, 2020:

  Embedded Derivative 
Balance – January 1, 2020 $- 
Additions  1,187 
Measurement adjustments  503 
Balance – December 30, 2020 $1,690 

Note 12. Loss Per Share

Basic loss per share is computed by dividing the net loss after tax attributable to common stockholders by the weighted average shares outstanding during the period. Diluted loss per share is computed by including potentially dilutive securities outstanding during the period in the calculation of weighted average shares outstanding. The Company did not have any dilutive securities during the periods presented; therefore, diluted loss per share is equal to basic loss per share.

85

Presented in the table below is a reconciliation of the numerator and denominator for the basic and diluted loss per share calculations for the years ended December 31, 2021 and 2020:

Schedule of Reconciliation of Numerator and Denominator for Basic and Diluted Loss Per Share

  2021  2020 
  December 31, 
  2021  2020 
Net loss from continuing operations $(18,575) $(8,650)
Net loss from discontinuing operations  (22,284)  - 
Net loss $

(40,859

) $

(8,650

)
Basic and diluted weighted average shares outstanding  22,614,449   2,485,968 
Basic and diluted net loss per share:        
Continuing operations $(0.82) $(3.48)
Discontinuing operations  (0.99)  - 
Net loss $(1.81) $(3.48)

The following securities were not included in the computation of diluted shares outstanding for the years ended December 31, 2021 and 2020 because the effect would be anti-dilutive:

Schedule of Computation of Diluted Shares Outstanding

  2021  2020 
  December 31, 
  2021  2020 
Series A Preferred Stock  -   4,611,587 
Series B Preferred Stock  -   3,489,470 
Series A Warrants  -   48,714 
Series B Warrants  -   9,943 
Common Stock Warrants  2,296,913   - 
Common Stock Options  2,320,097   756,000 
2020 Convertible Notes  -   1,678,796 
Total  4,617,010   10,594,510 

Note 13. Stock-Based Compensation


We have two

The Company has three legacy equity incentive plans: the Cancer Genetics, Inc. 2008 Stock Option Plan (the “2008 Plan”) and the Cancer Genetics Inc. 2011 Equity Incentive Plan (the “2011 Plan”), and the StemoniX Inc. 2015 Stock Option Plan (the “2015 Plan”, and together with the 2008 Plan, and the “Stock2011 Plan, the “Frozen Stock Option Plans”). The Frozen Stock Option Plans as well as the 2021 Plan (as defined below) are meant to provide additional incentive to officers, employees and consultants to remain in ourthe Company’s employment. Options granted are generally exercisable for up to 10 years.


The Board of Directors adopted Effective with the 2011 Plan on June 30, 2011 and reserved 350,000 shares of common stock for issuance under the 2011 Plan. On May 22, 2014, May 14, 2015 and on October 11, 2016, the stockholders voted to increase the number of shares reserved by the plan to 2,000,000, 2,650,000, and 3,150,000 shares of common stock, respectively, under several types of equity awards including stock options, stock appreciation rights, restricted stock awards and other awards defined in the 2011 Plan.
The Board of Directors adopted the 2008 Plan on April 29, 2008 and reserved 251,475 shares of common stock for issuance under the plan. On April 1, 2010, the stockholders voted to increase the number of shares reserved by the plan to 550,000. Effective April 9, 2018,Merger, the Company is no longer able to issue options from the 2008 Plan. Prior to April 9, 2018, we were authorized to issue incentiveFrozen Stock Option Plans. The number of common stock options or non-statutoryissued under the 2015 plan were adjusted for the Merger exchange ratio resulting in an incremental 191,880 options outstanding.

Effective with the Merger, the Vyant Bio 2021 Equity Incentive Plan (the “2021 Plan”) came into effect, pursuant to which the Company’s Board of Directors may grant up to 4,500,000 of equity-based instruments to officers, key employees, and non-employee consultants. On March 30, 2021, the Company granted 1,151,500 stock options to eligible participants, as defined inofficers and other employees, 78,090 stock options to independent Board members and a restricted stock unit (“RSU”) of 8,676 shares to the Company’s Board chair. The options granted to officers and employees vest 25% one year from the grant date and thereafter equally over the next 36 months. The options granted to Board members vested upon grant. The Board chair RSU vests one year from the grant date.

As StemoniX was the acquirer for accounting purposes, the pre-Merger vested stock options granted by CGI under the 2008 Plan.



At December 31, 2018, weand 2011 Plans are deemed to have 36,000 options outstanding that were issued outsidebeen exchanged for equity awards of the Stock Option Plans.

At December 31, 2018, 215,988 shares remain availableCompany. The exchange of StemoniX stock options for future awards underoptions to purchase Company common stock was accounted for as a modification of the 2011 Plan.
As of December 31, 2018, noStemoniX stock appreciation rights and 363,334 shares of restricted stock had been awarded underoptions; however, the Stock Option Plans.
A summary of employee and non-employee stock option activity formodification did not result in any incremental compensation expense as the years ended December 31, 2018 and 2017 is as follows:
  Options Outstanding 
Weighted-
Average
Remaining
Contractual
Term (in years)
 
Aggregate
Intrinsic
Value
(in thousands)
  
Number of
Shares
(in thousands)
 
Weighted-
Average
Exercise
Price
 
Outstanding January 1, 2017 2,198
 $9.09
 7.04 $
Granted 902
 2.85
    
Exercised (3) 2.23
    
Cancelled or expired (253) 10.34
    
Outstanding December 31, 2017 2,844
 7.00
 6.96 $4
Granted 857
 0.84
    
Cancelled or expired (697) 4.74
    
Outstanding December 31, 2018 3,004
 $5.77
 5.70 $
Exercisable, December 31, 2018 1,868
 $8.36
 3.65 $
Aggregate intrinsic value represents the difference betweenmodification did not increase the fair value of ourthe stock options.

86

For StemoniX stock options issued prior to the Merger, the expected volatility was estimated based on the average historical volatility of similar entities with publicly traded shares as StemoniX’s shares historically were not publicly traded and its shares rarely traded privately. For common stock and the exercise price of outstanding, in-the-money options. During the year ended December 31, 2018, no options were exercised. We received $6,500 from the exercise of options during the year ended December 31, 2017.

As of December 31, 2018, total unrecognized compensation cost related to non-vested stock options granted at the time of the Merger, the Company used Vyant Bio’s historical volatility to employees was $987,659, which we expectdetermine the expected volatility of post-Merger option grants. Subsequently, the Company used a comparable public company group to recognize overestimate the next 3.06 years.

anticipated volatility of the Company’s stock. The fair value of options granted to employees is estimated on the grant date using the Black-Scholes option valuation model. This valuation model requires us to make assumptions and judgments about the variables used in the calculation, includingrisk-free rate for the expected term (the period of time that the options granted are expected to be outstanding), the volatility of our common stock, a risk-free interest rate, and expected dividends. We record forfeitures of unvested stock options when they occur. No compensation cost is recorded for options that do not vest. We use the simplified calculation of expected life described in the SEC’s Staff Accounting Bulletin No. 107, Share-Based Payment, and volatility is based on the historical volatility of our common stock. The risk-free rateoption is based on the U.S. Treasury yield curve in effect at the timedate of grant.

The Company uses a simplified method to determine the expected term for the valuation of employee options. This method effectively assumes that exercise occurs over the period from vesting until expiration, and therefore, the expected term is the midpoint between the service period and the contractual term of the award. The simplified method is applicable to options with service conditions. For options granted to nonemployees, the contractual term is used for the valuation of the options.

As of December 31, 2021, there were 3,075,734 additional shares available for the Company to grant under the 2021 Plan. The grant-date fair value of each option award is estimated on the date of grant using the Black-Scholes-Merton option-pricing model. The assumptions for periods corresponding withstock option grants during the expected life of the option. We use an expected dividend yield of zero, as we do not anticipate paying any dividendsyears ended December 31, 2021 and 2020 are provided in the foreseeable future.

following table.

Schedule of Assumptions for Stock Option Grants

  2021  2020 
Valuation assumptions        
Expected dividend yield  0.0%  0.0%
Expected volatility  69.5% –123.0% 85.0% – 88.3%
Expected term (years) – simplified method  5.56.1   5.2 10.0 
Risk-free interest rate  0.95% – 1.39%  0.24% – .60%

Stock option activity during years ended December 31, 2021 and 2020 is as follows:

Schedule of Share Option Activity

  Number of Options  Weighted average exercise price  Weighted average remaining contractual term 
Balance as of January 1, 2020  509,173  $1.30   7.4 
Granted  592,726   2.01     
Number of Options, StemoniX options exchanged for Vyant Bio options            
Weighted average exercise price, StemoniX options exchanged for Vyant Bio options            
Number of Options, Vyant Bio options issued to StemoniX option holders            
Weighted average exercise price, Vyant Bio options issued to StemoniX option holders            
Number of Options, assumed in Merger            
Weighted average exercise price, Options assumed in Merger            
Exercised  (75,909)  1.64     
Forfeited  (90,774)  1.76     
Expired  (179,483)  1.02     
Balance as of December 31, 2020  755,733  $1.82   8.7 
Exercisable as of December 31, 2020  339,987  $1.61   6.9 
             
Balance as of January 1, 2021  755,733  $1.82   8.7 
Granted  1,539,939   4.21     
StemoniX options exchanged for Vyant Bio options  

(681,380

)  

1.84

     
Vyant Bio options issued to StemoniX option holders  873,260   

1.44

     
Options assumed in Merger  55,840   45.95     
Exercised  (37,097)  1.21     
Forfeited  (172,311)  

3.69

     
Expired  (13,887)  1.92     
Balance as of December 31, 2021  2,320,097  $4.19   8.6 
Exercisable as of December 31, 2021  635,597  $5.58   7.1 

The following table presents the weighted-average assumptions used to estimate theweighted average grant-date fair value of options granted to employees during the periods presented: 

  Year Ended December 31,
  2018 2017
Volatility 77.79% 74.58%
Risk free interest rate 2.88% 1.98%
Dividend yield 
 
Term (years) 6.45
 5.92
Weighted-average fair value of options granted during the period $0.59
 $1.87

In May 2014, we issued 200,000 options to a Director, with an exercise price of $15.89. See Note 20 for additional information. The following table presents the weighted-average assumptions used to estimate the fair value of options reaching their measurement date for non-employees during the yearyears ended December 31, 2017.
2021 and 2020 were $3.51 and $1.42, respectively.

Volatility75.59%
Risk free interest rate2.24%
Dividend yield
Term (years)6.76
87
Restricted stock awards have been granted to employees, directors and consultants as

The Company recognized stock-based compensation for services. At December 31, 2018, there was $62,737 of unrecognized compensation costin continuing operations related to non-vested restricted stock granted to employees; we expect to recognize the cost over 0.69 years.

The following table summarizes the activities for our non-vested restricted stock awardsdifferent instruments for the years ended December 31, 2018as follows:

Schedule of Share Based Compensation Activity

       
  December 31, 
  2021  2020 
Stock options $973  $216 
Shares issued for services  

30

   156 
Total $1,003  $372 

As of December 31, 2021, there was $4.0 million of total unrecognized compensation cost related to unvested stock options granted under the Plan. That cost is expected to be recognized over a weighted average period of 3.3 years.

Note 14. Segment Information

The Company reports segment information based on how the Company’s chief operating decision maker (“CODM”) regularly reviews operating results, allocates resources and 2017:

    Non-vested Restricted Stock Awards
    Number of Shares (in thousands) Weighted-Average Grant Date Fair Value
Non-vested at January 1, 2017   80
 $6.30
Granted   70
 3.26
Vested   (57) 5.73
Forfeited/cancelled   (2) 11.36
Non-vested at December 31, 2017   91
 4.21
Vested   (40) 3.36
Forfeited/cancelled   (22) 6.77
Non-vested at December 31, 2018   29
 $3.43
The followingmakes decisions regarding business operations. For segment reporting purposes, the Company’s business structure is comprised of one operating and reportable segment.

During years ended December 31, 2021 and 2020, three customers and two customers accounted for approximately 47% and 39%, respectively, of the consolidated revenue from continuing operations.

During both years ended December 31, 2021 and 2020, approximately 21% of the Company’s consolidated revenue from continuing operations was earned outside of the U.S.

Customers representing 10% or more of the Company’s total revenue from continuing operations for years ended December 31, 2021 and 2020, are presented in the table presentsbelow:

Schedule of Customers Representing Total Revenues

  December 31, 
  2021  2020 
Customer A  19%  1%
Customer B  18%  13%
Customer C  11%  2%
Customer D  

9

%  26%

Note 15. Related Party Transactions

In January 2020, a Company officer advanced $25 thousand to the effects of stock-based compensation relatedCompany. On August 12, 2020, to settle debt and accrued interest aggregating $26 thousand owed to the Company officer, the executive used this amount to exercise a vested Company stock option and restricted stock awards to employees and non-employees on our Consolidated Statements of Operations and Other Comprehensive Loss during the periods presented (in thousands):

  Year Ended December 31,
  2018 2017
Cost of revenues $285
 $346
Research and development 54
 133
General and administrative 515
 1,299
Sales and marketing 67
 117
Total stock-based compensation $921
 $1,895


Note 14. Warrants
During 2016 and 2017, wewas issued warrants containing a contingent net cash settlement feature (identified as 2016 Offerings and 2017 Offering, respectively, under the heading “derivative” in the table below). These warrants are recorded as a warrant liability, and all subsequent changes in their fair value are recognized in earnings until they are exercised, amended or expired. During 2017, we issued warrants that were subject to a 20% reduction if we achieved certain financial milestones as part of our debt refinancing in March 2017 (identified as 2017 Debt in the table below). These warrants were recorded as a warrant liability, and all subsequent changes in their fair value were recognized in earnings until April 2, 2018, when the number of12,693 shares of common stock issuable upon exercisestock.

During 2020, a Company officer who was also a Board member, loaned the Company $55 thousand. On July 10, 2020, the loan matured and it was rolled over into a new $55 thousand loan. On August 12, 2020, principal and accrued interest owed to the executive were converted into the 2020 Convertible Notes at the same terms of other third-party investors.

During 2020, related parties including former StemoniX Board members, officers of the warrants became fixed. On June 30, 2018,Company or their immediate family purchased $44 thousand, or 8,003 shares of Series B Preferred Stock and converted 200,611 shares of Series B Preferred Stock into $1.1 millionof the 2017 Debt warrants2020 Convertible Notes. In all instances the terms of these transactions were modified to adjust the exercise pricesame as third-party investors.

In 2020, the Company raised approximately $1.5 million from $2.82 per share to $0.92 per share.

A certain numberthe sale of our warrants are held by Mr. Pappajohn,2020 Convertible Notes in 2020 from related parties, including former StemoniX Board members as well as one shareholder who owned more than 5% of Series B Preferred stock. The Company raised approximately $3.9 million from the Chairmansale of our2020 Convertible Notes from January 1, 2021 through March 12, 2021 from related parties, including former StemoniX Board members as well as one shareholder who owned more than 5% of DirectorsSeries B Preferred stock. This Series B preferred stock shareholder was also a Major Investor and stockholder. See Note 20received an Investor Warrant on February 23, 2021. Effective with the Merger, the Investor Warrant was exchanged for additional details on these warrants.

On March 22, 2017, we issued seven year warrants to the lendersa warrant to purchase an aggregate of 443,262143,890 shares of ourthe Company’s common stock at an exercise price of $2.82$5.9059 per shareshare.

88

During the fourth quarter of 2021, the Company paid a third-party collaboration partner $89 thousand as a reimbursement of third-party costs incurred by the collaborator in connection with the PFG Term Note.collaboration arrangement. In September 2021, an executive’s family member became an employee of this collaborator. Separately, in the fourth quarter of 2021, the Company entered into a $60 thousand consulting agreement with this third-party collaborator. The warrants canarrangements with this third-party collaborator had arms-length terms.

Note 16. Contingencies

We are not currently subject to any material legal proceedings. However, we may from time to time become a party to various legal proceedings arising in the ordinary course of our business.

Note 17. Subsequent Events

The Company has evaluated subsequent events from the balance sheet date through March 30, 2022, the date at which the financial statements were available to be net settledissued as follows:

Continuing Operations

In January 2022, the Company signed a new lease for its research and development facility in La Jolla, California. The new five-year lease commencing in March 2022 requires monthly payments of $22 thousand.

In February 2022, two employees, including the Company’s former Chief Innovation Officer, terminated their employment with the Company. The Company will record a charge of $386 thousand in 2022 related to termination benefits which will be paid in 2022 for these employees.

On March 4, 2022, the Compensation Committee of the Board of Directors approved the granting on March 15, 2022 of (a) 271,719 common stock usingoptions to employees which vest equally upon the average 90-trading dayfiling of a new drug application with the U.S. Food and Drug Agency for Rett Syndrome and CDKL5; (b) 88,581 common stock options to non-executive employees pursuant to the 2021 Company bonus plan which vest 50% upon grant and 50% one year after the grant date; and (c) 335,000 common stock options to the Company’s executives which vest 25% upon grant with the remaining 75% vesting equally upon the filing of a new drug application with the U.S. Food and Drug Agency for Rett Syndrome and CDKL5. All these option grants have an exercise price of our $1.00 per share. The Compensation Committee also modified the vesting criteria for 231,230 common stock. These warrants are definedstock options granted to current employees who were also former StemoniX employees to change the vesting criteria from milestone to time-based from the option’s initial grant date. The options were originally granted in the table below as 2017 Debt warrants. On June 30, 2018, the 2017 Debt warrants were modifiedMay and July 2020 and will continue to adjust the exercise pricevest 1/48 per month over a four-year period from $2.82 per common share to $0.92 per common share.


their original grant date.

On March 24, 2017, warrant holders exercised warrants28, 2022, the Company entered into a purchase agreement, or Purchase Agreement, with Lincoln Park Capital Fund, LLC (“Lincoln Park”), which, subject to the terms and conditions, provides that the Company has the right to sell to Lincoln Park and Lincoln Park is obligated to purchase 375,700up to $15.0 million of its common shares. Additionally, on March 28, 2022, the Company entered into a registration rights agreement (the “Registration Rights Agreement”) with Lincoln Park, pursuant to which the Company agreed to file a registration statement with the Securities and Exchange Commission (the “SEC”), covering the resale of shares of common stock at an exercise priceissued to Lincoln Park under the Purchase Agreement. In addition, under the Purchase Agreement, the Company agreed to issue a commitment fee of $2.25 per share, resulting in proceeds405,953 common shares, or the Commitment Shares, as consideration for Lincoln Park entering into the Purchase Agreement. The Company cannot sell any shares to Lincoln Park until the date that a registration statement covering the resale of $845,325.


On March 27, 2017, warrant holders exercised warrants to purchase 214,300 shares of common stock that have been, and may in the future be, issued to Lincoln Park under the Purchase Agreement is declared effective by the SEC and a final prospectus in connection therewith is filed and all of the other conditions set forth in the Purchase Agreement are satisfied (such date, the “Commencement Date”). Under the Purchase Agreement, the Company may from time to time for 30 months following the Commencement Date, at an exerciseits discretion, direct Lincoln Park to purchase on any single business day, or a Regular Purchase, up to (i) 50,000 common shares, (ii) 75,000 common shares if the closing sale price of $2.25its common shares is not below $1.50 per share resulting in proceeds of $482,175.

On March 28, 2017, warrant holders exercised warrants to purchase 64,200on Nasdaq or (iii) 100,000 common shares of common stock at an exerciseif the closing sale price of $2.25 per share, resulting in proceeds of $144,450.

On March 28, 2017, warrant holders exercised warrants to purchase 90,063its common shares of common stock at an exercise price of $2.25 per share using the net issuance exercise method whereby 45,162 shares were surrendered as payment in full of the exercise price resulting in a net issuance of 44,901 shares.

On March 30, 2017, warrant holders exercised warrants to purchase 123,700 shares of common stock at an exercise price of $2.25 per share, resulting in proceeds of $278,325.

On May 22, 2017, warrant holders exercised warrants to purchase 9,000 shares of common stock at an exercise price of $2.25 per share, resulting in proceeds of $20,250.

On August 9, 2017, warrant holders exercised warrants to purchase 25,000 shares of common stock at an exercise price of $2.25 per share, resulting in proceeds of $56,250.

On November 26, 2017, 194,007 warrants held by Mr. Pappajohn expired unexercised.

On December 8, 2017, we issued warrants to purchase 3,500,000 shares of our common stock at $2.35 per share and warrants to purchase 175,000 shares of our common stock atis not below $2.50 per share on Nasdaq. In addition to our placement agent, referredRegular Purchases, the Company may also direct Lincoln Park to belowpurchase other amounts as accelerated purchases or as additional accelerated purchases on the 2017 Offering. Subjectterms and subject to certain ownership limitations, the warrantsconditions set forth in the Purchase Agreement. In any case, Lincoln Park’s commitment in any single Regular Purchase may not exceed $1.0 million absent a mutual agreement to increase such amount. The purchase price per share for each Regular Purchase will be initially exercisable six months from the issuance date and are exercisable for twelve months from the initial exercise date. These warrants contain a contingent net cash settlement feature and are part of derivative warrants in the table below.

In January 2019, we issued warrants to purchase 933,334and1,065,217 shares of our common stock at $0.2475 and $0.253 per share, respectively, in conjunction with our 2019 Offerings described in Note 21.

The following table summarizes the warrant activity for the years ending December 31, 2018 and 2017 (in thousands, except exercise price):


Issued With / For Exercise
Price
  Warrants
Outstanding
January 1,
2017
 2017
Warrants
Issued
 2017
Warrants
Exercised
 2017
Warrants
Expired
 Warrants
Outstanding
December 31,
2017
 Transfer Between Derivative Warrants and Non-Derivative Warrants Warrants
Outstanding
December 31,
2018
Non-Derivative Warrants:                 
Financing $10.00
  243
 
 
 
 243
 
 243
Financing 15.00
  361
 
 
 (85) 276
 
 276
Debt Guarantee 15.00
  109
 
 
 (109) 
 
 
2015 Offering 5.00
  3,450
 
 
 
 3,450
 
 3,450
2017 Debt 0.92
A 
 
 
 
 
 443
 443
  5.49
C 4,163
 
 
 (194) 3,969
 443
 4,412
Derivative Warrants:                 
2016 Offerings 2.25
B 2,870
 
 (902) 
 1,968
 

 1,968
2017 Debt 0.92
A 
 443
 
 
 443
 (443) 
2017 Offering 2.35
B 
 3,500
 
 
 3,500
 
 3,500
2017 Offering 2.50
B 
 175
 
 
 175
 
 175
  2.32
C 2,870
 4,118
 (902) 
 6,086
 (443) 5,643
  $3.71
C 7,033
 4,118
 (902) (194) 10,055
 
 10,055
________________________
AThese warrants were subject to fair value accounting until the number of shares issuable upon the exercise of the warrants became fixed on April 2, 2018. Effective June 30, 2018, the exercise price was reduced from $2.82 per share to $0.92 per share. See Note 15.
BThese warrants are subject to fair value accounting and contain a contingent net cash settlement feature. See Note 15.
CWeighted average exercisebased on prevailing market prices are as of December 31, 2018.


Note 15. Fair Value of Warrants

The derivative warrants issued as part of the 2016 Offerings are valued using a probability-weighted Binomial model, while the derivative warrants issued as part of the 2017 Debt refinancing were valued using a Monte Carlo model. The derivative warrants issued in conjunction with the 2017 Offering are valued using a Black-Scholes model. The following tables summarize the assumptions used in computing the fair value of derivative warrants subject to fair value accounting at December 31, 2018 and 2017, and the fair value of derivative warrants issued, exercised and reclassified during the years then ended.
  As of December 31, 2018 As of December 31, 2017 Exercised During the Year Ended December 31, 2017
2016 Offerings   
Exercise price $2.25
 $2.25
 $2.25
Expected life (years) 3.08
 4.08
 4.78
Expected volatility 100.51% 73.44% 76.24%
Risk-free interest rate 2.46% 2.11% 1.94%
Expected dividend yield 0.00% 0.00% 0.00%

  Reclassified to Equity During the Year Ended December 31, 2018 As of
December 31, 2017
 Issued During the Year Ended December 31, 2017
2017 Debt   
Exercise price $2.82
 $2.82
 $2.82
Expected life (years) 5.97
 6.22
 7.00
Expected volatility 73.40% 74.18% 74.61%
Risk-free interest rate 2.55% 2.33% 2.22%
Expected dividend yield 0.00% 0.00% 0.00%

  As of December 31, 2018 As of December 31, 2017 Issued During the Year Ended December 31, 2017
2017 Offering   
Exercise price $2.36
 $2.36
 $2.36
Expected life (years) 0.44
 1.43
 1.50
Expected volatility 172.50% 77.55% 76.03%
Risk-free interest rate 2.56% 1.83% 1.73%
Expected dividend yield 0.00% 0.00% 0.00%
The range of Company stock prices used in computing the warrant fair value for warrants issued during the year ended December 31, 2017 was $1.95—$2.90. The range of Company stock prices used in computing the fair value for warrants exercised during 2017 was $3.55—$5.05. The Company stock price used in computing the fair value for warrants reclassified to equity during 2018 was $1.65. In determining the fair value of warrants outstanding at each reporting date, the Company stock price was $0.24 and $1.85 (the closing price on the NASDAQ Capital Market) at December 31, 2018 and 2017, respectively.
The following table summarizes the derivative warrant activity subject to fair value accounting for the years ended December 31, 2018 and 2017 (in thousands):

  Issued with 2016 Offerings Issued with 2017 Debt Issued with 2017 Offering Total
Fair value of warrants outstanding as of January 1, 2017 $2,018
 $
 $
 $2,018
Fair value of warrants issued 
 1,004
 2,199
 3,203
Fair value of warrants exercised (2,782) 
 
 (2,782)
Change in fair value of warrants 2,693
 (503) (226) 1,964
Fair value of warrants outstanding as of December 31, 2017 1,929
 501
 1,973
 4,403
Fair value of warrants reclassified to equity 
 (423) 
 (423)
Change in fair value of warrants (1,704) (78) (1,950) (3,732)
Fair value of warrants outstanding as of December 31, 2018 $225
 $
 $23
 $248

Note 16. Fair Value Measurements

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. The Fair Value Measurements and Disclosures Topic of the FASB Accounting Standards Codification requires the use of valuation techniques that are consistent with the market approach, the income approach and/or the cost approach. Inputs to valuation techniques refer to the assumptions that market participants would use in pricing the asset or liability. Inputs may be observable, meaning those that reflect the assumptions market participants would use in pricing the asset or liability developed based on market data obtained from independent sources, or unobservable, meaning those that reflect our own assumptions about the assumptions market participants would use in pricing the asset or liability developed based on the best information available in the circumstances. In that regard, the Topic establishes a fair value hierarchy for valuation inputs that give the highest priority to quoted prices in active markets for identical assets or liabilities and the lowest priority to unobservable inputs.
The fair value hierarchy is as follows:
Level 1: Quoted prices (unadjusted) for identical assets or liabilities in active markets that we have the ability to access as of the measurement date.
Level 2: Significant other observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active, or other inputs that are observable or can be corroborated by observable market data.

Level 3: Significant unobservable inputs that reflect our own assumptions about the assumptions that market participants would use in pricing an asset or liability.
The following table summarizes the financial liabilities measured at fair value on a recurring basis segregated by the level of valuation inputs within the fair value hierarchy utilized to measure fair value (in thousands):
  2018
  Total Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
 Significant Other
Observable
Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
Warrant liability $248
 $
 $
 $248
Notes payable 20
 
 
 20
Other derivatives 86
 
 
 86
  $354
 $
 $
 $354
         


  2017
  Total Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
 Significant Other
Observable
Inputs
(Level 2)
 Significant
Unobservable
Inputs
(Level 3)
Warrant liability $4,403
 $
 $
 $4,403
Notes payable 156
 
 
 156
  $4,559
 $
 $
 $4,559
At December 31, 2018, the warrant liability consists of stock warrants issued as part of the 2016 Offerings and 2017 Offering that contain contingent redemption features. In accordance with derivative accounting for warrants, we calculated the fair value of warrants and the assumptions used are described in Note 15, “Fair Value of Warrants.” Realized and unrealized gains and losses related to the change in fair value of the warrant liability are included in other income (expense) on the Consolidated Statements of Operations and Other Comprehensive Loss.
At December 31, 2018 and 2017, the Company had a note payable to VenturEast from a prior acquisition. The ultimate repayment of the note will be the value of 84,278 shares of common stock atCommon Stock immediately preceding the time of payment.sale as computed in accordance with the terms set forth in the Purchase Agreement. There are no upper limits on the price per share that Lincoln Park must pay for shares of Common Stock under the Purchase Agreement. The valuePurchase Agreement may be terminated by the Company at any time after the Commencement Date, at its sole discretion, without any cost or penalty, by giving one business day notice to Lincoln Park to terminate the Purchase Agreement.

Discontinuing Operations

In January 2022, the vivoPharm business signed two leases. The first lease is a five-year extension to the Hershey, Pennsylvania office and laboratory facility. This lease requires monthly payments of $16 thousand which increase 2.5% per annum. The second lease is an eight-year lease to expand the vivoPharm South Australian laboratory facilities. There is not rent due under the lease for the first two years. Commencing in year 3, annual rents are $19 thousand for three years and $29 thousand for the remaining three years of the note payable to VenturEast was determined using the fair valuelease.

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

None.

Item 9A.Controls and Procedures.

Evaluation of our common stock at the reporting date. During the years ended December 31, 2018Disclosure Controls and 2017, we recognized a gain of $136,000Procedures

The Company maintains disclosure controls and loss of $42,000, respectively, due to the changesprocedures as defined in value of the note. RealizedRules 13a-15(e) and unrealized gains and losses related to the VenturEast note are included in other income (expense) on the Consolidated Statements of Operations and Other Comprehensive Loss.

The following table summarizes the activity of the notes payable to VenturEast and our derivative warrants, which were measured at fair value using Level 3 inputs (in thousands):
  Note Payable Warrant Other
  to VenturEast Liability Derivatives
Fair value at January 1, 2017 $114
 $2,018
 $
Change in fair value 42
 1,964
 
Fair value of warrants issued 
 3,203
 
Fair value of warrants exercised 
 (2,782) 
Fair value at December 31, 2017 156
 4,403
 
Change in fair value (136) (3,732) 
Fair value of warrants reclassified to equity 
 (423) 
Fair value of certain default provisions 
 
 86
Fair value at December 31, 2018 $20
 $248
 $86

Note 17. Contingencies

On April 5, 2018 and April 12, 2018, purported stockholders of the Company filed nearly identical putative class action lawsuits in the U.S. District Court for the District of New Jersey, against the Company, Panna L. Sharma, John A. Roberts, and Igor Gitelman, captioned Ben Phetteplace v. Cancer Genetics, Inc. et al., No. 2:18-cv-05612 and Ruo Fen Zhang v. Cancer Genetics, Inc. et al., No. 2:18-06353, respectively. The complaints alleged violations of Sections 10(b) and 20(a)15d-15(e) of the Securities Exchange Act of 1934, and SEC Rule 10b-5 based on allegedly false and misleading statements and omissions regarding our business, operational, and financial results. The lawsuits sought, among other things, unspecified compensatory damages in connection with purchases of our stock between March 23, 2017 and April 2, 2018, as well as interest, attorneys’ fees, and costs. On August 28, 2018, the Court consolidated the two actions in one action captioned In re Cancer Genetics, Inc. Securities Litigationamended (the “Securities Litigation”) and appointed shareholder Randy Clark as the lead plaintiff. On October 30, 2018, the lead plaintiff filed an amended complaint, adding Edward Sitar as a defendant and seeking, among other things, compensatory damages in connection with purchases of CGI stock between March 10, 2016 and April 2, 2018. On December 31, 2018, Defendants filed a motion to dismiss the amended complaint for failure to state a claim. The Company is unable to predict the ultimate outcome of the Securities Litigation and therefore cannot estimate possible losses or ranges of losses, if any.


In addition, on June 1, 2018, September 20, 2018, and September 25, 2018, purported stockholders of the Company filed nearly identical derivative lawsuits on behalf of the Company in the U.S. District Court for the District of New Jersey against the Company (as a nominal defendant) and current and former members of the Company’s Board of Directors and current and former officers of the Company. The three cases are captioned: Bell v. Sharma et al., No. 2:18-cv-10009-CCC-MF, McNeece v. Pappajohn et al., No. 2:18-cv-14093, and Workman v. Pappajohn, et al., No. 2:18-cv-14259 (the “Derivative Litigation”). The complaints allege claims for breach of fiduciary duty, violations of Section 14(a) of the Securities Exchange Act of 1934 (premised upon alleged omissions in the Company’s 2017 proxy statement), and unjust enrichment, and allege that the individual defendants failed to implement and maintain adequate controls, which resulted in ineffective disclosure controls and procedures, and conspired to conceal this alleged failure. The lawsuits seek, among other things, damages and/or restitution to the Company, appropriate equitable relief to remedy the alleged breaches of fiduciary duty, and attorneys’ fees and costs. On November 9, 2018, the Court in the Bell v. Sharma action entered a stipulation filed by the parties staying the Bell action until the Securities Litigation is dismissed, with prejudice, and all appeals have been exhausted; or the defendants’ motion to dismiss in the Securities Litigation is denied in whole or in part; or either of the parties in the Bell action gives 30 days’ notice that they no longer consent to the stay. On December 10, 2018, the parties in the McNeece action filed a stipulation that is substantially identical to the Bell stipulation. On February 1, 2019, the Court in the Workman action granted a stipulation that is substantially identical to the Bell stipulation. The Company is unable to predict the ultimate outcome of the Derivative Litigation and therefore cannot estimate possible losses or ranges of losses, if any.

Note 18. Acquisition of vivoPharm Pty, Ltd.

On August 15, 2017, we purchased all of the outstanding stock of vivoPharm, with its principal place of business in Victoria, Australia, in a transaction valued at approximately $1.6 million in cash and shares of the Company's common stock, valued at $8.1 million based on the closing price of the stock on August 15, 2017. The Company deposited in escrow 20% of the stock consideration until the expiration of twelve months from the closing date to serve as the initial source for any indemnification claims and adjustments. On August 15, 2018, the escrowed shares were released. The Company incurred approximately $135,000 in transaction costs associated with the purchase of vivoPharm, which were expensed during the year ended December 31, 2017.

Prior to the acquisition, vivoPharm was a contract research organization (“CRO”“Exchange Act”) that specialized in planning and conducting unique, specialized studies to guide drug discovery and development programs with a concentration in oncology and immuno-oncology. The transaction is being accounted for using the acquisition method of accounting for business combinations. Under this method, the total consideration transferred to consummate the acquisition is being allocated to the identifiable tangible and intangible assets acquired and liabilities assumed based on their respective fair values as of the closing date of the acquisition. Goodwill arising from the acquisition of vivoPharm relates to expected growth and synergies, as well as an assembled workforce. Goodwill is not deductible for income tax purposes.

The acquisition method of accounting requires extensive use of estimates and judgments to allocate the consideration transferred to the identifiable tangible and intangible assets acquired and liabilities assumed.

The measurement period expired on August 15, 2018 and the final valuation was deemed consistent with the preliminary valuation completed during the acquisition diligence phase, specifically concerning lab supplies, deferred revenue and deferred taxes. Subsequent to the measurement period expiration, a review of deferred revenue surfaced a refinement in contract completion estimate of $0.2 million associated with the acquisition valuation and accordingly the current revenue offset was recorded in the statement of operations during the year ended December 31, 2018.

The final allocation of the purchase price as of August 15, 2017 consists of the following (in thousands):


 Amount
Cash$544
Accounts receivable905
Lab supplies350
Prepaid expenses and other current assets60
Fixed assets765
Intangible assets3,160
Goodwill5,960
Accounts payable(913)
Deferred revenue(814)
Deferred rent and other(222)
Obligations under capital lease(76)
Total purchase price$9,719

The following table provides certain 2017 pro forma financial information for the Company as if the acquisition of vivoPharm discussed above occurred on January 1, 2017 (in thousands except per share amounts):

 Unaudited Year Ended December 31, 2017
Revenue$32,880
Net income (loss)(20,961)
  
Basic and dilutive net loss per share$(0.92)

The pro forma numbers above are derived from historical numbers of the Company and vivoPharm and reflect adjustments for pro forma amortization and certain operating expenses. The Company's results of operations for the year ended December 31, 2017 include the operations of vivoPharm from August 15, 2017, with revenues of approximately $2,717,000. The net income (loss) of vivoPharm cannot be determined, as its operations were integrated with Cancer Genetics.

Note 19. Joint Venture Agreement

In November 2011, we entered into an affiliation agreement with the Mayo Foundation for Medical Education and Research (“Mayo”), subsequently amended. Under the agreement, we formed a joint venture with Mayo in May 2013 to focus on developing oncology diagnostic services and tests utilizing next generation sequencing. The joint venture is a limited liability company, with each party initially holding fifty percent of the issued and outstanding membership interests of the new entity (the “JV”). In exchange for our membership interest in the JV, we made an initial capital contribution of $1.0 million in October 2013. In addition, we issued 10,000 shares of our common stock to Mayo pursuant to our affiliation agreement and recorded an expense of approximately $175,000. We also recorded additional expense of approximately $231,000 during the fourth quarter of 2013 related to shares issued to Mayo in November of 2011 as the JV achieved certain performance milestones. In the third quarter of 2014 we made an additional $1.0 million capital contribution.

The agreement also requires aggregate total capital contributions by us of up to an additional $4.0 million. The timing of the remaining installments is subject to the JV's achievement of certain operational milestones agreed upon by the board of governors of the JV. In exchange for its membership interest, Mayo’s capital contribution will take the form of cash, staff, services, hardware and software resources, laboratory space and instrumentation, the fair market value of which will be approximately equal to $6.0 million. Mayo’s continued contribution will also be conditioned upon the JV’s achievement of certain milestones. During 2018, we received a cash distribution from the JV of $150,000, and we are in the process of winding down the JV.

The joint venture is considered a variable interest entity under ASC 810-10, but we are not the primary beneficiary as we do not have the power to direct the activities of the joint venture that most significantly impact its performance. Our evaluation of ability to impact performance is based on our equal board membership and voting rights and day to day management functions which are performed by the Mayo personnel.

Note 20. Related Party Transactions

John Pappajohn, a member of the Board of Directors and stockholder, had personally guaranteed our revolving line of credit with Wells Fargo Bank through March 31, 2014. As consideration for his guarantee, as well as each of the eight extensions of this facility through March 31, 2014, Mr. Pappajohn received warrants to purchase an aggregate of 1,051,506 shares of common stock of which Mr. Pappajohn assigned warrants to purchase 284,000 shares of common stock to certain third parties. Through December 31, 2018, warrants to purchase 440,113 shares of common stock have been exercised by Mr. Pappajohn, and the remaining warrants expired unexercised.

In addition, John Pappajohn also had loaned us an aggregate of $6,750,000 (all of which was converted into 675,000 shares of common stock at the IPO price of $10.00 per share). In connection with these loans, Mr. Pappajohn received warrants to purchase an aggregate of 202,630 shares of common stock. After adjustment pursuant to the terms of the warrants in conjunction with our IPO, the number of warrants outstanding was 275,556 at $15.00 per share at December 31, 2018.

We have a consulting agreement with Equity Dynamics, Inc. (“EDI”), an entity controlled by John Pappajohn, effective April 1, 2014 pursuant to which EDI receives a monthly fee of $10,000. We expensed $120,000 annually for the years ended December 31, 2018 and 2017 related to this agreement. At December 31, 2018 and 2017, we owed EDI $70,000 and $10,000, respectively.

Pursuant to a consulting and advisory agreement that ended December 31, 2016, Dr. Chaganti received $5,000 per month for providing consulting and technical support services. Pursuant to the terms of the consulting agreement, Dr. Chaganti received an option to purchase 200,000 shares of our common stock at a purchase price of $15.89 per share vesting over a period of four years. Total non-cash stock-based compensation recognized under this consulting agreement for the year ended December 31, 2017 was $69,250.

As further described in Note 21, subsequent to year-end the Company closed two public offerings, in which various executives and directors purchased shares at the public offering price. On January 14, 2019, John Pappajohn, John Roberts, our President and Chief Executive Officer, and Geoffrey Harris, a Director, purchased 1,000,000 shares, 100,000 shares and 100,000 shares, respectively, at the public offering price of $0.225 per share. On January 31, 2019, John Pappajohn, John Roberts, Edmund Cannon, a Director, and M. Glenn Miles, our Chief Financial Officer, purchased 1,000,000 shares, 185,436 shares, 43,479 shares and 150,000 shares, respectively, at the public offering price of $0.23 per share.

Note 21. Subsequent Events

2019 Offerings

On January 9, 2019, we entered into an underwriting agreement with H.C. Wainwright & Co., LLC (“H.C. Wainwright”), relating to an underwritten public offering of 13,333,334 shares of our common stock for $0.225 per share. We received proceeds from the offering of approximately $2,437,000, net of expenses and discounts of approximately $563,000. We also issued warrants to purchase 933,334 shares of common stock to H.C. Wainwright in connection with this offering. The warrants are exercisable for five years from the date of issuance at a per share price of $0.2475.

On January 26, 2019, we issued 15,217,392 shares of common stock at a public offering price of $0.23 per share. We received proceeds from the offering of approximately $2,975,000, net of expenses and discounts of approximately $525,000. We also issued warrants to purchase 1,065,217 shares of common stock to the underwriter, H.C. Wainwright, in connection with this offering. The warrants are exercisable for five years from the date of issuance at a per share price of $0.253.

As disclosed in Note 20, certain of our directors and executives purchased shares during the 2019 Offerings at the public offering price.

Forbearance Agreements


On January 16, 2019, we entered into forbearance agreements with both PFG and SVB that among other things, (i) require us to comply with certain milestones in connection with a potential strategic transaction satisfactory to PFG and SVB with an anticipated closing date of on or before April 15, 2019 (the “Milestones”), (ii) provide for PFG and SVB’s forbearance of their respective rights and remedies resulting from existing and stated potential events of default under the PFG Term Note and ABL until the earlier of (a) the occurrence of an additional event of default or (b) February 15, 2019; provided such date shall be automatically extended to (1) February 28, 2019 and then to (2) April 15, 2019 so long as we are in compliance with the Milestones required as of such dates. In addition, the ABL interest rate was increased to 2.25% over the Wall Street Journal prime rate, and the maturity date was extended until April 15, 2019.
Standstill Agreement

On February 15, 2019, we entered into a standstill agreement with Iliad, related to the Convertible Note dated July 17, 2018. The standstill agreement, among other things, (i) provides that Iliad will not seek to redeem any portion of the Convertible Note until March 10, 2019 (the “Standstill”); (ii) increases the outstanding balance of the Convertible Note by approximately $139,000, representing a fee to Iliad for such Standstill; and (iii) allows us the option to elect that Iliad not seek to redeem any portion of the Convertible Note until April 15, 2019, provided that upon such election the outstanding balance of the Convertible Note would increase again by approximately $63,000. We elected to extend the Standstill until April 15, 2019.

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

None.

Item 9A.Controls and Procedures.

Evaluation of Disclosure Controls and Procedures.

We evaluated, under the supervision and with the participation of our principal executive officer and principal financial officer, the effectiveness of the design and operation of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities and Exchange Act of 1934 (“Exchange Act”), as amended) as of December 31, 2018, the end of the period covered by this report on Form 10-K. Based on this evaluation, the principal executive officer and the principal financial officer have concluded that our disclosure controls and procedures were not effective at December 31, 2018 as a result of the material weakness in internal controls described below. Disclosure controls and procedures are designed to ensure that information required to be disclosed by us in theour reports that we file or submitfiled under the Exchange Act, (i) is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms, and were operating in an effective manner for the period covered by this report, and (ii)that such information is accumulated and communicated to our management, including
our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.

In designing and evaluating the 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, and no evaluation can provide absolute assurance that all control issues and instances of fraud, if any, within the Company have been detected.

The Company evaluated, under the supervision and with the participation of the principal executive officer and principal financial officer, or the person performing similar functionseffectiveness of the design and operation of the Company’s disclosure controls and procedures (as defined in Rule 13a-15(e) and Rule 15d-15(e) under the Securities and Exchange Act of 1934, as appropriate,amended (“Exchange Act”), as of December 31, 2021, the end of the period covered by this report on Form 10-K. Based on this evaluation, the Company’s President and Chief Executive Officer (principal executive officer) and its Chief Financial Officer (principal financial officer) have concluded that its disclosure controls and procedures were not effective at December 31, 2021 because of the material weakness in the Company’s internal control over financial reporting related to allow timely decisions regarding required disclosures.


the accounting for potential impairment of intangible assets that existed at December 31, 2020 had not been remediated by the end of the period covered by this Annual Report on Form 10-K.

Management’s Report on Internal Control Over Financial Reporting.


Our

The Company’s management is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rule 13a-15(f) and 15d-15(f) under the Securities Exchange Act of 1934.


The 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 and includes those policies and procedures that:

Pertain (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;
Provide (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 ourthe Company’s management and directors; and
Provide provide reasonable assurance regarding 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 risk that controls may become inadequate because


of changes in conditions or because of declines in the degree of compliance with policies or procedures. Our management assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2018. In making this assessment, ourthe Company’s management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”) in Internal Control-Integrated Framework (2013).

In connection with this assessment, we reportthe Company reports the material weakness, as described below, in our internal control over financial reporting as of December 31, 2018. This material weakness was initially reported in our filings for December 31, 2017 and subsequent quarterly filings.2021. A material weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a material misstatement for the annual or interim financial statements will not be prevented or detected on a timely basis. Because of the material weakness described below, and based on management’s assessment, as of December 31, 2018,2021, the Company’s internal control over financial reporting was not effective:effective.

89

Accounting for uncollectible clinical services revenue: The Company’s quarterly and year- end review procedures includes management’s assessment of collectability and adjustment of its allowance for doubtful accounts. During the fourth quarter of 2017, management revised its estimation process and as a result of the low collection patterns during the fourth quarter of 2017 principally related to clinical service revenues from claims generated by the Los Angeles location, a determination was made to significantly increase the allowance for doubtful accounts to reflect this change in estimate, and recorded audit adjustments in 2017 pertaining to contractual allowances. Further, in 2018, management reviewed collection patterns across the year as part of the year end process, and upon a further detailed review of its accounts receivable balances noted that its procedures and controls did not provide accurate aging for its uncollectible accounts receivable from previous years and recorded significant adjustments. Although management does perform overall review of revenue and related reserves at each reporting date, the controls designed to identify material misstatements did not operate at a sufficient level of precision to prevent or detect such errors in its determination of this significant accounting estimate. Our management has determined that this control deficiency constitutes a material weakness at December 31, 2018.

Remediation plan and procedures: Management is committed to remediating the material weakness. We began the process of implementing changes to our internal control over financial reporting to remediate the control deficiencies that gave rise to the material weakness, including further improvements in our processes and analyses that support the estimate of the allowance for doubtful accounts and the related bad debt expense and performing a comprehensive review of the need for additional corporate accounting and financial personnel and supplemented by external resources as appropriate, with the requisite skill and technical expertise during 2018. However, management’s focus on ensuring funding to continue operations, closure of its California location, consolidation of its clinical services operations, strategic initiatives and adoption of revenue recognition standard impaired its ability to sufficiently remediate the process. While resource constraints, staff turnover, the departure of the previous chief accounting officer, and the appointment of a new principal financial officer (November 2018) has occurred amidst efforts to address the control environment, the material weakness continued as of December 31, 2018. In 2019, management plans to include additional reconciliations between its general ledger and billing systems to enhance its remediation efforts. The Company expects this deficiency to be corrected by the end of 2019.

Changes in Internal Control over Financial Reporting.


Reporting

Other than the continuation of the previously disclosed material weakness andchanges related to the remediation plan set forth above,activities discussed below, there were no changes in ourthe Company’s internal control over financial reporting during the three monthsfourth quarter ended December 31, 20182021 that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.


Material Weakness in Internal Control over Financial Reporting

A material weakness in the Company’s internal control over financial reporting was reported in “Item 9A. Controls and Procedures” of the Company’s Annual Report on Form 10-K for the year ended December 31, 2020 because the Company did not have appropriate controls to forecast revenue and cash flows to support the carrying value of assets. After the Merger, the Company implemented the following enhancements to internal controls to address this material weakness:

Hired a new CFO with significant experience in internal controls, US GAAP and financial forecasting;
Established a financial planning and analysis function in June 2021 to analyze, forecast and report on the Company’s operations; and
Developed a financial model to forecast vivoPharm revenue based on inputs from management.

We determined that the underlying revenue forecasting model to support the determination of cash flows for our vivoPharm business contained data input errors that required additional analysis and validation during the first quarter of 2022. While these data errors did not impact our assessment of the carrying value of our vivoPharm business as of December 31, 2021, the redesign of this control and ongoing testing of its operational effectiveness will not occur until 2022. As a result, the Company concluded that the deficiency in our internal control over financial reporting related to revenue and cash flow forecasting would give rise to the level of a material weakness as of December 31, 2021. The Company expects to remediate this control in 2022 through enhanced data validation and management review.

Item 9B.Other Information.

On March 28, 2022, Vyant Bio, Inc. (the “Company” or “we”) entered into a purchase agreement, dated as of March 28, 2022 (the “Purchase Agreement”), and a registration rights agreement, dated as of March 28, 2022 (the “Registration Rights Agreement”), with Lincoln Park Capital Fund, LLC (“Lincoln Park”), pursuant to which Lincoln Park has committed to purchase up to $15.0 million of the Company’s common stock, par value $0.0001 per share (the “Common Stock”).

Under the terms and subject to the conditions of the Purchase Agreement, the Company has the right, but not the obligation, to sell to Lincoln Park, and Lincoln Park is obligated to purchase up to $15.0 million of the Company’s Common Stock. Such sales of Common Stock by the Company, if any, will be subject to certain limitations set forth in the Purchase Agreement, and may occur from time to time, at the Company’s sole discretion, over the 30-month period commencing on the date that the conditions to Lincoln Park’s purchase obligation set forth in the Purchase Agreement are satisfied, including that a registration statement covering the resale by Lincoln Park of shares of Common Stock that have been and may be issued to Lincoln Park under the Purchase Agreement, which the Company agreed to file with the Securities and Exchange Commission (the “SEC”) pursuant to the Registration Rights Agreement, is declared effective by the SEC and a final prospectus relating thereto is filed with the SEC (the date on which all of such conditions are satisfied, the “Commencement Date”).

From and after the Commencement Date, the Company may from time to time on any business day, by written notice delivered by us to Lincoln Park, direct Lincoln Park to purchase up to 50,000 shares of Common Stock on such business day, at a purchase price per share that will be determined and fixed in accordance with the Purchase Agreement at the time we deliver such written notice to Lincoln Park (each, a “Regular Purchase”), provided, however, that the maximum number of shares we may sell to Lincoln Park in a Regular Purchase may be increased to up to 100,000 shares if the closing sale price of the Common Stock on the applicable purchase date is not below $2.50, in each case, subject to adjustment for any reorganization, recapitalization, non-cash dividend, stock split, reverse stock split or other similar transaction as provided in the Purchase Agreement; provided, however, that Lincoln Park’s maximum purchase commitment in any single Regular Purchase may not exceed $1,000,000. The purchase price per share of Common Stock sold in each such Regular Purchase, if any, will be based on prevailing market prices of the Common Stock immediately preceding the time of sale as computed under the Purchase Agreement.

In addition to Regular Purchases, provided that we have directed Lincoln Park to purchase the maximum amount of shares that we are then able to sell to Lincoln Park in a Regular Purchase, we may, in our sole discretion, also direct Lincoln Park to purchase additional shares of Common Stock in “accelerated purchases,” and “additional accelerated purchases” as set forth in the Purchase Agreement. The purchase price per share of Common Stock sold in each such accelerated purchase and additional accelerated purchase, if any, will be based on prevailing market prices of the Common Stock at the time of sale as computed under the Purchase Agreement. There are no upper limits on the price per share that Lincoln Park must pay for shares of Common Stock in any purchase under the Purchase Agreement.

The Company will control the timing and amount of any sales of Common Stock to Lincoln Park pursuant to the Purchase Agreement. Lincoln Park has no right to require the Company to sell any shares of Common Stock to Lincoln Park, but Lincoln Park is obligated to make purchases as the Company directs, subject to certain conditions.

Actual sales of shares of Common Stock to Lincoln Park will depend on a variety of factors to be determined by the Company from time to time, including, among others, market conditions, the trading price of the Company’s Common Stock and determinations by the Company as to the appropriate sources of funding for the Company and its operations. The net proceeds under the Purchase Agreement to the Company will depend on the frequency and prices at which the Company sells shares of its stock to Lincoln Park. The Company expects that any proceeds received by the Company from such sales to Lincoln Park will be used for working capital and general corporate purposes.

Item 9B.Other Information.90

The aggregate number of shares that the Company can issue to Lincoln Park under the Purchase Agreement may in no case exceed 5,796,733 shares (inclusive of the Commitment Shares defined below, and subject to adjustment as described above) of the Common Stock (which is equal to approximately 19.99% of the shares of the Common Stock outstanding immediately prior to the execution of the Purchase Agreement) (the “Exchange Cap”), unless (i) stockholder approval is obtained to issue Purchase Shares above the Exchange Cap, in which case the Exchange Cap will no longer apply, or (ii) the average price of all applicable sales of our Common Stock to Lincoln Park under the Purchase Agreement equals or exceeds $1.2474 per share so that the issuances of Common Stock under the Purchase Agreement do not constitute issuances below the market price on the date of the Purchase Agreement pursuant to the rules of The Nasdaq Capital Market.

The Purchase Agreement prohibits the Company from directing Lincoln Park to purchase any shares of Common Stock if those shares, when aggregated with all other shares of Common Stock then beneficially owned by Lincoln Park (as calculated pursuant to Section 13(d) of the Securities Exchange Act of 1934, as amended, and Rule 13d-3 thereunder), would result in Lincoln Park beneficially owning more than 9.99% of the outstanding shares of Common Stock.

There are no restrictions on future financings, rights of first refusal, participation rights, penalties or liquidated damages in the Purchase Agreement or Registration Rights Agreement, except the Company is prohibited (with certain specified exceptions) from effecting or entering into an agreement to effect an “equity line of credit” or substantially similar transaction whereby an investor is irrevocably bound to purchase the Company’s securities over a period of time at a price based on the market price of the Common Stock at the time of each such purchase. Lincoln Park has agreed not to engage in or effect, directly or indirectly, for its own principal account or for the principal account of any of its affiliates, any short sales of the Common Stock or hedging transaction that establishes a net short position in the Common Stock during the term of the Purchase Agreement.

As consideration for Lincoln Park’s irrevocable commitment to purchase shares of the Company’s Common Stock upon the terms of and subject to satisfaction of the conditions set forth in the Purchase Agreement, the Company agreed to issue 405,953 shares of its Common Stock immediately to Lincoln Park as commitment shares.

The Purchase Agreement and the Registration Rights Agreement contain customary representations, warranties, conditions and indemnification obligations of the parties. The Company has the right to terminate the Purchase Agreement at any time with one business days’ notice, at no cost or penalty. During any “event of default” under the Purchase Agreement, Lincoln Park does not have the right to terminate the Purchase Agreement; however, the Company may not initiate any regular or other purchase of shares by Lincoln Park, until such event of default is cured.

The foregoing descriptions of the Purchase Agreement and the Registration Rights Agreement are qualified in their entirety by reference to the full text of such agreements, copies of which are attached hereto as Exhibits 10.34 and 10.35, respectively, and each of which is incorporated herein in its entirety by reference. The representations, warranties and covenants contained in such agreements were made only for purposes of such agreements and as of specific dates, were solely for the benefit of the parties to such agreements and may be subject to limitations agreed upon by the contracting parties.

In the Purchase Agreement, Lincoln Park represented to the Company, among other things, that it is an “accredited investor” (as such term is defined in Rule 501(a)(3) of Regulation D under the Securities Act of 1933, as amended (the “Securities Act”)). The securities referred to in this Item 9B are being issued and sold by the Company to Lincoln Park in reliance upon the exemptions from the registration requirements of the Securities Act afforded by Section 4(a)(2) of the Securities Act and Rule 506(b) of Regulation D thereunder.

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

Not applicable.


PART III

Item 10.Directors, Executive Officers and Corporate Governance.

Directors

The following table sets forth certain information about the current directors of the Company. Directors are elected to hold office until the next annual meeting of stockholders and until their successors are elected and qualified.

Directors Age Year First
Became Director
John Fletcher (Board Chair) 76 2021
Geoffrey Harris 59 2014
Joanna Horobin 67 2021
Howard McLeod 55 2014
Marcus Boehm 62 2021
Paul Hansen 59 2021
John A. Roberts 63 2021
Yung-Ping Yeh 46 2021

Set forth below are brief biographical descriptions of the non-employees currently serving as the Company’s directors, based on information furnished to the Company by such individuals.

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John Fletcher

Mr. Fletcher is chair of the Company’s Board since the Merger and brings to the board more than 30 years of strategy and financing experience across the pharmaceutical and healthcare industry. Mr. Fletcher also services on the Company’s Audit, and Nominating and Corporate Committees of the Board of Directors. In 1983, Mr. Fletcher founded Fletcher Spaght, Inc., a consulting firm that provides growth-focused strategy assistance to client companies, and since its founding has served as its Chief Executive Officer. Since 2001, Mr. Fletcher has also served as the Managing Partner of Fletcher Spaght Ventures, a venture capital fund. Mr. Fletcher’s current and past board experience includes both public and private companies. Mr. Fletcher currently serves as the board chairman of publicly-held Koru Medical and Clearpoint Neuro, Inc., as well as privately-held Metabolon. Mr. Fletcher previously served on the boards of The Spectranetics Corporation, Autoimmune, Inc., Axcelis Technologies, Inc., Fischer Imaging Corp., Panacos Pharmaceuticals Inc., NMT Medical Inc., and Quick Study Radiology Inc., all of which are public companies, and on the board of GlycoFi, Inc., a private company. In addition, Mr. Fletcher has served on the boards of many academic and non-profit institutions. Mr. Fletcher worked on the $2 billion acquisition of Spectranetics by Koninklijke Philips N.V. (Royal Philips) and the $400 million acquisition of GlycoFi by Merck & Co., Inc., and received the National Association of Corporate Directors (NACD) Director of the Year Award in 2018 specifically for his work at Spectranetics. He is Chairman Emeritus of the Corporate Collaboration Council at the Thayer School of Engineering/Tuck School of Business at Dartmouth College and serves on the Board of Advisors of Beth Israel Deaconess Medical Center and the Whitehead Institute at MIT. Mr. Fletcher is a graduate of Southern Illinois University (MBA), Central Michigan University (Master’s Degree in International Finance), and George Washington University (BA) and is an instructor in International Business and a PhD candidate at the Wharton School of Business, and as a Captain and jet pilot in the United States Air Force.

Geoffrey Harris

Geoffrey Harris is the chair of the Company’s Audit Committee of the Board and is a managing partner of c7 Advisors (a money management and healthcare advisory firm) since April 2014. Mr. Harris also services on the Company’s Compensation Committee of the Board of Directors. From 2011 to 2014 he served as a managing director and co-head of the healthcare investment banking group at Cantor Fitzgerald, and from 2009-2011, he held a similar position at Gleacher & Company. Mr. Harris is also currently on the board of directors of Telemynd, Inc. (formerly known as MYnd Analytics), a data analysis company focused on improving mental health care; PointRight Inc., a privately-held software company; and MoleSafe, Inc., a privately-held company focused on the early detection of melanoma. Mr. Harris graduated from MIT’s Sloan School of Management with an MS in Finance Management.

Joanna Horobin

Dr. Horobin serves as the Chair of the Company’s Compensation Committee of the Board of Directors and also serves on its Nominating and Corporate Governance Committee. Dr. Horobin served as the Senior Vice President and Chief Medical Officer of Idera Pharmaceuticals, Inc., a publicly traded clinical-stage biopharmaceutical company focused on the clinical development, and ultimately the commercialization, of drug candidates for both oncology and rare disease indications, from November 2015 until July 2019. Previously, Dr. Horobin served as the Chief Medical Officer of Verastem, Inc., a publicly traded biopharmaceutical company focused on developing and commercializing medicines to improve the survival and quality of life of cancer patients, from September 2012 to July 2015. Dr. Horobin currently serves as a member of the board of directors of Kynera Therapeutics Inc., a publicly-traded biopharmaceutical company, non-executive director of Nordic Nanovector ASA (publicly traded on the Oslo Stock Exchange), a member of the board of directors of Liquidia Corporation, a publicly traded biotechnology company, and chair of the board of directors of iOnctura SA. Dr. Horobin received her medical degree from the University of Manchester, England.

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Howard McLeod, Pharm.D.

Dr. McLeod serves as the Chair of the Company’s Nominating and Corporate Governance Committee of the Board of Directors. Dr. McLeod is a member of the Company’s Board and is the Executive Clinical Director for Precision Health at Intermountain Healthcare. Most recently he was Medical Director, Precision Medicine for the Geriatric Oncology Consortium and a Professor at the University of South Florida Taneja College of Pharmacy. Previously he was Chair of the Department of Individualized Cancer Management and Medical Director of the DeBartolo Family Personalized Medicine Institute at the Moffitt Cancer Center and previously a Senior Member of the Moffitt Cancer Center’s Division of Population Sciences. He also chaired the Department of Individualized Cancer Management at Moffitt. He joined Moffitt Cancer Center in September 2013. Prior to joining the Moffitt Cancer Center, Dr. McLeod was a Founding Director of the University of North Carolina Institute for Pharmacogenomics and Individualized Therapy since 2006. Dr. McLeod also held the prestigious title of Fred Eshelman Distinguished Professor at the UNC Eshelman School of Pharmacy from 2006 to 2013. Dr. McLeod has published over 580 peer-reviewed papers on pharmacogenomics, applied therapeutics and clinical pharmacology. He had served as Chief Scientific Advisor and a member of the board of directors of Gentris Corporation before its acquisition by Cancer Genetics (CGIX) in July 2014.

Marcus Boehm

Dr. McLeod serves on the Company’s Nominating and Corporate Governance Committee of the Board of Directors. Dr. Boehm has led research and development programs in biotechnology for 29 years. He is co-founder of Escient Pharmaceuticals, Inc. where he has served as Chief Scientific Officer since 2018. Escient Pharmaceuticals, Inc. is a San Diego-based pre-clinical stage company focused on finding novel solutions to auto-reactive clinical conditions with high unmet medical need. Previously, he was co-founder and Chief Technology Officer at Receptos, Inc. from 2009 to 2015, when it was acquired by Celgene Corporation. At Receptos, Inc., Mr. Boehm collaborated to develop treatments for multiple sclerosis, ulcerative colitis, and eosinophilic esophagitis and also led early discovery research and development programs, chemical manufacturing and controls, and supported corporate financing and partnering activities. In 2001, Dr. Boehm served as Vice President, Chemistry at Conforma Therapeutics Corp, where he led a team that discovered and developed a treatment for solid tumors. Dr. Boehm started his industry career with Ligand Pharmaceuticals in 1991 where he held various positions with progressing responsibility. He led chemistry efforts on programs resulting in the discovery and development of treatment of patients with AIDS-related complications. He is a co-author and inventor of over 100 patents and publications in the area of oncology, autoimmune and metabolic diseases. He has served on Board of Directors for StemoniX and previously served as a member of its Scientific Advisory Board. Dr. Boehm received a B.A. in Chemistry from the University of California, San Diego, a Ph.D. in Chemistry from the State University of New York Stony Brook and completed a National Institutes of Health Postdoctoral Fellowship at Columbia University.

Paul Hansen

Mr. Hansen serves on the Company’s Audit Committee of the Board of Directors. Mr. Hansen became a Board member upon the close of the Merger and was member of the Board of Directors of StemoniX since 2015. Since 2014, Mr. Hansen has served as a Senior Fellow with the University of Minnesota’s Technological Leadership Institute. Mr. Hansen is a founder and, since 2016, has been President of Minnepura Technologies, SBC. From 1999 to 2014, Mr. Hansen held senior executive positions at 3M Company, including President and CEO of 3M Mexico. Mr. Hansen holds a BA in Chemistry and Economics from St. Olaf College and an MBA in Marketing Management from the Carlson School of Management at the University of Minnesota.

John A. Roberts

See biography under “Executive Officers”.

Yung-Ping Yeh

Mr. Yeh, MS, MBA, PgMP, PMP, served as our Chief Information Officer from March 2021 to February 2022. Mr. Yeh co-founded StemoniX in April 2014 and had served as its Chief Executive Officer and a Board Member. Prior to co-founding StemoniX, Mr. Yeh commercialized multiple technologies to the tech industry. Highlights include serving as team lead for the first solid state drive product for Seagate Technology, leading the global partnership between Samsung and Seagate to create new flash technology and program managing the operating system software development for Dell enterprise storage systems. Mr. Yeh has successfully led through a multi-disciplinary approach for the last two decades of career. Mr. Yeh holds a Bachelor of Science and master’s degree in mechanical engineering (nanotechnology) from University of California, San Diego, and a master’s degree in business administration from University of Minnesota’s Carlson School of Management. He has attained professional certifications in program and project management from the Project Management Institute and Mergers and Acquisitions from Northwestern’s Kellogg School of Management. Mr. Yeh serves on the UC San Diego Alumni and Medical Alley (Minnesota) Boards of Directors.

Executive Officers

The following table sets forth certain information about the current executive officers of the Company:

Executive OfficersAgePosition and Office
John A. Roberts63President and Chief Executive Officer
Ralf Brandt59President, Discovery & Early Development Sciences
Andrew D. C. LaFrence59Chief Financial Officer
Robert Fremeau67Chief Scientific Officer

Set forth below are brief biographical descriptions of the individuals currently serving as the Company’s executive officers, based on information furnished to the Company by such individuals.

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John A. Roberts

On April 30, 2018, Mr. Roberts was appointed as the Company’s Chief Executive Officer and President. Prior to that, Mr. Roberts had been the Company’s interim Chief Executive Officer since February 2, 2018. Mr. Roberts had previously served as the Company’s Chief Operating Officer since July 11, 2016. Prior to joining us, from August 1, 2015 to June 30, 2016, Mr. Roberts served as the Chief Financial Officer for VirMedica, Inc., an innovative technology solutions company that provides an end-to-end platform that enables specialty drug manufacturers and pharmacies to optimize product commercialization and management. Prior to VirMedica, from August 1, 2011 to July 31, 2015, Mr. Roberts was the Chief Financial and Administrative Officer for AdvantEdge Healthcare Solutions, a global healthcare analytics and services organization. Prior to that, Mr. Roberts was the Chief Financial Officer and Treasurer for InfoLogix, Inc., a publicly-traded healthcare-centric mobile software and solutions provider. He has also held CFO roles at leading public medical device and healthcare services firms including Clarient, Inc., a publicly-traded provider of diagnostic laboratory services and Daou Systems, Inc., a publicly-traded healthcare IT software development and services firm. In addition, he has held key senior executive roles with MEDecision, Inc., HealthOnline, Inc. and the Center for Health Information. Mr. Roberts earned a Bachelor of Science and a Master’s degree in Business Administration from the University of Maine. He is a member of the Board of Directors and Immediate Past Chair for the Drug Information Association, a global neutral forum enabling drug developers and regulators access to education and collaboration. Mr. Roberts also serves on the Board of Directors of Cohere-Med Inc., a clinical analytics company, from February 2020 to present.

Ralf Brandt, PhD

Dr. Ralf Brandt, PhD was appointed as the Company’s President of Discovery & Early Development Services following the Company’s acquisition of vivoPharm Pty Ltd in August 2017. Dr. Brandt co-founded vivoPharm Pty Ltd in 2003 and served as its Chief Executive Officer and Managing Director until August 2017. Previously he was employed at research positions at the National Cancer Institute in Bethesda, MD, USA and at Schering AG, Germany. He led the Tumour Biology program at Novartis Pharma AG, Switzerland and established several transgenic mouse lines developing tumors under the control of oncogenes. He serves as a Member of the Scientific Advisory Board at Receptor Inc. in Toronto Canada. Dr. Brandt serves as a Member of Scientific Advisory Board at Propanc Health Group Corporation at Propanc Health Group Corporation. He received his Licence (BSc in Biochemistry and Animal Physiology) in 1986 and his PhD (in Biochemistry) in 1991 from the Martin-Luther University of Halle-Wittenberg, Germany.

Andrew D.C. LaFrence, CPA

Mr. LaFrence became the Company’s Chief Financial Officer upon the close of the Merger. Previously, he served as StemoniX’s Chief Financial Officer since August 2019 and, and in March 2020, he also appointed as its Chief Operating Officer. Mr. LaFrence has 38 years of accounting and finance experience, including executive management positions at public and private life sciences companies. Previously, he was Senior Vice President and Chief Financial Officer of Biothera Pharmaceuticals, Inc. from May 2018 to August 2019, as well as Vice President Finance, Information Systems and Chief Financial officer at Surmodics, Inc. (NASDAQ: SRDX) for five years. Prior to Surmodics, Mr. LaFrence served as Chief Financial Officer for CNS Therapeutics, a venture-backed intrathecal drug company. He was an audit partner at KPMG LLP where he focused on supporting venture-backed, high-growth medical technology, pharmaceutical, biotech and clean tech private and public companies. Mr. LaFrence is a certified public accountant and has a bachelor’s degree in accounting and a minor in business administration from Illinois State University. Mr. LaFrence currently serves on the Board of Directors of InSitu Biologics, Inc., a nonopioid drug company, and American National Bank, an upper Midwest community bank and is the Board Chair at the University Enterprise Lab, St. Paul, MN, a life science incubator.

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Robert Fremeau, PhD

On October 25, 2021, Robert T. Fremeau, Jr., Ph.D. was appointed Chief Scientific Officer at Vyant Bio. Dr. Fremeau is an experienced R&D leader with 30 years’ experience in academia and industry. as well as target validation, translation, and clinical development. Prior to joining Vyant Bio, Dr. Fremeau was a consultant for Stoke Therapeutics and Rarebase, Inc. from January 2021 to November 2021, where he developed therapeutic roadmaps for the discovery of novel therapeutics for rare CNS genetic disorders and automated platforms for high throughput screening of patient-derived induced pluripotent stem cells. Prior to that, Dr. Fremeau was recruited to CAMP4 Therapeutics as an Executive Director in November 2019, to build a new Neuroimmunology Therapeutic Area where he served until January 2021. His team applied novel experimental and computational approaches to elucidate cell- and disease-gene specific regulatory circuitry, including transcription factors, non-coding RNA’s, and corresponding cellular signaling pathway, that can be targeted by various therapeutic modalities. Prior to that, Dr. Fremeau served as VP of R&D at AegisCN from 2017-2019 where he was Principal Investigator on an STTR grant from the National Institutes of Neurological Disorders and Stroke to develop apolipoprotein E-mimetics for the treatment of acute brain injury and to identify blood biomarkers for clinical drug effect. In addition, he managed an international collaboration with the National Engineering Research Center for Protein Drugs, Beijing C&N Intl. Sci-tech Co. Ltd., Beijing, China. Prior to that, Dr. Fremeau served as Chief Scientific Officer and co-founder of Resolute Bio from 2015-2016, where he contributed to the development of an innovative platform applying unique computational design and synthetic methods to develop orally bioavailable D-peptides as therapeutic candidates for neurologic disorders. Prior to Resolute Bio, Dr. Fremeau served as Scientific Director in the Department of Neuroscience at Amgen, Inc. from July 2004 until December 2014. At Amgen, he led teams responsible for the identification and prioritization of neuropathic pain and Alzheimer’s disease drug targets and was team leader for Amgen’s two largest multi-site, cross-functional small molecule drug discovery programs: the beta-secretase program for Alzheimer’s disease, and the NaV1.7 program for chronic and neuropathic pain. He further introduced novel research programs to investigate non-amyloid targets for Alzheimer’s disease and leveraged his expertise in sodium channel pharmacology to develop clinically translatable biomarkers. Before moving into biotechnology, Dr. Fremeau was a Visiting Scientist in the Department of Neurology and Physiology at the University of California San Francisco from 1999-2004. Prior to that he was an Assistant Professor of Pharmacology, Cancer Biology and Neurobiology at the Duke University Medical Center. During his academic career, Dr. Fremeau contributed t to the first molecular and functional characterization of the receptors and transporters for the biogenic amine and amino acid neurotransmitters, important targets for drugs with powerful behavioral effects. He is an author on more than 65 peer-reviewed publications in leading journals and multiple patents, and has been a principal investigator on multiple grants from the National Institutes of Health and the National Science Foundation. He served on the Editorial Board of Molecular Pharmacology, the flagship journal for the American Society of Pharmacology and Experimental Therapeutics and has served as a grant reviewer for the National Institutes of Health and the National Science Foundation. He received his BS degree in Microbiology from the University of Maryland, College Park; his PhD degree in Biochemistry from The George Washington University Medical Center; and conducted Postdoctoral training in Molecular Neuroscience at the Columbia University Center for neurobiology and Behavior.

Section 16(a) Beneficial Ownership Reporting Compliance

Section 16(a) of the Securities Exchange Act of 1934, as amended, requires the Company’s directors and executive, officers, and persons who are beneficial owners of more than 10% of a registered class of the Company’s equity securities, to file reports of ownership and changes in ownership with the SEC. These persons are required by this item will be contained inSEC regulations to furnish the Proxy Statement for our 2019 Annual MeetingCompany with copies of Stockholders, which we anticipate will beall Section 16(a) forms they file.

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Based solely upon the Company’s review of copies of Forms 3, 4 and 5 furnished to the Company, the Company believes that all of its directors, executive officers and any other applicable stockholders timely filed no later than 120 days afterall reports required by Section 16(a) of the end of ourExchange Act during the fiscal year ended December 31, 20182021, except for the following: (i) a Form 4 for John A. Roberts that was due on May 26, 2021 was filed on May 27, 2021 and (ii) a Form 3 and a Form 4 for Robert Fremeau that were due on November 1, 2021 were filed on November 17, 2021.

Code of Business Conduct and Ethics

The Company has adopted a Code of Business Conduct and Ethics that applies to its directors, officers and employees. The purpose of the Code of Business Conduct and Ethics is incorporatedto deter wrongdoing and to provide guidance to the Company’s directors, officers and employees to help them recognize and deal with ethical issues, to provide mechanisms to report unethical or illegal conduct and to contribute positively to the Company’s culture of honesty and accountability. The Company’s Code of Business Conduct and Ethics is publicly available on the Company’s website at www.vyantbio.com. If the Company makes any substantive amendments to the Code of Business Conduct and Ethics or grants any waiver, including any implicit waiver from a provision of the Code of Business Conduct and Ethics to its directors or executive officers, the Company will disclose the nature of such amendments or waiver on its website or in a current report on Form 8-K.

Audit Committee

The Board has established an Audit Committee currently consisting of Mr. Harris, Mr. Fletcher and Mr. Hansen. The Audit Committee’s primary functions are to oversee and review: the integrity of the Company’s financial statements and other financial information furnished by the Company, the Company’s compliance with legal and regulatory requirements, the Company’s systems of internal accounting and financial controls, the independent auditor’s engagement, qualifications, performance, compensation and independence, related party transactions, and compliance with the Company’s Code of Business Conduct and Ethics.

Each member of the Audit Committee is “independent” as that term is defined under the applicable rules of the Securities and Exchange Commission (the “SEC”) and the applicable rules of The NASDAQ Stock Market. The Board has determined that each Audit Committee member has sufficient knowledge in financial and auditing matters to serve on the Committee. The Board determined that Mr. Harris is an “audit committee financial expert,” as defined under the applicable rules of the SEC and the applicable rules of The NASDAQ Stock Market. The Company’s Board has adopted an Audit Committee Charter, which is available for viewing at www.vyantbio.com.

Item 11.Executive Compensation.

Summary Compensation Table

The following table shows the compensation awarded to or earned by each person serving as the Company’s principal executive officer during fiscal year 2020, the Company’s two most highly compensated executive officers who were serving as executive officers as of December 31, 2021 and up to two additional individuals for whom disclosure would have been provided but for the fact that such individuals were not serving as an executive officer as of December 31, 2021. The persons listed in the following table are referred to herein by reference herein.


as the “named executive officers.”

Item 11.Executive Compensation.96

SUMMARY COMPENSATION TABLE
Name and Principal Position Year  

Salary

($)

  

Bonus

($)

  

Stock

Awards

($) (1)

  

Option

Awards

($) (1)

  

All Other

Compensation

($)

  Total ($) 
John A. Roberts  2021  $422,692(2) $175,000  $-  $993,972 $-  $1,591,664 
Chief Executive Officer and President  2020  $279,260(3) $-  $        -  $-  $-  $279,260 
Ralf Brandt  2021  $353,335  $50,000  $-  $397,589  $ 42,148(4) $843,072 
President, Discovery & Early Development Services  2020  $353,179  $-  $-  $44,460  $ 38,620(4) $436,259 
Andrew D. C. LaFrence  2021  $244,212(6) $-  $-  $397,589  $ 32,000(8) $673,801 
Chief Financial Officer (5)                            
Yung-Ping Yeh  2021  $244,295(7) $-  $-  $596,383  $ 28,000(8) $868,678 
Chief Information Officer (5)                            

(1) Represents the aggregate grant date fair value for grants made in 2021 and 2020 computed in accordance with FASB ASC Topic 718. This calculation does not give effect to any estimate of forfeitures related to service-based vesting, but assumes that the executive will perform the requisite service for the award to vest in full. The information requiredassumptions used in valuing options are described in Note 13 to the Company’s financial statements included in this Annual Report on Form 10-K.

(2) Represents Mr. Robert’s gross salary of $350,000 through March 31, 2021 and effective with the close of the Merger, $450,000 thereafter.

(3) Represents Mr. Robert’s gross salary of $350,000 less reimbursements of $70,740 received from the buyer of CGI’s biopharma services business prior to the Merger.

(4) Consists of a monthly housing allowance.

(5) Mr. LaFrence’s and Mr. Yeh’s employment with the Company commenced on March 30, 2021, upon the close of the Merger. Effective February 11, 2022, Mr. Yeh’s employment with the Company was terminated. He continues to serve on our Board of Directors.

(6) Represents Mr. LaFrence’s $325,000 salary pro-rated after the close of the Merger.

(7) Represents Mr. Yeh’s $325,000 salary pro-rated after the close of the Merger. Effective February 11, 2022, Mr. Yeh’s employment with the Company was terminated. He continues to serve on our Board of Directors.

(8) Represents payment of pre-Merger deferred compensation to Mr. LaFrence and Mr. Yeh’s after the close of the Merger.

Narrative Disclosure to Summary Compensation Table

Employment Agreements

The material terms of each named executive officer’s employment agreement or arrangement are described below.

John A. Roberts

On March 30, 2021, the Company entered into an amendment (the “Roberts Amendment”) with John A. Roberts to the employment agreement between the Company and Mr. Roberts dated June 27, 2016 (the “Roberts Agreement”). Pursuant to the Roberts Amendment, (a) Mr. Roberts’ salary was increased to $450,000 from the current $350,000; (b) he became eligible for an annual cash bonus of up to 50% of base salary (increased from 35%); (c) he became entitled to a lump sum payment equal to twelve months of his then base salary plus an amount equal to the prior year bonus, and all unvested stock options held by this item will be containedMr. Roberts vesting in full, in the Proxy Statementevent his employment is terminated for ourany reason within twelve months following a change of control; and (d) he became entitled to monthly payments equal to his base salary immediately prior to such termination for a period of twelve months (increased from 6 months) in the event his employment is terminated without “cause” or Mr. Roberts resigns for “good reason” not in connection with a “change of control” (each as defined in the Roberts Agreement). Further, the Roberts Agreement provides for (a) monthly payment equal to his base salary immediately prior to such termination for a period of twelve months in the event his employment is terminated due to illness, injury or disability or (b) a lump sum payment equal to twelve months of his then base salary plus an amount equal to the prior year bonus in the event his employment is terminated for any reason within twelve months following a change of control. The Roberts Agreement further provides that Mr. Roberts will not engage in competitive activity for a period of twelve months following termination of employment.

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Ralf Brandt

The Company entered into an employment agreement with Dr. Brandt effective as of August 15, 2017 (“Brandt Agreement”). The Brandt Agreement provides for, among other things: (i) an annual base salary of $330,000, (ii) eligibility for an annual cash bonus of up to 30% of base salary, (iii) a one-time grant of a stock option to purchase 3,333 shares of common stock, vesting in equal quarterly increments over a two-year period beginning October 1, 2017, (iv) a one-time grant of 1,000 shares of restricted stock, vesting in equal annual increments over a three-year period beginning October 1, 2017, and the following post-termination benefits: (a) any bonus earned under any performance bonus plan then in effect, pro rata for his period of actual employment during the year, payable at the regular bonus payment time but only if other employees are then paid their bonus amounts, (b) monthly payments equal to his base salary immediately prior to such termination for a period of for three months in the event of his death or resignation other than for “good reason”, (c) monthly payment equal to his base salary immediately prior to such termination for a period of four months in the event his employment is terminated due to illness, injury or disability, (d) monthly payments equal to his base salary immediately prior to such termination for the greater of six months or the remainder of his initial two-year employment period in the event his employment is terminated without “cause” or Dr. Brandt resigns for “good reason” not in connection with a “change of control”, (e) a lump sum payment equal to his base salary immediately prior to such termination for the greater of six months or the remainder of his initial two-year employment period in the event his employment is terminated for any reason within twelve months following a “change of control”. The Brandt Agreement further provides that Dr. Brandt will not engage in competitive activity for a period lasting the greater of six months or the remainder of his initial two-year employment period. The Brandt Agreement has an initial term of August 15, 2017 to August 14, 2019, Annual Meetingand automatically renews for additional one-year terms.

Ping Yeh

The Company has entered into an Employment Agreement with Mr. Yeh (the “Yeh Agreement”) on March 30, 2021 setting forth his employment as Chief Innovation Officer. Effective February 11, 2022, Mr. Yeh stepped down as Chief Innovation Officer and the Yeh Agreement was deemed terminated as of Stockholders,that date by the Company without cause. In connection with his separation, Mr. Yeh entered into a separation agreement with the Company effective February 11, 2022, confirming his severance benefits as set forth in the Yeh Agreement. Pursuant to the Yeh Agreement, Mr. Yeh is entitled to: (i) an annual base salary of $325,000, or such greater amount as may be determined by the board of directors of the post-merger company from time to time; (ii) eligibility for an annual cash bonus of up to 40% of base salary; and (iii) the following post-termination benefits: (a) payment of all base compensation and bonuses earned and unpaid through the date of termination, (b) payment for all accrued but unused paid time off, (c) payment for any performance bonus plan, then in effect, pro rata for his period of actual employment during the year, payable at a commensurate time as other employees are paid their bonus amounts, (d) in the event of Mr. Yeh’s employment is terminated due to his death, monthly payments to his estate equal to his base salary immediately prior to such termination for a period of 90 days, (e) in the event Mr. Yeh’s employment is terminated due to illness, injury or disability, monthly payments equal to his base salary immediately prior to such termination for a period of six months, (f) monthly payments equal to his base salary immediately prior to termination for a period of nine months in the event his employment is terminated without “cause” or Mr. Yeh resigns for “good reason” not in connection with a “change of control”, plus the greater of the actual prior-year and current-year target bonus times the number of days from the beginning of the current fiscal year through the termination date divided by 365 days, (g) a lump sum payment equal to twelve months of his then base salary plus an amount equal to the prior year bonus, and all unvested stock options held by Mr. Yeh shall vest in full, in the event his employment is terminated for any reason within twelve months following a change of control, and (h) continuation of medical/dental, disability and life benefits for a period of 12 months following termination of employment pursuant to certain events, subject to Mr. Yeh’s execution of a release of claims, and except to the extent Mr. Yeh receives comparable benefits from a new employer within 12 months following termination of employment in which we anticipate willcase such benefits shall end upon his enrollment in the new employers plans). The Yeh Agreement provides that Mr. Yeh is subject to customary non-competition and non-solicitation of employees and customers covenants for twelve months following termination of employment.

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Andrew D. C. LaFrence

The Company has entered into an Employment Agreement with Mr. LaFrence (the “LaFrence Agreement”) on March 30, 2021 setting forth his employment as Chief Financial Officer. Pursuant to the LaFrence Agreement, Mr. LaFrence is entitled to: (i) an annual base salary of $325,000, or such greater amount as may be filed no later than 120determined by the board of directors of the post-merger company from time to time; (ii) eligibility for an annual cash bonus of up to 40% of base salary; and (iii) the following post-termination benefits: (a) payment of all base compensation and bonuses earned and unpaid through the date of termination, (b) payment for all accrued but unused paid time off, (c) payment for any performance bonus plan, then in effect, pro rata for his period of actual employment during the year, payable at a commensurate time as other employees are paid their bonus amounts, (d) in the event of Mr. LaFrence’s employment is terminated due to his death, monthly payments to his estate equal to his base salary immediately prior to such termination for a period of 90 days, (e) in the event Mr. LaFrence’s employment is terminated due to illness, injury or disability, monthly payments equal to his base salary immediately prior to such termination for a period of six months, (f) monthly payments equal to his base salary immediately prior to termination for a period of nine months in the event his employment is terminated without “cause” or Mr. LaFrence resigns for “good reason” not in connection with a “change of control”, plus the greater of the actual prior-year and current-year target bonus times the number of days from the beginning of the current fiscal year through the termination date divided by 365 days, (g) a lump sum payment equal to twelve months of his then base salary plus an amount equal to the prior year bonus, and all unvested stock options held by Mr. LaFrence shall vest in full, in the event his employment is terminated for any reason within twelve months following a change of control, and (h) continuation of medical/dental, disability and life benefits for a period of 12 months following termination of employment pursuant to certain events, subject to Mr. LaFrence’s execution of a release of claims, and except to the extent Mr. LaFrence receives comparable benefits from a new employer within 12 months following termination of employment in which case such benefits shall end upon his enrollment in the new employers plans). The LaFrence Agreement provides that Mr. LaFrence is subject to customary non-competition and non-solicitation of employees and customers covenants for twelve months following termination of employment.

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Outstanding Equity Awards at Fiscal Year End

The following table sets forth certain information, on an award-by-award basis, concerning unexercised options to purchase common stock, restricted shares of common stock and common stock that has not yet vested for each named executive officer and outstanding as of December 31, 2021.

OUTSTANDING EQUITY AWARDS AT FISCAL YEAR END - 2021

  Option Awards
Name 

Number of

Securities

Underlying

Unexercised

Options (#)

Exercisable

  

Number of

Securities

Underlying

Unexercised

Options (#)

Unexercisable

  

Option

Exercise

Price ($)

  

Option

Expiration

Date

John A. Roberts  4,000(1)  -(1) $60.00  7/10/2026
   1,000(2)  -(2) $75.00  2/21/2027
   -(3)  250,000(3) $4.61  3/29/2031
Ralf Brandt  3,333(4)  -(4) $93.00  8/14/2027
   3,583(5)  1,417(5) $26.70  5/9/2028
   10,000(6)  -(6) $5.53  1/1/2030
   -(3)  100,000(3) $4.61  3/29/2031
Andrew D. C. LaFrence  162,607(7)  28,781(7) $1.56  5/21/2030
   -(8)  38,809(8) $1.56  5/21/2030
   -(3)  100,000(3) $4.61  3/29/2031
Yung-Ping Yeh  -(3)  150,000(3) $4.61  5/12/2022
   -(8)  51,745(8) $1.56  5/21/2030

(1) 83 options vested on July 11, 2016. The remaining options vested in 15 equal quarterly installments of 250 options commencing October 11, 2016 and 167 options vesting on July 11, 2020.

(2) Options vested in 48 equal monthly installments of 21 options commencing one month after the endgrant date.

(3) Options vest 25% one year from the grant date and in 36 equal monthly installments thereafter.

(4) Options vested in 8 equal quarterly installments of our fiscal417 options, commencing on October 1, 2017.

(5) 20% of the options vested one year ended December 31, 2018after the grant date, with the remaining options vest in equal monthly installments of 83 options over the next 48 months.

(6) Options vested in 12 equal monthly installments of 833 options commencing one month after the grant date.

(7) 25% of the options vested on the vesting commencement date of August 30, 2019, with the remaining options vesting in equal monthly installments of 36 over the next 36 months.

(8) Options were granted to a number of StemoniX employees prior to the Merger and vested based on milestones appropriate for the pre-Merger StemoniX business. On March 4, 2022, the Compensation Committee of the Board of Directors approved a change to vesting criteria for these grants for the StemoniX employees which were based on pre-Merger StemoniX vesting criteria to time-based vesting based on the original grant date of these options, being 25% 1 year (retroactive to the original grant dates in May and July 2020) and the remainder vesting 1/36 per month over the subsequent three years.

Director Compensation

Non-Employee Director Compensation Policy

Prior to Closing of the Merger

In July 2019, the Company amended its director compensation policy. The Company’s amended director compensation policy provides for the following cash compensation to its non-employee directors:

each non-employee director receives a monthly retainer fee, paid in advance, of $2,500;

● the Company’s chairman of the board receives an additional monthly retainer fee of $2,500;

the chairman of the Company’s audit committee receives a monthly retainer fee of $1,000;

other audit committee members and compensation committee members receive a quarterly retainer fee of $1,000; and

each non-employee director receives a meeting fee of $250 for each teleconference or $750 for each in-person meeting (exclusive of all travel related reimbursement).

This policy provides for the following equity compensation to the Company’s non-employee directors:

each non-employee director receives a one-time 3,333 share stock option at fair market value on the date of grant, vesting monthly in 12 equal installments over 12 months.

On July 23, 2019, in connection with the adoption of the amended director compensation policy, the Company granted each non-employee director options to purchase 3,333 shares of common stock.

The Company also reimburses non-employee directors for reasonable expenses incurred in connection with attending Board and committee meetings.

After Closing of the Merger

Upon the closing of the Merger on March 30, 2021, the Company amended its Board compensation policy as follows:

Cash Compensation

● each non-employee director receives an annual cash retainer of $30,000 payable in four equal quarterly installments of $7,500 per quarter;

● the chair of the Company’s Audit Committee receives an annual quarterly fee of $10,000 payable in four equal installments of $2,500 per quarter;

● the chair of the Company’s Compensation Committee receives an annual quarterly fee of $7,500 payable in four equal installments of $1,875 per quarter;

● the chair of the Company’s Nominating and Governance Committee receives an annual quarterly fee of $5,000 payable in four equal installments of $1,250 per quarter; and

● each non-employee director is incorporated by reference herein.


expected to serve on one Board committee and for each incremental Board committee, a Board member received an annual fee of $2,500, payable in equal quarterly installments of $625 per quarter.

Equity Compensation

● Upon initial election to Board: A stock option to acquire the equivalent of $60,000 of common stock of the Company valued on the date of grant, exercisable at fair market value, and vesting in full on the date of grant;

● in the years subsequent the initial stock grant, on March 30 each Director receives an annual restricted stock unit valued at $70,000 which vests on March 30 of the following year; and

the non-executive chairman receives an annual restricted stock unit grant of the equivalent to $40,000 vesting on the anniversary of the date of the grant.

100

Except as set forth in the table below, the non-employee directors did not receive any cash or equity compensation during 2021:

DIRECTOR COMPENSATION
                
Name 

Fees Earned

or Paid

in Cash ($)

  

Stock

Awards

($) (1)

  

Option

Awards

($) (1)

  

All Other

Compensation

($)

  Total ($) 
John Fletcher $19,500  $100,000  $51,285  $-  $170,786 
Geoffrey Harris $54,313  $60,000  $51,285  $      -  $165,598 
Howard McLeod $47,000  $60,000  $51,285  $-  $158,285 
Joanna Horobin $23,001  $60,000  $51,285  $-  $134,286 
Paul Hansen $18,751  $60,000  $51,285  $-  $130,036 
Marcus Boehm $15,000  $60,000  $51,285  $-  $126,286 

(1) Represents the aggregate grant date fair value for grants made in 2021 computed in accordance with FASB ASC Topic 718. This calculation does not give effect to any estimate of forfeitures related to service-based vesting, but assumes that the executive will perform the requisite service for the award to vest in full. The assumptions used in valuing options are described in Note 13 to the Company’s financial statements included in this Annual Report on Form 10-K.

(2) Effective with the fourth quarter of 2021, Directors were given the option to receive all or part of their cash fees paid in restricted stock units. Cash fees earned have been reduced for restricted stock units granted in 2022 for fourth quarter 2021 cash fees based on individual director elections.

Compensation Committee Interlocks and Insider Participation

The Compensation Committee of the Board of Directors is currently composed of the following three non-employee directors: Dr. Boehm, Mr. Harris and Ms. Horobin. None of these Compensation Committee members was an officer or employee of the Company during the year. No Compensation Committee interlocks between the Company and another entity existed.

Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.

Security Ownership of Certain Beneficial Owners and Management

The following table sets forth certain information as of March 15, 2022 with respect to the beneficial ownership of common stock of the Company by the following: (i) each of the Company’s current directors; (ii) each of the named executive officers; (iii) all of the current executive officers and directors as a group; and (iv) each person known by the Company to own beneficially more than five percent (5%) of the outstanding shares of the Company’s common stock.

For purposes of the following table, beneficial ownership is determined in accordance with the applicable SEC rules and the information is not necessarily indicative of beneficial ownership for any other purpose. Except as otherwise noted in the footnotes to the table, the Company believes that each person or entity named in the table has sole voting and investment power with respect to all shares of the Company’s common stock shown as beneficially owned by that person or entity (or shares such power with his or her spouse). Under the SEC’s rules, shares of the Company’s common stock issuable under options that are exercisable on or within 60 days after March 22, 2022 (“Presently Exercisable Options”) are deemed outstanding and therefore included in the number of shares reported as beneficially owned by a person or entity named in the table and are used to compute the percentage of the common stock beneficially owned by that person or entity. These shares are not, however, deemed outstanding for computing the percentage of the common stock beneficially owned by any other person or entity.

101

The percentage of the common stock beneficially owned by each person or entity named in the following table is based on 28,992,995 shares of common stock issued and outstanding as of March 23, 2022 plus any shares issuable upon exercise of Presently Exercisable Options held by such person or entity.

Name and Address of Beneficial Owner Number of Shares Beneficially Owned  Percentage of Shares Beneficially Owned 
Named Executive Officers, Executive Officers and Directors:        
John Fletcher  70,916(1)  * 
Geoffrey Harris  21,929(2)  * 
Howard McLeod  18,130(3)  * 
John A. Roberts  150,015(4)  * 
Marcus Boehm  164,001(5)  * 
Joanna Horobin  18,075(6)  * 
Paul Hanson  695,873(7)  2.40%
Ping Yeh  1,772,548(8)  4.66%
Andrew LaFrence  295,585(9)   1.01%
Ralf Brandt  73,055(10)  * 
All current executive officers and directors as a group (11 persons)  2,909,333   9.84%
         
5% Holders        
The Robert John Petcavich Living Trust  1,699,433   5.86%
Khejri Pte LTD  1,772,548(11)  6.11%
FOD Capital  1,618,825(12)  5.55%

(*) Less than 1%.

(1) Includes 23,264 shares of common stock underlying options exercisable on or before May 15, 2022.

(2) Includes 17,681 shares of common stock underlying options exercisable on or before May 15, 2022.

(3) Includes 17,681 shares of common stock underlying options exercisable on or before May 15, 2022.

(4) Includes 110,208 shares of common stock underlying options exercisable on or before May 15, 2022.

(5) Includes 128,786 common shares owned by the Boehm Family Trust and 35,215 shares of common stock underlying options exercisable on or before May 15, 2022.

(6) Includes 18,075 shares of common stock underlying options exercisable on or before May 15, 2022.

(7) Includes 13,015 shares of common stock underlying options exercisable on or before May 15, 2022.

(8) Includes 1,327,625 shares of common stock owned by the Yung-Ping Yeh Revocable Trust 24,794 shares of common stock underlying options exercisable on or before May 15, 2022.

(9) Includes 64,222 common shares owned by the Trust Agreement of Andrew David Chapman LaFrence and Kimberly Ann Chapman LaFrence dated August 11, 2017, and 231,468 shares of common stock underlying options exercisable on or before May 15, 2022.

(10) Includes 55,722 shares of common stock owned through the Brandt Family Trust. Includes 45,416 shares of common stock underlying options exercisable on or before May 15, 2022.

(11) Includes 15,323 shares of common stock underlying options exercisable on or before May 15, 2022 by Sriram Nadathur, a beneficial owner of Khejri Pte LTD.

(12) Includes 143,890 shares of common stock underlying warrants exercisable on or before May 15, 2022.

102

Equity Compensation Plan Information

Effective with the Merger, the Vyant Bio 2021 Equity Incentive Plan (the “2021 Plan”) came into effect, pursuant to which the Company’s Board of Directors may grant up to 4,500,000 of equity-based instruments to officers, key employees, and non-employee consultants.The following table provides information required by this itemas of December 31, 2021 regarding shares of the Company’s common stock that may be issued under (i) the three legacy equity incentive plans: the Cancer Genetics, Inc. 2008 Stock Option Plan (the “2008 Plan”) and the Cancer Genetics Inc. 2011 Equity Incentive Plan (the “2011 Plan”), and the StemoniX Inc. 2015 Stock Option Plan (the “2015 Plan”, and together with the 2008 Plan, and the 2011 Plan, the “Frozen Stock Option Plans”) and (ii) the 2021 Plan.

  Equity Compensation Plan Information 
Plan Category (a)
Number of securities
to be issued upon exercise
of outstanding options
and rights (1)
  (b)
Weighted average
exercise price of
outstanding options
and rights
  (c)
Number of securities
remaining available for
future issuance under equity
compensation plan
(excluding securities
referenced in column (a))
 
Equity compensation plans approved by security holders (2)  2,328,773  $4.19(3)  3,075,734(4)

(1) Does not include any restricted stock as such shares are already reflected in the Company’s outstanding shares, does include 8,676 restricted stock units outstanding.

(2) Consists of the 2008 Plan, the 2011 Plan, the 2015 Plan and the 2021 Plan.

(3) The weighted-average exercise price does not reflect the shares that will be containedissued in connection with the Proxy Statementsettlement of RSUs, since RSUs have no exercise price.

(4) Includes securities available for our 2019 Annual Meeting of Stockholders, which we anticipate will be filedfuture issuance under the 2021 Plan. The Company is no later than 120 days afterlonger able to issue securities from the end of our fiscal year ended December 31, 20182008 Plan, the 2011 Plan and is incorporated by reference herein.


the 2015 Plan.

Item 13.Certain Relationships and Related Transactions, and Director Independence.

Other than compensation arrangements for named executive officers and directors, the Company describes below each transaction and series of similar transactions, since the beginning of fiscal year 2021, to which the Company were a party or will be a party, in which:

● the amounts involved exceeded or will exceed the lesser of $120,000 or one percent of the average of the smaller reporting company’s total assets at year-end for the last two completed fiscal years; and

● any of the Company’s directors, nominees for director, executive officers or holders of more than 5% of the Company’s common stock, or any member of the immediate family of the foregoing persons, had or will have a direct or indirect material interest.

In January 2020, a Mr. Andrew LaFrence, the CFO of StemoniX, Inc., advanced $25 thousand to the Company. On August 12, 2020, to settle debt and accrued interest aggregating $26 thousand owed to Mr. LaFrence, the executive used this amount to exercise a vested Company stock option and was issued 12,693 shares of common stock.

During the quarter ended June 30, 2020, Dr. Robert Petcavich, who was then the StemoniX Chief Scientific Officer and a StemoniX Board member, loaned the Company $55 thousand. On August 12, 2020, principal and accrued interest owed to Dr. Petcavich were converted into the 2020 Convertible Notes at the same terms of other third-party investors.

During 2020, related parties including former StemoniX Board members, officers of the Company or their immediate family members purchased $44 thousand, or 8,003 shares of Series B Preferred Stock. In May 2020, Dr. Petcavich converted 64,000 shares of Series B Preferred Stock into $351 thousand of the 2020 Convertible Notes. In May 2020, Khejri Pte LTD converted 136,611 shares of Series B Preferred Stock into $750 thousand of the 2020 Convertible Notes. In all instances the terms of these transactions were the same as third-party investors.

In 2020, the Company raised approximately $1.5 million from the sale of 2020 Convertible Notes in 2020 from the following related parties: FOD Capital ($689 thousand); Khejri Pte LTD ($400 thousand); Mr. Paul Hansen ($200 thousand); Dr. Petcavich ($150 thousand); Kevin Gunderson ($25 thousand); and Mr. Ping Yeh ($7 thousand).

The Company raised approximately $3.9 million from the sale of 2020 Convertible Notes from January 1, 2021 through March 12, 2021 from the following related parties: FOD Capital ($3.6 million); Mr. Hansen ($325 thousand) and Mr. Yeh ($7 thousand). FOD Capital also received a warrant in connection with their investment which upon the close of the Merger was exchanged for a warrant to purchase 143,890 shares of the Company’s common stock at an exercise price of $5.9059 per share.

103

The information required

During the fourth quarter of 2021, the Company paid a third-party collaboration partner $89 thousand as a reimbursement of third-party costs incurred by the collaborator in connection with the collaboration arrangement. In September 2021, Mr. LaFrence’s son became an employee of this item will be containedcollaborator. Separately, in the Proxy Statementfourth quarter of 2021, the Company entered into a $60 thousand consulting agreement with this third-party collaborator. The arrangements with this third-party collaborator had arms-length fair value terms.

Compensation arrangements for our 2019 Annual Meetingthe Company’s named executive officers and directors are described in the section entitled “Executive Compensation”.  

Indemnification Agreements

The Company has entered into indemnification agreements with each of Stockholders,its current directors and executive officers. These agreements will require the Company to indemnify these individuals to the fullest extent permitted under Delaware law against liabilities that may arise by reason of their service to the Company, and to advance expenses incurred as a result of any proceeding against them as to which we anticipate willthey could be filedindemnified. The Company also intends to enter into indemnification agreements with its future directors and executive officers.

Policies and Procedures for Related Party Transactions

The Company adopted a policy that its executive officers, directors, nominees for election as a director, beneficial owners of more than 5% of any class of the Company’s common stock, any members of the immediate family of any of the foregoing persons and any firms, corporations or other entities in which any of the foregoing persons is employed or is a partner or principal or in a similar position or in which such person has a 5% or greater beneficial ownership interest (collectively, “related parties”) are not permitted to enter into a transaction with the Company without the prior consent of the Company’s board of directors acting through the audit committee or, in certain circumstances, the chairman of the audit committee. Any request for the Company to enter into a transaction with a related party, in which such related party would have a direct or indirect interest in the transaction, must first be presented to the Company’s audit committee, or in certain circumstances the chairman of the Company’s audit committee, for review, consideration and approval. In approving or rejecting any such proposal, the Company’s audit committee is to consider the material facts of the transaction, including, but not limited to, whether the transaction is on terms no laterless favorable than 120 days afterterms generally available to an unaffiliated third party under the endsame or similar circumstances, the extent of our fiscal year ended December 31, 2018the benefits to us, the availability of other sources of comparable products or services and is incorporated by reference herein.


the extent of the related person’s interest in the transaction.

104

Director Independence

The Company is currently managed by a four-member board of directors. All of the Company’s current directors are “independent” as that term is defined under the rules of The NASDAQ Stock Market.

Item 14.Principal Accounting Fees and Services.

The following table summarizes the fees for professional services rendered by Deloitte & Touche LLP, the Company’s independent registered public accounting firms, for each of the respective last two fiscal years:

Fee Category 2021  2020 
Audit Fees $569,234  $198,203 
Audit-Related Fees  40,000   277,000 
Tax Fees  -   - 
  $609,234  $475,003 

Audit Fees

Represents fees for professional services provided in connection with the audit of the Company’s annual financial statements and reviews of the Company’s quarterly interim financial statements.

Audit-Related Fees

Fees related to review of registration statements, acquisition due diligence and statutory audits.

Tax Fees

Tax fees are associated with tax compliance, tax advice, tax planning and tax preparation services.

The Audit Committee is responsible for appointing, setting compensation and overseeing the work of the independent auditors. The Audit Committee is required to review and approve the proposed retention of independent auditors to perform any proposed auditing and non-auditing services as outlined in its charter. The Audit Committee has established policies and procedures separate from its charter concerning the pre-approval of auditing and non-auditing related services. As required by Section 10A of the Exchange Act, our Audit Committee has authorized all auditing and non-auditing services provided by Deloitte & Touche LLP during 2021 and 2020 and the fees paid for such services. However, the pre-approval requirement may be waived with respect to the provision of non-audit services for the Company if the “de minimis” provisions of Section 10A(i)(1)(B) of the Exchange Act are satisfied

105

The informationAudit Committee has considered whether the provision of Audit-Related Fees, Tax Fees, and all other fees as described above is compatible with maintaining Deloitte & Touche LLP’s independence and has determined that such services for fiscal years 2021 and 2020 were compatible. All such services were approved by the Audit Committee pursuant to Rule 2-01 of Regulation S-X under the Exchange Act to the extent that rule was applicable.

The Audit Committee is responsible for reviewing and discussing the audit financial statements with management, discussing with the independent registered public accountants the matters required by this item willPublic Company Accounting Oversight Board Auditing Standard No. 1301 Communications with Audit Committees, receiving written disclosures from the independent registered public accountants required by the applicable requirements of the Public Company Accounting Oversight Board regarding the independent registered public accountants’ communications with the Audit Committee concerning independence and discussing with the independent registered public accountants their independence, and recommending to the Board that the audit financial statements be containedincluded in the Proxy Statement for our 2019Company’s Annual Meeting of Stockholders, which we anticipate will be filed no later than 120 days after the end of our fiscal year ended December 31, 2018 and is incorporated by reference herein.



Report on Form 10-K.

PART IV

Item 15.Exhibits, Financial Statement Schedules.

(a)(1) Financial Statements. The financial statements filed as part of this report are listed on the Index to the Consolidated Financial Statements.


(a)(2) Financial Statement Schedules. Schedules are omitted because they are not applicable or the required information is shown in the consolidated financial statements or notes thereto.


(a)(3) Exhibits. Reference is made to the Exhibit Index. The exhibits are included, or incorporated by reference, in this annual report on Form 10-K and are numbered in accordance with Item 601 of Regulation S-K.


Item 16.Form 10-K Summary.

None.

106

None.

SIGNATURES

Pursuant to the requirements 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.

Vyant Bio, Inc.
(Registrant)
Date: March 30, 2022
Cancer Genetics, Inc.
(Registrant)
Date: April 15, 2019/s/ John A. Roberts
John A. Roberts

President and Chief Executive Officer

(Principal Executive Officer and

duly authorized signatory)

/s/ Andrew D.C. LaFrence
Date: April 15, 2019/s/ M. Glenn MilesAndrew D.C. LaFrence
M. Glenn Miles

Chief Financial Officer

(Principal Financial and Accounting Officer)

Officer and

duly authorized signatory)




SIGNATURES AND POWER OF ATTORNEY

KNOW ALL BY THESE PRESENTS, that each person whose signature appears below hereby constitutes and appoints John A. Roberts and M. Glenn Miles, and each of them,Andrew D.C. LaFrence, his true and lawful agent, proxy and attorney-in-fact, with full power of substitution and resubstitution, for him and in his name, place and stead, in any and all capacities, to (i) act on, sign and file with the Securities and Exchange Commission any and all amendments to this annual report on Form 10-K together with all schedules and exhibits thereto, (ii) act on, sign and file such certificates, instruments, agreements and other documents as may be necessary or appropriate in connection therewith and, (iii) take any and all actions which may be necessary or appropriate to be done, as fully for all intents and purposes as he might or could do in person, hereby approving, ratifying and confirming all that such agent, proxy and attorney-in-fact or any of his substitutes may lawfully do or cause to be done by virtue thereof.

Pursuant to the requirements of the Securities Act, this annual report on Form 10-K has been signed by the following persons in the capacities and on the dates indicated.

SignatureTitleDate
/s/ John A. RobertsPresident and Chief Executive OfficerMarch 30, 2022
John A. Roberts(Principal Executive Officer)
/s/ Andrew D.C. LaFrence Chief Financial Officer March 30, 2022
SignatureAndrew D.C. LaFrence TitleDate
(Principal Financial and Accounting Officer)  
     
/s/ John A. RobertsFletcherPresident and Chief Executive OfficerApril 15, 2019
John A. Roberts(Principal Executive Officer)
/s/ M. Glenn MilesChief Financial OfficerApril 15, 2019
M. Glenn Miles(Principal Financial and Accounting Officer)
/s/ John PappajohnChairman of the Board of DirectorsApril 15, 2019March 30, 2022
John PappajohnFletcher
/s/ Geoffrey HarrisDirectorApril 15, 2019March 30, 2022
Geoffrey Harris
/s/ Edmund CannonYung-Ping YehDirectorApril 15, 2019March 30, 2022
Edmund CannonYung-Ping Yeh
/s/ Marcus BoehmDirectorMarch 30, 2022
Marcus Boehm
/s/ Howard McLeodDirectorApril 15, 2019March 30, 2022
Howard McLeod
/s/ Michael J. WelshJoanna HorobinDirectorApril 15, 2019March 30, 2022
Michael J. WelshJoanna Horobin
/s/ Raju S. K. ChagantiPaul HansenDirectorApril 15, 2019March 30, 2022
Raju S. K. Chaganti, Ph.D.Paul Hansen

/s/ Franklyn G. PrendergastDirectorApril 15, 2019
Franklyn G. Prendergast, M.D., Ph.D.
/s/ Thomas F. WidmannDirectorApril 15, 2019
Thomas F. Widmann
107

INDEX TO EXHIBITS

Exhibit

No.

Description
Exhibit
No.
2.1#
Description
2.1
2.2
3.12.2#
2.3#Amendment No. 1 to Agreement and Plan of Merger and Reorganization, by and among Cancer Genetics, Inc., StemoniX, Inc., and CGI Acquisition, Inc., dated February 8, 2021 (incorporated by reference to Exhibit 2.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on February 8, 2021).
2.4#Amendment No. 2 to Agreement and Plan of Merger and Reorganization, by and among Cancer Genetics, Inc., StemoniX, Inc., and CGI Acquisition, Inc., dated February 26, 2021 (incorporated by reference to Exhibit 2.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on February 26, 2021).
3.1Fourth Amended and Restated Certificate of Incorporation of Cancer Genetics, Inc., filed as (incorporated by reference to Exhibit 3.1 to quarterly reportof the Company’s Quarterly Report on Form 10-Q, filed with the Securities and Exchange Commission on May 15, 2013 and incorporated herein by reference.2013).
3.2
3.3Amended and Restated Bylaws of Cancer Genetics, Inc., filed as (incorporated by reference to Exhibit 3.4 toof the Company’s Registration Statement on Form S-1/A (File No. 333-178836), filed with the Securities and Exchange Commission on April 30, 2012 (File No. 333-178836) and incorporated herein by reference.2012).
4.1
4.2
4.3
4.4
4.5
4.6
4.74.3
4.8
4.9
4.104.4
4.11
4.124.5
4.13
4.144.6
4.7*Description of Securities.

108

Exhibit

No.

Description
   

4.8Form of Underwriter Warrants of Cancer Genetics, Inc., dated November 2, 2020 (incorporated by reference to Exhibit 4.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on November 2, 2020).
Exhibit
No.
4.9
DescriptionForm of Common Warrant dated February 1, 2021 (incorporated by reference to Exhibit 4.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on February 1, 2021).
10.14.10
4.11Warrant dated February 16, 2021 (incorporated by reference to Exhibit 4.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on February 16, 2021).
4.12Form of Exchange Warrant dated March 30, 2021 (incorporated by reference to Exhibit 4.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on April 5, 2021).
10.1†Amended and Restated 2008 Stock Option Plan filed as(incorporated by reference to Exhibit 10.1 toof the Company’s Registration Statement on Form S-1/A (File No. 333-178836), filed with the Securities and Exchange Commission on October 23, 2012 (File No. 333-178836) and incorporated herein by reference.2012). †
10.210.2†
10.310.3†
10.410.4†
10.510.5†
10.610.6†
   
10.7
10.8
10.9
10.10
10.11
10.12
10.13
10.14
10.15
10.16
10.17
10.18
10.19
10.20

Exhibit
No.
Description
10.21
10.22
10.2310.8†
10.24
10.25
10.26
10.27
10.28
10.29
10.30
10.31
10.32
10.33
10.44
10.45
10.4610.9†
10.47
10.48

Exhibit
No.
Description
10.49
10.5010.10†
10.51

109

Exhibit

No.

Description
   
10.5210.11
10.53
10.54
10.5510.12
10.56
10.57
10.5810.13†
10.14Form of Securities Purchase Agreement dated December 8, 2017, by and between Cancer Genetics, Inc. and various purchasers named thereinJanuary 28, 2021 (incorporated by reference to Exhibit 10.1 the Company's current reportCompany’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on December 8, 2017)February 1, 2021).
10.5910.15
10.6010.16
10.61
10.62
10.63
10.17Form of Securities Purchase Agreement dated February 10, 2021 (incorporated by reference to Exhibit 10.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on February 16, 2021).
10.18†Vyant Bio, Inc. 2021 Equity Incentive Plan (incorporated by reference to Exhibit 10.1 of the Company’s Current Report on Form 8-K, filed with the Securities and Exchange Commission on April 27, 2018)5, 2021).
10.6410.19†
10.65
10.66

10.20†
Exhibit
No.
Description
10.67
10.6810.21†
10.69
10.7010.22†
10.7110.23†
10.7210.24†

10.7310.25*†
10.25***Research and Collaboration Agreement dated November 27, 2019 by and between Cancer Genetics,among Atomwise Inc., Atomwise-StemoniX JV1, LLC, and NovellusDx LtdStemoniX, Inc. (incorporated by reference to Exhibit 10.310.41 of the Company's current reportCompany’s Registration Statement on Form 8-K,S-4/A (File No. 333-249513), filed with the Securities and Exchange Commission on September 21, 2018)February 8, 2021).
10.7410.26
10.7510.27***

110

Exhibit

No.

Description
   
10.7610.28***
10.7710.29†
10.30*Lease Agreement dated January 7, 2022 by and between StemoniX, Inc. and Nancy Ridge Technology Center, L.P..
10.31*Lease Agreement dated July 17, 2017 by and between StemoniX, Inc. and WBL Properties 1 LLC.
10.32*First Amendment to Lease dated August 10, 2020 by and between StemoniX, Inc. and WBL Properties 1 LLC.
   
10.7810.33* 
   
10.7910.34* 
   
10.80*10.35* 

   
10.81*21.1*
10.82*23.1*
10.83*
21.1*
23.1*
24.1

111

Exhibit

No.

Exhibit
No.
Description
   
31.1*
31.2*
32.1**
32.2**
101*101.INS*The following financial statements from this annual report on Form 10-KInline XBRL Instance Document—the instance document does not appear in the Interactive Data File as 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.DEF*Inline XBRL Taxonomy Extension Definition Linkbase Document.
101.LAB*Inline XBRL Taxonomy Extension Label Linkbase Document.
101.PRE*Inline XBRL Taxonomy Extension Presentation Linkbase Document.
104*Cover Page Interactive Data File—the cover page interactive data file does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.

*Filed herewith.
**Furnished herewith.
***Portions of Cancer Genetics, Inc. for the year ended December 31, 2018, filed on April 15, 2019, formatted in XBRL (eXtensible Business Reporting Language): (i) the Consolidated Balance Sheets, (ii) the Consolidated Statementsexhibit have been omitted pursuant to Item 601(b)(10) of Operations and Other Comprehensive Loss, (iii) the Consolidated StatementsRegulation S-K. A copy of Cash Flows, (iv) the Consolidated Statements of Stockholders' Equity and (v) the Notesany omitted portions will be furnished to the Consolidated Financial Statements.

Securities and Exchange Commission upon request.
*Filed herewith.
**Furnished herewith.
Indicates a management contract or compensation plan, contract or arrangement.
#Schedules and exhibits have been omitted pursuant to Item 601(b)(2) of Regulation S-K. VYNT hereby undertakes to furnish supplementally copies of any of the omitted schedules upon request by the SEC.

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