UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
WASHINGTON,
DC 20549
FORM
10-K
(Mark One)
For the fiscal year ended December 31, 2023
Or
For the transition period from _______ to _______
Commission
file number 001-15771
ABEONA
THERAPEUTICS INC.
(Exact
name of registrant as specified in its charter)
6555
Carnegie Avenue, 4th
Floor, Cleveland, OH44103
(Address
of principal executive offices, zip code)
(646)813-4701
(Registrant’s
telephone number, including area code)
Securities
registered pursuant to Section 12(b) of the Securities Exchange Act of 1934:
Title of each class Trading Symbol(s) Name of each exchange on which registered
Common Stock, $0.01 par value ABEO Nasdaq Capital Market
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒
Indicate
by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule
405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant
was required to submit such files). Yes ☒ No ☐
Indicate
by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See definitions of “large accelerated filer,” “accelerated filer,” “smaller
reporting company” and “emerging growth company” in Rule 12b-2 of the Act:
Large accelerated filer ☐ Accelerated filer ☐
Non-accelerated filer ☒ Smaller reporting company ☒
Emerging growth company ☐
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered
public accounting firm that prepared or issued its audit report. Yes ☐ No ☒
If
securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant
included in the filing reflect the correction of an error to previously issued financial statements. Yes ☐ No ☒
Indicate
by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation
received by any of the registrant’s executive officers during the relevant recovery period pursuant to § 240.10D-1(b). Yes
☐ No ☒
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒
The
aggregate market value of the voting and non-voting common equity held by non-affiliates computed by reference to the average bid and
asked price of such common equity, as of June 30, 2023, was approximately $78,468,000.
The
number of shares outstanding of the registrant’s common stock as of March 6, 2024 was 27,355,037.
ABEONA
THERAPEUTICS INC.
Annual
Report on Form 10-K
Table
of Contents
Page
Part I
Item 1. Business 3
Item 1A. Risk Factors 27
Item 1B. Unresolved Staff Comments 55
Item 1C. Cybersecurity 55
Item 2. Properties 56
Item 3. Legal Proceedings 56
Item 4. Mine Safety Disclosures 56
Part II
Item 7A. Quantitative and Qualitative Disclosures About Market Risk 69
Item 8. Financial Statements and Supplementary Data 69
Item 9A. Controls and Procedures 69
Item 9B. Other Information 70
Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections 70
Part III
Item 10. Directors, Executive Officers and Corporate Governance 71
Item 11. Executive Compensation 71
Item 14. Principal Accounting Fees and Services 71
Part IV
Item 15. Exhibits, Financial Statement Schedules 72
Signatures 74
FORWARD-LOOKING
STATEMENTS
This
Form 10-K (including information incorporated by reference) contains statements that express management’s opinions, expectations,
beliefs, plans, objectives, assumptions or projections regarding future events or future results and therefore are, or may be deemed
to be, “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section
21E of the Securities Exchange Act of 1934, as amended. Words such as “expects,” “anticipates,” “intends,”
“plans,” “believes,” “could,” “would,” “seeks,” “estimates,”
and variations of such words and similar expressions, and the negatives thereof, are intended to identify such forward-looking statements.
Such “forward-looking statements” speak only as of the date made and are not guarantees of future performance and involve
certain risks, uncertainties, estimates, and assumptions by management that are difficult to predict. Various factors, some of which
are beyond the Company’s control, could cause actual results to differ materially from those expressed in, or implied by, such
forward-looking statements. In addition, we disclaim any obligation to update any forward-looking statements to reflect events or circumstances
after the date of this report, except as may otherwise be required by the federal securities laws.
Forward-looking
statements necessarily involve risks and uncertainties, and our actual results could differ materially from those anticipated in forward-looking
statements due to a number of factors. These statements include statements about: the outcome of our submission of a Biologics License
Application for pz-cel and the timing thereof; our plans to continue development of AAV-based gene therapies designed to treat ophthalmic
and other diseases and next-generation AAV-based gene therapies; the achievement of or expected timing, progress and results of clinical
development, clinical trials and potential regulatory approvals; our pipeline of product candidates; our belief that pz-cel could potentially
benefit patients with RDEB; development of our novel AAV-based gene therapy platform technology; our belief in the adequacy of the clinical
trial data from our VIITALTM clinical trial, together with the data generated in the program to date, to support regulatory approvals;
our dependence upon our third-party customers and vendors and their compliance with regulatory bodies; our estimates regarding expenses,
future revenues, capital requirements, and needs for additional financing; our intellectual property position and our ability to obtain,
maintain and enforce intellectual property protection and exclusivity for our proprietary assets; our estimates regarding the size of
the potential markets for our product candidates, the strength of our commercialization strategies and our ability to serve and supply
those markets; and future economic conditions or performance.
Important
factors that could affect performance and cause results to differ materially from management’s expectations are described in the
sections entitled “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results
of Operations” in this Form 10-K. These factors include: the outcome of our submission of a Biologics License Application for pz-cel
and the timing thereof; our ability to access our existing at-the-market sale agreement; our ability to access additional financial resources
and/or our financial flexibility to reduce operating expenses if required; our ability to obtain additional equity funding from current
or new stockholders; the potential impacts of global healthcare emergencies, such as pandemics, on our business, operations, and financial
condition; our ability to out-license technology and/or other assets, deferring and/or eliminating planned expenditures, restructuring
operations and/or reducing headcount, and sales of assets; the dilutive effect that raising additional funds by selling additional equity
securities would have on the relative equity ownership of our existing investors, including under our existing at-the-market sale agreement;
the outcome of any interactions with the U.S. Food and Drug Administration (“FDA”) or other regulatory agencies relating
to any of our products or product candidates; our ability to continue to secure and maintain regulatory designations for our product
candidates; our ability to develop manufacturing capabilities compliant with current good manufacturing practices for our product candidates;
our ability to manufacture cell and gene therapy products and produce an adequate product supply to support clinical trials and potentially
future commercialization; the rate and degree of market acceptance of our product candidates for any indication once approved; and our
ability to meet our obligations contained in license agreements to which we are party.
PART
I
ITEM
1. BUSINESS
Business
Abeona
Therapeutics Inc., a Delaware corporation (together with our subsidiaries, “we,” “our,” “Abeona”
or the “Company”), is a clinical-stage biopharmaceutical company developing cell and gene therapies for life-threatening
diseases. Our lead clinical program is for prademagene zamikeracel (“pz-cel”), our investigational autologous, COL7A1 gene-corrected
epidermal sheets currently in development for recessive dystrophic epidermolysis bullosa (“RDEB”). Pz-cel has been granted
Orphan Drug and Rare Pediatric Disease (“RPD”) designations by the U.S. Food and Drug Administration (“FDA”)
and Orphan Drug Designation by the European Medicines Agency (“EMA”).
We
plan to continue development of adeno-associated virus (“AAV”) based gene therapies designed to treat ophthalmic diseases
with high unmet medical need using the novel AIMTM capsid platform that we have exclusively licensed from the University of North
Carolina at Chapel Hill (“UNC”), and internal AAV vector research programs. Abeona’s novel, next-generation AAV capsids
are being evaluated to improve tropism profiles for a variety of devastating diseases.
Our
Mission and Strategy
Abeona
is a fully-integrated cell and gene therapy company featuring research and clinical development programs, in-house manufacturing facilities,
and scientific and clinical leadership. Our mission is to create, develop, manufacture, and deliver cell and gene therapies to transform
the lives of people impacted by life-threatening diseases. In 2023, we continued to make progress toward fulfilling our goal of harnessing
the promise of genetic medicine and redefining the standard of care through cell and gene therapies. In September 2023, we submitted
a Biologics License Application (“BLA”) for pz-cel to the FDA. In November 2023, the FDA accepted and granted priority review
for our BLA for pz-cel. Under the Prescription Drug User Fee Act (“PDUFA”), the FDA has set a target action date of May 25,
2024.
We
partner with leading academic researchers, patient advocacy organizations, caregivers and other biotechnology companies to develop therapies
that address the underlying cause of a broad spectrum of rare genetic diseases for which no effective treatment options exist today.
Our
strategy consists of:
Advancing
and Commercializing our Late-Stage Clinical Cell and Gene Therapy Programs with a Focus on Life-Threatening Diseases.
Through
our cell and gene therapy expertise in research and development, we believe we are positioned to introduce efficacious and safe therapeutics
to transform the standard of care in devastating diseases and establish our leadership position in the field. We intend to commercialize
our assets either by ourselves or through strategic partnerships, subject to FDA approval.
Developing
Novel In-Vivo Gene Therapies Using AIMTM Capsid Technology.
We
are researching and developing AAV-based gene therapy using our novel capsids developed from the AIMTM Capsid Technology Platform
and additional Company-invented AAV capsids. We plan to continue to develop our chimeric AAV capsids capable of improved tissue targeting
for various indications and potentially evading immunity to wild-type AAV vectors.
Leveraging
our Leadership Position in Commercial-Scale Cell and Gene Therapy Manufacturing.
We
established current Good Manufacturing Practice (“cGMP”), clinical-scale manufacturing capabilities for engineered cell therapy
and AAV-based gene therapies in our state-of-the-art Cleveland, Ohio facility. We believe that our platform provides us with distinct
advantages, including flexibility, scale, reliability, and the potential for reduced development risk, reduced cost, and faster times
to market. We have focused on establishing internal Chemistry, Manufacturing and Controls (“CMC”) capabilities that drive
value for our organization through process development, assay development and manufacturing. We have also deployed robust quality systems
governing all aspects of product lifecycle from preclinical through commercial stage.
Establishing
Additional Cell and Gene Therapy Franchises and Adjacencies through In-Licensing and Strategic Partnerships.
We
seek to be the partner of choice in cell and gene therapy treatments and have closely collaborated with leading academic institutions,
key opinion leaders, patient foundations, and industry partners to accelerate research and development, understand the needs of patients
and their families, and generate novel intellectual property.
Maintaining
and Growing our IP Portfolio.
We
seek patent rights for various aspects of our programs, including vector engineering and construct design, our production process, and
all features of our clinical products including composition of matter and method of administration and delivery. We expect to continue
to expand our intellectual property portfolio by aggressively seeking patent rights for promising aspects of our product engine and product
candidates.
Developing
Next-Generation Cell and Gene Therapy
Pz-cel
for the Treatment of RDEB
Disease
Overview
RDEB
belongs to a broad group of genetic skin disorders known as epidermolysis bullosa. Patients with RDEB have a defect in the COL7A1 gene,
resulting in the inability to produce Type VII collagen, which plays a vital role in skin functioning by anchoring the skin’s dermal
and epidermal layers to one another.
As
a result of the genetic defect, RDEB patients have fragile skin, which can easily damage to produce open and blistering wounds,
disfiguring scars throughout the body, fused fingers and toes, limits in range of motion at joints (e.g., arms and legs), corneal
abrasions, and an abnormal narrowing of the esophagus. Long-term RDEB patients can suffer from anemia, are at high risk of
developing aggressive squamous cell carcinomas, infections, and premature death. The most severe patients are approximately 20 times
more likely to die by 30 years of age than the general population.
Similar
to other rare diseases, the incidence and prevalence of RDEB are not well defined. Incidence of 0.2 to 3.05 per million births and prevalence
of 0.14 to 1.35 per million people have been observed across different geographies, primarily estimated by limited population analyses
of clinical databases or registries (Eichstadt et al.; Clinical, Cosmetic and Investigational Dermatology, 2019). Using genetic modeling
of COL7A1 variants, which is believed to cause RDEB, Stanford University estimated the incidence of RDEB to be approximately 63 per million
births, and prevalence could be up to 3,850 patients in the U.S., whose wounds may benefit from COL7A1-mediated treatments such as pz-cel.
RDEB
patients have an active disease with the majority of the wounds typically > 20 cm2 (Stanford University; Solis, D., et
al., 2017). In 2020, a survey of RDEB patients reported that approximately 60% have active wounds covering greater than 30% of their
bodies (Bruckner et al.; Orphanet Journal of Rare Diseases, 2020). Wounds covering up to approximately 80% of body surface area have
been recorded in some EB patients (Hirsch et al.; Nature Research, 2017).
In
our VIITALTM phase 3 and phase 1/2a clinical trials, pz-cel was applied as a one-time surgical procedure onto RDEB wounds
and has shown up to 8 years of durable wound healing and associated pain reduction even in the toughest-to-treat in RDEB wounds. Patients
evaluated in the VIITALTM phase 3 trial had large wounds (> 20cm2) and, on average, had wounds remained open
for 6.2 years, and in some cases up to 21 years, prior to pz-cel treatment. Most RDEB patients have large and chronic wounds that carry
the highest burden, including the need for frequent dressing changes, pain, pruritus, risk of infection, and developing skin cancer.
Current
Management of RDEB
Standard
of care in RDEB wound management currently consists of time and labor-intensive supportive care to limit contamination and
infection, and reduction in mechanical forces that produce new blisters. Care usually includes treatment of new blisters by lancing
and draining. Wounds are then dressed with a non-adherent material, covered with padding for stability and protection, and secured
with an elastic wrap for integrity. In a cost analysis conducted by Debra of America, based on 3,274 patient’s health insurance
claims from private insurance the annual cost of dystrophic epidermolysis bullosa (DEB) was identified to be 465% greater than the
annual cost to the healthcare system from all people. The cost of wound care supplies could be as high as
$996,000 per year.
RDEB
patients also have periodic surgeries to relieve disease related issues such as narrowing of their esophagus, fusing of fingers, and
corneal abrasions.
In
2023, Vyjuvek® and Filsuvez® were approved by the FDA for treatment of wounds associated with DEB and
wounds associated with Junctional (JEB) and DEB, respectively. The introduction of these drugs may further increase the total cost of care.
Program
Status
Pz-cel
is our investigational autologous epidermal sheets in which a functioning COL7A1 gene is inserted into a patient’s own skin cells
(keratinocytes) using a retrovirus. The keratinocytes are then grown into credit card sized sheets and surgically applied to the patient to restore Type VII collagen expression
and skin function.
Results
from a completed Phase 1/2a study that enrolled seven patients with large and chronic RDEB wounds at Stanford University showed that
pz-cel was well-tolerated and resulted in significant and durable wound healing (Siprashvili, Z., et al., 2016), with up to eight years
of follow-up (So. Y, Nazaraoff, et al., Orphanet Journal Rare Disease 2022). To date, there have been no reported serious adverse events.
In
November 2022, we announced positive topline data from our VIITALTM study. The pivotal phase 3 VIITALTM study evaluated the
efficacy, safety, and tolerability of pz-cel in 43 large chronic wound pairs in 11 subjects with RDEB. The large chronic wounds randomized
and treated in VIITALTM measured greater than 20 cm2 of surface area and had remained open for a minimum of six months
and a maximum of 21 years (mean 6.2 years). The co-primary endpoints of the study were: (1) the proportion of RDEB wound sites with greater
than or equal to 50% healing from baseline, comparing randomized treated with matched untreated (control) wound sites at the six-month
timepoint, as determined by direct investigator assessment; and (2) pain reduction associated with wound dressing change assessed by
the mean differences in scores of the Wong-Baker FACES® Pain Rating Scale between randomized treated and matched untreated
(control) wounds at the six-month timepoint.
The
VIITALTM study met its two co-primary efficacy endpoints demonstrating statistically significant, clinically meaningful improvements
in wound healing and pain reduction in large chronic RDEB wounds. Pz-cel was shown to be well-tolerated with no serious treatment-related
adverse events observed, consistent with past clinical experience. There were no deaths or instances of positive replication-competent
retrovirus results, and no systemic immunologic responses were reported during the study, as well as no squamous cell carcinoma at treatment
sites after application of pz-cel. Two subjects reported at least one serious adverse event unrelated to pz-cel. Four subjects reported
related treatment emergent adverse events, including procedural pain, muscle spasms and pruritis. Infections unrelated to pz-cel were
observed in eight patients.
In
September 2023, we submitted a BLA for pz-cel to the FDA. In November 2023, the FDA accepted for filing and granted priority review
for our BLA for pz-cel. Under the PDUFA, the FDA has set a target action date of May 25, 2024. Pz-cel has been granted Regenerative
Medicine Advanced Therapy (“RMAT”), Breakthrough Therapy, Orphan Drug and RPD designations by the by the FDA as well as
Orphan Drug designation by the EMA.
Among
the potential benefits of Orphan Drug designation are a potential seven years of market exclusivity following FDA approval, potentially
preventing FDA approval of another product deemed to be the same as the approved product for the same indication, waiver of application
fees, and tax credits for qualified clinical testing expenses conducted after orphan designation is received. A sponsor who receives
an approval for a BLA with RPD designation may qualify for a Priority Review Voucher (“PRV”), subject to final determination
by the FDA. A PRV may be used to receive expedited review of a subsequent marketing application for a different product or sold to another
company.
We
have continued to prepare our cGMP commercial facility in Cleveland for manufacturing pz-cel to support our planned BLA filing. Pz-cel
study drug product for all our VIITALTM study participants has been manufactured at our Cleveland facility.
ABO-503
for the treatment of X-linked Retinoschisis (“XLRS”).
Disease
Overview and Program Overview
XLRS
is a rare, monogenic retinal disease that results in the irreversible loss of photoreceptor cells and severe visual impairment. XLRS
is caused by mutations in the RS1 protein, which is normally secreted by retinal photoreceptors and bipolar neurons and functions to
mediate cell-cell adhesion. XLRS is characterized by abnormal splitting of the layers of the retina, resulting in poor visual acuity,
which can progress to legal blindness. The incidence of XLRS is estimated to be between 1 in 5,000 and 1 in 20,000 in males, with an
estimated prevalence of 35,000 in the United States and Europe combined. There are currently no disease modifying therapies approved
for XLRS, but because the genetics of the disease are well understood, early intervention via gene therapy has significant potential
to reverse or stabilize disease progression at early stages and prevent vision loss.
ABO-503,
composed of a functional human RS1 packaged in the novel AIMTM capsid AAV204, has shown preclinical efficacy following delivery
to the retina in a mouse model of XLRS. Preclinical studies have demonstrated robust RS1 expression in the retina, improved cone photoreceptor
density and overall photoreceptor cell survival, as well as a restoration of outer retina architecture. Results of these studies were
presented at the American Society of Gene and Cell Therapy (ASGCT) Annual Meeting in May 2023. A pre-IND meeting for ABO-503 was conducted
with the FDA in April 2023 and provided Abeona with comprehensive feedback to support a future IND submission.
ABO-504
for the Treatment of Stargardt Disease
Disease
Overview and Program Overview
Autosomal
recessive Stargardt disease, the most common form of juvenile macular degeneration with estimated incidence of 1 in 8,000 to 10,000 people,
causes vision loss in children and young adults. The most common form of Stargardt disease is caused by mutations in the ABCA4 gene,
which prevent removal of toxic compounds from photoreceptor cells that results in photoreceptor cell death and progressive vision loss.
There are currently no FDA approved treatments available, and to date, development of investigational gene modifying therapies has remained
challenging in part due to the large size of the ABCA4 gene, which exceeds the encapsidation capacity of a single AAV vector.
Abeona’s
internal research and development team developed ABO-504, which is designed to efficiently reconstitute the full-length ABCA4 gene by
implementing a dual AAV vector strategy using the Cre-LoxP recombinase system. Abeona previously reported preclinical data demonstrating
the ability of the dual AAV vector system to produce full length ABCA4 protein in cell culture. Recent proof-of-concept studies, presented
at the 2023 ASGCT Annual Meeting, have extended these findings by showing expression of ABCA4 mRNA and full-length ABCA4 protein in the
retina of subretinally dosed abca4-/- knockout mice, at levels similar to endogenous ABCA4 in wild-type animals. A pre-IND meeting for
ABO-504 was conducted with the FDA in June 2023 and provided Abeona with comprehensive feedback to support a future IND submission.
ABO-505
for the Treatment of Autosomal Dominant Optic Atrophy (“ADOA”)
Disease
Overview and Program Overview
ADOA,
a form of hereditary vision loss associated with retinal ganglion cell (“RGC”) death, is predominantly caused by mutations
in the Opa1 gene. Opa1, a dynamin-related GTPase, acts to stabilize the inner mitochondrial membrane and acts in mitochondrial fusion
and inner membrane remodeling. Mutant phenotypes present with a progressive loss of RGCs that results in optic nerve degeneration and
legal blindness with a loss of visual acuity, optic disc pallor, and color vision deficits. ADOA affects approximately 1 in 30,000 people
worldwide. Currently, there is no approved treatment for people living with ADOA.
ABO-505
is designed to express a functional copy of human Opa1 in the retina following para-retinal injection. ABO-505 aims to take advantage
of the robust optic nerve and RGC transduction ability of AAV204 to deliver its genetic payload to the cells most affected by ADOA. Preclinical
studies have confirmed expression of Opa1 in both cell culture and the retinas of dosed wild-type and disease model animals. Initial
efficacy results suggest an improvement in retinal signaling to the brain and improved visual acuity in treated mutant mice. These studies
were presented at the ASGCT Annual Meeting in May 2023.
Gene
Therapy Treatments anchored in AIMTM Vector Platform
In
2016, we licensed a library of novel AAV capsids from UNC. The AIMTM vector system is a platform of AAV capsids capable of widespread
central nervous system gene transfer and can be used to confer high transduction efficiency for various therapeutic indications. In partnership
with academic institutions, our own scientific research teams have identified vectors within the AIMTM capsid library showing strong
potential to successfully target and reach the central nervous system as well as ocular, lung, muscle, liver, and other tissues. Based
on continuing research by Abeona and our research partners, we have observed improvements in gene delivery to specific tissues compared
to currently available AAV technology. We believe AIMTM vectors also have the potential for redosing subjects who previously received
certain AAV gene therapy or subjects who have pre-existing antibodies to naturally occurring AAV serotypes.
Strategic
Licensing Agreements
We
have out-licensed certain clinical and research programs, including for the treatment of Sanfilippo syndrome type A (MPS IIIA) to Ultragenyx
Pharmaceutical Inc. (“Ultragenyx”), and for CLN1 disease (infantile Batten disease) and Rett syndrome to Taysha Gene Therapies,
Inc. (“Taysha”). Under the terms of our agreement with Ultragenyx, we are eligible to receive payments based on the achievement
of certain sales milestones and royalties on net sales. Under our agreements with Taysha, we are eligible to receive payments based on
certain clinical, regulatory, and sales milestones and royalties on net sales.
Leveraging
Leadership Position in Commercial-Scale Cell and Gene-Therapy Manufacturing
We
have established a cGMP manufacturing facility, the Elisa Linton Center located in Cleveland, Ohio, which enables us to enhance supply
chain control, establish tighter quality control testing, increase supply capacity, reduce production costs and gain manufacturing efficiency
for clinical trials related to our product candidates and ensure commercial demand is met in the event our therapies receive marketing
approval. Our facility is led by a team of highly skilled production, process/assay development and quality control scientists with expertise
in cell and gene therapy, particularly in cell culture, upstream manufacturing, downstream purification, assay development and wet lab
techniques.
We
have completed our 16,000+ square foot manufacturing build-out in Cleveland, Ohio. The first phase, completed in 2018, was a 6,000 square
foot state-of-the-art cGMP production facility for the manufacturing of cell and gene therapies. The facility is designed to initially
manufacture clinical drug products with intent of manufacturing commercial grade cGMP drug product. The second phase, completed in 2019,
was the completion of an additional 8,000 square feet of state-of-the-art laboratory space to support our expanding quality control,
process development, and assay development teams. The second phase also included nearly 2,000 square feet of cGMP Inventory Control space.
We
have advanced our in-house manufacturing capabilities for pz-cel. The product is manufactured as a multilayer cellular sheet containing
corrected keratinocytes that is fastened to a petrolatum gauze backing with surgical titanium ligating clips. Engineered sheets are applied
over wound areas, where they provide keratinocytes with functional Type VII collagen, providing immediate wound coverage and allowing
for long-term wound healing. A key component to the pz-cel drug product manufacturing process is the retroviral vector, which delivers
the functional copy of the Collagen VII Alpha 1 cDNA to the autologous patient cells. Initially developed at the Indiana University Vector
Production Facility, we have transferred the cGMP manufacturing process for the LZRSE-Col7A1 retroviral vector to our Cleveland facility
and have demonstrated analytical comparability between IUVPF and Abeona-produced retroviral vector. In order to support licensure, we
have produced three cGMP process validation lots and have also created and characterized a cGMP master cell bank and a working cell bank
to support the cGMP production of the retroviral vector.
We
have established AAV vector manufacturing capabilities that use the triple plasmid transient transfection method. We insert, or transfect,
many copies of three DNA plasmids encoding the specific therapeutic gene sequence, or transgene, the capsid coding sequence, and helper
sequences into AAV-293 cells using a serum-free, suspension-based bioreactor vector production technology. During an incubation period
following transfection, each cell produces AAV vectors through biosynthesis using the cells’ natural machinery. At the end of the
incubation period, the newly generated AAV vectors are harvested, filtered, and purified in a multi-step process.
We
have established and maintained strong and collaborative relationships with third-party companies specializing in the testing of cell
and gene therapy material to complement our process and assay development needs.
We
have made significant investments in developing optimized manufacturing processes and believe that our processes and methods developed
to date provide a comprehensive manufacturing process for pz-cel and AAV-based vector therapies, including:
● sufficient scale to support commercial manufacturing requirements for pz-cel
● processes related to product release testing for pz-cel
● processes related to the manufacture and release testing of retroviral vector
● AAV serum-free suspension technology that is readily scalable
We
believe that these improvements will enable us to develop best-in-class, next-generation cell and gene therapy products. As we look to
commercialize pz-cel (subject to FDA approval), we have filed our BLA to support commercial manufacturing of pz-cel from our Cleveland
facility.
Maintain
Strong Intellectual Property Protection
We
strive to protect our commercially important proprietary technology, inventions, and know-how, including by seeking, maintaining, and
defending patent rights, both for inventions developed internally and for inventions licensed from third parties. We also rely on trade
secrets and know-how relating to our proprietary technology platforms, continuing technological innovation, and in-licensing opportunities
to develop, strengthen and maintain our position in the field of cell and gene therapy. We may also rely on the additional protections
afforded by data exclusivity (currently 12 years for biologics), other market exclusivities such as orphan drug exclusivity, and patent
term extensions, where applicable.
Our
success may depend in part on our ability to obtain and maintain patents and other protections for commercially important technology,
inventions, and know-how related to our business; defend and enforce our patents; preserve the confidentiality of our trade secrets;
and operate without infringing the valid enforceable patents and other intellectual property rights of third parties. Our ability to
stop third parties from making, having made, using, selling, offering to sell, or importing our products may depend on the extent to
which we have rights under valid and enforceable licenses, patents, or trade secrets that cover these activities. In some cases, these
rights may need to be enforced by third-party licensors. With respect to both licensed and company-owned intellectual property, we may
not be granted patents with respect to any of our pending patent applications or with respect to any patent applications filed by us
in the future, nor can we be sure that any of our existing patents or any patents that may be granted to us in the future will be commercially
useful in protecting our commercial products and methods of manufacturing the same.
We
are actively seeking U.S. and international patent protection, together with our licensors, for a variety of technologies, including
AAV capsids, AAV-based biological products, methods of designing novel AAV constructs, methods for treating diseases of interest, including
RDEB, and methods for manufacturing, packaging, and transporting our product candidates. We also intend to seek patent protection or
rely upon trade secret rights to protect other technologies that may be used to discover and validate targets and that may be used to
identify and develop novel biological products. We seek protection, in part, through confidentiality and proprietary information agreements.
We are a party to various license agreements that give us rights to use specific technologies in our research and development, and future
commercialization.
Licensed
Technologies and Intellectual Property
1. Recessive Dystrophic Epidermolysis Bullosa
To
support our EB franchise, we have licensed a patent family from Stanford University covering pz-cel and its use in the treatment of RDEB.
Patents covering our investigational pz-cel product have been granted by the European Patent Office (EP3400287B1) and in other geographical
regions, and are expected to expire in early 2037. Patent applications remain pending in the United States which, if granted, would be
expected to expire in 2037. We have also filed United States and Canadian patent applications directed to the packaging and transport
of pz-cel, which, if granted, are not expected to expire before 2040.
We
may also rely on the additional protection afforded by data exclusivity (currently 12 years for biologics like pz-cel), other market
exclusivity such as orphan drug exclusivity (currently seven years), and patent term extensions, where applicable.
2. AIMTM Capsids
We
have an exclusive license to an international patent family from The University of North Carolina at Chapel Hill (“UNC”)
covering novel AAV capsids (“AIMTM capsids”) that may potentially be used to deliver a wide variety of therapeutic transgenes
to human cells to treat genetic diseases. National stage applications directed to the AIMTM capsids have been filed in the United
States, Europe and other geographical regions. The first U.S. patent in this patent family, U.S. Patent No. 10,532,110 (the “‘110
Patent”), was issued to UNC on January 14, 2020. The ‘110 Patent is entitled to 352 days of patent term adjustment, making
its projected expiration date November 6, 2036. The second U.S. patent in this patent family, U.S. Patent No. 10,561,743 (the “‘743
Patent”), was issued to UNC on February 18, 2020. The ‘743 Patent is expected to expire on November 20, 2035. A third U.S.
patent in this patent family, U.S. Patent No. 11,491,242 (the “‘242 Patent”) issued on November 8, 2022. The ‘242
Patent is entitled to 429 days of patent term adjustment and will not expire before January 22, 2037. Patents have also been granted
in Australia (AU2015349759B2), Israel (IL252072), and Russia (RU2727015). We have exclusive rights to these patents under our license
with UNC.
We
also own a second patent family directed to certain AAV capsids and have filed national stage applications in the United States, Europe
and other geographical regions. Patents issuing from these applications are not expected to expire before 2039.
3. CLN1 Disease (Infantile Batten Disease)
We
have also licensed from UNC rights to two patent families directed to treating CLN1 disease (also known as infantile Batten disease).
The first patent family is directed to optimized CLN1 genes and expression cassettes for use in treating CLN1 disease, which has applications
pending in the United States, Europe, and other geographical regions. One U.S. patent in the first patent family, U.S. Patent No. 11,504,435
(the “‘435 Patent”), was issued to UNC on November 22, 2022. The ‘435 Patent is entitled to 578 days of patent
term adjustment, making its projected expiration date January 12, 2039. The second patent family is directed to treating CLN1 disease
using a combination of intrathecal and intravenous administrations, which has applications pending in the United States, Europe and other
geographical regions. Patents issuing from applications in the second patent family will have a 20-year expiration date of no earlier
than 2040. We have entered into agreements exclusively sublicensing these two CLN1 patent families to Taysha Gene Therapies, Inc.
4. Rett Syndrome
We
have licensed rights to one patent family from UNC and two patent families from The University Court of the University of Edinburgh (“U.
Edinburgh”) and The University Court of the University of Glasgow (“U. Glasgow”) relating to gene therapy for the treatment
of Rett Syndrome. The patent family licensed from UNC at Chapel Hill are directed to viral genomes designed to regulate expression of
the MeCP2 gene, which is mutated in patients with Rett Syndrome. This patent family has pending applications in the United States, Europe
and other geographical regions. Patents issuing from these applications will have a 20-year expiration date of no earlier than 2039.
The patent families licensed from U. Edinburgh and U. Glasgow are directed to expression cassettes for MeCP2 polypeptides and to synthetic
MeCP2 polypeptides. The patent family directed to MeCP2 expression cassettes has pending applications in the United States, Europe and
other geographical regions. The patent family directed to synthetic MeCP2 polypeptides has pending applications in the United States
and other geographical regions. Patents issuing from applications in the Edinburgh patent families will have a 20-year expiration date
of no earlier than 2038. In October 2020, we entered into an agreement exclusively sublicensing these UNC and University of Edinburgh
patent rights to Taysha Gene Therapies.
5. Multipartite AAV Delivery of Large Transgenes
We
own a patent family directed to multipartite delivery of large transgenes using AAV vectors and have filed national stage applications
in the United States, Europe and other geographical regions. Patents issuing from these applications are not expected to expire before
2041.
We
also own a pending U.S. provisional application directed to multipartite AAV delivery and its use for treating Stargardt disease.
We
own a patent family directed to (i) novel AAV capsid proteins and (ii) treating ophthalmic diseases via para-retinal administration of
AAV vectors, and have filed national stage applications in the United States, Europe, and other geographical regions. Patents issuing
from these applications are not expected to expire before 2042.
7. Treatment of Dominant Optic Atrophy and X-linked Retinoschisis
We
own a pending PCT application (PCT/US2023/065877) directed to compositions and methods for treating dominant optic atrophy and x-linked
retinoschisis. Patents issuing from future national stage applications of this PCT application are not expected to expire before 2043.
We
expect to explore in due course strategies to support patent term extensions for all of our patent portfolios.
U.S.
Biologic Products Development Process
In
the United States, the FDA regulates biologic products including gene therapy products under the Federal Food, Drug, and Cosmetic Act
(“FDCA”), the Public Health Service Act (“PHSA”), and regulations implementing these laws. The FDCA, PHSA and
their corresponding regulations govern, among other things, the testing, manufacturing, safety, efficacy, labeling, packaging, storage,
record keeping, distribution, advertising, and promotion of biologic products. Applications to the FDA are required before conducting
human clinical testing of biologic products. FDA approval also must be obtained before marketing of biologic products. Gene therapy studies
may also need to comply with the National Institutes of Health (“NIH”) Guidelines for Research Involving Recombinant or Synthetic
Nucleic Acid Molecules (“NIH Guidelines”), which includes additional requirements, such as the review and approval of the
study by an Institutional Biosafety Committee.
Within
the FDA, the Center for Biologics Evaluation and Research (“CBER”) regulates gene therapy products. Within CBER, the review
of gene therapy and related products is consolidated in the Office of Tissues and Advanced Therapies (“OTAT”) and the FDA
has established the Cellular, Tissue and Gene Therapies Advisory Committee (“CTGTAC”), a panel of medical and scientific
experts and consumer representatives, to advise CBER on its reviews. The FDA has issued a growing body of guidance documents on CMC,
clinical investigations and other areas of gene therapy development, all of which are intended to facilitate the industry’s development
of gene therapy products.
The
process required by the FDA before a biologic product candidate may be marketed in the United States generally involves the following:
Before
testing any biologic product candidate on humans, including a gene therapy product candidate, the product candidate must undergo preclinical
testing. Preclinical tests, also referred to as nonclinical studies, include laboratory evaluations of product chemistry, toxicity, and
formulation, as well as in vivo studies to assess the potential safety and activity of the product candidate. The conduct of the preclinical
tests must comply with federal regulations and requirements including GLPs.
If
a gene therapy trial is conducted at, or sponsored by, institutions receiving NIH funding for recombinant DNA research, the study must
also comply with the NIH Guidelines. Compliance with the NIH Guidelines is mandatory for investigators at institutions receiving NIH
funds for research involving recombinant DNA. However, many companies and other institutions, not otherwise subject to the NIH Guidelines,
voluntarily follow them.
The
clinical trial sponsor must submit the results of the preclinical tests, together with manufacturing information, analytical data, any
available clinical data or literature and a proposed clinical protocol, to the FDA as part of the IND. Some preclinical testing may continue
even after the IND is submitted. The IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA places the
clinical trial on a clinical hold. In such a case, the IND sponsor and the FDA must resolve any outstanding concerns before the clinical
trial can begin. The FDA also may impose clinical holds on a biologic product candidate at any time before or during clinical trials
due to safety concerns or non-compliance. If the FDA imposes a clinical hold, trials may not commence or recommence without FDA authorization
and then only under terms authorized by the FDA.
Human
clinical trials under an IND
Clinical
trials involve the administration of the biologic product candidate to healthy volunteers or patients under the supervision of qualified
investigators, which generally are physicians not employed by, or under the control of, the trial sponsor. Investigators must also provide
certain information to the clinical trial sponsors to allow the sponsors to make certain financial disclosures to the FDA. Clinical trials
are conducted under protocols detailing, among other things, the objectives of the clinical trial, dosing procedures, subject selection
and exclusion criteria and the parameters to be used to monitor subject safety, including stopping rules that assure a clinical trial
will be stopped if certain adverse events should occur. Each protocol and any amendments to the protocol must be submitted to the FDA
as part of the IND. Clinical trials must be conducted and monitored in accordance with the FDA’s regulations comprising the GCP
requirements, including the requirement that all research subjects provide informed consent.
Further,
each clinical trial must be reviewed and approved by an IRB at or servicing each institution at which the clinical trial will be conducted.
An IRB is charged with protecting the welfare and rights of trial participants and considers items such as whether the risks to individuals
participating in the clinical trials are minimized and are reasonable in relation to anticipated benefits. The IRB also approves communications
to study subjects before a study commences at that site and the form and content of the informed consent that must be signed by each
clinical trial subject, or his or her legal representative, and must monitor the clinical trial until completed. Clinical trials involving
recombinant DNA also must be reviewed by an institutional biosafety committee (“IBC”), a local institutional committee that
reviews and oversees basic and clinical research that utilizes recombinant DNA at that institution. The IBC assesses the safety of the
research and identifies any potential risk to public health or the environment.
Information
about certain clinical trials, including a description of the study and study results, must be submitted within specific timeframes to
NIH for public dissemination on their clinicaltrials.gov website. Sponsors or distributors of investigational products for the diagnosis,
monitoring, or treatment of one or more serious diseases or conditions must also have a publicly available policy on evaluating and responding
to requests for expanded access requests.
Investigational
biologics and therapeutic substances imported into the United States are also subject to regulation by the FDA. Further, the export of
investigational products outside of the United States is subject to regulatory requirements of the receiving country as well as U.S.
export requirements under the FDCA.
Human
clinical trials typically are conducted in three sequential phases that may overlap or be combined:
Additional
kinds of data may also help to support a BLA, such as patient experience data. Real world evidence may also support a BLA, and, for appropriate
indications sought through supplemental BLAs, data summaries may provide marketing application support. For genetically targeted products
and variant protein targeted products intended to address an unmet medical need in one or more patient subgroups with a serious or life
threatening rare disease or condition, the FDA may allow a sponsor to rely upon data and information previously developed by the sponsor
or for which the sponsor has a right of reference, that was submitted previously to support an approved application for a product that
incorporates or utilizes the same or similar genetically targeted technology or a product that is the same or utilizes the same variant
protein targeted drug as the product that is the subject of the application.
Post-approval
clinical trials, sometimes referred to as phase IV clinical trials, may be conducted or may be required by FDA after initial approval.
These clinical trials are used to gain additional experience from the treatment of patients in the intended therapeutic indication, particularly
for long-term safety follow-up.
During
all phases of clinical development, regulatory agencies require extensive monitoring and auditing of all clinical activities, clinical
data, and clinical trial investigators. Annual progress reports detailing the results of the clinical trials must be submitted to the
FDA.
Written
IND safety reports must be promptly submitted to the FDA, IRBs, IBCs, and the investigators for serious and unexpected adverse events;
any findings from other trials, in vivo laboratory tests or in vitro testing that suggest a significant risk for human subjects; any
clinically important increase in the rate of a serious suspected adverse reaction over that listed in the protocol or investigator brochure,
or other safety information. The sponsor must submit an IND safety report within 15 calendar days after the sponsor determines that the
information qualifies for reporting. The sponsor also must notify the FDA of any unexpected fatal or life-threatening suspected adverse
reaction within seven calendar days after the sponsor’s initial receipt of the information.
The