You should read the following discussion and analysis of our financial condition and results of operations together with our audited financial statements and the related notes and other financial information included elsewhere in this Annual Report on Form 10-K. Some of the information contained in this discussion and analysis or elsewhere in this Annual Report on Form 10-K, including information with respect to our plans and strategy for our business, include forward-looking statements that involve risks and uncertainties. You should review the "Risk Factors" set forth in this Annual Report on Form 10-K for a discussion of important factors that could cause our actual results to differ materially from the results described in or implied by the forward-looking statements contained in the following discussion and analysis.

Company Overview

We are a pharmaceutical company dedicated to the development of best-in-class therapeutics that improve and extend the lives of patients with cancer. Our initial focus is on the development of tesetaxel, an investigational, orally administered chemotherapy agent that belongs to a class of drugs known as taxanes, which are widely used in the treatment of cancer. Tesetaxel has several properties that make it unique among taxanes, including:



  • oral administration with a low pill burden;


   •   a long (~8-day) terminal plasma half-life in humans, enabling the
       maintenance of adequate drug levels with relatively infrequent dosing;


  • no history of hypersensitivity (allergic) reactions; and


  • significant activity against chemotherapy-resistant tumors.

In patients with metastatic breast cancer ("MBC"), tesetaxel was shown to have significant, single-agent antitumor activity in two multicenter, Phase 2 studies. Tesetaxel currently is the subject of three studies in breast cancer, including a multinational, multicenter, randomized, Phase 3 study in patients with MBC, known as CONTESSA. Positive results of CONTESSA were presented at the 2020 San Antonio Breast Cancer Symposium. We plan to submit a New Drug Application for tesetaxel to the U.S. Food and Drug Administration in mid-2021. Our goal for tesetaxel is to develop an effective chemotherapy choice for patients that provides quality-of-life advantages over current alternatives.

Results of Operations



The following table summarizes our results of operations for each of the periods
below (in thousands):

                                           Year Ended
                                          December 31,
                                       2020          2019

Research and development expense $ 117,041 $ 104,034 General and administrative expense $ 10,392 $ 10,896 Other income, net

$   1,083     $   3,105

Research and Development Expense

Research and development expense consists of expense associated with the development of tesetaxel and includes non-personnel-related and personnel-related expense. Non-personnel-related expense includes expense related to: (i) clinical study site payments; (ii) acquiring clinical study materials and the clinical study supply chain; (iii) manufacturing development and scale-up, including manufacturing registration and validation batches of tesetaxel; (iv) clinical and quality systems; and (v) regulatory submissions. Personnel-related expense includes expense related to salaries, benefits and equity-based compensation for personnel engaged in research and development functions.


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Research and development expense is charged to operations as incurred when the expenditures relate to our research and development efforts and have no alternative future use. Payments made prior to the receipt of goods or services to be used in research and development are capitalized until the goods or services are received.

All of our research and development expense incurred to date has been incurred in connection with the development of tesetaxel. We do not expect our research and development expense to change significantly in the near term.

The following table summarizes our research and development expense for each of the periods below (in thousands):



                                               Year Ended
                                              December 31,
                                           2020          2019
Non-personnel expense:
Clinical development                     $  72,697     $  63,748
Other                                        1,966         2,209
Total non-personnel expense                 74,663        65,957
Personnel expense:
Salaries, bonuses and benefits              33,673        28,137
Equity-based compensation expense            8,705         9,940
Total personnel expense                     42,378        38,077

Total research and development expense $ 117,041 $ 104,034

Research and development expense was $117.0 million and $104.0 million for the years ended December 31, 2020 and 2019, respectively. The increase in research and development expense of $13.0 million was due primarily to increased activities and headcount in connection with our tesetaxel clinical development program.

General and Administrative Expense

General and administrative expense includes non-personnel and personnel-related expense. Non-personnel-related expense includes expense related to: (i) professional fees for legal, patent, consulting, accounting and audit services; (ii) insurance; and (iii) facilities and information technology. Personnel-related expense includes expense related to salaries, benefits and equity-based compensation for personnel engaged in finance and administrative functions. We do not expect our general and administrative expense to change significantly in the near term.

The following table summarizes our general and administrative expense for each of the periods below (in thousands):



                                                Year Ended
                                               December 31,
                                             2020         2019
Non-personnel expense                      $  5,256     $  5,199
Personnel expense:
Salaries, bonuses and benefits                4,013        4,193
Equity-based compensation expense             1,123        1,504
Total personnel expense                       5,136        5,697

Total general and administrative expense $ 10,392 $ 10,896

General and administrative expense of $10.4 million for the year ended December 31, 2020 remained consistent compared to $10.9 million for the year ended December 31, 2019.


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Other Income, Net

Other income, net consists primarily of interest income generated from cash held in savings accounts. Other income, net also includes losses on disposal of property and equipment and gains and losses on foreign currency transactions.

Other income, net was $1.1 million and $3.1 million for the years ended December 31, 2020 and December 31, 2019, respectively. The decrease in other income, net was due primarily to decreased interest income as a result of lower interest rates during the year ended December 31, 2020.

Liquidity and Capital Resources

As of December 31, 2020 and 2019, we had cash in the amount of $157.3 million and $180.5 million, respectively. We believe that our existing cash will be sufficient to meet our anticipated cash requirements through at least one year from the date this Annual Report on Form 10-K is filed with the U.S. Securities and Exchange Commission.

We have incurred losses in each year since our inception. Our net loss was $126.4 million and $111.8 million for the years ended December 31, 2020 and 2019, respectively. As of December 31, 2020 and 2019, we had an accumulated deficit of $366.4 million and $240.1 million, respectively. Substantially all of our operating losses resulted from expenses incurred in connection with advancing tesetaxel through development activities and general and administrative costs associated with our operations.

To date, we have funded our operations through the sale of equity securities. For a discussion of the underwritten public offerings closed during the years ended December 31, 2020 and 2019, see Note 5 to our audited financial statements included in Item 8 of this Annual Report on Form 10-K. Since our inception, we have raised $467.4 million in net proceeds from the sale of equity securities.

The following table summarizes our net cash flow activity for each of the periods below (in thousands):



                                                             Year Ended
                                                            December 31,
                                                         2020          2019
Net cash (used in) provided by:
Operating activities                                  $ (113,130 )   $ (96,638 )
Investing activities                                        (432 )        (166 )
Financing activities                                      90,367       138,677

Net (decrease) increase in cash and restricted cash $ (23,195 ) $ 41,873

Net cash used in operating activities was $113.1 million and $96.6 million for the years ended December 31, 2020 and 2019, respectively. Net cash used in operating activities was primarily the result of our net loss and change in working capital, partially offset by equity-based compensation expense, depreciation and amortization expense and non-cash lease expense.

Net cash used in investing activities was $0.4 million and $0.2 million for the years ended December 31, 2020 and 2019, respectively. Net cash used in investing activities was the result of purchases of property and equipment.

Net cash provided by financing activities was $90.4 million and $138.7 million for the years ended December 31, 2020 and 2019, respectively. Net cash provided by financing activities was primarily the result of net proceeds from the sale of common stock in underwritten public offerings.

Until such time as we can generate substantial product revenues, we expect to finance our cash needs through a combination of equity offerings, debt financings, collaborations, strategic partnerships and licensing arrangements. To the extent that we raise additional capital through the sale of equity or convertible debt securities, the ownership interest of our stockholders will be or could be diluted, and the


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terms of these securities may include liquidation or other preferences that adversely affect the rights of our common stockholders. Debt financing, if available, may involve agreements that include covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we raise additional funds through collaborations, strategic partnerships or licensing arrangements with third parties, we may have to relinquish valuable rights to our product candidates, associated intellectual property, our other technologies, future revenue streams or research programs or grant licenses on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed, we may be required to delay, limit, reduce or terminate our product development or future commercialization efforts or grant rights to develop and market our product candidate even if we would otherwise prefer to develop and market such product candidate ourselves.

Impact of the COVID-19 Pandemic

Although the ongoing Coronavirus Disease 2019 ("COVID-19") pandemic did not have a material impact on our results of operations, financial condition or clinical studies during the year ended December 31, 2020, we are unable to accurately predict the full impact that the COVID-19 pandemic will have on our business in the future due to numerous factors that are not within our control, including its duration and severity.

Contractual Obligations and Commitments

In February 2018, we entered into an agreement to lease office space in New York, New York (the "New York Lease") with aggregate payments of approximately $2.8 million over the 7-year term of the lease. We have an option to extend the New York Lease for an additional three years at the end of the initial term. Further, we provided a standby letter of credit of $0.3 million in lieu of a security deposit during the term of the lease, subject to a reduction 3.5 years after the lease commencement. As of December 31, 2020, $0.3 million was pledged as collateral for the letter of credit and was recorded as restricted cash.

In March 2018, we entered into an agreement to lease office space in San Diego, California (the "San Diego Lease") with aggregate payments of approximately $0.8 million over the term of the lease. The San Diego Lease originally provided for expiration on December 31, 2019. In August 2019, we entered into a First Amendment to the San Diego Lease to extend the term of the lease through the commencement of the New San Diego Lease (defined below).

In October 2019, we entered into an agreement to lease office space in San Diego, California (the "New San Diego Lease") with aggregate payments of approximately $4.1 million over the 7.5-year term of the lease. The New San Diego Lease commenced in July 2020. We have an option to extend the New San Diego Lease for an additional 5 years at the end of the initial term. Further, we provided a standby letter of credit of $0.5 million as a security deposit during the term of the lease, subject to certain reductions beginning 4 years after the lease commencement. As of December 31, 2020, $0.5 million was pledged as collateral for the letter of credit and recorded as restricted cash.

We enter into contracts in the normal course of business with contract development and manufacturing organizations and other service providers and vendors. These contracts generally provide for termination on notice and, therefore, are cancellable contracts and not considered contractual obligations and commitments.


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In 2013, we licensed rights to tesetaxel in all major markets from Daiichi Sankyo Company, Limited ("Daiichi Sankyo"), the original inventor of the product. Under the Daiichi Sankyo license agreement, we are obligated to use commercially reasonable efforts to develop and commercialize tesetaxel in the following countries: France, Germany, Italy, Spain, the United Kingdom and the U.S. We are required to make aggregate future milestone payments of up to $31.0 million, contingent on attainment of certain regulatory milestones. Additionally, we are obligated to pay Daiichi Sankyo a tiered royalty that ranges from the low to high single digits, depending on annual net sales of tesetaxel.

Off-Balance Sheet Arrangements

During the periods presented, we did not have, nor do we currently have, any off-balance sheet arrangements as defined under the rules of the SEC.

Jumpstart Our Business Startups Act

We are an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012 (the "JOBS Act"). Under this act, an emerging growth company can delay the adoption of new or revised accounting standards issued subsequent to the enactment of the JOBS Act until those standards would otherwise apply to private companies. We have irrevocably elected not to avail ourselves of this exemption from new or revised accounting standards and, therefore, will be subject to the same new or revised accounting standards as other public companies that are not emerging growth companies. However, we intend to rely on other exemptions provided by the JOBS Act, including without limitation, an exemption from the auditor attestation requirements of Section 404(b) of the Sarbanes-Oxley Act of 2002, as amended. We will remain an emerging growth company until December 31, 2023 unless, prior to that time, we: (i) have more than $1.07 billion in annual gross revenue; (ii) have a market value for shares of our common stock held by non-affiliates of more than $700 million as of the last day of our second quarter of any year; or (iii) issue more than $1.0 billion of non-convertible debt over a three-year period.

Critical Accounting Policies and Significant Judgments and Estimates

Our management's discussion and analysis of financial condition and results of operations is based on our audited financial statements, which have been prepared in accordance with generally accepted accounting principles in the U.S. ("GAAP"). The preparation of these financial statements requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements, as well as the reported expenses during the reporting periods. These items are monitored and analyzed by us for changes in facts and circumstances, and material changes in these estimates could occur in the future. We base our estimates on historical experience and on various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Changes in estimates are reflected in reported results for the period in which they become known. Actual results may differ materially from these estimates under different assumptions or conditions.

While our significant accounting policies are more fully described in the notes to our audited financial statements elsewhere in this Annual Report on Form 10-K, we believe that the following accounting policies related to accrued expenses and equity-based compensation are most critical to understanding and evaluating our reported financial results.

Accrued Expenses

As part of the process of preparing our financial statements, we are required to estimate our accrued expenses. This process involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the actual cost. The majority of our service providers invoice us monthly in arrears for


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services performed or when contractual milestones are met. We make estimates of our accrued expenses as of each balance sheet date in our financial statements based on facts and circumstances known to us at that time. We periodically confirm the accuracy of our estimates with the service providers and make adjustments if necessary. Examples of estimated accrued expenses include costs associated with conducting our development and regulatory activities, including fees paid to third-party professional consultants and service providers, and costs to develop and manufacture clinical study materials.

We base our accrued expenses on our estimates of the services received and efforts expended pursuant to our contractual arrangements. The financial terms of these agreements are subject to negotiation, vary from contract to contract and may result in uneven payment flows. There may be instances in which payments made to our service providers will exceed the level of services provided and result in a prepayment of the expense. In accruing service fees, we estimate the time period over which services will be performed and the level of effort to be expended in each period. If the actual timing of the performance of services or the level of effort varies from our estimate, we adjust the accrual or prepayment accordingly.

Although we do not expect our estimates to be materially different from amounts actually incurred, if our estimates of the status and timing of services performed differs from the actual status and timing of services performed, we may report amounts that are too high or too low in any particular period. To date, there have been no material differences from our estimates to the amount actually incurred.

Equity-based Compensation Expense

We issue stock options and had historically issued incentive units, considered "profits interests" within the meaning of U.S. federal and state tax rules, to directors, officers, employees and consultants. Equity-based compensation expense represents the estimated fair value of equity awards, which are comprised of stock options and incentive units, expected to vest. We estimate the fair value of each equity award on the date of grant using the Black-Scholes option-pricing model. The Black-Scholes option-pricing model requires the use of estimates and assumptions, including expected volatility of our stock price, expected term of the equity awards, the risk-free interest rate, expected dividend yield and estimated forfeiture rate. We recognize equity-based compensation expense over the requisite service period of the equity awards (usually the vesting period) on a straight-line basis. For stock options with a performance condition, we recognize expense in accordance with Financial Accounting Standards Board Accounting Standards Codification 718-10-25-20.

Recent Accounting Pronouncements

See Note 2 to the audited financial statements included in Item 8 of this Annual Report on Form 10-K.

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