ITEM 1A. RISK FACTORS 16
ITEM 1B. UNRESOLVED STAFF COMMENTS 54
ITEM 1C CYBERSECURITY 54
ITEM 2. PROPERTIES 55
ITEM 3. LEGAL PROCEEDINGS 55
ITEM 4. MINE SAFETY DISCLOSURES 55
ITEM 6. RESERVED 57
ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK 76
ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA 76
ITEM 9A. CONTROLS AND PROCEDURES 76
ITEM 9B. OTHER INFORMATION 78
ITEM 9C. DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS 78
PART III 79
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE 79
ITEM 11. EXECUTIVE COMPENSATION 83
ITEM 14. PRINCIPAL ACCOUNTANT FEES AND SERVICES 94
ITEM 15. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES 95
INDEX TO EXHIBITS 96
CONSOLIDATED FINANCIAL STATEMENTS F-1
Introductory
Comment
Throughout
this Annual Report on Form 10-K, the terms “we,” “us,” “our,” “our company,” “Lixte,”
the “Company” and the “Registrant” refer to Lixte Biotechnology Holdings, Inc., a Delaware corporation, and Lixte
Biotechnology, Inc., a Delaware corporation, our wholly-owned subsidiary.
FORWARD-LOOKING
STATEMENTS
This
Annual Report on Form 10-K (the “Report”) contains certain forward-looking statements. For example, statements regarding
our financial position, business strategy and other plans and objectives for future operations, and assumptions and predictions about
future product demand, supply, manufacturing, costs, marketing and pricing factors are all forward-looking statements. These statements
are generally accompanied by words such as “intend,” “anticipate,” “believe,” “estimate,”
“potential(ly),” “continue,” “forecast,” “predict,” “plan,” “may,”
“will,” “could,” “would,” “should,” “expect” or the negative of such terms
or other comparable terminology. We believe that the assumptions and expectations reflected in such forward-looking statements are reasonable,
based on information available to us on the date hereof, but we cannot assure you that these assumptions and expectations will prove
to have been correct or that we will take any action that we may presently be planning. However, these forward-looking statements are
inherently subject to known and unknown risks and uncertainties. Actual results or experience may differ materially from those expected
or anticipated in the forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited
to, regulatory policies, competition from other similar businesses, and market and general policies, competition from other similar businesses,
and market and general economic factors. This discussion should be read in conjunction with the consolidated financial statements and
notes thereto included in this Report.
If
one or more of these or other risks or uncertainties materialize, or if our underlying assumptions prove to be incorrect, actual results
may vary materially from what we project. Any forward-looking statement you read in this Report reflects our current views with respect
to future events and is subject to these and other risks, uncertainties and assumptions relating to our operations, results of operations,
growth strategy, and liquidity. All subsequent forward-looking statements attributable to us or individuals acting on our behalf are
expressly qualified in their entirety by this paragraph. You should specifically consider the factors identified in this Report, which
would cause actual results to differ before making an investment decision. We are under no duty to update any of these forward-looking
statements after the date of this Report or to conform these statements to actual results.
PART
I
ITEM
1. BUSINESS
Company
Overview
The
Company is a clinical-stage biopharmaceutical and proton cancer therapy company focused on identifying new targets for cancer drug development
and developing and commercializing cancer therapies. The Company’s drug product pipeline is primarily focused on inhibitors of
protein phosphatase 2A, which is used to enhance cytotoxic agents, radiation, immune checkpoint blockers and other cancer therapies.
The Company believes that inhibitors of protein phosphatases have significant therapeutic potential for a broad range of cancers. The
Company is focusing on the clinical development of a specific protein phosphatase inhibitor, referred to as LB-100, which has been shown
to have clinical anti-cancer activity.
The
Company is the majority shareholder of Liora Technologies Europe Ltd., which is pioneering the development of electronically controlled
proton therapy systems for treating tumors in various types of cancers. Liora’s proprietary technology, known as LiGHT System (Linac
for Image Guided Hadron Therapy), has significant advantages over currently available technologies for treating tumors with proton therapy.
Liora is an excellent complement to the pharmaceutical side of the Company’s business and ongoing clinical trials with LB-100 for
Ovarian Clear Cell Carcinoma and Metastatic Colon Cancer,
LB-100
The
Company believes that the mechanism by which LB-100 affects cancer cell growth is different from cancer agents currently approved for
clinical use. LB-100 is currently being tested in clinical trials in Ovarian Clear Cell Carcinoma, Metastatic Micro Satellite Stable
(MSS) Colon Cancer, and Advanced Soft Tissue Sarcoma. LB-100 has shown anti-cancer activity in animal models of glioblastoma multiforme,
neuroblastoma, and medulloblastoma, all cancers of neural tissue. LB-100 has also been shown to enhance the effectiveness of commonly
used anti-cancer drugs in animal models of melanoma, breast cancer and sarcoma. The enhancement of anti-cancer activity of these anti-cancer
drugs occurs at doses of LB-100 that do not significantly increase toxicity in animals. It is therefore hoped that, when combined with
standard anti-cancer regimens against many tumor types, LB-100 will improve therapeutic benefit.
As
a compound moves through the FDA-approval process, it becomes an increasingly valuable property, but at a cost of additional investment
at each stage. As the potential effectiveness of LB-100 has been documented at the clinical trial level, the Company has allocated resources
to expand the breadth and depth of its patent portfolio. The Company’s approach has been to operate with a minimum of overhead,
moving compounds forward as efficiently and inexpensively as possible, and to raise funds to support each of these stages as certain
milestones are reached. The Company’s longer-term objective is to secure one or more strategic partnerships or licensing agreements
with pharmaceutical companies with major programs in cancer.
The
Company’s activities are subject to significant risks and uncertainties, including the need for additional capital. The Company
has not yet commenced any revenue-generating operations, does not have positive cash flows from operations, relies on stock-based compensation
for a substantial portion of employee and consultant compensation, and is dependent on periodic access to equity capital to fund its
operating requirements.
Description
of LB-100 Business
Most
cancer patients are treated with either chemotherapy or immunotherapy or both. These therapies often have limited benefit and there is
a high unmet medical need to enhance their effects. In many preclinical models we have shown that LB-100 enhances the effect of both
chemotherapy and Immunotherapy
LB-100,
a small molecule potent inhibitor of PP2A, was designed and developed by us. Numerous preclinical studies have documented that LB-100
potentiates most if not all anti-cancer drugs that damage DNA. LB-100 is not associated with any increase in cytotoxicity when given
with cytotoxic drugs. This synergy involves transient interruption of several DNA damage repair pathways by LB-100 and an increase in
cell division rate. LB-100 has FDA Investigational New Drug status in the US and Investigational Medicinal Product Dossier approval in
the European Union.
In
its initial Phase 1 clinical trial, LB-100 given alone daily for 3 days was non-toxic, except for a transient increase in serum creatinine
believed to be caused by inhibition of PP2A in the renal tubules. In the Phase 1 clinical trial, the Maximum Tolerated Dose (“MTD”)
was 2.33mg/m2 daily for 3 days every 3 weeks. Of the 25 patients with heavily-treated advanced solid tumors with measurable disease,
3 patients had stable disease for 2 cycles, 3 patients had stable disease for 4 cycles, and 3 patients had stable disease for 6 cycles.
One patient with pancreatic cancer had a partial response after 12 cycles lasting 534 days.
Low
doses of LB-100 have now been shown to enhance immune checkpoint inhibition (“ICI”) by several different mechanisms affecting
the tumor compartment and immune T-cell compartment. LB-100 increases CD8+T-cell infiltration and CD8-Treg ratio, CD8+T-cell proliferation,
and cytokine production induces microsatellite instability, neoantigen production and immune responsiveness, converting immunologically
“cold” to “hot” cancers.
Ovarian
clear cell carcinoma patients with inactivating mutations in PPP2R1A, a gene coding for a scaffold component of PP2A, and treated with
immune checkpoint inhibitors, were recently found to have markedly longer survival than patients without the mutation in their cancers.
Retrospective reviews of patients with a variety of cancers treated with ICI or chemotherapy show much longer survival of ICI-treated
patients with a PPP2R1A mutation in their tumors.
Based
on the observations in ovarian clear cell carcinoma, we have initiated a clinical trial in this disease combining LB-100 with a monoclonal
antibody blocking PD-1, a protein found on T-cells (NCT06065462).
Given
these preclinical and clinical observations, it is likely that LB-100 may be a general way to enhance immunotherapy responses.
The
research on the LB-100 series was initiated in 2006 under a Cooperative Research and Development
Agreement (“CRADA”) with the National Institute of Neurologic Disorders and Stroke
or NINDS of the National Institutes of Health or NIH dated March 22, 2006 that was subsequently
extended through a series of amendments until it terminated on April 1, 2013.
We
have also designed and developed the LB-200 series, which consists of histone deacetylase inhibitors (HDACi). LB-200 has not advanced
to the clinical stage and would require additional capital to fund further development. Accordingly, because of our focus on the clinical
development of LB-100 and analogs for cancer therapy as described below in more detail, we have decided not to actively pursue the preclinical
development of our LB-200 series of compounds at this time.
Clinical
Trial Agreements
Spanish
Sarcoma Group Collaboration Agreement
Effective
July 31, 2019, we entered into a Collaboration Agreement for an Investigator-Initiated Clinical Trial with the Spanish Sarcoma Group
(Grupo Español de Investigación en Sarcomas or “GEIS”), Madrid, Spain, to carry out a study entitled “Randomized
phase I/II trial of LB-100 plus doxorubicin vs. doxorubicin alone in first line of advanced soft tissue sarcoma”. The purpose of
this clinical trial is to obtain information with respect to the efficacy and safety of LB-100 combined with doxorubicin in soft tissue
sarcomas. Doxorubicin is the global standard for initial treatment of advanced soft tissue sarcomas (“ASTS”). Doxorubicin
alone has been the mainstay of first line treatment of ASTS for over 40 years, with little improvement in survival from adding cytotoxic
compounds to or substituting other cytotoxic compounds for doxorubicin. In animal models, LB-100 consistently enhances the anti-tumor
activity of doxorubicin without apparent increases in toxicity.
GEIS
has a network of referral centers in Spain and across Europe that have an impressive track record of efficiently conducting innovative
studies in ASTS. We agreed to provide GEIS with a supply of LB-100 to be utilized in the conduct of this clinical trial, as well as to
provide funding for the clinical trial. The goal is to enter approximately 150 to 170 patients in this clinical trial over a period of
two to four years. The Phase 1 portion of the study began in the quarter ended June 30, 2023 to determine the recommended Phase 2 dose
of the combination of doxorubicin and LB-100. As advanced sarcoma is a very aggressive disease, the design of the Phase 2 portion of
the study assumes a median progression-free survival (“PFS”), no evidence of disease progression or death from any cause)
of 4.5 months in the doxorubicin arm and an alternative median PFS of 7.5 months in the doxorubicin plus LB-100 arm to demonstrate a
statistically significant decrease in relative risk of progression or death by adding LB-100. There is a planned interim analysis of
the primary endpoint when approximately 50% of the 102 events required for final analysis is reached.
On
October 13, 2022, we announced that the Spanish Agency for Medicines and Health Products (Agencia Española de Medicamentos y Productos
Sanitarios or “AEMPS”) had authorized a Phase 1b/randomized Phase 2 study of LB-100, our lead clinical compound, plus doxorubicin,
versus doxorubicin alone, the global standard for initial treatment of advanced soft tissue sarcomas (ASTS). Consequently, this clinical
trial commenced during the quarter ended June 30, 2023 and to be completed and a report prepared by December 31, 2026. In April 2023,
GEIS completed its first site initiation visit in preparation for the clinical trial at Fundación Jiménez Díaz University
Hospital (Madrid). Up to 170 patents will be entered into the clinical trial. The recruitment phase of the Phase 1b portion of the protocol
was completed during the quarter ended September 30, 2024. We expect to have data on toxicity and preliminary efficacy from this portion
of the clinical trial during the quarter ending March 31, 2026.
Given
the focus on the combination of LB-100 with immunotherapy in ovarian clear cell carcinoma and colorectal cancer and the availability
of capital resources, the Company entered into Amendment No. 1 to the Collaboration Agreement effective March 11, 2025 that relieved
the Company of the financial obligation to support the randomized Phase 2 portion of the clinical trial contemplated in the Collaboration
Agreement of approximately $3,095,000. As a result, the Phase 2 portion of this clinical trial will not proceed and the trial will be
closed after completion of the first phase in Q1 2026.
Clinical
Research Support Agreement Relating to Small Cell Lung Cancer
We
had executed a Clinical Research Support Agreement with the City of Hope National Medical
Center to carry out a Phase 1b clinical trial of LB-100 combined with an FDA-approved standard
regiment for treatment of untreated extensive-stage disease small cell lung cancer. The clinical
trial was initiated on March 9, 2021. However, due to the lack of patient accrual, the Company
provided notice to the City of Hope National Medical Center of the Company’s intent
to terminate the Clinical Research Support Agreement effective as of July 8, 2024.
MD
Anderson Cancer Center Clinical Trial
On
September 20, 2023, we announced an investigator-initiated Phase 1b/2 collaborative clinical trial to assess whether adding LB-100 to
a human programmed death receptor-1 (“PD-1”) blocking antibody of GSK plc (“GSK”), dostarlimab-gxly, may enhance
the effectiveness of immunotherapy in the treatment of ovarian clear cell carcinoma (“OCCC”). The clinical trial is being
sponsored by The University of Texas MD Anderson Cancer Center (“MD Anderson”) and is being conducted at The University of
Texas - MD Anderson Cancer Center. We are providing LB-100 and GSK is providing dostarlimab-gxly and financial support for the clinical
trial. On January 29, 2024, we announced the entry of the first patient into this clinical trial. We currently expect that this clinical
trial will be completed by December 31, 2028.
On
February 25, 2025, we announced that we had added the Robert H. Lurie Comprehensive Cancer Center (Lurie Cancer Center) of Northwestern
University as a second site in a clinical trial combining the Company’s proprietary compound LB-100 with GSK’s dostarlimab
to treat ovarian clear cell cancer. Patient recruitment is underway, and the first patient has been dosed.
On
December 23, 2025 we announced that we are going to expand the enrollment of the trial from 21 to 42 patients in collaboration with GSK,
MD Anderson and Northwestern University. We completed the enrollment of the first 21 patients in Q4, 2025 and expect patient 22 to be
enrolled in Q1 2026.
Netherlands
Cancer Institute Clinical Trial
Effective
June 10, 2024, we entered into a Clinical Trial Agreement with the Netherlands Cancer Institute (“NKI”) to conduct a Phase
1b clinical trial of the Company’s protein phosphatase inhibitor, LB-100, combined with atezolizumab, a PD-L1 inhibitor, the proprietary
molecule of F. Hoffman-La Roche Ltd. (“Roche”), for patients with microsatellite stable metastatic colon cancer. Under the
agreement, we will provide our lead clinical compound, LB-100, and under a separate agreement between NKI and Roche, Roche will provide
atezolizumab and financial support for the clinical trial. We have no obligation to and will not provide any reimbursement of clinical
trial costs. Pursuant to the agreement and the protocol set forth in the agreement, the clinical trial will be conducted by NKI at NKI’s
site in Amsterdam by principal investigator Neeltje Steeghs, MD, PhD, and NKI will be responsible for the recruitment of patients. The
agreement provides for the protection of the respective intellectual property rights of each of Lixte, NKI and Roche.
This
Phase 1b clinical trial will evaluate safety, optimal dose and preliminary efficacy of LB-100 combined with atezolizumab for the treatment
of patients with metastatic microsatellite stable colorectal cancer. Immunotherapy using monoclonal antibodies like atezolizumab can
enhance the body’s immune response against cancer and hinder tumor growth and spread. LB-100 has been found to improve the effectiveness
of anticancer drugs in killing cancer cells by inhibiting a protein called PP2A on cell surfaces. Blocking PP2A increases stress signals
in tumor cells expressing the PP2A protein. Accordingly, combining atezolizumab with LB-100 may enhance treatment efficacy for metastatic
colorectal cancer, as cancer cells with heightened stress signals are more vulnerable to immunotherapy.
This
study comprises a dose escalation phase and a dose expansion phase. The objective of the dose escalation phase is to determine the recommended
Phase 2 dose (RP2D) of LB-100 when combined with the standard dosage of atezolizumab. The dose expansion phase will further investigate
the preliminary efficacy, safety, tolerability, and pharmacokinetics/dynamics of the LB-100 and atezolizumab combination. The clinical
trial opened in August 2024 with the enrollment of the first patient. Patient accrual is expected to take up to 24 months, with a maximum
of 37 patients with advanced colorectal cancer to be enrolled in this study.
The
principal investigator of the colorectal study testing LB-100 in combination with atezolizumab is currently investigating two Serious
Adverse Events (“SAEs”) observed in the clinical trial that was launched in August 2024. The Investigational Review Board
(IRB) of the Netherlands Cancer Institute requested additional information with respect to these SAEs and the study has been paused for
enrollment until the IRB’s questions were addressed, as more fully discussed at “Item 7. Management’s Discussion and
Analysis of Financial Condition and Results of Operations – Specific Risks Associated with the Company’s Business Activities
– Serious Adverse Events”. As of Q4 2025 the questions of the IRB have been sufficiently addressed, and the trial opened
for enrollment again.
Patent
and License Agreements
National
Institute of Health
Effective
February 23, 2024, we entered into a Patent License Agreement (the “License Agreement”) with the National Institute of Neurological
Disorders and Stroke (“NINDS”) and the National Cancer Institute (“NCI”), each an institute or center of the
National Institute of Health (“NIH”). Pursuant to the License Agreement, we have licensed exclusively NIH’s intellectual
property rights claimed for a Cooperative Research and Development Agreement (“CRADA”) subject invention co-developed with
the Company, and the licensed field of use, which focuses on promoting anti-cancer activity alone, or in combination with standard anti-cancer
drugs. The scope of this clinical research extends to checkpoint inhibitors, immunotherapy, and radiation for the treatment of cancer.
The License Agreement is effective, and shall extend, on a licensed product, licensed process, and country basis, until the expiration
of the last-to-expire valid claim of the jointly owned licensed patent rights in each such country in the licensed territory, unless
sooner terminated.
The
License Agreement contemplates that we will seek to work with pharmaceutical companies and clinical trial sites (including comprehensive
cancer centers) to initiate clinical trials within timeframes that will meet certain benchmarks. Data from the clinical trials will be
the subject of various regulatory filings for marketing approval in applicable countries in the licensed territories. Subject to the
receipt of marketing approval, we would be expected to commercialize the licensed products in markets where regulatory approval has been
obtained.
Other
Significant Agreements and Contracts
Netherlands
Cancer Institute
On
October 8, 2021, we entered into a Development Collaboration Agreement with the Netherlands Cancer Institute, Amsterdam (“NKI”),
one of the world’s leading comprehensive cancer centers, and Oncode Institute, Utrecht, a major independent cancer research center,
for a term of three years. The Development Collaboration Agreement was subsequently modified by Amendment No. 1 thereto.
The
Development Collaboration Agreement is a preclinical study intended to identify the most promising drugs to be combined with LB-100,
and potentially LB-100 analogues, to be used to treat a range of cancers, as well as to identify the specific molecular mechanisms underlying
the identified combinations. We agreed to fund the preclinical study, at an approximate cost of 391,000 Euros and provide a sufficient
supply of LB-100 to conduct the preclinical study.
On
October 3, 2023, we entered into Amendment No. 2 to the Development Collaboration Agreement with NKI, which provides for additional research
activities, extends the termination date of the Development Collaboration Agreement by two years to October 8, 2026, and added 500,000
Euros to the operating budget being funded by us.
On
October 4, 2024, we entered into Amendment No. 3 to the Development Collaboration Agreement with NKI, which suspended Amendment No. 2
and provided for a new study term of one year and starts upon the dosing of the first patient in the clinical trial at a project cost
of 100,000 Euros.
On
March 31, 2025 we announced we will conduct a new pre-clinical study in collaboration with the NKI to test whether “initiated”
cells that carry mutations found in cancer cells can be eliminated by treatment with LIXTE’s proprietary compound LB-100.
Effective
as of June 15, 2022, Dr. René Bernards was appointed to our Board of Directors as an independent director. Dr. Bernards is a leader
in the field of molecular carcinogenesis and is employed by NKI. On August 18, 2025, Dr. Bernards resigned from the board and was appointed
Chairman of the Scientific Advisory Board.
Intellectual
Property
Our
intellectual property includes proprietary know-how, proprietary methodologies and extensive clinical validation data and publications.
To provide legal protection of our intellectual property, we rely on a combination of patents, licenses, trade secrets, trademarks, confidentiality
and non-disclosure clauses and agreements, and other forms of intellectual property protection to define and protect our rights to our
products.
Our
products are expected to be covered by our patents. These patents now cover sole rights to the composition and synthesis of our LB-100
series of drugs, which is the Company’s lead clinical compound in development. Lixte has filed patent applications covering the
treatment of cancer with LB-100. Lixte has also filed joint patent applications with the NIH and the Netherlands Cancer Institute for
the treatment of cancer using LB-100 in combination with other drugs like immune checkpoint inhibitors and WEE1 inhibitors.
Patent
applications for the LB-100 series have been filed in the United States and internationally under the Patent Cooperation Treaty. Patents
for composition of matter and for several uses of the LB-100 series have been issued in the United States, Mexico, Australia, Japan,
China, Hong Kong, Canada, and by the European Patent Office
The
Company strives to protect and enhance the proprietary technology, inventions, and improvements that are commercially important to the
development of its business, including seeking, maintaining, and defending its patent rights, which are owned solely by our wholly-owned
Delaware subsidiary, Lixte Biotechnology, Inc., except in several instances jointly with one of many of our collaborators. The Company
also relies on trade secrets relating to its proprietary pipeline of product candidates and on know-how and continuing technological
innovation to develop and strengthen its pipeline. The Company intends to rely on regulatory protection afforded by regulatory agencies
through data exclusivity, market exclusivity, and patent term extensions, where available.
The
Company’s success will depend in large part on its ability to obtain and maintain patent and other proprietary protection for commercially
important technology, inventions and know-how related to its business; defend and enforce its patents; preserve the confidentiality of
its trade secrets; and operate without infringing valid and enforceable patents or proprietary rights of third parties. The Company’s
ability to stop third parties from making, using, selling, offering to sell, or importing our technology may depend on the extent to
which the Company has rights under valid and enforceable licenses, patents, or trade secrets that cover these activities. In some cases,
enforcement of these rights may depend on cooperation of the joint owners of our jointly owned patents and patent applications.
With
respect to both the Company’s solely and jointly owned intellectual property, the Company cannot be sure that patents will be granted
on any of its pending patent applications or on any patent applications filed solely or jointly by the Company in the future; we cannot
be sure that any of the Company’s existing patents or any patents that may be granted to us in the future will be commercially
useful in protecting the Company’s intended commercial products or therapeutic methods; and the Company cannot be sure that an
agency or court would determine that the Company’s solely or jointly owned patents are valid and enforceable.
The
patent portfolios for the Company’s most important programs involving the development of the LB-100 series are summarized and presented
below, along with related information, as of January 12, 2026, followed by a detailed listing of U.S. and non-U.S. patents that have
been issued. The projected patent expiration dates noted below assume that that all required maintenance or annuity fees for the patents
are timely paid and that a court or agency does not determine that the patents are invalid or unenforceable.
LB-100.
The Company’s lead compound LB-100 is covered by U.S. Patent Nos. 8,822,461 and 7,998,957, which are solely owned by Lixte Biotechnology,
Inc. These patents are projected to expire in 2030 or 2028, exclusive of any available patent term extension. Counterpart non-U.S. patents
are projected to expire in 2028. Pharmaceutical compositions of LB-100 are covered by U.S. Patent Nos. 10,532,050, 10,023,587 and 8,822,461,
which are solely owned by Lixte Biotechnology, Inc. These patents and their non-U.S. counterparts are projected to expire in 2034 or
2028, exclusive of any available patent term extension.
LB-100
Combination Therapy with a Checkpoint Inhibitor. LB-100 combination therapy with a checkpoint inhibitor for treating cancer is
covered by U.S. Patent No. 12,168,008 and a pending U.S. patent application, as well as by non-U.S. patents and patent applications.
These patents and patent applications are jointly owned by Lixte Biotechnology, Inc., and The United States of America, as represented
by the Secretary, Department of Health and Human Services. These patents and patents issuing from these patent applications are projected
to expire in 2037, exclusive of any patent term extension.
LB-100
Combination Therapy with Doxorubicin. LB-100 combination therapy with doxorubicin for treating soft tissue sarcoma is covered
by U.S. Patent No. 12,343,342, which is solely owned by Lixte Biotechnology, Inc. This patent is projected to expire in 2034, exclusive
of any patent term extension.
LB-100
Combination Therapy with Another Investigational Compound. LB-100 combination therapy with one of several other investigational
compounds for treating cancer, or preventing, inhibiting or reducing risk of metastasis of cancer, is covered by pending U.S. and non-U.S.
patent applications that are jointly owned by Lixte Biotechnology, Inc., and Stichting Het Nederlands Kanker Instituut – Antoni
Van Leeuwenhoek Ziekenhuis. Patents issuing from these patent applications are projected to expire in 2043, exclusive of any patent term
extension.
LB-100
for Treating Cancer. LB-100 for treating breast cancer, colon cancer, large cell lung cancer, adenocarcinoma of the lung, small
cell lung cancer, stomach cancer, liver cancer, ovary adenocarcinoma, pancreas carcinoma, prostate carcinoma, promyelocytic leukemia,
chronic myelocytic leukemia or acute lymphocytic leukemia, is covered by U.S. Patent No. 9,079,917, which is solely owned by Lixte Biotechnology,
Inc. LB-100 for treating glioblastoma multiforme, medulloblastoma, ovarian cancer, kidney cancer and colorectal cancer is covered by
U.S. Patent No. 10,399,993. These patents and their non-U.S. counterparts are projected to expire in 2028, exclusive of any patent term
extension.
LB-100
Prodrugs and Analogs. LB-100 prodrugs and analogs are covered by U.S. Patent Nos. 11,866,444, 10,618,908, 10,364,252, 9,988,394,
8,822,461, 8,541,458, 8,426,444, 8,227,473 and 7,998,957, which are solely owned by Lixte Biotechnology, Inc. These patents and their
non-U.S. counterparts are projected to expire in 2036, 2030 or 2028, exclusive of any patent term extension. Pharmaceutical compositions
of LB-100 prodrugs or analogs are covered by U.S. Patent Nos. 11,931,354, 11,236,102, 10,532,050, 10,023,587, 8,822,461, 8,227,473 and
7,998,957, which are solely owned by Lixte Biotechnology, Inc. These patents and their non-U.S. counterparts are projected to expire
in 2034, 2030 or 2028, exclusive of any patent term extension.
Our
portfolio of solely or jointly owned U.S. and non-U.S. issued patents is summarized below. We have additional U.S. and non-U.S. patent
applications pending.
Oxabicycloheptanes
and Oxabicycloheptenes, Their Preparation and Use
Patent Issue/Grant Date Expiration Date
1
EP 2124550 validated and pending in Germany, Spain, France, United Kingdom and Italy
Formulations
of Oxabicycloheptanes and Oxabicycloheptenes
Patent Issue/Grant Date Expiration Date
1
EP 2983661 validated and pending as Unitary Patent, and in Spain, United Kingdom and Switzerland
Process
of Synthesizing 3-(4-Methylpiperazine-1-Carbonyl)-7-Oxabicyclo [2.2.1] Heptane-2-Carboxylic Acid
Patent Issue/Grant Date Expiration Date
Oxabicycloheptane Prodrugs
Patent Issue/Grant Date Expiration Date
1
EP 3294287 validated and pending in Austria, Switzerland, Czechia, Germany, Denmark, Spain, France, United Kingdom, Hungary, Ireland,
Italy, Netherlands, and Sweden
2
EP 3736275 validated and pending as Unitary Patent, and in Spain, United Kingdom and Switzerland
Oxabicycloheptanes
for Modulation of Immune Response
Patent Issue/Grant Date Expiration Date
1
EP 3551629 validated and pending in Belgium, Germany, Denmark, Spain, France, United Kingdom, Ireland, Iceland, Italy, Netherlands, Norway,
Sweden and Switzerland
The
Market
Anti-Cancer
Drugs
We
believe that the mechanism by which compounds of the LB-100 series affects cancer cell growth is different from cancer agents currently
approved for clinical use. Lead compounds of the LB-100 series have activity against a broad spectrum of common and rarer human cancers
in cell culture systems. In addition, lead compounds of the LB-100 series have anti-cancer activity in animal models of glioblastoma
multiforme, neuroblastoma, and medulloblastoma, all cancers of neural tissue. Lead compounds of the LB-100 series also have activity
against melanoma, breast cancer and sarcoma in animal models and enhance the effectiveness of commonly used anti-cancer drugs in animal
models. The enhancement of anti-cancer activity of these commonly-used anti-cancer drugs occurs at doses of LB-100 that do not significantly
increase toxicity in animals. It is therefore hoped that when combined with standard anti-cancer regimens against many tumor types, LB-100
will improve therapeutic benefit without unacceptable toxicity in humans.
LB-100
is part of a pioneering effort in an entirely new field of cancer biology – activation lethality – that is advancing a new
treatment paradigm. The Company is the only company that has a drug in clinical trials with demonstrated capacity to over-activate oncogenic
signaling. The pre-clinical data obtained with LB-100 were recently posted online in a paper titled “Paradoxical Activation
of Oncogenic Signaling as a Cancer Treatment Strategy” in the scientific journal Cancer Discovery, and were published in
the July 2024 issue of Cancer Discovery. This study showed that LB-100 triggers hyper-activation of the signals that are responsible
for the deregulated proliferation of cancer cells, thus leading to cell death. This approach is the opposite of most of the current generation
of cancer therapies and opens potentially new treatment strategies.
Marketing
Plan
Our
primary goal to date has been to take our primary compound, LB-100, through Phase 2 clinical trials evaluating whether LB-100 will enhance
anti-cancer therapies. Because of the novelty and spectrum of activity of LB-100, we believe it is reasonably likely we may find a partner
in the pharmaceutical industry with interest in this compound at some stage of its clinical development. However, we would prefer to
delay the partnering/licensing decision until the potential value of our products are augmented by demonstrating there is no impediment
to clinical evaluation and a therapeutic dose level is determined in clinical trials. Demonstration of clinical usefulness would be expected
to substantially increase the value of our product.
Product
Development
We
are subject to FDA regulations as it conducts clinical trials. Additionally, any product for which we obtain marketing approval, along
with the manufacturing processes, post-approval clinical data and promotional activities for such product, will be subject to continual
review and periodic inspections by the FDA and other regulatory bodies. Even if regulatory approval of a product is granted, the approval
may be subject to limitations on the indicated uses for which the product may be marketed or contain requirements for costly post-marketing
testing and surveillance to monitor the safety or efficacy of the product. Later discovery of previously unknown problems with our products,
including unanticipated adverse events or adverse events of unanticipated severity or frequency, manufacturer or manufacturing processes,
or failure to comply with regulatory requirements, may result in restrictions on such products or manufacturing processes, withdrawal
of the products from the market, voluntary or mandatory recall, fines, suspension of regulatory approvals, product seizures, injunctions
or the imposition of civil or criminal penalties.
Competition
The
life sciences industry is highly competitive and subject to rapid and profound technological change. Our present and potential competitors
include major pharmaceutical companies, as well as specialized biotechnology and life sciences firms in the United States and in other
countries. Most of these companies have considerably greater financial, technical and marketing resources than we do. Additionally, mergers
and acquisitions in the pharmaceutical and biotechnology industries may result in even more resources being concentrated in our competitors.
Our existing or prospective competitors may develop processes or products that are more effective than ours or be more effective at implementing
their technologies to develop commercial products faster. Our competitors may succeed in obtaining patent protection and/or receiving
regulatory approval for commercializing products before we do. Developments by our competitors may render our product candidates obsolete
or non-competitive.
We
also experience competition from universities and other research institutions, and we are likely to compete with others in acquiring
technology from those sources. There can be no assurance that other organizations will not develop technologies with significant advantages
over those that we are seeking to develop. Any such development could harm our business.
We
compete with universities and other research institutions engaged in research in these areas. Many of our competitors have greater technical
and financial resources than we do.
Our
ability to compete successfully is based on numerous factors, including:
If
we are unable to distinguish our products from competing products, or if competing products reach the market first, we may be unable
to compete successfully with current or future competitors.
Facilities
As
of March 31, 2026, the Company does not operate or lease any facilities for LB-100. We contract out research and development activities,
drug production, and drug storage to various commercial laboratories, drug manufacturers and storage facilities.
Government
Regulation
Our
business is subject to the regulations of the FDA as it conducts clinical trials. Clinical trials are research studies to answer specific
questions about new therapies or new ways of using known treatments. Clinical trials determine whether new drugs or treatments are both
safe and effective and the FDA has determined that carefully conducted clinical trials are the fastest and safest way to find treatments
that work in people.
The
FDA also requires that an independent review body consider the benefits and risks of a clinical trial and grant approval for the proposed
study including selecting of initial doses, plans for escalation of dose, plans for modification of dose if toxicity is encountered,
plans for monitoring the wellbeing of individuals participating in the study, and for defining and measuring, to the extent possible,
any untoward effects related to drug administration. Serious adverse effects, such as life-threatening toxicities and death, are immediately
reportable to the review body and to the FDA. To minimize risk when studying a new drug, the initial dose is well below that expected
to cause any toxicity. No more than three patients are entered at a given dose. In general, a dose is not escalated within an individual
patient. Once safety is established by the absence of toxicity or low toxicity in a group of three patients, a planned higher dose is
then evaluated in a subsequent group of three individuals and so on until dose-limiting toxicity is encountered. The dose level producing
acceptable toxicity is then selected as the dose level to be evaluated in Phase 2 trials. Thus, the goal of Phase 1 studies is to determine
the appropriate dose level for evaluation of drug efficacy in patients with cancer.
In
addition to regulations imposed by the FDA, depending on our future activities, we may become subject to regulation under various federal
and state statutes and regulations, such as the Occupational Safety and Health Act, the Environmental Protection Act, the Toxic Substances
Control Act, the Research Conservation and Recovery Act, national restrictions on technology transfer, and import, export and customs
regulations. From time to time, other federal agencies and congressional committees have indicated an interest in implementing further
regulation of biotechnology applications. We are not able to predict whether any such regulations will be adopted or whether, if adopted,
such regulations will apply to our business, or whether we or our collaborators would be able to comply with any applicable regulations.
In
addition, as we intend to market our products in international markets, we will be required to obtain separate regulatory approvals from
the European Union and many other foreign jurisdictions. Approval by the FDA does not ensure approval by regulatory authorities in other
countries, and approval by one foreign regulatory authority does not ensure approval by regulatory authorities in other foreign countries
or by the FDA. We may not be able to file for regulatory approvals and may not receive necessary approvals to commercialize our products
in any market.
LIORA
TECHNOLOGIES EUROPE LTD.
The
primary aim of radiation therapy is to irradiate the cancer cells and minimize radiation to healthy cells. X-rays radiate all
cells along their trajectory, the healthy cells in front of, and behind the tumor. Protons are subatomic particles with a positive
electric charge. Due to an effect called the Bragg peak, a proton radiates a small volume at a depth (d) given by the incident
energy of the proton. The radiation at depths greater than d is zero.
The
required range of depths, dictated by the location of the tumor is controlled by variation of the proton beam energy. Since the proton
is charged, the radiation deposition can be controlled in the horizontal and vertical dimensions by electromagnets.
Cyclotrons
are fixed-energy accelerators. For proton therapy, the required beam energy is achieved in cyclotrons by placing an object (“absorber”)
in the beam path. The mechanical absorber not only reduces the beam energy but also greatly reduces the beam intensity and produces a
large amount of unwanted radiation. The unwanted radiation must be shielded by large concrete blocks.
Description
of Business
The
Liora’s LiGHT machine is a proton linear accelerator that electronically controls the beam energy and does not need absorbers.
The LiGHT machine is superior to existing cyclotrons both from treatment efficiency and overall cost considerations.
The
linear accelerator concept originated from research conducted at CERN and the TERA Foundation, and was further developed by ADAM SA,
which was a spin-off from CERN. The accelerator chain consists of:
● a Radio Frequency Quadrupole (RFQ),
● Side-Coupled Drift Tube Linac (SCDTL) modules, and
The
combination of proton therapy and immune checkpoint inhibition acts at several stages of the antitumor response, suggesting a mechanism
of synergy between the two modalities. The possibility of reducing the side-effects of oncology therapy and reversing the spread of metastatic
disease has created tremendous global demand for this type of treatment. However, widespread use of the combination therapies is limited
by the availability of proton therapy centers. As of early 2026, there are only 47 centers in the U.S.
Cancer
irradiation with hadron beams, a method to which CERN contributed by advancing carbon ion therapy of radioresistant tumors into the medical
world some thirty years ago, has treated more than 300,000 patients to date. Unfortunately, present proton and ion therapy centers are
large and very demanding on the design of accelerators and guiding systems.
The
highly adaptable Linac Image-Guided Hadron Technology (LiGHT) accelerator developed by Liora provides a proton beam allowing the
delivery of ultra-high dose rates to deep-seated tumors. LiGHT, the first linear accelerator used for proton cancer treatment worldwide,
operates with components and designs developed by CERN, the linac design reduces beam losses, stray radiation and, consequently, the
volume of shielding material required. This will allow not only large tertiary care centers to provide proton therapy.
The
unique biologic effects of ultra-high-dose-rate radiotherapy delivered at more than 40 Gy/sec, now known as FLASH therapy, were first
reported more than 50 years ago. Interest in this modality began re-emerging recently.
Multiple
animal experiments have demonstrated that FLASH can increase the therapeutic ratio of radiotherapy by decreasing normal tissue injury
while maintaining the tumoricidal effects of conventional-dose-rate radiotherapy (conventional radiotherapy) or by allowing for dose
escalation and improved tumor control probability without increasing normal tissue injury.
As
such, FLASH is the holy grail in the industry. As its name sounds, this consists of delivering radiation in a “flash”. By
doing so, the opportunity is to treat a cancer patient in a single visit as opposed to 25/35 visits. Typically, radiation (measured in
Grays (Gy)) is delivered at a rate of 2Gy per minute. With FLASH, radiation must be delivered at ... 40-60Gy per ... second.
The higher the number of Gy is, the higher the number of protons in a pulse. This means that the delivery of a FLASH treatment requires
two things:
Fast
delivery: a fast delivery of radiation and a high level of radiation (i.e. number of protons per pulse). LiGHT – because
of its design and the electronic (i.e. without a slow mechanical) control of the proton beam – can deliver pulses of proton at
a frequency of 200 times per second as opposed to conventional systems which deliver radiation at a frequency of only 2-3 times per second.
This means the property of protons (i.e. its high precision) is leveraged for the benefits of patients in the case of FLASH when using
our LiGHT system: Within a second, LiGHT can hit various points (voxels) of the tumour.
High
throughput: The LiGHT system is highly efficient. In other words, up to 98/99% of the protons which are accelerated and energised
reach their targets, i.e. the tumour. With circular accelerators, that % is as low as 1/2% when treating superficial tumours, the rest
of the accelerated and energised protons being “lost” and creating neutrons, which must be shielded to protect operators
and patients. This advantage of LiGHT is therefore compounded in the case of FLASH whereby the dose rate (40-60Gys per second) is high,
and a high number of protons must be accelerated.
Current
Development
The
LiGHT machine is a physically complete linear accelerator, with all components manufactured and assembled, that has demonstrated the
ability to generate a 230 MeV proton beam, which is widely recognized as the clinical gold standard for proton therapy. Unlike conventional
proton therapy systems, which typically rely on large cyclotrons or synchrotrons, the LIGHT Machine is based on a modular, high-frequency
linear accelerator architecture. The design enables a more compact footprint for precise control of the treatment dose delivery, rapid
energy modulation, and ultimately lower installation and operating costs for single-room proton therapy facilities. Proton energy can
be modulated up to 200Hz in a range from 70 to 230 MeV by varying the gradient of the accelerating structures. Achieving a stable 230
MeV beam is the point at which proton accelerators can be clinically used.
The
LiGHT system’s main aspects are complete, and no substantive research and development is needed. It is currently a non-clinical
prototype system. However, the system was powered down for an extended period prior to the acquisition by the Company. The system will
be subject to a safety assessment to be done before switching on the equipment. This will require updating all computers, screens, and
software in the control rooms, beamline integration, safety checks, and regulatory clearance. The timeline to make the LiGHT machine
operational is estimated to take twenty-four months and cost approximately two million dollars.
There
is no resolving scientific uncertainty, inventing new technology, or proving that the LIGHT system can do what physics already has shown
it can do. Liora is not planning incremental research and development beyond commissioning.
The
Market
The
LiGHT System is the first Linac system in the market, as all other proton therapy systems are based on cyclotron technology. This makes
the LiGHT system a disruptive technology offering applications that are not possible with the current cyclotron technology and offers
a much increased capacity of patient throughput.
Whether
the LiGHT system beam is directed at a brain tumor, a prostate tumor, or another tissue does not change the fundamental nature of the
Accelerator. The LiGHT machine produces a proton beam with defined energy, stability, and modulation. How the beam is clinically applied
is a decision that does not fundamentally alter the machine. The LiGHT system is not tied to a single experiment, a single protocol,
or a single disease. It is inherently capable of supporting multiple clinical uses over a long period of time.
Marketing
Plan
Liora
does not plan to make the LiGHT system saleable as a clinical system. To become operational for clinical use would require tens of millions
of dollars in additional funding for key elements, including but not limited to integrated patient positioning and imaging, clinical
commissioning and dosimetry validation, certified safety interlock systems, extensive reliability, endurance testing, and site-specific
installation, shielding, and licensing.
The
Company’s marketing plan for the LiGHT system is to position it as a functional prototype asset (rather than a turnkey clinical
system), valued primarily for its intellectual property, accelerator hardware configuration, and accumulated engineering work, without
immediate clinical operability. It will be saleable as a functional unlicensed prototype to be copied and licensed at locations closer
to large patient populations.
The
LiGHT machine offers cost advantages over competitors in the proton therapy market. These advantages include:
● Low unwanted radiation levels:
○ Huge reduction in radiation shielding,
○ Lower replacement rate of electronics and components,
Competition
The
market for proton therapy products is still developing and is characterized by rapidly evolving technology and pricing pressure. Our
primary competitors in the proton therapy market are IBA Worldwide, Varian Medical Systems (Siemens Healthineers), Hitachi, Mevion
Medical Systems, ProNova Solutions, P-Cure, and Sumitomo Heavy Industries. These companies dominate the market by providing
advanced, high-energy particle accelerators for pencil beam scanning and intensity-modulated proton therapy. These manufacturers primarily
focus on improving tumor-targeting precision while minimizing damage to healthy tissues, particularly using Pencil Beam Scanning (PBS)