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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-K

~~☒ ANNUAL REPORT UNDER SECTION 13 OR 15~~(dMark One)

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

~~FOR~~For ~~THE~~the ~~FISCAL~~fiscal ~~YEAR~~year ~~ENDED~~ended ~~OCTOBER~~December 31, ~~2022~~2023

ORor

☐ TRANSITION REPORT ~~UNDER~~PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES EXCHANGE ACT OF 1934

OFFor ~~THE~~the ~~SECURITIES~~transition ~~EXCHANGE~~period ~~ACT~~from ~~OF 1934~~________to________

~~FOR~~Commission ~~THE~~File ~~TRANSITION~~Number ~~PERIOD FROM ______ TO ______~~001-36138

COMMISSION FILE NUMBER 001-36138

AYALA PHARMACEUTICALS, INC.

(Exact name of registrant as specified in its charter)

Delaware		02-0563870
(State or other jurisdiction of		(~~IRS~~I.R.S. Employer
incorporation or organization)		Identification No.)

9 Deer Park Drive, Suite K-1, Monmouth Junction, NJ		08852
(Address of principal executive offices)		(Zip Code)

(609) 452-9813

(Registrant’s telephone number, including area code)

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

Securities registered pursuant to Section 12(g) of the Act.

Common Stock, par value $0.001 per share

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

Large Accelerated Filer ☐ Accelerated Filer ☐ Non-accelerated Filer ☒ Smaller ~~Reporting~~reporting ~~Company~~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 ~~prepare~~prepared or issued its audit report. ☐

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. ☐

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). ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).

Yes ☐ No ☒

As of ~~April~~June 2930, ~~2022~~2023, the aggregate market value of the voting common equity held by non-affiliates was approximately $~~11,863,538~~3.7 million based on the closing bid price of the registrant’s common stock on the - OTCQX ® Best Market (~~For~~for purposes of determining this amount, only directors, executive officers, and 10% or greater shareholders and their respective affiliates have been deemed affiliates). ☒

The registrant had 442,~~838~~633,~~321~~400 shares of common stock, par value $0.001 per share, outstanding as of ~~January~~April 318, ~~2023~~2024.

Documents Incorporated by Reference

Portions of the definitive proxy statement for the registrant’s 2024 Annual Meeting of Stockholders (the “2024 Proxy Statement”) are incorporated by reference into Items 10, 11, 12, 13 and 14 in Part III of this Annual Report on Form 10-K. If the 2024 Proxy Statement is not filed by April 29, 2024 (the day that is 120 days after the last day of the registrant’s 2023 fiscal year), an amendment to this annual report on Form 10-K setting forth this information will be duly filed with the Securities and Exchange Commission.

Table of Contents

Form 10-K Index

		Page
PART I

Item 1.	Business	5

Item 1A.	Risk Factors	18

Item 1B.	Unresolved Staff Comments	18

Item 1C.	Cybersecurity	18

Item 2.	Properties	19

Item 3.	Legal Proceedings	19

Item 4.	Mine Safety Disclosures	19

PART II

Item 5.	Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities	20

Item 6.	[Reserved]	20

Item 7.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	20

Item 7A.	Quantitative and Qualitative Disclosures About Market Risk	31

Item 8.	Financial Statements and Supplementary Data	F-1

Item 9.	Changes in and Disagreements with Accountants on Accounting and Financial Disclosure	32

Item 9A.	Controls and Procedures	32

Item 9B.	Other Information	32

Item 9C.	Disclosure Regarding Foreign Jurisdictions That Prevent Inspections	32

PART III

Item 10.	Directors, Executive Officers, and Corporate Governance	33

Item 11.	Executive Compensation	33

Item 12.	Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters	33

Item 13.	Certain Relationships and Related Transactions, and Director Independence	33

Item 14.	Principal Accounting Fees and Services	33

PART IV

Item 15.	Exhibits and Financial Statement Schedules	34

Item 16.	Form 10-K Summary	38

PART 1
Item 1:	Business	5
Item 1A:	Risk Factors	27
Item 1B:	Unresolved Staff Comments	59
Item 2:	Properties	59
Item 3:	Legal Proceedings	59
Item 4:	Mine Safety Disclosures	59
PART II
Item 5:	Market for Registrant’s Common Equity, Related Shareholder Matters and Issuer Purchases of Equity Securities	60
Item 6:	Selected Financial Data	60
Item 7:	Management’s Discussion and Analysis of Financial Condition and Results of Operations	60
Item 7A:	Quantitative and Qualitative Disclosures About Market Risk	68
Item 8:	Financial Statements and Supplementary Data	68
Item 9:	Changes in and Disagreements with Accountants on Accounting and Financial Disclosures	68
Item 9A:	Controls and Procedures	69
Item 9B:	Other Information	69
Item 9C:	Disclosure Regarding Foreign Jurisdictions that Prevent Inspections	69
PART III
Item 10:	Directors, Executive Officers, and Corporate Governance	70
Item 11:	Executive Compensation	75
Item 12:	Security Ownership of Certain Beneficial Owners and Management and Related Shareholder Matters	79
Item 13:	Certain Relationships and Related Transactions, and Director Independence	81
Item 14:	Principal Accounting Fees and Services	81
Part IV
Item 15:	Exhibits, Financial Statements Schedules	82
Item 16:	Form 10-K Summary	86
Signatures		87

~~PART~~INTRODUCTORY INOTE

~~INTRODUCTORY~~Merger ~~NOTE~~of ~~REGARDING~~Advaxis, ~~RECENT~~Inc. ~~DEVELOPMENTS~~with Ayala Pharmaceuticals, Inc.

On October 18, 2022, the Registrant entered into an Agreement and Plan of Merger (the “Merger Agreement”), by and among the Registrant, Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.), a Delaware corporation (“Old Ayala”), and Doe Merger Sub, Inc. (“Merger Sub”), a Delaware corporation and a wholly-owned subsidiary of ~~Advaxis,~~the ~~Inc~~Registrant. ~~(“New Ayala”).~~ On January 19, 2023 (the “Closing Date”), pursuant to the Merger Agreement, Merger Sub merged with and into Old Ayala, with Old Ayala continuing as the surviving company and a wholly-owned subsidiary of the Registrant (the “Merger”).

The Merger Agreement and additional information on the details of the Merger may be found in the Current Report on Form 8-K filed with the Securities and Exchange Commission (“SEC”) by the Registrant on October 19, 2022.

At the effective time of the Merger (the “Effective Time”), which occurred on January 19, 2023, (i) each share of the common stock, par value $0.01 per share, of Old Ayala (the “Old Ayala Common Stock”) issued and outstanding immediately prior to the Merger was automatically converted into the right to receive 0.1874 shares (the “Exchange Ratio”) of the common stock, par value $0.001 per share, of the Registrant (the “~~New Ayala~~ Common Stock”), (ii) each outstanding option to purchase shares of the Old Ayala Common Stock (each, an “Old Ayala Option”) was substituted and converted automatically into an option (each, an “New Ayala Replacement Option”) to purchase the number of shares of New Ayala Common Stock equal to the product obtained by multiplying (a) the number of shares of Old Ayala Common Stock subject to such Old Ayala Option immediately prior to the effective time of the Merger, by (b) the Exchange Ratio, with any fractional shares rounded down to the nearest whole share, with each such New Ayala Replacement Option to have an exercise price per share of ~~New Ayala~~ Common Stock equal to (x) the per share exercise price for the shares of Old Ayala Common Stock subject to the corresponding Old Ayala Option immediately prior to the effective time of the Merger, divided by (y) the Exchange Ratio, rounded up to the nearest whole cent, and (iii) each restricted stock unit of Old Ayala (each, an “Old Ayala RSU”) outstanding immediately prior to the effective time of the Merger, whether or not vested or issuable, was substituted and converted automatically into a restricted stock unit award of New Ayala with respect to a number of shares of ~~New Ayala~~ Common Stock equal to the product obtained by multiplying (a) the total number of shares of Old Ayala Common Stock subject to such Old Ayala RSU immediately prior to the effective time of the Merger by (b) the Exchange Ratio, with any fractional shares rounded down to the nearest whole share.

The issuance of ~~New Ayala~~ Common Stock in connection with the Merger Agreement was registered under the Securities Act of 1933, as amended, (the “Securities Act”), pursuant to The Registrant’s registration statement on Form S-4 (Registration No. 333-268586) declared effective by the SEC on December 12, 2022 (the “Registration Statement”). The proxy statement/prospectus in the Registration Statement contains additional information about the Merger.

As a result of the consummation of the Merger, Old Ayala, the surviving entity in the Merger, became a wholly-owned subsidiary of the Registrant. For accounting purposes, the Merger was treated as a “reverse acquisition” and Old Ayala was considered the accounting acquirer. Accordingly, Old Ayala will be reflected as the predecessor and acquirer in the financial statements of the Registrant (the legal acquirer) for periods ending after December 31, 2022. The Registrant’s historical financial condition and results of operations shown for comparative purposes in ~~future~~ periodic filings ~~will~~for periods ending after December 31, 2022 reflect Old Ayala’s historical results.

Merger with Biosight Ltd.

On July 26, 2023, the Registrant, Advaxis Israel Ltd., a company organized under the laws of the State of Israel and a wholly owned subsidiary of the Registrant (“ADXS Merger Sub”) and Biosight, Ltd., a company organized under the laws of the State of Israel (“Biosight”) entered into an Agreement and Plan of Merger and Reorganization (the “Biosight Merger Agreement”). On October 18, 2023 (the “Closing Date”), pursuant to the Merger Agreement, ADXS Merger Sub consummated the merger with and into Biosight, with Biosight continuing as the surviving company and a wholly-owned subsidiary of the Registrant (the “Biosight Merger”).

The Biosight Merger Agreement and additional information on the details of the Biosight Merger may be found in the Current Report on Form 8-K filed with the SEC by the Registrant on October 20, 2023.

The Biosight Merger Agreement provided, among other things, that on the terms and subject to the conditions set forth therein, each share of Biosight issued and outstanding immediately prior to the effective time of the Merger (excluding any shares held by any of Biosight’s subsidiaries, the Registrant, ADXS Merger Sub or any of their respective subsidiaries, which will remain outstanding, and certain dormant shares under Israeli law, which will be cancelled, retired and cease to exist) was automatically deemed to have been transferred to the Registrant in exchange for the right to receive 1.82285 shares (the “Exchange Ratio”) of Common Stock. The Exchange Ratio was subject to equitable adjustment pursuant to the terms of the Biosight Merger Agreement. Each outstanding option or other right to purchase ordinary or preferred shares of Biosight was cancelled as of the Effective Time and will have no further force or effect. In connection with the closing of the Biosight Merger, the Registrant issued approximately 5,913,480 shares of the Common Stock to former holders of Biosight shares.

The issuance of the shares of Common Stock in the Biosight Merger was made pursuant to exemptions from the registration requirements of the Securities Act pursuant to Regulations D and S thereunder.

~~FORWARD~~Sale ~~LOOKING~~of ~~STATEMENTS~~Assets to Immunome, Inc.

~~This~~On ~~annual~~February ~~report on Form 10-K (“Form 10-K”) includes statements that are~~5, ~~or may be deemed to be~~2024, ~~“forward-looking statements.” In some cases, these forward-looking statements can be identified by~~ the ~~use~~Registrant ofand ~~forward-looking terminology~~Immunome, ~~including~~ ~~the~~Inc. ~~terms~~ (“~~believes,~~Immunome” ~~“estimates~~),” ~~“anticipates,”~~entered ~~“expects,” “plans,”~~into ~~“intends,”~~an ~~“may,”~~Asset ~~“could,”~~Purchase ~~“might,”~~Agreement (the “~~will,”~~Asset ~~“should,”~~Purchase ~~“approximately~~Agreement”) ~~or,~~pursuant into ~~each~~which ~~case,~~Immunome ~~their~~agreed ~~negative~~to oracquire ~~other~~certain ~~variations thereon or comparable terminology, although not all forward-looking statements contain these words. They appear in a number~~ of places throughout this Form 10-K and include statements regarding our intentions, beliefs, projections, outlook, analyses or current expectations concerning, among other things, our ongoing and planned discovery and development of drug candidates, the ~~strength~~Registrant’s ~~and~~assets ~~breadth of our intellectual property, our ongoing~~ and ~~planned~~liabilities ~~preclinical studies and clinical trials, our available cash, liquidity, prospects,~~related ~~growth and strategies, the timing of and our ability~~ to ~~make~~its ~~regulatory~~AL101 ~~filings~~ and ~~obtain~~AL102 ~~and~~programs ~~maintain regulatory approvals for our product candidates,~~ (the ~~degree~~“Asset ~~of clinical utility of our product candidates~~Sale”), ~~particularly~~which inconstitute ~~specific~~substantially ~~patient~~all ~~populations, expectations regarding clinical trial data, our results~~ of ~~operations, financial condition, impacts of~~ the ~~ongoing conflict in the Ukraine, inflation and the Federal Reserve~~Registrant’s ~~responses~~ thereto, including increasing interest rates, the length of time that we will be able to continue to fund our operating expenses and capital expenditures, our expected financing needs and sources of financing, the industry in which we operate and the trends that may affect our industry or usassets.

On March 25, 2024, the Registrant and Immunome consummated the Asset Sale pursuant to the Asset Purchase Agreement. Immunome paid to the Registrant an aggregate purchase price of $20,000,000 in cash (of which $4,000,000 had been paid upon entering into the Asset Purchase Agreement), subject to certain adjustments and issued to the Registrant 2,175,489 shares (the “Shares”) of Immunome’s common stock, $0.0001 par value. The Asset Purchase Agreement further provides that Immunome may pay the Registrant up to $37,500,000 in cash due upon the achievement of certain development and commercial milestone events set forth in the Asset Purchase Agreement. At the March 25, 2023 closing, Immunome paid the remaining $16,000,000 of the cash consideration to the Company, at the Company’s direction, to certain vendors of the Company.

The Asset Purchase Agreement contains customary representations, warranties, conditions and covenants, including covenants (i) concerning the conduct of business by the Registrant prior to the closing of the Asset Sale, (ii) prohibiting the Registrant and its representatives from soliciting, initiating or knowingly inducing, encouraging or facilitating any competing acquisition proposal, (iii) prohibiting the Registrant and its controlled affiliates from competing with Immunome for five years following the closing of the Asset Sale in certain fields, and (iv) restricting the Registrant’s ability to make distributions to stockholders, dissolve or wind up its business or file for bankruptcy for six months following the closing of the Asset Sale.

The Asset Purchase Agreement and additional information on the details of the Asset Sale may be found in the Current Report on Form 8-K filed with the SEC by the Registrant on February 6, 2024.

SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

This annual report on Form 10-K for the year ended December 31, 2023 (“Form 10-K”) includes statements that are, or may be deemed to be, “forward-looking statements.” In some cases, these forward-looking statements can be identified by the use of forward-looking terminology, including the terms “believes,” “estimates,” “anticipates,” “expects,” “plans,” “intends,” “may,” “could,” “might,” “will,” “should,” “approximately” or, in each case, their negative or other variations thereon or comparable terminology, although not all forward-looking statements contain these words. They appear in a number of places throughout this Form 10-K and include statements regarding our intentions, beliefs, projections, outlook, analyses or current expectations concerning, among other things, our ongoing and planned discovery and development of drug candidates, the strength and breadth of our intellectual property, our ongoing and planned preclinical studies and clinical trials, our available cash, liquidity, prospects, growth and strategies, the timing of and our ability to make regulatory filings and obtain and maintain regulatory approvals for our product candidates, the degree of clinical utility of our product candidates, particularly in specific patient populations, expectations regarding clinical trial data, our results of operations, financial condition, impacts of the ongoing conflicts in the Ukraine and the Middle East, inflation and the Federal Reserve’s responses thereto, including increasing interest rates, the length of time that we will be able to continue to fund our operating expenses and capital expenditures, our expected financing needs and sources of financing, the industry in which we operate and the trends that may affect our industry or us.

By their nature, forward-looking statements involve risks and uncertainties because they relate to events, competitive dynamics, and healthcare, regulatory and scientific developments and depend on the economic circumstances that may or may not occur in the future or may occur on longer or shorter timelines than anticipated. Although we believe that we have a reasonable basis for each forward-looking statement contained in this Form 10-K, we caution you that forward-looking statements are not guarantees of future performance and that our actual results of operations, financial condition and liquidity, and the development of the industry in which we operate may differ materially from the forward-looking statements contained in this Form 10-K. In addition, even if our results of operations, financial condition and liquidity, and the development of the industry in which we operate are consistent with the forward-looking statements contained in this Form 10-K, they may not be predictive of results or developments in future periods.

Some of the factors that we believe could cause actual results to differ from those anticipated or predicted include:

● the success and timing of our clinical trials, including patient accrual; ● our available cash; ● our ability to obtain and maintain regulatory approval and/or reimbursement of our product candidates for marketing; ● our ability to obtain the appropriate labeling of our products under any regulatory approval; ● our plans to develop and commercialize our products; ● the successful development and implementation of future sales and marketing campaigns; ● the change of key scientific or management personnel; ● the size and growth of the potential markets for our product candidates and our ability to serve those markets; ● our ability to successfully compete in the potential markets for our product candidates, if commercialized; ● regulatory developments in the United States and foreign countries; ● our ability to continue as a going concern; ● the rate and degree of market acceptance of any of our product candidates; ● new products, product candidates or new uses for existing products or technologies introduced or announced by our competitors and the timing of these introductions or announcements; ● market conditions in the pharmaceutical and biotechnology sectors; ● the accuracy of our estimates regarding expenses, future revenues, capital requirements and needs for additional financing; ● our ability to obtain additional funding; ● any outcomes from our review of strategic transactions and options to maximize stockholder value;

● the ability of our product candidates to successfully perform in clinical trials and to resolve any clinical holds that may occur; ● our ability to obtain and maintain approval of our product candidates for trial initiation; ● the performance of third-party manufacturers; ● our ability to identify license and collaboration partners and to maintain existing relationships; ● the performance of our clinical research organizations, clinical trial sponsors and clinical trial investigators, and collaboration partners for any clinical trials we conduct; ● our ability to successfully implement our strategy; and ● our ability to maintain the listing of our common stock on the OTCQX® Best Market (“OTCQX”).

Any forward-looking statements that we make in this Form 10-K speak only as of the date of such statement, and we undertake no obligation to update such statements to reflect events or circumstances after the date of this Form 10-K. You should also read carefully the factors described in the “Risk Factors” section of this Form 10-K to better understand the risks and uncertainties inherent in our business and underlying any forward-looking statements. As a result of these factors, we cannot assure you that the forward-looking statements in this Form 10-K will prove to be accurate.

This Form 10-K includes statistical and other industry and market data that we obtained from industry publications and research, surveys and studies conducted by third-parties. Industry publications and third-party research, surveys and studies generally indicate that their information has been obtained from sources believed to be reliable, although they do not guarantee the accuracy or completeness of such information. While we believe these industry publications and third-party research, surveys and studies are reliable, we have not independently verified such data.

We qualify all of our forward-looking statements by these cautionary statements. In addition, with respect to all of our forward-looking statements, we claim the protection of the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995.

In this Form 10-K, unless otherwise stated or the context otherwise indicates, references to “New Ayala,” “Advaxis,” the “Company,” “we,” “us,” “our” and similar references refer to Ayala Pharmaceuticals, Inc., a Delaware corporation, which prior to the change of its name effected on January 19, 2023 was known as Advaxis, Inc.

PART I

Item 1. Business.

~~Introductory Note~~Recent Developments

~~The following~~Recent ~~discussion~~Strategic relates to the business of New Ayala as it existed prior to the Merger. Following the Merger, New Ayala has combined such existing business and the business of Old Ayala. In accordance with Rule 12b-23 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), we are incorporating into this Item 1 the description of the business of Old Ayala set forth in pages 233-273 of the Definitive Proxy Statement of Old Ayala for the Special Meeting of Stockholders of Old Ayala held on January 13, 2023, which was filed with the Commission on December 12, 2022 and which pages are set forth on Exhibit 99.1 to this Annual Report on Form 10-K.Transactions

See “Introductory Note” beginning on page 3 of this Annual Report on Form 10-K.

The Company has incurred recurring losses since inception as a research and development organization. For the year ended December 31, 2023, the Company used approximately $29.5 million of cash in operations and incurred a net loss of $48.1 million. As of December 31, 2023, the Company had $4.9 million in cash and cash equivalents, $25.0 million in current liabilities and an accumulated deficit of $197.2 million.

Upon closing of the Asset Sale, on March 25, 2024, the Company received $13.0 million in cash, and Immunome paid $3.0 million of the Company’s liabilities directly to vendors of the Company. In addition, under the Asset Sale Agreement the Company received 2,175,489 shares of Immunome’s common stock (the “Immunome Shares”). The Asset Sale Agreement prohibits the Company from selling more than 50% of the Immunome Shares in the first six months following the closing of the Asset Sale. In addition, on March 1, 2024, the Company issued additional convertible notes and warrants in exchange for $2.0 million in funding from the Convertible Notes investors. As of the date of this filing, the cash proceeds received from the Asset Sale and the convertible notes sold on March 1, 2024 were not sufficient to pay the Company’s existing liabilities. Therefore, the Company has limited available cash resources and requires additional financing, through the sale of a portion of the Immunome Shares or otherwise, in order to continue to fund its current operations beyond May 2024.

Raising additional funds or the satisfactory sale of a portion of the Immunome Shares prior to the end of May 2024 is essential to provide sufficient cash flow to meet future liabilities and other obligations, such as tax payments arising from the Asset Sale. Furthermore, even if the Company is successful in selling a portion of the Immunome Shares or raising additional funds through other means, the Company cannot give any assurance that it will, in the future, be able to achieve a level of profitability from the sale of its products to sustain its operations.

If the Company is unable to obtain funding, or able to receive sufficient funds from the sale of a portion of the Immunome Shares, the Company would be forced to delay, reduce, or eliminate its research and development programs, or the Company may be unable to continue operations. As such, those factors raise substantial doubt about the Company’s ability to continue as a going concern.

As part of a cost reduction plan, during the year ended December 31, 2023, the Company had a reduction in workforce in which the employment of approximately 50% of the Company’s employees was terminated. During the first quarter of 2024, the Company gave notice of termination to 18 additional employees and two officers (including the Chief Financial Officer, whose employment will terminate on June 25, 2024). After the effectiveness of such terminations, the Chief Executive Officer will be the only employee of the Company. The Company expects to be able to meet its financial obligations to its employees.

The Company can give no assurances that it will be successful in raising funds through the sale of a portion of the Immunome Shares or any other alternative. Any inability to so obtain additional financing or funding will likely cause the Company to cease business operations. The consolidated financial statements have been prepared assuming that the Company will continue as a going concern. Therefore, the consolidated financial statements for the year ended December 31, 2023, do not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or the amounts and classification of liabilities that may result from uncertainty related to the Company’s ability to continue as a going concern.

Overview

Following the completion of the Asset Sale on March 25, 2024, the Company is a clinical-stage oncology company whose primary clinical assets currently include aspacytarabine (BST-236), a novel proprietary anti-metabolite for first line treatment in unfit acute myeloid leukemia (AML). BST-236 is a novel prodrug of cytarabine, enabling delivery of high cytarabine doses with reduced systemic toxicity, creating a potential new backbone for AML combination regimens. We believe that our novel product candidates, if approved, have the potential to transform treatment outcomes for patients suffering from solid and hematological cancers. We also continue to conduct certain operations relating to former Advaxis’ operations as clinical-stage biotechnology company focused on the development and commercialization of proprietary Listeria monocytogenes (“Lm”)-based antigen delivery products. These efforts are primarily focused on the development of ADXS-504, an Lm-based therapy for early-stage prostate cancer.

~~General~~We have incurred significant net operating losses in every year since our inception and expect to continue to incur significant expenses and increasing operating losses for the foreseeable future. Our net losses may fluctuate significantly from quarter to quarter and year to year and could be substantial. Our net losses were approximately $48.1 million and $38.0 million for the years ended December 31, 2023 and 2022, respectively. As of December 31, 2023, we had an accumulated deficit of $197.2 million.

~~Prior~~Following toclosing ~~the~~of ~~Merger, New Ayala was a clinical-stage biotechnology company that was focused on~~ the ~~development and commercialization~~ sale of ~~proprietary~~AL102 Listeria monocytogenes, or Lm, Technology antigen delivery products based on a platform technology that utilizes live attenuated Lm bioengineered to secrete antigen/adjuvant fusion proteins. These Lm-based strains are believed to be a significant advancement in immunotherapy as they integrate multiple functions into a single immunotherapy and ~~are~~AL101 ~~designed~~ to ~~access and direct antigen presenting cells to stimulate anti-tumor T cell immunity~~Immunome, ~~activate the~~we ~~immune~~anticipate ~~system with the equivalent of multiple adjuvants, and simultaneously reduce tumor protection in the Tumor Microenvironment, or TME, to enable T cells to eliminate tumors. The Company believes~~ that Lmour ~~Technology~~expenses ~~immunotherapies~~will ~~can~~decrease ~~complement~~as and address significant unmet needs in the current oncology treatment landscape. Specifically, the Company’s product candidates have the potential to optimize the clinical impact of checkpoint inhibitors while having a generally well-tolerated safety profile. The Company’s passion for the clinical potential of Lm Technology is balanced by focus and fiscal discipline which is directed towards improving treatment options for cancer patients and increasing shareholder value.we:

Prior to the Merger, New Ayala was focused on multiple antigen delivery products which are in various stages of clinical development. All of the Company’s products are anchored in the Company’s Lm TechnologyTM, a unique platform designed for its ability to target various cancers in multiple ways. As an intracellular bacterium, Lm is an effective vector for the presentation of antigens through both the Major Histocompatibility Complex, or MHC, I and II pathways, due to its active phagocytosis by Antigen Presenting Cells, or APCs. Within the APCs, Lm produces virulence factors which allow survival in the host cytosol and potently stimulate the immune system.

	●	Continue to conduct certain operations related to advancing the development of BST-236
	●	Satisfy certain debts and obligations remaining from our operations prior to the consummation of the Asset Sale

~~Through a~~We ~~license~~do ~~from~~not ~~the~~expect ~~University~~to ofgenerate ~~Pennsylvania~~revenue from ~~and~~product ~~through~~sales ~~its~~unless ~~own~~and ~~development~~until ~~efforts,~~we ~~New~~successfully ~~Ayala~~complete ~~has~~clinical ~~exclusive~~development ~~access~~and toobtain ~~a proprietary~~regulatory ~~formulation~~approval offor ~~attenuated~~a Lmproduct ~~that is called Lm Technology~~candidate. ~~Lm Technology is designed to optimize~~ ~~this natural system~~Additionally, ~~and~~we ~~one~~currently ofuse ~~the~~contract ~~keys~~research ~~to the enhanced immunogenicity of Lm Technology is the tLLO-fusion protein~~organizations, ~~which~~ ~~is made up of tumor associated antigen,~~ or ~~TAA~~CROs, ~~fused~~ to acarry ~~highly~~out ~~immunogenic~~our ~~bacterial~~clinical ~~protein~~development ~~that triggers potent cellular immunity~~activities. ~~The tLLO-fusion protein is also designed to help reduce immune tolerance in the TME and to promote antigen spreading~~Furthermore, we ~~thereby~~incur ~~improving~~additional ~~activity~~costs inassociated ~~the~~with ~~TME.~~operating ~~Multiple~~as ~~copies~~a ofpublic ~~the tLLO-fusion protein within each construct may increase antigen presentation and TME impact~~company.

AsThe ~~the~~Company ~~field~~has ofincurred ~~immunotherapy~~recurring ~~continues~~losses tosince ~~evolve,~~inception ~~the~~as ~~flexibility~~a ofresearch ~~the~~and Lmdevelopment ~~Technology~~organization. ~~platform~~For ~~allowed~~the ~~New~~year ~~Ayala~~ended toDecember ~~develop~~31, ~~highly innovative products. To date~~2023, Lmthe ~~Technology~~Company ~~has~~used ~~demonstrated~~approximately $29.5 ~~preclinical~~million ~~synergy~~of ~~with~~cash ~~multiple~~in ~~checkpoint~~operations ~~inhibitors, co-stimulatory agents~~ and ~~radiation therapy.~~incurred ~~The~~a ~~safety~~net ~~profile~~loss of ~~all~~$48.1 Lmmillion. ~~Technology~~As ~~constructs~~of ~~seen~~December to31, ~~date~~2023, ~~across~~the ~~over~~Company ~~470~~had ~~patients~~$4.9 ~~has~~million ~~been generally predictable~~in cash and ~~manageable~~cash equivalents, ~~consisting~~$25.0 ~~mostly~~million ofin ~~mild~~current toliabilities ~~moderate~~and ~~flu-like~~an ~~symptoms~~accumulated ~~that~~deficit ~~have~~of ~~been~~$197.2 ~~transient and associated with infusion~~million.

Upon closing of the Asset Sale, on March 25, 2024, the Company received $13.0 million in cash, and Immunome paid $3.0 million of the Company’s liabilities directly to vendors of the Company. In addition, under the Asset Sale Agreement the Company received 2,175,489 shares of Immunome’s common stock (the “Immunome Shares”). The Asset Sale Agreement prohibits the Company from selling more than 50% of the Immunome Shares ~~New~~in ~~Ayala~~the ~~Corporate~~first ~~Strategy~~six months following the closing of the Asset Sale. In addition, on March 1, 2024, the Company issued additional convertible notes and ~~Strategic~~warrants ~~Considerations~~in exchange for $2.0 million in funding from the Convertible Notes investors. As of the date of this filing, the cash proceeds received from the Asset Sale and the convertible notes sold on March 1, 2024 were not sufficient to pay the Company’s existing liabilities. Therefore, the Company has limited available cash resources and requires additional financing, through the sale of a portion of the Immunome Shares or otherwise, in order to continue to fund its current operations beyond May 2024.

~~Prior~~Raising additional funds or the tosatisfactory completion of the ~~Merger,~~sell ~~New~~of ~~Ayala’s~~Immunome ~~strategy~~Shares ~~was~~prior to ~~advance~~ the Lmend ~~Technology~~of ~~platform~~May ~~and~~2024 ~~leverage~~is ~~its~~essential ~~unique~~to ~~capabilities~~provide sufficient cash flow to meet ~~design~~future liabilities and ~~develop~~other anobligations, ~~array~~such ofas ~~cancer~~tax ~~treatments.~~payments Weresulted ~~are~~from ~~currently~~the ~~conducting~~Asset ~~clinical~~Sale. ~~studies~~Furthermore, ofeven Lmif ~~Technology~~the ~~immunotherapies~~Company inis ~~early~~successful ~~prostate~~in ~~cancer.~~selling Wethe ~~identified~~Immunome ~~and~~Shares ~~worked~~or ~~with~~raising ~~collaborators~~additional ~~and~~funds, ~~potential~~the ~~licensees~~Company ~~for these~~cannot ~~programs~~give ~~and~~any ~~others~~assurance ~~for~~that ~~first-generation~~it Lmwill, ~~immunotherapies~~in ~~like~~the ~~ADXS-HPV~~future, ~~for~~be ~~HPV-associated~~able to ~~cancer~~achieve ~~and~~a ~~ADXS-HER-2~~level ~~for pediatric~~of ~~osteosarcoma~~profitability from the sale of its products to sustain its operations.

~~New Ayala~~If ~~mainly~~the ~~concentrated~~Company onis ~~its~~unable ~~disease-focused~~to obtain funding, ~~hotspot/”off-the-shelf”~~or ~~neoantigen-directed~~able ~~therapies~~to ~~called~~receive ~~ADXS-HOT. ADXS-HOT~~sufficient isfunds afrom ~~program~~sale ~~that~~of ~~leverages~~Immunome Shares the Company’s ~~proprietary~~would Lmbe ~~technology~~forced to ~~target~~delay, ~~hotspot~~reduce, ~~mutations~~or ~~that~~eliminate ~~commonly~~its ~~occur~~research inand ~~specific~~development ~~cancer~~programs, ~~types.~~or ~~ADXS-HOT~~the ~~drug~~Company ~~candidates~~may ~~are~~be ~~designed~~unable to ~~target~~continue ~~acquired~~operations. ~~shared~~As orsuch, ~~“public”~~those ~~mutations~~factors ~~in tumor~~raise ~~driver~~substantial ~~genes~~doubt about ~~along~~the ~~with~~Company’s ~~other~~ability ~~cancer-associated~~to ~~antigens~~continue ~~that~~as ~~also~~a ~~commonly~~going ~~occur in specific cancer types~~concern.

~~Prior to~~As ~~the~~part ~~Merger,~~of ~~New~~a ~~Ayala~~cost ~~expected~~reduction toplan, during ~~continue~~the ~~investing~~year ~~exclusively~~ended inDecember 31, 2023, the ~~HOT~~Company ~~construct~~had ~~ADXS-504~~a reduction in ~~early~~workforce ~~prostate~~in ~~cancer through~~which anthe ~~ongoing~~employment ~~Investigator~~of ~~Sponsored~~approximately ~~Trial~~50% ~~(IST)~~of atthe Company’s ~~Columbia~~employees ~~University~~was ~~in NYC~~terminated. ~~The~~During ~~study~~the ~~with~~first ~~ADXS-503~~quarter ~~immunotherapy~~of in2024, ~~non-small~~the ~~cell~~Company ~~lung~~gave ~~cancer~~notice ~~was~~of ~~stopped~~termination ~~due~~ to ~~the~~18 additional employees ~~difficulty~~and intwo ~~enrolling~~officers ~~additional~~(including ~~patients.~~the ~~The~~Chief LmFinancial ~~Technology~~Officer, ~~platform~~whose isemployment ~~protected~~will byterminate aon ~~range~~June 25, 2024). After the effectiveness of such ~~patents~~terminations, ~~covering~~the ~~both product~~Chief ~~and~~Executive ~~process,~~Officer ~~some~~will be the only employee of ~~which~~the weCompany. ~~believe~~The ~~can~~Company expects to be ~~maintained~~able ~~into~~to ~~2039~~meet its financial obligations to its employees.

InThe Company can give no assurances ~~October~~that ~~2022,~~it wewill ~~announced~~be successful in raising funds through the sale of a portion of the Immunome Shares or any other alternative. Any inability to so obtain additional financing or funding will likely cause the Company to cease business operations. The consolidated financial statements have been prepared assuming that wethe ~~had~~Company ~~entered~~will ~~into~~continue as a going concern. Therefore, the ~~Merger~~consolidated ~~Agreement~~financial ~~with~~statements ~~Old~~for ~~Ayala~~the year ended December 31, ~~pursuant~~2023, todo ~~which~~not ~~Old~~include ~~Ayala~~any isadjustments to ~~merge~~reflect ~~with~~the possible future effects on the recoverability and ~~into~~classification of ~~Merger~~assets ~~Sub,~~or the amounts and classification of liabilities that may result from uncertainty related to the Company’s ability to continue as a ~~direct,~~going ~~wholly-owned~~concern. ~~subsidiary~~See “— Liquidity and Capital Resources.” Substantial doubt about our ability to continue as a going concern may materially and adversely affect the price per share of ~~Old~~our ~~Ayala~~common stock, and it may be more difficult for us to obtain financing. If potential collaborators decline to do business with ~~New~~us ~~Ayala~~or ~~continuing~~potential asinvestors decline to participate in any future financings due to such concerns, our ability to increase our cash position may be limited. We will need to generate significant revenues to achieve profitability, and we may never do so. Because of the ~~surviving~~numerous ~~company~~risks and auncertainties ~~wholly-owned~~associated ~~subsidiary~~with the development of our current and any future product candidates and because the ~~Merger.~~extent ~~The~~to ~~Merger~~which ~~closed~~we onmay ~~January~~enter 19into collaborations with third parties for the development of any of our product candidates is unknown, ~~2023~~we are unable to estimate the amounts of increased capital outlays and operating expenses required for completing the research and development of our product candidates.

Lm Technology and the Immunotherapy Landscape

The challenge of cancer immunotherapy has been to find the best overall balance between efficacy and side effects when mobilizing the body’s immune system to fight against cancer. The development of immune checkpoint inhibitors was a significant step forward, particularly with anti-PD-1 therapies, and brought with it impressive clinical activity in many different types of cancers, including melanoma, lung, head and neck and urothelial cancers. However, a literature review published in Science in 2018 noted that anti-PD-1 monotherapy response rates are only in the 15-25% range, and rise to ≥50% only in selected groups of patients with desmoplastic melanoma, Merkel carcinoma or tumors with mismatch-repair deficiency. Development of secondary resistance with disease progression is yet another common limitation of these therapies. Therefore, for most cancer patients, there is room for improvement. Checkpoint inhibitors can expand existing cancer fighting cells that may already be present in low numbers and support their activity against cancer cells, but if the right cancer-fighting cells are not present, checkpoint inhibitors may not provide clinical benefit. Similarly, there are many mechanisms of immune tolerance that are distinct from the checkpoints which may also be blocking the immune system from fighting cancer. Based on both pre-clinical and early clinical data, New Ayala believes that checkpoint inhibitors, when combined with treatments such as Lm Technology, can have an amplified anti-tumor effect. Lm Technology incorporates several complementary elements that include innate immune stimulation, potent generation of cancer-targeted T cells, ability to boost immunity through multiple treatments, enhancing lymphocyte infiltration into tumors, reduction of non-checkpoint mediated immune tolerance within the tumor microenvironment, and promotion of antigen spreading which may amplify the effects of treatment. These results provide rationale for further testing of Lm Technology agents alone and in combination with checkpoint inhibitors.

Traditional cancer vaccines were another development within immunotherapy and have a history beginning over 30 years ago. Unfortunately, these vaccines have largely been unsuccessful for a variety of potential reasons. These include poor selection of targets, imbalanced antigen presentation by inclusion of certain immune enhancing agents (adjuvants), failure to consider the blocking actions of immune tolerance, and choice of vaccine vectors. In some cases, patients may develop neutralizing antibodies, preventing further treatments. In contrast to traditional cancer vaccines, Lm Technology takes advantage of a natural pathway in the immune system that evolved to protect us against Listeria infections, that also happens to generate the same type of immunity that is required when fighting cancer. The live but weakened (attenuated) bacteria stimulate a balanced concert of innate immune triggers and present the tumor antigen target precisely where it needs to be able to generate potent cancer fighting cells from within the immune system itself. The multitude of accompanying signals serves to broadly mobilize most of the immune system in support of fighting what seems to be a Listeria infection, and is then “re-directed” against cancer cell targets. Additionally, the unique intracellular lifecycle of Listeria avoids the creation of neutralizing antibodies, thereby allowing for repeat administration as a chronic therapy with a sustained enhancing of tumor antigen-specific T cell immunity.

Looking back on the last two decades, there have been promising technology advancements to harness and activate killer T cells against cancers and every day more is learned about the interplay between immunity and cancer that can lead to improved treatments. However, there are still significant unmet needs in the immunotherapy landscape that New Ayala, feels Lm Technology may be able to address and complement. Specifically, Lm Technology has the potential to optimize and expand checkpoint inhibitor activity in combination. It also avoids many of the limitations of previous cancer vaccine attempts by tapping into the pathway reserved for defense against Listeria infection while incorporating the best cancer targets science can identify, including neoantigens that result from mutations in the cancer. Moreover, these immunotherapies could be effectively used as adjuvant therapies for patients who have had clinical response to radical therapy, in order to prevent emergence of new metastases and disease progression. To date, Lm Technology products have a manageable safety profile, do not generate neutralizing antibodies lending themselves to retreatments, and most of the products are designed to be immediately available for treatment without the complication and expense of modifying a patient’s own cells in a laboratory.

Lm Technology: An optimized Listeria -based antigen delivery system

New Ayala’s Listeria -based immunotherapies are designed for antigen delivery through a process of insertion of multiple copies of the proprietary tLLO-fusion protein into each extrachromosomal protein expression and secretion plasmid that makes and secretes the target protein right inside the patient’s antigen presenting cells to initiate and/or boost their immune response. The tLLO-fusion protein approach was developed at the University of Pennsylvania as an improvement over insertion of a single copy of the target gene, as an ACT-A (or other Lm peptide) fusion, within the bacterial genome for four key reasons:

1. Multiple copies of the DNA in the plasmids per bacteria can result in larger amounts of tLLO -fusion protein being expressed simultaneously, versus a single copy. This is designed to improve antigen presentation and immunologic priming and increases the number of T cells generated for a particular treatment.

2. tLLO expressed on plasmids (with or without a tumor target protein attached) has been shown preclinically to reduce numbers and immune suppressive function of Tregs and myeloid-derived suppressor cells, or MDSCs, in the tumor microenvironment. Presented preclinical data demonstrates that Tregs are destroyed as soon as five days after the first Lm Technology treatment and that suppressive M2 tumor-associated macrophages, or TAMs, are replaced by M1 macrophages which support antigen presentation and adoptive immunity. 3. The extrachromosal DNA plasmids themselves also contain CpG sequence patterns that trigger TLR-9, which confers additional innate immune stimulation beyond a Listeria without the plasmids. 4. The multiple copies of bacterial DNA plasmids (up to 80-100 per bacteria) confers additional stimulation of the STING receptor within APC’s which has been associated with enhancing anti-cancer immunity in patients.

Clinical Pipeline

Prior to the Merger, New Ayala was focused on the development and commercialization of proprietary Lm Technology antigen delivery products. New Ayala is currently winding down or has wound down clinical studies of Lm Technology immunotherapies in four program areas:

● Non-small cell lung cancer (ADXS-503) ● Human Papilloma Virus (“HPV”)-associated cancers ● Personalized neoantigen-directed therapies ● Human epidermal growth factor receptor-2 (HER-2) associated cancers

All these clinical program areas are anchored in the Company’s Lm Technology™, a unique platform designed for its ability to safely and effectively target various cancers in multiple ways. The Phase 1/2 study with ADXS-PSA ± pembrolizumab in metastatic castration-resistant prostate cancer patients was closed on January 25, 2021. The MEDI Phase 2 combo study (AZ) with AXAL ± durvalumab in Cervical and Head and Neck Cancer and the AIM2CERV Phase 3 clinical trial with ADXS-HPV (AXAL) in cervical cancer were closed on August 22, 2019 and June 11, 2021, respectively. The study with personalized neoantigen-directed therapies (ADXS-NEO) was closed on May 22, 2020 and the NEO program-IND inactivation request was submitted to the FDA on May 10, 2021. On October 18, 2022, New Ayala announced that it would begin the orderly wind down of its ADXS-503 product in the 4Q 2022 to focus primarily on the Old Ayala product line and its other products.

While we are currently winding down clinical studies of Lm Technology immunotherapies in these program areas, our license agreements continue with OS Therapies, LLC, for ADXS-HER2, and with GBP for the exclusive license for the development and commercialization of ADXS-HPV or AXAL in Asia, Africa, and the former USSR territory, exclusive of India and certain other countries.

New Ayala Pipeline of Product Candidates

Disease-focused hotspot/’off -the-shelf’ neoantigen therapies (ADXS-HOT)

Prior to the Merger, New Ayala created a new group of immunotherapy constructs for major solid tumor cancers that combines our optimized Lm Technology vector with promising targets designed to generate potent anti-cancer immunity. The ADXS-HOT program is a series of novel cancer immunotherapies that will target somatic mutations, or hotspots; cancer testis antigens, or CTAs; and oncofetal antigens, or OFAs. These three types of targets form the basis of the ADXS-HOT program because they are designed to be more capable of generating potent, tumor-specific, and high-strength killer T cells, versus more traditional over-expressed native sequence tumor associated antigens. Most hotspot mutations and OFA/CTA proteins play critical roles in oncogenesis; targeting both at once could significantly impair cancer proliferation. The ADXS-HOT products will combine many of the potential high avidity targets that are expressed in all patients with the target disease into one “off-the-shelf,” ready-to-administer treatment. The ADXS-HOT technology has a strong intellectual property, or IP, position, with potential protection into 2037, and an IP filing strategy provides for broad coverage opportunities across multiple disease platforms and combination therapies. New Ayala entered into an agreement with Columbia University Irving Medical Center in April 2021 to fund a phase 1 clinical study evaluating ADXS-504 in patients with biochemically recurrent prostate cancer. The study started early in 3Q 2021 and was the first clinical evaluation of ADXS-504, New Ayala’s off-the-shelf neoantigen immunotherapy drug candidate for early prostate cancer.

Nearly 248,530 men in the United States will be diagnosed with prostate cancer in 2021. It has been estimated that ~135,000 new cases undergo radical prostatectomy (RP) or radiotherapy (RT). Of these cases, 20–40% of pts with RP and 30–50% with RT will experience rising prostate specific antigen (PSA) levels following local therapy (BCR) within 10 years, a condition known as biochemical recurrence (BCR). BCR is not typically associated with imminent death, and biochemical progression may occur over a prolonged period. Clinicians treating men with BCR thus face a difficult set of decisions in attempting to delay the onset of metastatic disease and death while avoiding over-treating patients whose disease may never affect their overall survival or quality of life.

The phase 1 open-label study is evaluating the safety and tolerability of ADXS-504 monotherapy, administered via infusion, in 9-18 patients with biochemically recurrent prostate cancer, i.e., those with elevation of prostate-specific antigen (PSA) in the blood after radical prostatectomy or radical radiotherapy (external beam or brachytherapy) and who are not currently receiving androgen ablation therapy. The study will also evaluate if the body’s immune system can control the prostate cancer following treatment with ADXS-504 monotherapy.

HPV-Related Cancers

The Company conducted several studies evaluating axalimogene filolisbac, or AXAL, for HPV-related cancers. AXAL is an Lm-based antigen delivery product directed against HPV and designed to target cells expressing HPV.

In June 2019, the Company announced the closing of its AIM2CERV Phase 3 clinical trial with axalimogene filolisbac (AXAL) in high-risk locally advanced cervical cancer. Company estimates showed that the remaining cost to complete the AIM2CERV trial ranged from $80 million to $90 million, and initial efficacy data was not anticipated for at least three years. Therefore, results from the clinical trial were not the basis for the decision to close the study, nor was safety as the trial recently underwent its third Independent Data Monitoring Committee (IDMC) review with no safety issues noted. The Company has unblinded the AIM2CERV clinical data generated to date and currently has no plans to present it at any medical conference as the data set is incomplete and inconclusive. The Company’s clinical study report of the AIM2CERV Phase 3 study was completed on January 3, 2022 and submitted to the FDA.

In 2014, New Ayala granted Global BioPharma, or GBP, an exclusive license for the development and commercialization of AXAL in Asia, Africa, and the former USSR territory, exclusive of India and certain other countries. GBP is responsible for all development and commercial costs and activities associated with the development in their territories.

Personalized Neoantigen-directed Therapies (ADXS-NEO)

ADXS-NEO is an individualized Lm Technology antigen delivery product developed using whole-exome sequencing of a patient’s tumor to identify neoantigens. ADXS-NEO is designed to work by presenting a large payload of neoantigens directly into dendritic cells within the patient’s immune system and stimulating a T cell response against cancerous cells. In October 2019, the Company announced that it has dosed its last patient in Part A, in monotherapy, and does not intend to continue into Part B, in combination with a checkpoint inhibitor. As a result, New Ayala has closed this study. The Company has completed the clinical study report from Part A of the ADXS-NEO study and the NEO program-IND inactivation request has been submitted to FDA.

Prostate Cancer (ADXS-PSA)

According to the American Cancer Society, prostate cancer is the second most common type of cancer found in American men and is the second leading cause of cancer death in men, behind only lung cancer. More than 160,000 men are estimated to be diagnosed with prostate cancer in 2018, with approximately 30,000 deaths each year. Unfortunately, in about 10-20% of cases, men with prostate cancer will go on to develop castration-resistant prostate cancer, or CRPC, which refers to prostate cancer that progresses despite androgen deprivation therapy. Metastatic CRPC, or mCRPC, occurs when the cancer spreads to other parts of the body and there is a rising prostate-specific antigen, PSA, level. This stage of prostate cancer has an average survival of 9-13 months, is associated with deterioration in quality of life, and has few therapeutic options available.

Recent data regarding checkpoint inhibitor monotherapy has shown some antitumor activity that provides disease control in a subset of patients with bone predominant mCRPC previously treated with next generation hormonal agents and docetaxel. Data from the KEYNOTE-199 trial in bone predominant-mCRPC patients treated with KEYTRUDA®, or pembrolizumab, was updated at the ASCO GU meeting in 2019. In this trial, the total stable disease/disease stabilization rate was 39% with no responses reported so far, and only one patient with ≥50% decrease in the post-baseline PSA value. It is hypothesized that the limited activity in mCRPC may be due to 1) the inability of the checkpoint inhibitor to infiltrate the tumor microenvironment and 2) the presence of an immunosuppressive tumor micro-environment, or TME. The combination therapy with agents—like Lm constructs—that induce T cell infiltration within the tumor and decrease negative regulators in the TME may improve performance of checkpoints in prostate cancer.

Lm Technology constructs demonstrated the ability to induce anti-tumor T cell responses and T cell infiltration in the TME and to reduce the number and suppressive function of Tregs and MDSCs in the TME. For example, destruction of Tregs in the TME has been documented as soon as five days after dosing Lm constructs in models. This reduction of immune suppression in the tumors has been attributed to our proprietary tLLO-fusion peptides expressed by multiple copies of the plasmids in each bacteria. Because of all these effects, it is hypothesized that Lm constructs can turn “cold prostate tumors” into “hot tumors” that better respond to checkpoint inhibitors. Advaxis believes that the combination of ADXS-PSA, its immunotherapy designed to target the PSA antigen, with a checkpoint inhibitor may provide an alternative treatment option for patients with mCRPC.

New Ayala entered into a clinical trial collaboration and supply agreement with Merck to evaluate the safety and efficacy of ADXS-PSA as monotherapy and in combination with KEYTRUDA®, Merck’s anti PD-1 antibody, in a Phase 1/2, open-label, multicenter, dose determination and expansion trial in patients with previously treated metastatic, castration-resistant prostate cancer (KEYNOTE-046). ADXS-PSA was tested alone or in combination with KEYTRUDA in an advanced and heavily pretreated patient population who had progressed on androgen deprivation therapy. A total of 13 and 37 patients were evaluated on monotherapy and combination therapy, respectively. For the ADXS-PSA monotherapy dose escalation and determination portion of the trial, cohorts were started at a dose of 1 x 109 cfu (n=7) and successfully escalated to higher dose levels of 5x109 cfu (n=3) and 1x1010 cfu (n=3) without achieving a maximum tolerated dose. TEAEs noted at these higher dose levels were generally consistent with those observed at the lower dose level (1 x 109 cfu) other than a higher occurrence rate of Grade 2/3 hypotension. The Recommended Phase II Dose of ADXS-PSA monotherapy was determined to be 1x 109 cfu based on a review of the totality of the clinical data. This dose was used in combination with 200mg of pembrolizumab in a cohort of six patients to evaluate the safety of the combination before moving into an expanded cohort of patients. The safety of the combination was confirmed and enrollment in the expansion cohort phase was initiated. Enrollment in the study was completed in January 2017.

At the final data cutoff of September 16, 2019, median overall survival for 37 patients in the combination arm was 33.6 months (95% CI, range 15.4-33.6 months). This updated median overall survival is an increase from the previous data presented at the American Association for Cancer Research Annual Meeting in April 2019, where median overall survival was 21.1 months in the combination arm. The combination of ADXS-PSA with KEYTRUDA®, might be associated with prolonged OS in this population, particularly in patients with unmet medical needs like visceral metastasis (16.4 months, range 4.0 - not reached) and those with prior docetaxel (16 months, range 6.4-34.6). The majority of TEAEs consisted of transient and reversible Grade 1-2 chills/rigors, fever, hypotension, nausea and fatigue. The combination of ADXS-PSA and KEYTRUDA® has appeared to be well-tolerated to date, with no additive toxicity observed. The Company presented these new data at the ASCO Genitourinary Cancers Symposium in San Francisco, CA. on February 2020 and the final results were published in the peer-reviewed journal “The Oncologist” in 2022. New Ayala has also completed the clinical study report for the ADXS-PSA study.

Other Lm Technology Products

HER2 Expressing Solid Tumors

HER2 is overexpressed in a percentage of solid tumors including osteosarcoma. According to published literature, up to 60% of osteosarcomas are HER2 positive, and this overexpression is associated with poor outcomes for patients. ADXS-HER2 is an Lm Technology antigen delivery product candidate designed to target HER2 expressing solid tumors including human and canine osteosarcoma. ADXS-HER2 has received FDA and EMA ODD for osteosarcoma and has received Fast Track designation from the FDA for patients with newly-diagnosed, non-metastatic, surgically-resectable osteosarcoma.

A phase 1B dose escalation study of ADXS31-164 in subjects with HER-2 expressing tumors was completed, and the database lock was completed in November 2018. Overall, ADXS31-164 IV infusion at the dose of 1×109 CFU appeared to be safe and well tolerated in 12 subjects treated and evaluable. No objective responses were observed in this late stage heavily pre-treated patient cohort. The results of this study were primarily intended to describe the safety and tolerability of ADXS31-164. This study was not intended to contribute to the evaluation of the effectiveness of ADXS31-164 for the treatment of patients with a history of HER2 expressing tumors. New Ayala has completed the clinical study report and it has been transferred along with the ADXS31-164 program-IND to OS Therapies, as described below.

In September 2018, the Company announced that it had granted a license to OS Therapies, LLC, or OS Therapies, for the use of ADXS31-164, also known as ADXS-HER2, for evaluation in the treatment of osteosarcoma in humans. Under the terms of the license agreement, OS Therapies, in collaboration with the Children’s Oncology Group, will be responsible for the conduct and funding of a clinical study evaluating ADXS-HER2 in recurrent, completely resected osteosarcoma. In December 2020 and January 2021, we received an aggregate of $1,415,000 from OS Therapies upon achievement of the $1,550,000 funding milestone set forth in the license agreement. In April 2021, the Company achieved the second milestone set forth in the license agreement for evaluation in the treatment of osteosarcoma in humans and received the amount due from OS Therapies of $1,375,000 in May 2021. For more information, see Note 12, “Licensing Agreements” of the “Notes to the Consolidated Financial Statements” included in Item 8.

Canine Osteosarcoma

On March 19, 2014, we entered into a definitive Exclusive License Agreement, or Aratana Agreement, with Aratana Therapeutics, Inc., or Aratana, where we granted Aratana an exclusive, worldwide, royalty-bearing license, with the right to sublicense, certain of our proprietary technology that enables Aratana to develop and commercialize animal health products that will be targeted for treatment of osteosarcoma and other cancer indications in animals. A product license request was filed by Aratana for ADXS-HER2 (also known as AT-014 by Aratana) for the treatment of canine osteosarcoma with the United States Department of Agriculture, or USDA. Aratana received communication in December 2017 that the USDA granted Aratana conditional licensure for AT-014 for the treatment of dogs diagnosed with osteosarcoma, one year of age or older. Initially, Aratana plans to make the therapeutic available for purchase at approximately two dozen veterinary oncology practice groups across the United States who participate in the study. Aratana received communication in December 2017 that the USDA granted Aratana conditional licensure for AT-014 for the treatment of dogs diagnosed with osteosarcoma, one year of age or older. Aratana is currently conducting an extended field study which is a requirement for full USDA licensure. Initially, Aratana plans to make the therapeutic available for purchase at approximately two dozen veterinary oncology practice groups across the United States who participate in the study.

Under the terms of the Aratana Agreement, Aratana paid an upfront payment to New Ayala in the amount of $1,000,000 upon signing of the Aratana Agreement. Aratana will also pay New Ayala: (a) up to $36.5 million based on the achievement of milestone relating to the advancement of products through the approval process with the USDA in the United States and the relevant regulatory authorities in the European Union, or E.U., in all four therapeutic areas and up to an additional $15 million in cumulative sales milestones based on achievement of gross sales revenue targets for sales of any and all products for use in non-human animal health applications, or the Aratana Field, (regardless of therapeutic area), and (b) tiered royalties starting at 5% and going up to 10%, which will be paid based on net sales of any and all products (regardless of therapeutic area) in the Aratana Field in the United States. Royalties for sales of products outside of the United States will be paid at a rate equal to half of the royalty rate payable by Aratana on net sales of products in the United States (starting at 2.5% and going up to 5%). Royalties will be payable on a product-by-product and country-by-country basis from first commercial sale of a product in a country until the later of (a) the 10th anniversary of first commercial sale of such product by Aratana, its affiliates or sub licensees in such country or (b) the expiration of the last-to-expire valid claim of our patents or joint patents claiming or covering the composition of matter, formulation or method of use of such product in such country. Aratana will also pay us 50% of all sublicense royalties received by Aratana and its affiliates. In fiscal year 2019, the Company received approximately $8,000 in royalty revenue from Aratana. Additionally, in July 2019, Aratana announced that their shareholders approved a merger agreement with Elanco Animal Health, or Elanco, whereby Elanco is now the majority shareholder of Aratana. On October 6, 2020, the Company received a notice from Aratana, dated September 17, 2020, indicating that Aratana was terminating the Exclusive License Agreement effective December 21, 2020. The Company did not incur any early termination penalties as a result of the termination. Aratana was required to make all payments to the Company that were otherwise payable under the Exclusive License Agreement through the effective date of termination.

Corporate Information

We were originally incorporated in the State of Colorado on June 5, 1987 under the name Great Expectations, Inc. We were a publicly-traded “shell” company without any business until November 12, 2004 when we acquired New Ayala, a Delaware corporation, through a Share Exchange and Reorganization Agreement, dated as of August 25, 2004, which we refer to as the Share Exchange, by and among New Ayala, the stockholders of New Ayala and us. As a result of the Share Exchange, New Ayala became our wholly-owned subsidiary and our sole operating company. On December 23, 2004, we amended and restated our articles of incorporation and changed our name to New Ayala. On June 6, 2006, our stockholders approved the reincorporation of our company from Colorado to Delaware by merging the Colorado entity into our wholly-owned Delaware subsidiary. Our date of inception, for financial statement purposes, is March 1, 2002 and the Company was listed on The Nasdaq Capital Market (“Nasdaq”) in 2014. In December 2021, the Company was delisted from Nasdaq and accepted onto the OTCQX. Shares of New Ayala’s common stock are currently quoted on the OTCQX under the symbol “ADXS.” ~~We have filed an application for listing on Nasdaq, and intend to undertake the actions necessary to allow our common stock to be uplisted from the OTCQX to Nasdaq.~~

Our principal executive offices are located at 9 Deer Park Drive, Suite K-1, Monmouth Junction, New Jersey 08852, and our telephone number is (609) 452-9813. We maintain a corporate website at www.ayalapharma.com which contains descriptions of our technology, our product candidates and the development status of each drug. We make available free of charge through our internet website our annual reports on Form 10-K, quarterly reports on Form 10-Q and Current Reports on Form 8-K, and any amendments to these reports, as soon as reasonably practicable after we electronically file such material with, or furnish such material to, the SEC. We are not including the information on our website as a part of, nor incorporating it by reference into, this report. The SEC maintains a website that contains annual, quarterly, and current reports, proxy statements, and other information that issuers (including us) file electronically with the SEC. The SEC’s website address is http://www.sec.gov.

Intellectual Property

Protection of our intellectual property is important to our business. We have a robust patent portfolio that protects our product candidates and Lm Lm-based immunotherapy technology. Currently, we own or have rights to ~~several~~numerous ~~hundred~~ patents and applications, which are owned, licensed from, or co-owned with University of Pennsylvania, or Penn, ~~Merck,~~ National Institute of Health, or NIH, and/or Augusta University. We ~~aggressively prosecute and defend our patents and proprietary technology.~~ Our patents and applications are directed to the compositions of matter, use, and methods thereof, of our Lm-LLO immunotherapies for our product candidates, including AXAL, ADXS-PSA, ADXS-HOT, ADXS-HER2. We have and may continue to abandon prosecuting certain patents that are not strategically aligned with the direction of the Company.

Our approach to the intellectual property portfolio is to create, maintain, protect, enforce and defend our proprietary rights for the products we develop from our immunotherapy technology platform. ~~We endeavor to maintain a coherent and aggressive strategic approach to building our patent portfolio with an emphasis in the field of cancer vaccines.~~ Issued patents which are directed to AXAL, ADXS-PSA, and ADXS-HER2 in the United States, will expire between ~~2021~~ 2024 and 2032. Issued patents directed to our product candidates AXAL, ADXS-PSA, and ADXS-HER2 outside of the United States, will expire in 2032. Issued patents directed to our Lm -based immunotherapy platform in the United States, will expire between ~~2021~~2024 and 2031. Issued patents directed to our Lm-based immunotherapy platform outside of the United States, will expire between ~~2021~~2024 and 2033.

We have pending patent applications directed to our product candidates AXAL, ADXS-PSA, ADXS-HER2, and ADXS-HOT that, if issued would expire in the United States and in countries outside of the United States between 2021 and 2037. We have pending patent applications directed to methods of using of our product candidates AXAL, ADXS-PSA, ADXS-HOT, ADXS-HER2 directed to the following indications and others: prostate cancer and her2/neu-expressing cancer, that, if issued would expire in the United States and in countries outside of the United States between 2021 and 2037, depending on the specific indications.6

We have pending patent applications directed to our product candidates AXAL, ADXS-PSA, ADXS-HER2, and ADXS-HOT that, if issued would expire in the United States and in countries outside of the United States between 2024 and 2037. We have pending patent applications directed to methods of using of our product candidates AXAL, ADXS-PSA, ADXS-HOT, ADXS-HER2 directed to the following indications and others: prostate cancer and her2/neu-expressing cancer, that, if issued would expire in the United States and in countries outside of the United States between 2024 and 2037, depending on the specific indications.

We will be able to protect our technology from unauthorized use by third parties only to the extent it is covered by valid and enforceable patents or is effectively maintained as trade secrets. Patents and other proprietary rights are an essential element of our business.

~~Our success will depend in part on our ability to obtain and maintain proprietary protection for our product candidates, technology, and know~~BST-how, to operate without infringing on the proprietary rights of others, and to prevent others from infringing our proprietary rights. Our policy is to seek to protect our proprietary position by, among other methods, filing U.S. and foreign patent applications related to our proprietary technology, inventions, and improvements that are important to the development of our business. We also rely on trade secrets, know-how, continuing technological innovation, and in-licensing opportunities to develop and maintain our proprietary position.236

~~Any~~Our ~~patent~~commercial ~~applications~~success ~~which~~depends, wein ~~have~~part, ~~filed~~on orour ~~will~~ability ~~file or~~ to ~~which~~obtain weand ~~have~~maintain orproprietary ~~will~~protection ~~have~~for ~~license~~our ~~rights~~product ~~may not issue~~candidate, ~~and patents that~~ doBST-236, ~~issue~~as ~~may~~well ~~not~~any ~~contain~~future ~~commercially~~product ~~valuable~~candidates, ~~claims.~~novel ~~In addition~~discoveries, ~~any~~product ~~patents~~development ~~issued~~technologies toand usknow-how. orWe ~~our~~own ~~licensors~~all ~~may~~of ~~not afford meaningful~~our ~~protection~~intellectual ~~for~~property ~~our~~relating ~~products~~to orBST-236 ~~technology,~~and orhave ~~may~~a bepatent ~~subsequently~~portfolio ~~circumvented,~~that ~~invalidated,~~includes ~~narrowed,~~several orpatent ~~found~~families ~~unenforceable.~~that ~~Our~~cover ~~processes~~composition, methods and ~~potential~~use. ~~products~~We ~~may~~protect ~~also~~these ~~conflict~~intellectual ~~with~~property ~~patents~~rights, which ~~have~~are ~~been~~critical ~~or may be granted~~ to ~~competitors, academic institutions or others. As~~ the ~~pharmaceutical~~development, ~~industry~~formulation ~~expands~~ and ~~more~~marketing ~~patents~~of our ~~are~~product ~~issued~~candidate, ~~the~~by ~~risk~~filing ~~increases~~patents ~~that~~or ~~our~~patent ~~processes~~applications ~~and~~with ~~potential products may give rise to interferences filed by others in~~ the U.S. Patent ~~and~~& Trademark Office, orand tothe ~~claims of~~ comparable patent ~~infringement~~offices byof ~~other companies~~Israel, ~~institutions~~ orEurope ~~individuals. These entities or persons could bring legal actions against us claiming damages~~ and ~~seeking~~other tocountries. ~~enjoin~~In ~~clinical testing~~addition, ~~manufacturing~~we ~~and~~rely ~~marketing~~on ofknow-how, ~~the~~continuing ~~related~~technological ~~product or process. In recent years~~innovation, ~~several~~orphan drug ~~companies~~exclusivity ~~have~~and ~~been~~potential ~~extremely aggressive~~ in-licensing ~~challenging~~opportunities ~~patents~~to ~~covering~~develop ~~pharmaceutical products,~~ and ~~the~~maintain ~~challenges~~our ~~have~~proprietary ~~often been successful~~position. IfAs ~~any~~ of ~~these~~April ~~actions are successful~~4, in ~~addition to any potential liability for damages~~2024, we have ~~could~~filed bepatent ~~required~~applications torelating ~~cease the infringing activity or obtain a license in order~~ to ~~continue~~BST-236 ~~to manufacture or market the relevant product or process. We may not prevail~~ in ~~any~~multiple ~~such~~jurisdictions, ~~action~~including ~~and~~Australia, ~~any~~Brazil, ~~license~~Canada, ~~required under any such patent may not be made available on acceptable terms~~China, ~~if at all. Our failure to successfully defend a patent challenge~~Europe, orIndia, toJapan, ~~obtain~~Israel, aRussia, ~~license~~Korea, toHong ~~any~~Kong ~~technology~~and ~~that~~the weUnited ~~may~~States, ~~require~~as towell ~~commercialize~~as ~~our~~under ~~technologies~~the orPatent ~~potential~~Cooperation ~~products~~Treaty. ~~could~~We have ~~a materially~~been ~~adverse~~issued ~~effect~~five onpatents ~~our~~in ~~business.~~United ~~In addition~~States, ~~changes~~two in ~~either~~Europe ~~patent~~two ~~laws or~~ in ~~interpretations~~each of ~~patent~~Australia, ~~laws~~Israel, inCanada, ~~the~~Japan ~~United States~~ and ~~other~~Russia ~~countries~~and ~~may~~one ~~materially~~in ~~diminish~~each ~~the~~India and ~~value~~Macau. ofIssued ~~our~~patents ~~intellectual~~and ~~property~~currently orpending ~~narrow~~patent ~~the~~applications ~~scope~~are ofsummarized ~~our patent protection.~~below:

13● BIOST/002 patent family. We have two issued US patents (US 8,993,278, US 7,989,188) and one European patent (validated in France, United Kingdom and Germany) to cover BST-236, composition and use.

~~We also~~● ~~rely~~BIOST/004. ~~upon~~We ~~unpatented~~have ~~proprietary~~one ~~technology,~~granted ~~and~~patent in the ~~future~~US, ~~may~~two ~~determine~~granted inAustralia, ~~some~~One ~~cases~~granted ~~that~~in ~~our~~each ~~interests~~of ~~would~~Russia, beCanada, ~~better~~China, ~~served by~~Monaco, ~~reliance~~Israel onand ~~trade~~India ~~secrets or confidentiality agreements rather than patents or licenses. We may not be able to protect our rights to such unpatented proprietary technology~~ and ~~others~~one ~~may~~under ~~independently~~examination ~~develop~~in ~~substantially~~each ~~equivalent~~of ~~technologies.~~US, IfEP, weBrazil,, ~~are~~Japan ~~unable to~~(two ~~obtain strong proprietary rights~~ applications)to ~~our~~cover ~~processes~~BST-236 orpharmaceutically ~~products~~acceptable ~~after~~salts ~~obtaining regulatory clearance, competitors may be able to market competing processes~~ and ~~products~~use.

~~Others may~~● ~~obtain~~BIOST/005 ~~patents~~patent ~~having~~family. ~~claims~~We ~~which~~have ~~cover~~one ~~aspects~~granted ofpatent ~~our~~and ~~products~~one orallowed ~~processes~~patent ~~which~~in ~~are~~US, ~~necessary~~one ~~for,~~granted orin ~~useful~~each toof Australia, ~~the~~Russia, ~~development~~Israel, ~~use~~ orJapan, ~~manufacture~~Canada ofand ~~our~~one ~~services~~European orpatent ~~products.~~(validated ~~Should~~in ~~any~~Germany, ~~other~~France ~~group~~and ~~obtain~~United ~~patent~~Kingdom), ~~protection~~and ~~with~~one ~~respect~~under toexamination ~~our~~in ~~discoveries,~~each ~~our commercialization~~ of ~~potential~~, ~~therapeutic~~Brazil, ~~products~~China, Japan and ~~methods~~Israel ~~could~~to becover ~~limited or prohibited~~use.

~~The Drug~~● ~~Development~~BIOST/007. ~~Process~~We have one granted patent in Israel and one granted patent in Japan, and one under examination in each of US, Europe, Brazil, Japan, Canada, China, Korea and Hong Kong, to cover combination therapy.

~~The product~~● ~~candidates in our pipeline are at various stages of clinical development~~BIOST/008. ~~The~~We ~~path~~have topatents ~~regulatory~~under ~~approval~~examination ~~includes multiple phases of clinical trials~~ in ~~which~~US, weEurope, ~~collect~~Israel, ~~data~~Brazil, ~~that~~Canada, ~~will ultimately support an application to regulatory authorities to allow us to market a product for the treatment~~China, ofHong ~~a specific type of cancer. There are many difficulties and uncertainties inherent in research and development of new products~~Kong, ~~resulting~~Japan ~~in high costs~~ and ~~variable~~Korea ~~success rates. Bringing a drug from discovery~~ to ~~regulatory~~cover ~~approval, and ultimately to market, takes many years and significant costs~~use.

~~The process~~● ~~required~~BIOST/009. byWe ~~the~~have ~~FDA~~patents ~~before~~under ~~product~~examination ~~candidates~~in ~~may~~US, beEurope, ~~marketed~~Israel, inBrazil, ~~the~~Canada, ~~United~~China, ~~States~~Hong ~~generally~~Kong, ~~involves~~Japan ~~the~~and ~~following:~~Korea to cover formulation.

● ~~completion~~BIOST/010. ofWe ~~preclinical~~have ~~laboratory~~patents ~~tests,~~under ~~animal~~examination ~~studies, and formulation studies~~ in ~~compliance with the FDA’s Good Laboratory Practice~~US, ~~or GLP~~Europe, ~~regulations; ● submission to the FDA of an IND which must become effective before human clinical trials may begin at United States clinical trial sites; ● approval by an IRB for each clinical site~~Israel, ~~or centrally~~Australia, ~~before each trial may be initiated; ● adequate and well-controlled human clinical trials to establish the product candidate’s safety~~Brazil, ~~purity~~Canada, ~~and potency for its intended use~~China, ~~performed~~Hong ~~in accordance with GCPs; ● development of manufacturing processes to ensure the product candidate’s identity~~Kong, ~~strength~~India, ~~quality,~~Japan ~~purity,~~ and ~~potency;~~Korea ~~● submission~~ to ~~the~~cover FDA of a BLA; ● satisfactory completion of an FDA advisory committee review, if applicable; ● satisfactory completion of an FDA inspection of the manufacturing facility or facilities at which the products are produced to assess compliance with cGMPs and to assure that the facilities, methods, and controls are adequate to preserve the therapeutics’ identity, strength, quality, purity, and potency as well as satisfactory completion of an FDA inspection of selected clinical sites and selected clinical investigators to determine GCP compliance; andpolymorph.

14● BIOST/011. We have one patent under the PCT to cover Dimers.

● ~~FDA~~BIOST/012. ~~review~~We ~~and~~have ~~approval~~one ofpatent under the ~~BLA~~PCT to ~~permit~~cover ~~commercial~~Crystalline ~~marketing for particular indications for use~~forms.

~~Preclinical studies~~● ~~include laboratory evaluation of chemistry, pharmacology, toxicity, and product formulation, as well as animal studies to assess potential safety and efficacy~~BIOST/013. ~~Such~~We ~~studies~~have must generally be conducted in accordance with the FDA’s GLPs. Prior to commencing the first clinical trial at a United States investigational site with a product candidate, an IND sponsor must submit the results of the preclinical tests and preclinical literature, together with manufacturing information, analytical data, any available clinical data or literature, and proposed clinical study protocols among other things, to the FDA as part of an IND. An IND automatically becomes effective 30 days after receipt by the FDA, unless the FDA notifies the applicant of safety concerns or questions related to one orpatent ~~more~~under ~~proposed clinical trials and places~~ the ~~trial~~PCT 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. Clinical holds also may be imposed by the FDA at any time before or during trials due to ~~safety concerns~~cover ~~or non-compliance~~Intermediates. ~~A separate submission to an existing IND must also be made for each successive clinical trial conducted during product development.~~

Clinical testing, known as clinical trials or clinical studies, is either conducted internally by pharmaceutical or biotechnology companies or managed on behalf of these companies by Clinical Research Organizations, or CROsBIOST/011. ~~The process of conducting clinical studies is highly~~ ~~regulated~~We byhave ~~the~~one ~~FDA,~~patent asunder ~~well as by other governmental and professional bodies. In a clinical trial, participants receive specific interventions according to~~ the ~~research~~PCT plan or protocol created by the study sponsor and implemented by study investigators. Clinical trials must be conducted in accordance with federal regulations and GCP requirements, which include the requirements that all research subjects provide their informed consent in writing for their participation in any clinical trial, as well as review and approval of the study by an IRB. Additionally, some clinical trials are overseen by an independent data safety monitoring board, which reviews data and advises the study sponsor on study continuation. A protocol for each clinical trial, and any subsequent protocol amendments, must be submitted to ~~the~~cover ~~FDA as part of the IND~~Impurities.

Clinical trials may compare a new medical approach to a standard one that is already available or to a placebo that contains no active ingredients or to no intervention. Some clinical trials compare interventions that are already available to each other. When a new product or approach is being studied, it is not usually known whether it will be helpful, harmful, or no different than available alternatives. The investigators try to determine the safety and efficacy of the intervention by measuring certain clinical outcomes in the participants.7

~~Phase 1~~U. ~~Phase 1 clinical trials begin when regulatory agencies allow initiation of clinical investigation of a new drug or product candidate~~S. ~~They~~Drug ~~typically~~Development involve testing an investigational new drug on a limited number of patients. Phase 1 studies determine a drug’s basic safety, maximum tolerated dose, mechanism of action and how the drug is absorbed by, and eliminated from, the body. Typically, cancer therapies are initially tested on late-stage cancer patients.Process

~~Phase~~In 2.the ~~Phase~~United 2States, ~~clinical~~the ~~trials~~FDA ~~involve~~regulates ~~larger~~drugs ~~numbers~~under ofthe ~~patients~~federal ~~that~~Food, ~~have~~Drug, ~~been~~and ~~diagnosed~~Cosmetic ~~with~~Act, ~~the targeted disease~~ or ~~condition. Phase 2 clinical trials gather preliminary data on effectiveness (where~~ the ~~drug~~FDCA, ~~works~~and inits ~~people~~implementing ~~who~~regulations. The ~~have~~process aof ~~certain~~obtaining ~~disease~~regulatory orapprovals ~~condition)~~ and to ~~determine~~ the ~~common~~subsequent ~~short-term~~compliance ~~side effects and risks associated~~ with ~~the~~appropriate ~~drug.~~federal, Ifstate, ~~Phase~~local 2and ~~clinical~~foreign ~~trials show that an investigational~~statutes ~~new~~and ~~drug~~regulations ~~has~~require anthe ~~acceptable~~expenditure ~~range~~ of ~~safety~~substantial ~~risks~~time and ~~probable~~financial ~~effectiveness, a company will continue to evaluate the investigational new drug in Phase 3 studies~~resources.

~~Phase~~The 3.process ~~Phase~~required 3by ~~clinical trials are typically controlled multi-center trials that involve a larger number of patients to ensure~~ the ~~study results~~FDA ~~are~~before ~~statistically significant. The purpose is to confirm effectiveness and safety on~~ a ~~large~~drug scale and to provide an adequate basis for physician labeling. These trials are generally global in nature and are designed to generate clinical data necessary to submit an application for marketing approval to regulatory agencies. Typically, two Phase 3 trials are required for product approval. Under limited circumstances, however, approval may be ~~based~~marketed ~~upon~~in athe ~~single~~United ~~adequate~~States ~~and~~generally ~~well-controlled~~involves ~~clinical~~the ~~trial plus confirmatory evidence or a single large multicenter trial without confirmatory evidence.~~following:

15● completion of preclinical laboratory tests, animal studies and formulation studies in accordance with FDA’s good laboratory practice requirements and other applicable regulations;

~~The FDA~~● ~~may also consider additional kinds of data in support of a BLA, such as patient experience data and real-world evidence. For genetically~~submission ~~targeted populations 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,~~an ~~that~~investigational ~~was~~new ~~submitted~~drug ~~previously to support an approved~~ application ~~for~~, ~~a product that incorporates~~ or ~~utilizes~~IND, ~~the~~which ~~same~~must orbecome ~~similar~~effective ~~genetically~~before ~~targeted~~human ~~technology~~clinical ortrials amay ~~product that is the same or utilizes the same variant protein targeted drug as the product that is the subject of the application.~~begin;

~~Reports~~● approval ~~regarding~~by ~~clinical~~an ~~study~~independent ~~progress~~institutional ~~must~~review beboard, ~~submitted~~or ~~to the FDA and~~ IRB, ~~on an annual basis. Additional reports are required if serious adverse events~~ or ~~other~~ethics ~~significant~~committee ~~safety~~at ~~information~~each isclinical ~~found.~~site ~~Certain~~before ~~reports~~each trial may ~~also~~ be required to be submitted to the IBC. Investigational biologics must additionally be manufactured in accordance with cGMPs, imported in accordance with FDA requirements, and exported in accordance with the requirements of the receiving country as well as FDA.initiated;

~~Additionally,~~● performance ~~under~~of ~~the~~adequate ~~Pediatric~~and ~~Research~~well-controlled ~~Equity~~human ~~Act,~~clinical ortrials ~~PREA,~~in ~~BLAs~~accordance orwith ~~BLA~~good ~~supplements~~clinical ~~for~~practice ~~a new active ingredient~~requirements, ~~dosage form, dosage regimen,~~ or ~~route~~ ofGCPs ~~administration, unless subject~~ to ~~the~~establish ~~below requirement for molecularly targeted cancer products, must contain data to assess~~ the safety and ~~effectiveness~~efficacy of the ~~product~~proposed indrug ~~all relevant pediatric subpopulations. The FDA may, however, grant deferrals or full or partial waivers of this requirement. PREA does not apply to orphan designated products approved solely~~ for ~~the~~its ~~orphan~~intended ~~indication.~~use;

~~If a~~● ~~product is intended for the treatment of adult cancer and is directed at molecular targets that the FDA determines to be substantially~~submission ~~relevant~~ to the ~~growth~~FDA ~~or progression~~ of ~~pediatric~~an ~~cancer,~~NDA ~~even~~after ifcompletion the product has orphan designation, the application sponsors must submit, reports from molecularly targeted pediatric cancer investigations designed to yield clinically meaningful pediatric study data, gathered using appropriate formulations for each applicable age group, to inform potential pediatric labeling. Like PREA, FDA may grant deferrals or waivers of ~~some or~~ all ofpivotal ~~this data requirement.~~trials;

~~Certain gene~~● ~~therapy studies are also subject to the National Institutes of Health’s Guidelines for Research Involving Recombinant DNA~~satisfactory ~~Molecules,~~completion ~~or NIH Guidelines. The NIH Guidelines include the review~~ of ~~the~~an ~~study~~FDA byadvisory ~~a local institutional~~ committee ~~called an institutional biosafety committee~~review, orif ~~IBC. The IBC assesses the compliance of the research with the NIH Guidelines, assesses the safety of the research and identifies any potential risk to public health or the environment.~~applicable;

In● satisfactory ~~addition~~completion toof ~~the~~an ~~regulations~~FDA ~~discussed~~inspection ~~above, there are a number~~ of ~~additional~~the ~~standards~~manufacturing ~~that~~facility ~~apply~~or tofacilities ~~clinical~~at ~~trials~~which ~~involving~~ the ~~use of~~drug ~~gene~~is ~~therapy.~~produced ~~The~~to ~~FDA~~assess ~~has~~compliance ~~issued~~with ~~various~~cGMP requirements ~~guidance~~to ~~documents~~assure ~~regarding gene therapies, which outline additional factors~~ that the ~~FDA will consider during product development. These include guidance regarding preclinical studies; chemistry~~facilities, ~~manufacturing,~~methods and controls~~; the~~ ~~measurement~~are ofadequate ~~product~~to ~~potency;~~preserve ~~how FDA will determine whether a gene therapy product is~~ the ~~same as another product for the purpose of the agency~~drug’s ~~orphan~~identity, ~~drug~~strength, ~~regulations;~~ quality and ~~long~~purity, ~~term~~and ~~patient~~of ~~and~~selected clinical ~~study~~investigation ~~subject~~sites ~~follow~~to upassess ~~and~~compliance ~~regulatory~~with ~~reporting.~~GCPs; and

To● FDA ~~lessen~~review ~~the~~and ~~burden~~approval of ~~subjects~~the ~~being~~NDA ~~required~~ to ~~travel~~permit tocommercial ~~the~~marketing ~~clinic for an onsite visit during the Lm surveillance phase~~ of the ~~studies,~~ ~~the~~product Lmfor ~~surveillance~~particular ~~period~~indications ~~was~~for ~~reduced~~use toin ~~1 year instead of 3 years based on an agreement with~~ the ~~FDA~~United ~~in November 2020~~States.

~~Biologic~~Prior ~~License~~to ~~Application~~beginning ~~(BLA).~~the ~~During~~first clinical ~~trials~~trial with a product candidate in the United States, ~~companies~~we ~~usually~~must ~~also~~submit ~~complete~~an ~~additional~~IND ~~preclinical~~to ~~studies~~the FDA. ~~Companies~~An ~~further develop~~IND ~~additional~~is ~~information~~a ~~about~~request for authorization from the ~~product~~FDA ~~candidate’s~~to ~~physical~~administer ~~characteristics~~an ~~and~~investigational ~~finalize~~new ~~the~~drug ~~cGMP~~product ~~manufacturing~~to ~~process~~humans. The ~~results~~central focus of ~~the~~an ~~clinical~~IND ~~trials~~submission ~~using~~is on ~~biologics~~the ~~are~~general ~~submitted~~investigational toplan and the ~~FDA~~protocol(s) asfor ~~part~~clinical ofstudies. aThe ~~BLA.~~IND ~~Following~~also ~~the~~includes ~~completion~~results of ~~Phase~~animal 3and in vitro studies, ifassessing the ~~sponsor~~toxicology, ofpharmacokinetics, apharmacology, ~~potential~~and ~~product~~pharmacodynamics incharacteristics of the ~~United~~product; ~~States~~chemistry, ~~believes~~manufacturing, and itcontrols ~~has~~information; ~~sufficient~~and ~~information~~any available human data or literature to support the ~~safety~~use ~~and effectiveness~~ of the investigational ~~biologic,~~product. ~~the~~An ~~sponsor~~IND ~~submits~~must abecome effective ~~BLA~~before tohuman ~~the~~clinical ~~FDA~~trials ~~requesting~~may ~~marketing approval~~begin. The ~~application~~IND isautomatically abecomes ~~comprehensive filing~~effective ~~that~~30 ~~includes~~days after receipt by the ~~results~~FDA, ofunless ~~all~~the FDA, ~~preclinical~~within ~~and~~the ~~clinical~~30-day ~~studies~~time period, ~~information~~raises safety concerns or questions about the ~~product’s~~proposed ~~composition~~clinical trial. In such a case, the IND may be placed on clinical hold and the IND sponsor’s ~~plans~~and ~~for~~the ~~manufacturing,~~FDA ~~packaging,~~must ~~labeling~~resolve ~~and~~any ~~testing~~outstanding concerns or questions before the ~~investigational~~clinical ~~new~~trial can ~~product~~begin. Submission of an IND therefore may or may not result in FDA authorization to begin a clinical trial.

16Clinical trials involve the administration of the investigational product to human subjects under the supervision of qualified investigators in accordance with GCPs, which include the requirement that all research subjects provide their informed consent for their participation in any clinical study. Clinical trials are conducted under protocols detailing, among other things, the objectives of the study, the parameters to be used in monitoring safety and the effectiveness criteria to be evaluated. A separate submission to the existing IND must be made for each successive clinical trial conducted during product development and for any subsequent protocol amendments. While the IND is active, progress reports summarizing the results of the clinical trials and nonclinical studies performed since the last progress report, among other information, must be submitted at least annually to the FDA, and written IND safety reports must be submitted to the FDA and investigators for serious and unexpected suspected adverse events, findings from other studies suggesting a significant risk to humans exposed to the drug, findings from animal or in vitro testing suggesting a significant risk to humans exposed to the drug, and any clinically important increased rate of a serious suspected adverse reaction compared to that listed in the protocol or investigator brochure.

~~Subject~~Furthermore, toan ~~certain~~independent ~~exceptions,~~IRB ~~the~~for ~~BLA~~each ~~must~~site beproposing ~~accompanied~~to byconduct athe ~~substantial~~clinical ~~user~~trial ~~fee~~must atreview ~~the~~and ~~time~~approve of the ~~first~~plan ~~submission.~~for ~~FDA~~any ~~has~~clinical 60trial ~~days from~~and its ~~receipt~~informed ofconsent aform ~~BLA~~before ~~to determine whether~~ the ~~application~~clinical istrial ~~sufficiently~~begins ~~complete~~at ~~for~~that ~~filing~~site and ~~for~~must amonitor ~~substantive review. If~~ the ~~FDA determines~~study ~~that~~until ~~the~~completed. ~~NDA~~Regulatory ~~is incomplete~~authorities, the ~~FDA~~IRB ~~may~~or ~~refuse to file~~ the ~~application,~~sponsor inmay ~~which~~suspend ~~case~~a ~~the~~clinical ~~applicant~~trial ~~must~~at ~~address~~any ~~the~~time ~~FDA~~on ~~identified deficiencies~~various ~~before~~grounds, ~~refiling.~~including ~~After~~a ~~the~~finding ~~BLA~~that ~~is accepted for filing,~~ the ~~FDA~~subjects ~~reviews~~are ~~the~~being ~~application~~ exposed to ~~determine~~an ~~whether~~unacceptable ~~the~~health ~~product meets~~risk ~~FDA’s~~or ~~approval~~that ~~standards.~~the ~~The~~trial ~~FDA~~is ~~aims~~unlikely to ~~complete~~meet its ~~review~~stated ~~within~~objectives. ~~ten~~Some ~~months~~studies ofalso ~~the~~include ~~60-day~~oversight ~~filing~~by ~~date.~~an independent ~~For~~group ~~products~~of ~~that present~~qualified ~~significant~~experts ~~improvements~~organized inby the ~~safety~~clinical orstudy ~~effectiveness~~sponsor, ofknown ~~the~~as ~~treatment,~~a ~~diagnosis,~~data orsafety ~~prevention~~monitoring ofboard, ~~serious~~which ~~conditions FDA~~provides ~~aims~~authorization tofor ~~complete~~whether ~~its~~or ~~review~~not ~~within~~a 6study ~~months~~may ofmove ~~the~~forward ~~60-day~~at ~~filing~~designated ~~date.~~check ~~The~~points ~~FDA,~~based ~~however,~~on ~~does~~access ~~not~~to ~~always~~certain ~~meet~~data ~~its~~from ~~review~~the ~~goal.~~study ~~The review~~and ~~goal date~~ may ~~also~~halt bethe ~~extended~~clinical trial if ~~FDA~~it ~~requests~~determines orthat ~~the~~there ~~sponsor~~is ~~provides~~an ~~additional~~unacceptable ~~information~~safety ~~regarding~~risk ~~the~~for ~~application.~~subjects Asor ~~part~~other ~~of the approval process~~grounds, ~~FDA~~such ~~will~~as ~~typically~~no ~~inspect~~demonstration of ~~one~~efficacy. orThere ~~more~~are ~~clinical~~also ~~sites,~~requirements asgoverning ~~well as~~ the ~~facility~~reporting orof ~~the~~ongoing ~~facilities~~clinical atstudies ~~which~~and ~~the~~clinical ~~product is~~study ~~manufactured~~results to ~~ensure~~public ~~GCP and cGMP compliance~~registries.

~~FDA~~Human ~~may~~clinical ~~also~~trials ~~refer~~are antypically ~~application~~conducted ~~for~~in ~~review~~three bysequential anphases independent advisory committee. Specifically, for a product candidate for which no active ingredient (including any ester or salt of active ingredients) has previously been approved by the FDA, the FDA must either refer that ~~product~~ ~~candidate~~may tooverlap ~~an advisory committee~~ or ~~provide~~be in an action letter, a summary of the reasons why the FDA did not refer the product candidate to an advisory committee. While FDA is not bound by the recommendation of an advisory committee, it does carefully consider the committee’s recommendations.combined:

~~After~~● Phase ~~evaluating~~1: ~~the~~The ~~application,~~product ~~FDA~~candidate ~~may~~is ~~issue~~initially anintroduced ~~approval~~into ~~letter,~~healthy ~~authorizing~~human ~~product~~subjects ~~marketing,~~ or apatients ~~Complete~~with ~~Response~~the ~~Letter,~~target disease or ~~CRL,~~condition. ~~indicating~~These ~~that~~studies ~~the~~are ~~application~~designed isto ~~not~~test ~~ready~~the ~~for~~safety, ~~approval.~~dosage ~~The~~tolerance, ~~CRL~~absorption, ~~describes~~metabolism ~~the application’s deficiencies~~ and ~~conditions~~distribution ~~that~~of ~~must~~the beinvestigational ~~met~~product in ~~for~~humans, ~~product~~the ~~approval.~~side Ifeffects aassociated ~~CRL~~with isincreasing ~~issued~~doses, ~~the~~and, ~~applicant~~if ~~may~~possible, ~~resubmit~~to ~~the~~gain ~~application,~~early ~~addressing~~evidence ~~the~~on ~~deficiencies,~~effectiveness. ~~withdraw~~In the ~~application,~~case of orsome ~~request~~products afor ~~hearing.~~severe ~~Even~~or ~~with~~life-threatening ~~submission~~diseases, ofsuch ~~additional~~as ~~information~~cancer, ~~the~~especially ~~FDA~~when ~~ultimately~~the product may ~~decide~~be ~~that~~too inherently toxic to ethically administer to healthy volunteers, the ~~application~~initial human testing is ~~not~~often ~~approvable~~conducted in patients.

If approval is granted, the FDA may limit the indications for use, including the indicated population, require contraindications, warnings or precautions be included in the product labeling, including black box warnings, or may not approve label statements necessary for successful commercialization. FDA may also require, or companies may conduct, additional clinical trials following approval, called Phase 4 studies, which can confirm or refute the effectiveness of a product candidate, and can provide important safety information. FDA may also require the implementation of a REMS which may include requirements for a medication guide or patient package insert, a communication plan on product risks, or other elements to assure safe use.8

~~After~~● Phase ~~approval,~~2: ~~some~~The ~~types~~product ofcandidate ~~changes~~is administered to ~~the~~a ~~approved~~limited ~~product,~~patient ~~such~~population aswith ~~adding~~a ~~new~~specified ~~indications~~disease or ~~label~~condition ~~claims,~~to ~~which~~evaluate ~~may~~the ~~themselves require~~preliminary ~~further clinical testing~~efficacy, oroptimal ~~changing~~dosages ~~the~~and ~~manufacturing~~dosing ~~process~~schedule ~~are~~and ~~subject~~ to ~~further~~identify ~~FDA~~possible ~~review~~adverse side effects and ~~approval~~safety risks. ~~FDA~~Multiple ~~can~~Phase ~~also~~2 ~~require~~clinical ~~the~~trials ~~implementation~~may ~~REMS~~be orconducted ~~the~~to ~~conduct~~obtain ofinformation ~~phase~~prior 4to ~~studies~~beginning ~~after~~larger ~~product~~and ~~approval~~more expensive Phase 3 clinical trials.

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

Post-approval trials, sometimes referred to as Phase 4 studies, may be conducted after initial marketing approval. These trials are used to gain additional experience from the treatment of patients in the intended therapeutic indication. In certain instances, the FDA may mandate the performance of Phase 4 clinical trials as a condition of approval of an NDA.

During the development of a new drug, sponsors are given opportunities to meet with the FDA at certain points. These points may be prior to submission of an IND, at the end of Phase 2, and before an NDA is submitted. Meetings at other times may be requested. These meetings can provide an opportunity for the sponsor to share information about the data gathered to date, for the FDA to provide advice, and for the sponsor and the FDA to reach consensus on the next phase of development. Sponsors typically use the meetings at the end of the Phase 2 trial to discuss Phase 2 clinical results and present plans for the pivotal Phase 3 clinical trials that they believe will support approval of the new drug.

Concurrent with clinical trials, companies usually complete additional animal studies and must also develop additional information about the chemistry and physical characteristics of the drug and finalize a process for manufacturing the product in commercial quantities in accordance with cGMP requirements. The manufacturing process must be capable of consistently producing quality batches of the product candidate and, among other things, the manufacturer must develop methods for testing the identity, strength, quality and purity of the final drug. In addition, appropriate packaging must be selected and tested, and stability studies must be conducted to demonstrate that the product candidate does not undergo unacceptable deterioration over its shelf life.

U.S. Review and Approval Process

Assuming successful completion of all required testing in accordance with all applicable regulatory requirements, the results of product development, preclinical and other non-clinical studies and clinical trials, along with descriptions of the manufacturing process, analytical tests conducted on the chemistry of the drug, proposed labeling and other relevant information are submitted to the FDA as part of an NDA requesting approval to market the product. The submission of an NDA is subject to the payment of substantial user fees; a waiver of such fees may be obtained under certain limited circumstances. Additionally, no user fees are assessed on NDAs for products designated as orphan drugs, unless the product also includes a non-orphan indication. The FDA conducts a preliminary review of all NDAs within the first 60 days after submission, before accepting them for filing, to determine whether they are sufficiently complete to permit substantive review The FDA may request additional information rather than accept an NDA for filing. In this event, the NDA must be resubmitted with the additional information. The resubmitted application also is subject to review before the FDA accepts it for filing. Once filed, the FDA reviews an NDA to determine, among other things, whether a product is safe and effective for its intended use and whether its manufacturing is cGMP-compliant to assure and preserve the product’s identity, strength, quality and purity. Under the Prescription Drug User Fee Act, or PDUFA, guidelines that are currently in effect, the FDA has a goal of ten months from the date of “filing” of a standard NDA for a new molecular entity to review and act on the submission. This review typically takes twelve months from the date the NDA is submitted to FDA because the FDA has approximately two months to make a “filing” decision after it the application is submitted.

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

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

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

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

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

Government Regulations

General

Government authorities in the United States and other countries extensively regulate, among other things, the preclinical and clinical testing, manufacturing, labeling, storage, record-keeping, advertising, promotion, import, export, marketing and distribution of biopharmaceutical and drug products. In the United States, the FDA subjects drugs to rigorous review under the Federal Food, Drug and Cosmetic Act, or FDCA, the Public Health Service Act, or PHSA, and implementing regulations.

Orphan Drug Designation

Under the ODA, the FDA may grant ODD, to a drug or biological product intended to treat a rare disease or condition, which means a disease or condition that affects fewer than 200,000 individuals in the United States, or more than 200,000 individuals in the United States, but for which there is no reasonable expectation that the cost of developing and making a drug or biological product available in the United States will be recovered from domestic sales of the product. Additionally, sponsors must present a plausible hypothesis for clinical superiority to obtain ODD if there is a product already approved by the FDA that that is considered by the FDA to be the same as the already approved product and is intended for the same indication. This hypothesis must be demonstrated to obtain orphan exclusivity.

The benefits of ODD can be substantial, including research and development tax credits, grants and exemption from user fees. The tax advantages, however, were limited in the 2017 Tax Cuts and Jobs Act. Moreover, if there is no other product that the FDA considers to be the same product that is approve for the orphan indication, the orphan designated product is eligible for 7 years of orphan market exclusivity once the product is approved. During that period, the FDA generally may not approve any other application for the same product for the same indication, although there are exceptions, most notably when the later product is shown to be clinically superior to the product with exclusivity. Other applicants, however, may receive approval of different products for the orphan indication or the same product for a different indication during the orphan exclusivity period. In order to qualify for these incentives, a company must apply for designation of its product as an “Orphan Drug” and obtain approval from the FDA. Orphan product designation does not convey any advantage in or shorten the duration of the regulatory review and approval process.

In the EU, orphan drug designation provides up to 10 years of market exclusivity in Europe, in addition to the 7-year exclusivity in the U.S. as a result of the FDA’s orphan drug designation in 2019. EMA designation will also provide us with other benefits and incentives such as clinical protocol assistance, access to a centralized marketing authorization procedure that is valid in all European Union (“EU”) member states and reduced regulatory fees.

The Company has an ODD BST-236 (. As well as EMA ODD for BST-236.

We currently have ODD with the FDA for AXAL for treatment of anal cancer (granted August 2013), HPV-associated head and neck cancer (granted November 2013); and treatment of Stage II-IV invasive cervical cancer (granted May 2014). We also have ODD with the FDA for ADXS-HER2 for the treatment of osteosarcoma (granted May 2014).

In Europe, the Committee for Orphan Medicinal Products, COMP, has issued a positive opinion on the application for ODD of AXAL for the treatment of anal cancer (December 2015) and on the application for ODD of ADXS-HER2 for osteosarcoma (November 2015).

Expedited Review and Approval Programs for Serious Conditions

Four core FDA programs are intended to facilitate and expedite the development and review of new biologics to address unmet medical need in ~~the~~ the treatment of serious or life-threatening conditions: Fast Track designation, breakthrough therapy designation, accelerated approval, and priority review. We intend to avail ourselves of any and all of these programs as applicable to our products.

FDA is required to facilitate the development, and expedite the review, of products that are intended for the treatment of a serious or life-threatening disease or condition, and which demonstrate the potential to address unmet medical needs for the condition. Under the Fast Track program, the sponsor of a new biologic product candidate may request that the FDA designate the drug candidate for a specific indication as a ~~Fast~~ Fast Track drug concurrent with, or after, the filing of the IND for the product candidate. FDA must determine if the product candidate ~~qualifies~~ qualifies for Fast Track designation within 60 days of receipt of the sponsor’s request. If Fast Track designation is obtained, ~~sponsors~~ sponsors may be eligible for more frequent development meetings and correspondence with the FDA. FDA may also initiate review of sections of a Fast Track product’s BLA before the application is complete. This rolling review is available if the applicant provides, and ~~FDA~~ FDA approves, a schedule for the submission of the remaining information and the applicant pays applicable user fees. However, the FDA’s time period goal for reviewing an application does not begin until the last section of the BLA is submitted.

Under FDA’s accelerated approval programs, FDA may approve a product for a serious or life-threatening illness that provides meaningful therapeutic benefit to patients over existing treatments based upon a surrogate endpoint that is reasonably likely to predict clinical benefit, or on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity or prevalence of the condition and the availability or lack of alternative treatments.

In clinical trials, a surrogate endpoint is a measurement of laboratory or clinical signs of a disease or condition that substitutes for a direct measurement of how a patient feels, functions or survives. Surrogate endpoints can often be measured more easily or more rapidly than clinical endpoints. A product candidate approved on this basis is subject to rigorous post-marketing compliance requirements, including the completion of Phase 4 or post-approval clinical trials to confirm the effect on the clinical endpoint. Failure to conduct required post-approval studies, or confirm a clinical benefit during post-marketing studies, will allow the FDA to withdraw the product from the ~~market~~ market on an expedited basis. All promotional materials for product candidates approved under accelerated regulations are subject to prior review by the FDA.

18Under the provisions of the FDA Safety and Innovation Act, or FDASIA, enacted in 2012, a sponsor can request the designation of a product candidate as a “breakthrough therapy.” A breakthrough therapy is defined as a product that is intended, alone or in combination with one or more other products, to treat a serious or life-threatening disease or condition, and preliminary clinical evidence indicates that the product may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. Products designated as breakthrough therapies are eligible for intensive guidance on an efficient development program beginning as early as Phase 1 trials, a commitment from the FDA to involve senior managers and experienced review staff in a proactive collaborative and cross-disciplinary review, rolling review, and the facilitation of cross-disciplinary review.

Under the provisions of the FDA Safety and Innovation Act, or FDASIA, enacted in 2012, a sponsor can request designation of a product candidate as a “breakthrough therapy.” A breakthrough therapy is defined as a product that is intended, alone or in combination with one or more other products, to treat a serious or life-threatening disease or condition, and preliminary clinical evidence indicates that the product may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. Products designated as breakthrough therapies are eligible for intensive guidance on an efficient development program beginning as early as Phase 1 trials, a commitment from the FDA to involve senior managers and experienced review staff in a proactive collaborative and cross-disciplinary review, rolling review, and the facilitation of cross-disciplinary review.11

Another expedited pathway is the Regenerative Medicine Advanced Therapy, or RMAT, designation. Qualifying products must be a cell therapy, therapeutic tissue engineering product, human cell and tissue product, or a combination of such products, and not a product solely regulated as a human cell and tissue product. The product must be intended to treat, modify, reverse, or cure a serious or life-threatening disease or condition, and preliminary clinical evidence must indicate that the product has the potential to address an unmet need for such disease or condition. Advantages of the RMAT designation include all the benefits of the Fast Track and breakthrough therapy designation programs, including early interactions with the FDA. These early interactions may be used to discuss potential surrogate or intermediate endpoints to support accelerated approval.

Even if a product qualifies for one or more of these programs, the FDA may later decide that the product no longer meets the conditions for qualification or decide that the time period for FDA review or approval will not be shortened.

Disclosure of Clinical Trial Information

Sponsors of clinical trials of FDA regulated products, including biologics, are required to register and submit certain clinical trial information within specific timeframes to the National Institutes of Health, or NIH, for public dissemination on their clinicaltrials.gov website. Information related to the product, patient population, phase of the investigation, Trial sites and investigators, and other aspects of the clinical trial is then made public as part of the registration. Sponsors are also obligated to discuss the results of their clinical trials after completion. Disclosure of the results of these trials can be delayed in certain circumstances for up to two years, depending on the circumstances, after the date of completion of the trial. Competitors may use this publicly available information to gain knowledge regarding the progress of development programs.

Coverage, Pricing and Reimbursement

Successful commercialization of new drug products depends in part on the extent to which reimbursement for those drug products will be available from government health administration authorities, private health insurers and other organizations. Government authorities and third-party payors, such as private health insurers and health maintenance organizations, decide which drug products they will pay for and establish reimbursement levels. The availability and extent of reimbursement by governmental and private payors is essential for most patients to be able to afford a drug product. Sales of drug products depend substantially, both domestically and abroad, on the extent to which the costs of drugs products are paid for by health maintenance, managed care, pharmacy benefit and similar healthcare management organizations, or reimbursed by government health administration authorities, private health coverage insurers and other third-party payors.

A primary trend in the U.S. healthcare industry and elsewhere is cost containment. Government authorities and other third-party payors have attempted to control costs by limiting coverage and the amount of reimbursement for particular drug products. In many countries, the prices of drug products are subject to varying price control mechanisms as part of national health systems. In general, the prices of drug products under such systems are substantially lower than in the United States. Other countries allow companies to fix their own prices for drug products, but monitor and control company profits. Accordingly, in markets outside the United States, the reimbursement for drug products may be reduced compared with the United States. In the United States, the principal decisions about reimbursement for new drug products are typically made by CMS an agency within HHS. CMS decides whether and to what extent a new drug product will be covered and reimbursed under certain federal governmental healthcare programs, such as Medicare, and private payors tend to follow CMS to a substantial degree. However, no uniform policy of coverage and reimbursement for drug products exists among third-party payors and coverage and reimbursement levels for drug products can differ significantly from payor to payor. In the United States, the process for determining whether a third-party payor will provide coverage for a biological product typically is separate from the process for setting the price of such product or for establishing the reimbursement rate that the payor will pay for the product once coverage is approved. With respect to biologics, third-party payors may limit coverage to specific products on an approved list, also known as a formulary, which might not include all of the FDA-approved products for a particular indication, or place products at certain formulary levels that result in lower reimbursement levels and higher cost sharing obligation imposed on patients. A decision by a third-party payor not to cover our product candidates could reduce physician utilization of a product. Moreover, a third-party payor’s decision to provide coverage for a product does not imply that an adequate reimbursement rate will be approved. Adequate third-party reimbursement may not be available to enable a manufacturer to maintain price levels sufficient to realize an appropriate return on its investment in product development. Additionally, coverage and reimbursement for products can differ significantly from payor to payor. One third-party payor’s decision to cover a particular medical product does not ensure that other payors will also provide coverage for the medical product, or will provide coverage at an adequate reimbursement rate. As a result, the coverage determination process usually requires manufacturers to provide scientific and clinical support for the use of their products to each payor separately and is a time-consuming process.

Coverage policies and third-party reimbursement rates may change at any time. Even if favorable coverage and reimbursement status is attained for one or more products for which we receive regulatory approval, less favorable coverage policies and reimbursement rates may be implemented in the future. Third-party payors are increasingly challenging the prices charged for medical products and services, examining the medical necessity and reviewing the cost-effectiveness of pharmaceutical products, in addition to questioning safety and efficacy. If third-party payors do not consider a product to be cost-effective compared to other available therapies, they may not cover that product after FDA approval or, if they do, the level of payment may not be sufficient to allow a manufacturer to sell its product at a profit.

In addition, in many foreign countries, the proposed pricing for a drug must be approved before it may be lawfully marketed. The requirements governing drug pricing and reimbursement vary widely from country to country. In the European Union, governments influence the price of products through their pricing and reimbursement rules and control of national healthcare systems that fund a large part of the cost of those products to consumers. Some jurisdictions operate positive and negative list systems under which products may only be marketed once a reimbursement price has been agreed to by the government. To obtain reimbursement or pricing approval, some of these countries may require the completion of clinical trials that compare the cost effectiveness of a particular product to currently available therapies. Other member states allow companies to fix their own prices for medicines, but monitor and control company profits. There can be no assurance that any country that has price controls or reimbursement limitations for pharmaceutical products will allow favorable reimbursement and pricing arrangements for any of our products. The downward pressure on healthcare costs in general, particularly prescription products, has become very intense. As a result, increasingly high barriers are being erected to the entry of new products. In addition, in some countries, cross border imports from low-priced markets exert a commercial pressure on pricing within a country (particularly in the EEA where it is illegal to impede such imports from elsewhere within the EEA).

Other Healthcare Laws

Manufacturing, sales, promotion and other activities following product approval are also subject to regulation by numerous regulatory authorities in the United States in addition to the FDA, including CMS, the HHS Office of Inspector General and HHS Office for Civil Rights, other divisions of the HHS and the Department of Justice.

Healthcare providers, physicians, and third-party payors will play a primary role in the recommendation and prescription of any products for which we obtain marketing approval. Our current and future arrangements with third-party payors, healthcare providers and physicians may expose us to broadly applicable fraud and abuse and other healthcare laws and regulations that may constrain the business or financial arrangements and relationships through which we market, sell and distribute any drugs for which we obtain marketing approval. In the United States, these laws include, without limitation, state and federal anti-kickback, false claims, physician transparency, and patient data privacy and security laws and regulations, including but not limited to those described below.

The AKS prohibits, among other things, any person or entity from knowingly and willfully offering, paying, soliciting, receiving or providing any remuneration, directly or indirectly, overtly or covertly, to induce or in return for purchasing, leasing, ordering or arranging for or recommending the purchase, lease or order of any good, facility, item or service reimbursable, in whole or in part, under Medicare, Medicaid or other federal healthcare programs. The term “remuneration” has been broadly interpreted to include anything of value. The AKS has been interpreted to apply to arrangements between pharmaceutical and medical device manufacturers on the one hand and prescribers, purchasers, formulary managers and beneficiaries on the other hand. Although there are a number of statutory exceptions and regulatory safe harbors protecting some common activities from prosecution, the exceptions and safe harbors are drawn narrowly. Failure to meet all of the requirements of a particular applicable statutory exception or regulatory safe harbor does not make the conduct per se illegal under the AKS. Instead, the legality of the arrangement will be evaluated on a case-by-case basis based on a cumulative review of all its facts and circumstances. Several courts have interpreted the statute’s intent requirement to mean that if any one purpose of an arrangement involving remuneration is to induce referrals of federal healthcare covered business, the statute has been violated. In addition, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation. Moreover, a claim including items or services resulting from a violation of the AKS constitutes a false or fraudulent claim for purposes of the FCA.

Although we would not submit claims directly to payors, drug manufacturers can be held liable under the FCA, which imposes civil penalties, including through civil whistleblower or qui tam actions, against individuals or entities (including manufacturers) for, among other things, knowingly presenting, or causing to be presented to federal programs (including Medicare and Medicaid) claims for items or services, including drugs, that are false or fraudulent, claims for items or services not provided as claimed, or claims for medically unnecessary items or services. The government may deem manufacturers to have “caused” the submission of false or fraudulent claims by, for example, providing inaccurate billing or coding information to customers or promoting a product off-label. Several biopharmaceutical, medical device and other healthcare companies have been prosecuted under the FCA and civil monetary penalty laws for, among other things, allegedly providing free product to customers with the expectation that the customers would bill federal programs for the product. Other companies have been prosecuted for causing false claims to be submitted because of the companies’ marketing of products for unapproved (e.g., or off-label), and thus non-covered, uses. In addition, the civil monetary penalties statute imposes penalties against any person who is determined to have presented or caused to be presented a claim to a federal health program that the person knows or should know is for an item or service that was not provided as claimed or is false or fraudulent. Claims which include items or services resulting from a violation of the federal AKS are false or fraudulent claims for purposes of the FCA.

Our future marketing and activities relating to the reporting of wholesaler or estimated retail prices for our products, if approved, the reporting of prices used to calculate Medicaid rebate information and other information affecting federal, state and third-party reimbursement for our products, and the sale and marketing of our product candidates, are subject to scrutiny under these laws.

HIPAA, created additional federal criminal statutes that prohibit, among other actions, knowingly and willfully executing, or attempting to execute, a scheme to defraud or to obtain, by means of false or fraudulent pretenses, representations or promises, any money or property owned by, or under the control or custody of, any healthcare benefit program, including private third-party payors, knowingly and willfully embezzling or stealing from a healthcare benefit program, willfully obstructing a criminal investigation of a healthcare offense and knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services. Similar to the AKS, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation.

In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians and certain other healthcare providers. The Affordable Care Act, or the ACA, imposed, among other things, new annual reporting requirements through the Physician Payments Sunshine Act for covered manufacturers for certain payments and “transfers of value” provided to physicians and teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members. Failure to submit timely, accurately and completely the required information for all payments, transfers of value and ownership or investment interests may result in civil monetary penalties. Covered manufacturers must submit reports by the 90th day of each subsequent calendar year and the reported information is publicly made available on a searchable website.

We may also be subject to data privacy and security regulation by both the federal government and the states in which we conduct our business. HIPAA, as amended by HITECH and their respective implementing regulations, including the Final HIPAA Omnibus Rule published on January 25, 2013, impose specified requirements relating to the privacy, security and transmission of individually identifiable health information held by covered entities and their business associates. Among other things, HITECH made HIPAA’s security standards directly applicable to “business associates,” defined as independent contractors or agents of covered entities that create, receive, maintain or transmit protected health information in connection with providing a service for or on behalf of a covered entity, although it is unclear that we would be considered a “business associate” in the normal course of our business. HITECH also increased the civil and criminal penalties that may be imposed against covered entities, business associates and possibly other persons, and gave state attorneys general new authority to file civil actions for damages or injunctions in federal courts to enforce the federal HIPAA laws and seek attorney’s fees and costs associated with pursuing federal civil actions. In addition, state laws govern the privacy and security of health information in certain circumstances, many of which differ from each other in significant ways and may not have the same requirements, thus complicating compliance efforts.

Similar state and foreign fraud and abuse laws and regulations, such as state anti-kickback and false claims laws, may apply to sales or marketing arrangements and claims involving healthcare items or services. Such laws are generally broad and are enforced by various state agencies and private actions. Also, many states have similar fraud and abuse statutes or regulations that may be broader in scope and may apply regardless of payor, in addition to items and services reimbursed under Medicaid and other state programs. Some state laws require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant federal government compliance guidance, and require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers, marketing expenditures or drug pricing.

In order to distribute products commercially, we must comply with state laws that require the registration of manufacturers and wholesale distributors of drug and biological products in a state, including, in certain states, manufacturers and distributors who ship products into the state even if such manufacturers or distributors have no place of business within the state. Some states also impose requirements on manufacturers and distributors to establish the pedigree of product in the chain of distribution, including some states that require manufacturers and others to adopt new technology capable of tracking and tracing product as it moves through the distribution chain. Several states have enacted legislation requiring pharmaceutical and biotechnology companies to establish marketing compliance programs, file periodic reports with the state, make periodic public disclosures on sales, marketing, pricing, clinical trials and other activities, and/or register their sales representatives, as well as to prohibit pharmacies and other healthcare entities from providing certain physician prescribing data to pharmaceutical and biotechnology companies for use in sales and marketing, and to prohibit certain other sales and marketing practices. All of our activities are potentially subject to federal and state consumer protection and unfair competition laws.

The scope and enforcement of each of these laws is uncertain and subject to rapid change in the current environment of healthcare reform, especially in light of the lack of applicable precedent and regulations. Federal and state enforcement bodies have recently increased their scrutiny of interactions between healthcare companies and healthcare providers, which has led to a number of investigations, prosecutions, convictions and settlements in the healthcare industry. It is possible that governmental authorities will conclude that our business practices may not comply with current or future statutes, regulations or case law involving applicable fraud and abuse or other healthcare laws and regulations. If our operations are found to be in violation of any of these laws or any other governmental regulations that may apply to us, we may be subject to significant civil, criminal and administrative penalties, damages, fines, disgorgement, contractual damages, reputational harm, diminished profits and future earnings, imprisonment, exclusion of drugs from government funded healthcare programs, such as Medicare and Medicaid, and the curtailment or restructuring of our operations, as well as additional reporting obligations and oversight if we become subject to a corporate integrity agreement or other agreement to resolve allegations of non-compliance with these laws, any of which could adversely affect our ability to operate our business and our financial results. If any of the physicians or other healthcare providers or entities with whom we expect to do business is found to be not in compliance with applicable laws, they may be subject to significant criminal, civil or administrative sanctions, including exclusions from government funded healthcare programs. Ensuring business arrangements comply with applicable healthcare laws, as well as responding to possible investigations by government authorities, can be time- and resource-consuming and can divert a company’s attention from the business.

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Current and Future Legislation

In the United States and foreign jurisdictions, there have been a number of legislative and regulatory changes and proposed changes regarding the healthcare system that could prevent or delay marketing approval of our product candidates, restrict or regulate post-approval activities and affect our ability to profitably sell any product candidates for which we obtain marketing approval. We expect that current laws, as well as other healthcare reform measures that may be adopted in the future, may result in more rigorous coverage criteria and additional downward pressure on the price that we, or any collaborators, may receive for any approved products.

The ACA, for example, contains provisions that subject biological products to potential competition by lower-cost biosimilars and may reduce the profitability of drug products through increased rebates for drugs reimbursed by Medicaid programs, extend Medicaid rebates to Medicaid managed care plans, provide for mandatory discounts for certain Medicare Part D beneficiaries and annual fees based on pharmaceutical companies’ share of sales to federal healthcare programs. With the current Congress, there will likely be additional administrative or legislative changes, including modification, repeal or replacement of all, or certain provisions of the ACA, which may impact reimbursement for drugs and biologics. On January 20, 2017, former President Trump signed an Executive Order directing federal agencies with authorities and responsibilities under the ACA to waive, defer, grant exemptions from, or delay the implementation of any provision of the ACA that would impose a fiscal or regulatory burden on states, individuals, healthcare providers, health insurers, or manufacturers of pharmaceuticals or medical devices. On October 13, 2017, former President Trump signed an Executive Order terminating the cost-sharing subsidies that reimburse insurers under the ACA. Several state Attorneys General filed suit to stop the administration from terminating the subsidies, but their lawsuit was dismissed by a federal judge in California on July 18, 2018. In addition, CMS has recently finalized regulations that would give states greater flexibility in setting benchmarks for insurers in the individual and small group marketplaces, which may have the effect of relaxing the essential health benefits required under the ACA for plans sold through such marketplaces. Further, each chamber of Congress has put forth multiple bills, and may do so again in the future, designed to repeal or repeal and replace portions of the ACA.

While Congress has not passed repeal legislation, the Tax Reform Act includes a provision that repealed, effective January 1, 2019, the tax-based shared responsibility payment imposed by the ACA on certain individuals who fail to maintain qualifying health coverage for all or part of a year that is commonly referred to as the “individual mandate.” Further, the Bipartisan Budget Act of 2018, or the BBA, among other things, amended the ACA, effective January 1, 2019, to increase from 50 percent to 70 percent the point-of-sale discount that is owed by pharmaceutical manufacturers who participate in Medicare Part D and to close the coverage gap in most Medicare drug plans, commonly referred to as the “donut hole.” Congress may consider other legislation to repeal and replace elements of the ACA. On December 14, 2018, a U.S. District Court judge in the Northern District of Texas ruled that the individual mandate portion of the ACA is an essential and inseverable feature of the ACA, and therefore because the mandate was repealed as part of the Tax Cuts and Jobs Act, the remaining provisions of the ACA are invalid as well. The Trump administration and CMS have both stated that the ruling will have no immediate effect, and on December 30, 2018 the same judge issued an order staying the judgment pending appeal. A Fifth Circuit U.S. Court of Appeals hearing to determine whether certain states and the House of Representatives have standing to appeal the lower court decision was held on July 9, 2019, but it is unclear when a Court will render its decision on this hearing, and what effect it will have on the status of the ACA. Litigation and legislation over the ACA are likely to continue, with unpredictable and uncertain results.

Additionally, other federal health reform measures have been proposed and adopted in the United States since the ACA was enacted:

● The Budget Control Act of 2011, among other things, created measures for spending reductions by Congress. A Joint Select Committee on Deficit Reduction, tasked with recommending a targeted deficit reduction of at least $1.2 trillion for the years 2013 through 2021, was unable to reach required goals, thereby triggering the legislation’s automatic reduction to several government programs. These changes included aggregate reductions to Medicare payments to providers of up to 2% per fiscal year, which went into effect in April 2013 and, due to subsequent legislative amendments to the statute, including the BBA, will remain in effect through 2027, unless additional Congressional action is taken. ● The American Taxpayer Relief Act of 2012, among other things, reduced Medicare payments to several providers, and increased the statute of limitations period for the government to recover overpayments to providers from three to five years. ● The Middle Class Tax Relief and Job Creation Act of 2012 required that CMS reduce the Medicare clinical laboratory fee schedule by 2% in 2013, which served as a base for 2014 and subsequent years. In addition, effective January 1, 2014, CMS also began bundling the Medicare payments for certain laboratory tests ordered while a patient received services in a hospital outpatient setting.

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	●	The American Taxpayer Relief Act of 2012, among other things, reduced Medicare payments to several providers, and increased the statute of limitations period for the government to recover overpayments to providers from three to five years.
	●	The Middle Class Tax Relief and Job Creation Act of 2012 required that CMS reduce the Medicare clinical laboratory fee schedule by 2% in 2013, which served as a base for 2014 and subsequent years. In addition, effective January 1, 2014, CMS also began bundling the Medicare payments for certain laboratory tests ordered while a patient received services in a hospital outpatient setting.

Further, there has been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which have resulted in several recent Congressional inquiries and proposed and enacted bills designed to, among other things, bring more transparency to product pricing, review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for products. In addition, the U.S. government, state legislatures, and foreign governments have shown significant interest in implementing cost containment programs, including price-controls, restrictions on reimbursement and requirements for substitution of generic products for branded prescription drugs to limit the growth of government paid healthcare costs. For example, the U.S. government has passed legislation requiring pharmaceutical manufacturers to provide rebates and discounts to certain entities and governmental payors to participate in federal healthcare programs. Further, Congress and the current administration have each indicated that it will continue to seek new legislative and/or administrative measures to control drug costs, and the current administration recently released a “Blueprint”, or plan, to reduce the cost of drugs. The Blueprint contains certain measures that HHS is already working to implement. For example, in May 2019, CMS issued a final rule to allow Medicare Advantage Plans the option of using step therapy for Part B drugs beginning January 1, 2020. This final rule codified CMS’s policy change that was effective January 1, 2019. Congress has indicated that it will continue to seek new legislative and/or administrative measures to control drug costs. Individual states in the United States have also been increasingly passing legislation and implementing regulations designed to control pharmaceutical and biological product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product access and marketing cost disclosure and transparency measures, and, in some cases, designed to encourage importation from other countries and bulk purchasing.

Non-U.S. Regulation

Before our products can be marketed outside the United States, they are subject to regulatory approval of the respective authorities in the country in which the product should be marketed. The requirements governing the conduct of clinical trials, product licensing, pricing and reimbursement vary widely from country to country. No action can be taken to market any product in a country until an appropriate application has been approved by the regulatory authorities in that country. The time spent in gaining approval varies from that required for FDA approval, and in certain countries, the sales price of a product must also be approved. The pricing review period often begins after market approval is granted. Even if a product is approved by a regulatory authority, satisfactory prices might not be approved for such product.

Collaborations, Partnerships and Agreements

Collaborations, partnerships and agreements are a key component of New Ayala’s corporate strategy. As a clinical stage biotechnology company without sales revenue, partnerships are an essential part of the ongoing strategy. Additionally, the evolution of the field of immunotherapy has resulted in combination treatments becoming ubiquitous; ongoing clinical studies and agreements with many of the leading, large oncology pharmaceutical companies helps validate that Lm Technology may play a key role in the cancer treatment protocols of the future.

Our collaborators and partners include Merck, OS Therapies, Biocon, Global BioPharma, Knight, and others. For more information, see Note 12, “Licensing Agreements” of the “Notes to the Consolidated Financial Statements” included in Item 8.

We entered into an exclusive worldwide license agreement with Penn, on July 1, 2002 with respect to the innovative work of Yvonne Paterson, Ph.D., Associate Dean for Research at the School of Nursing at Penn, and former Professor of Microbiology at Penn, in the area of innate immunity, or the immune response attributed to immune cells, including dendritic cells, macrophages and natural killer cells, that respond to pathogens non-specifically (subject to certain U.S. government rights). This agreement was amended and restated as of February 13, 2007, and, thereafter, has been amended from time to time.

This license, unless sooner terminated in accordance with its terms, terminates upon the latter of (a) the expiration of the last to expire of the Penn patent rights; or (b) twenty years after the effective date of the license. Penn may terminate the license agreement early upon the occurrence of certain defaults by us, including, but not limited to, a material breach by us of the Penn license agreement that is not cured within 60 days after notice of the breach is provided to us.

The license provides us with the exclusive commercial rights to the patent portfolio developed by Penn as of the effective date of the license, in connection with Dr. Paterson and requires us to pay various milestone, legal, filing and licensing payments to commercialize the technology. In exchange for the license, Penn received shares of our Common Stock. In addition, Penn is entitled to receive a non-refundable initial license fee, royalty payments and milestone payments based on net sales and percentages of sublicense fees and certain commercial milestones. Under the amended licensing agreement, Penn is entitled to receive 2.5% of net sales in the territory. Should annual net sales exceed $250 million, the royalty rate will increase to 2.75%, but only with respect to those annual net sales in excess of $250 million. Additionally, Penn will receive tiered sales milestone payments upon the achievement of cumulative global sales ranging between $250 million and $2 billion, with the maximum aggregate amounts payable to Penn in the event that maximum sales milestones are achieved is $40 million. Notwithstanding these royalty rates, upon first in-human commercial sale (U.S. & E.U.), we have agreed to pay Penn a total of $775,000 over a four-year period as an advance minimum royalty, which shall serve as an advance royalty in conjunction with the above terms. In addition, under the license, we are obligated to pay an annual maintenance fee of $100,000 commencing on December 31, 2010, and each December 31st thereafter for the remainder of the term of the agreement until the first commercial sale of a Penn licensed product. We are responsible for filing new patents and maintaining and defending the existing patents licensed to us and we are obligated to reimburse Penn for all attorney’s fees, expenses, official fees and other charges incurred in the preparation, prosecution and maintenance of the patents licensed from Penn.

Upon first regulatory approval in humans (US or EU), Penn will be entitled to a milestone payment of $600,000. Furthermore, upon the achievement of the first sale of a product in certain fields, Penn will be entitled to certain milestone payments, as follows: $2.5 million will be due upon the first in-human commercial sale (US or EU) of the first product in the cancer field and $1.0 million will be due upon the date of first in-human commercial sale (US or EU) of a product in each of the secondary strategic fields sold.

Manufacturing

cGMPs, are the standards identified to conform to requirements by governmental agencies that control authorization and licensure for manufacture and distribution of biologic products for either clinical investigations or commercial sale. GMPs identify the requirements for procurement, manufacturing, testing, storage, distribution and the supporting quality systems to ensure that a drug product is safe for its intended application. cGMPs are enforced in the United States by the FDA, under the authorities of the Federal Food, Drug and Cosmetic Act and its implementing regulations and use the phrase “current good manufacturing practices” to describe these standards.

25Each of our wholly owned product candidates is manufactured using a platform process, with uniform methods and testing procedures. This allows for an expedited pathway from construct discovery to clinical product delivery, while helping to keep cost of goods low.

Each of New Ayala’s wholly owned product candidates is manufactured using a platform process, with uniform methods and testing procedures. This allows for an expedited pathway from construct discovery to clinical product delivery, while helping to keep cost of goods low.

New Ayala has entered into agreements with multiple third-party organizations, or CMOs, to handle the manufacturing, testing, and distribution of product candidates. These organizations have extensive experience within the biologics space and with the production of clinical and commercial GMP supplies.

Competition

The biotechnology and biopharmaceutical industries are characterized by rapid technological developments and a high degree of competition. As a result, our actual or proposed immunotherapies could become obsolete before we recoup any portion of our related research and development expenses. While we believe that our product candidates, technology, knowledge and experience provide us with competitive advantages, we face competition from established and emerging pharmaceutical and biotechnology companies, among others. The biotechnology and biopharmaceutical industries are highly competitive, and this competition comes from both biotechnology firms and from major pharmaceutical companies, including: BioNtech, Moderna, Gritstone, BMS, AstraZeneca, Merck, Neon Therapeutics, et al., each of which is pursuing cancer vaccines and/or immunotherapies.

Many of these companies have substantially greater financial, marketing, and human resources than we do (including, in some cases, substantially greater experience in clinical testing, manufacturing, and marketing of pharmaceutical products). We also experience competition in the development of our immunotherapies from universities and other research institutions and compete with others in acquiring technology from such universities and institutions. In addition, certain of our immunotherapies may be subject to competition from investigational new drugs and/or products developed using other technologies, some of which have completed numerous clinical trials.

Our competition will be determined in part by the potential indications for which drugs are developed and ultimately approved by regulatory authorities. Additionally, the timing of market introduction of some of our potential immunotherapies or of competitors’ products may be an important competitive factor. Accordingly, the speed with which we can develop immunotherapies, complete preclinical testing, clinical trials and approval processes and supply commercial quantities to market are expected to be important competitive factors. We expect that competition among products approved for sale will be based on various factors, including product efficacy, safety, administration, reliability, acceptance, availability, price and patent position.

The pharmaceutical industry is characterized by rapid evolution of technologies and intense competition. While we believe that our product candidates, technology, knowledge, experience and scientific resources provide us with competitive advantages, we face competition from major pharmaceutical and biotechnology companies, academic institutions, governmental agencies and public and private research institutions, among others. Any product candidates that we successfully develop and commercialize will compete with approved treatment options, if any, including off-label therapies, and new therapies that may become available in the future. Key considerations that would impact our ability to effectively compete with other therapies include the efficacy, safety, method of administration, cost, level of promotional activity and intellectual property protection of our products. Many of the companies against which we may compete have significantly greater financial resources and expertise than we do in research and development, manufacturing, preclinical testing, conducting clinical trials, obtaining regulatory approvals and marketing approved products.

With respect to MM, we are aware that other companies are, or may be, developing product candidates with GSI as anti-BCMA agents, including, but not limited to, Springworks Therapeutics, Inc. in collaboration with GlaxoSmithKline plc, Janssen, Allogene, Pfizer, Precision Biosciences and Celgene Corporation, recently acquired by BMS.

With respect to BST-236, our competitors include companies such as, but not limited to, AbbVie, Aprea, Astellas, BMS, Gilead, Jazz Pharmaceuticals, Novartis and Pfizer.

Smaller or early-stage companies, including oncology-focused therapeutics companies, may also prove to be significant competitors, particularly through collaborative arrangements with large and established companies. These companies may also compete with us in recruiting and retaining qualified scientific and management personnel, establishing clinical trial sites, enrolling patients in clinical trials and acquiring technologies complementary to, or necessary for, our programs.

The availability of reimbursement from government and private payors will also significantly impact the pricing and competitiveness of our products. Our competitors may obtain FDA or other regulatory approvals for their products more rapidly than we may obtain approvals for our product candidates, if any, which could result in our competitors establishing a strong market position before we are able to commercialize our product candidates.

Experience and Expertise

Our management team has extensive experience in oncology development, including contract research, development, manufacturing and commercialization across a board range of science, technologies, and process operations. We have built internal capabilities supporting research, clinical, medical, manufacturing and compliance operations and have extended our expertise with collaborations.

Employees

As of ~~October~~December 31, ~~2022~~2023, we had 21 15 employees, 1420 of which were full time employees. Of our full-time employees, 1seven ~~holds~~hold a M.D. or Ph.D. degree. None of our employees are represented by a labor union, and we consider our relationship with our employees to be good.

As part of a cost reduction plan, during the year ended December 31, 2023, we had a reduction in workforce in which the employment of approximately 50% of our employees was terminated. During the first quarter of 2024, we gave notice of termination to 18 additional employees and two officers (including the Chief Financial Officer, whose employment will terminate on June 25, 2024). After the effectiveness of such terminations, the Chief Executive Officer will be the only employee of the Company.

Properties

~~New~~Our ~~Ayala’s~~principal office is located at Oppenheimer 4, Rehovot 7670104, Israel. Our principal U.S. office is located at 9 Deer Park Drive, Suite K-1, Monmouth Junction, New Jersey 08852. We will continue to rent necessary offices and laboratories to support our business. ~~New~~We ~~Ayala~~believe ~~believes~~ that ~~its~~our facilities are sufficient to meet ~~its~~our current needs and that suitable additional space will be available as and when needed.

Legal Proceedings

The Company is from time to time involved in legal proceedings in the ordinary course of our business. The Company does not believe that any of these claims or proceedings against us is likely to have, individually or in the aggregate, a material adverse effect on the financial condition or results of operations. For more information regarding legal proceedings involving the Company, please see Note 87 – Commitments and Contingencies to our consolidated financial statements.

Item 1A. Risk Factors.

~~Summary of Risk Factors~~Omitted.

~~Below~~Item ~~is a summary of the principal factors that make an investment in New Ayala’s Common Stock speculative or risky~~1B. ~~This~~Unresolved ~~summary~~Staff ~~does not address all of the risks that New Ayala faces~~Comments. Additional discussion of the risks summarized in this risk factor summary, and other risks that New Ayala faces, can be found below under the heading “Risk Factors” and should be carefully considered, together with other information in this Form 10-K and New Ayala’s other filings with the SEC, before making an investment decision regarding New Ayala’s Common Stock.

● New Ayala has incurred significant losses since its inception and anticipate that it will continue to incur losses for the foreseeable future. ● New Ayala will require additional capital to fund its operations and if it fails to obtain necessary financing, it will not be able to complete the development and commercialization of its product candidates. ● The failure to successfully integrate the businesses and operations of Old Ayala and New Ayala in the expected time frame, and certain other factors relating to the Merger, may adversely affect the combined company’s future results. ● Our auditor’s report includes a going concern paragraph. ● New Ayala is significantly dependent on the success of its Lm Technology™ platform and its product candidates based on this platform. ● If New Ayala is unable to establish, manage or maintain strategic collaborations in the future, its revenue and drug development may be limited. ● New Ayala is subject to certain U.S. and foreign anti-corruption, anti-money laundering, export control, sanctions and other trade laws and regulations (“Trade Laws”). New Ayala can face serious consequences for violations. ● New Ayala depends upon its senior management and key consultants and their loss or unavailability could put it at a competitive disadvantage. ● The biotechnology and immunotherapy industries are characterized by rapid technological developments and a high degree of competition. New Ayala may be unable to compete with more substantial enterprises. ● New Ayala can provide no assurance that its clinical product candidates will obtain regulatory approval or that the results of clinical studies will be favorable.

● Drug discovery and development is a complex, time-consuming and expensive process that is fraught with risk and a high rate of failure. ● New Ayala may face legal claims; legal disputes are expensive and New Ayala may not be able to afford the costs. ● New Ayala can provide no assurance of the successful and timely development of new products. ● Ongoing healthcare legislative and regulatory reform measures may have a material adverse effect on New Ayala’s business and results of operations. ● New Ayala relies on patents to protect its technology. New Ayala may be unable to protect its intellectual property rights and it may be liable for infringing the intellectual property rights of others. ● The price of New Ayala’s Common Stock and warrants may be volatile.

Risk Factors

You should carefully consider the risks described below as well as other information provided to you in this annual report, including information in the section of this document entitled “Forward-Looking Statements.” The risks and uncertainties described below are not the only ones facing us. Additional risks and uncertainties not presently known to us or that we currently believe are immaterial may also impair our business operations. If any of the following risks actually occur, our business, financial condition or results of operations could be materially adversely affected, the value of our common stock could decline, and you may lose all or part of your investment.

Introductory Note

The following discussion sets forth the risk factors relating to the business of New Ayala as it existed prior to the Merger, as well as certain risk factors relating to the Merger and the combined business of the Company following the Merger. In addition, we are incorporating into this Item 1A the description of the risk factors relating to Old Ayala set forth in pages 64-131 of the Old Ayala Merger Proxy, which pages are set forth on Exhibit 99.2 to this Annual Report on Form 10-K.

Risks Related to New Ayala’s Financial Position, Capital Needs and Strategic Considerations

New Ayala has incurred significant losses since its inception and anticipate that it will continue to incur losses for the foreseeable future.

New Ayala is a clinical-stage biotechnology company. Investment in biotechnology product development is highly speculative because it entails substantial upfront capital expenditures and significant risk that a product candidate will fail to gain regulatory approval or become commercially viable. New Ayala has not generated any revenue from product sales to date, and it continues to incur significant development and other expenses related to its ongoing operations. As a result, New Ayala is not profitable and have incurred losses in each period since its inception.

New Ayala expects to continue to incur losses for the foreseeable future, and it expects these losses to increase as it continues its development of, and seek regulatory approvals for, New Ayala’s product candidates, and begin to commercialize any approved products. New Ayala may encounter unforeseen expenses, difficulties, complications, delays and other unknown factors that may adversely affect its business. The size of New Ayala’s future net losses will depend, in part, on the rate of future growth of its expenses and its ability to generate revenues. If any of New Ayala’s product candidates fail in clinical studies or do not gain regulatory approval, or if approved, fails to achieve market acceptance, New Ayala may never become profitable. Even if New Ayala achieves profitability in the future, it may not be able to sustain profitability in subsequent periods. New Ayala’s prior losses and expected future losses have had and will continue to have an adverse effect on its stockholders’ (deficit) equity and working capital.

New Ayala will require additional capital to fund its operations and if it fails to obtain necessary financing, it will not be able to complete the development and commercialization of its product candidates.

The research and development of New Ayala’s products have consumed substantial amounts of cash since inception. New Ayala expects to continue to invest in advancing the clinical development of its product candidates and to commercialize any product candidates for which it receives regulatory approval. As of October 31, 2022, New Ayala had cash and cash equivalents of approximately $25.2 million. New Ayala will require additional capital for the further development of its product candidates. New Ayala is pursuing various ways to support its development efforts including debt and/or equity financing as well as targeting potential collaborators of its products.

New Ayala cannot be certain that additional funding will be available on acceptable terms, or at all. If New Ayala is unable to raise additional capital in sufficient amounts or on terms acceptable to it, New Ayala may have to significantly delay, scale back or discontinue the development or commercialization of one or more of its products or product candidates or one or more of its other research and development initiatives. New Ayala’s forecast of the period of time through which its financial resources will be adequate to support its operations is a forward-looking statement and involves risks and uncertainties, and actual results could vary as a result of a number of factors, including the factors discussed elsewhere in this “Risk Factors” section. New Ayala has based this estimate on assumptions that may prove to be wrong, and it could utilize its available capital resources sooner than it currently expects. New Ayala’s future funding requirements, both near and long-term, will depend on many factors, including, but not limited to:

● The progress, timing, costs and results of the clinical studies underway; ● future clinical development plans it establishes for New Ayala’s product candidates; ● the number and characteristics of product candidates that New Ayala develops or may in-license; ● the outcome, timing and cost of meeting regulatory requirements established by the U.S. Food and Drug Administration, or the FDA, and comparable foreign regulatory authorities, including the potential for the FDA or comparable foreign regulatory authorities to require that New Ayala performs more studies than those that it currently expects; ● the cost of filing, prosecuting, defending and enforcing New Ayala’s patent claims and other intellectual property rights; ● the cost of defending intellectual property disputes, including patent infringement actions brought by third parties against New Ayala or its product candidates; ● the effect of competing technological and market developments; ● the cost and timing of completion of commercial-scale outsourced manufacturing activities; and ● the cost of establishing sales, marketing and distribution capabilities for any product candidates for which New Ayala may receive regulatory approval in regions where it chooses to commercialize its products on its own.

The failure to successfully integrate the businesses and operations of Old Ayala and New Ayala in the expected time frame may adversely affect the combined company’s future results.

New Ayala and Old Ayala operated independently and there can be no assurances that the businesses can be integrated successfully. It is possible that the integration process could result in the loss of key employees, independent contractors, principal investigators, Clinical Research Organizations (“CROs”), consultants, vendors, and any other third parties, the disruption of our ongoing businesses, inconsistencies in standards, controls, procedures and policies, unexpected integration issues, higher than expected integration costs and an overall integration process that takes longer than originally anticipated. Specifically, the following issues, among others, must be addressed in integrating the operations of Old Ayala and New Ayala in order to realize the anticipated benefits of the Merger so the combined company performs as expected:

● combining the companies’ operations and corporate functions; ● combining the businesses of Old Ayala and New Ayala and meeting the capital requirements of the combined company, in a manner that permits the combined company to achieve any cost savings or other synergies anticipated to result from the Merger, the failure of which would result in the anticipated benefits of the Merger not being realized in the time frame currently anticipated or at all; ● integrating personnel from the two companies, especially in the COVID-19 environment which has required many people to work remotely in many locations; ● integrating and unifying Old Ayala’s and New Ayala’s pipeline of product candidates in development; ● identifying and eliminating redundant and underperforming functions and assets; ● harmonizing the companies’ operating practices, employee development and compensation programs, internal controls and other policies, procedures and processes; ● maintaining existing agreements with employees, independent contractors, principal investigators, CROs, consultants, vendors, and any other third parties, avoiding delays in entering into new agreements with prospective employees, independent contractors, principal investigators, CROs, consultants, vendors, and any other third parties, and leveraging relationships with such third parties for the benefit of the combined company; ● addressing possible differences in business backgrounds, corporate cultures and management philosophies; ● consolidating the companies’ administrative and information technology infrastructure; ● coordinating research, commercialization, and marketing efforts; ● coordinating geographically dispersed organizations; and ● effecting actions that may be required in connection with obtaining regulatory or other governmental approvals.

In addition, at times the attention our management may be focused on the integration of the businesses of the two companies and diverted from day-to-day business operations or other opportunities that may have been beneficial to us, which may disrupt our ongoing business.

New Ayala and Old Ayala incurred substantial direct and indirect costs as a result of the Merger and New Ayala will incur substantial direct and indirect costs in connection with combining the businesses of New Ayala and Old Ayala following the Merger.

New Ayala and Old Ayala will incur substantial expenses in connection with and as a result of consummating the Merger, and over a period of time following the consummation of the Merger, the combined company also expects to incur substantial expenses in connection with coordinating and, in certain cases, combining the businesses, operations, policies and procedures of New Ayala and Old Ayala. These expenses could adversely affect the financial condition, results of operations and cash flows of the combined company following the consummation of the Merger.

Sales of shares of New Ayala Common Stock after the completion of the Merger may cause the market price of New Ayala Common Stock to fall.

Old Ayala stockholders may decide not to hold the shares of New Ayala Common Stock they received in the Merger and other Old Ayala stockholders, such as funds with limitations on the amount of stock they are permitted hold in individual issuers, may be required to sell shares of New Ayala Common Stock that they received in the Merger. Such sales, or market perception of such sales, of New Ayala Common Stock could result in higher than average trading volume and may cause the market price for New Ayala Common Stock to decline. Such sales may take place at anytime as there is no lock-up in place that would prevent institutional or larger stockholders from selling some or all of their New Ayala Common Stock now that the Merger has closed.

If third parties threaten to terminate, terminate or alter existing contracts or relationships with New Ayala or Old Ayala, New Ayala’s and Old Ayala’s respective businesses may be materially harmed.

Old Ayala had contracts with customers, suppliers, vendors, landlords, licensors and other business partners which may require Ayala to obtain consents from these other parties in connection with the Merger. If these consents cannot be obtained, the combined company may suffer a loss of potential future revenues and may lose rights that are material to the business of the combined company. In addition, third parties with whom Old Ayala or New Ayala had or have relationships may terminate or otherwise reduce the scope of their relationship with either. Any such disruptions could limit the Company’s ability to achieve the anticipated benefits of the Merger.

Both Old Ayala and New Ayala have operated with a loss and negative cash flows for the entirety of their existence and it is expected the Company will have to raise significant capital in the future that could be dilutive to stockholders.

Both Old Ayala and New Ayala have operated with a loss and negative cash flows for the entirety of their existence. Old Ayala and New Ayala have incurred significant net operating losses in every year since inception and expect to continue to incur significant expenses and operating losses for the foreseeable future. New Ayala’s net losses were approximately $14.4 million for the year ended October 31, 2022. Ayala’s net losses were approximately $40.3 million for the year ended December 31, 2021 and $28.4 million for the nine months ended September 30, 2022. Based on the combined company’s anticipated cash balances and recurring losses, there is substantial doubt about the Company’s ability to continue as a going concern as a standalone company.

The Company may not be able to raise capital to continue operations in the future which could result in bankruptcy or liquidation. As a result, adequate funding may not be available to the Company on acceptable terms, or at all.

Our auditor’s report includes a going concern paragraph.

Our auditor’s report on our financial statements for the year ended October 31, 2022 includes a going concern paragraph. The Company’s products that are being developed have not generated significant revenue. As a result, the Company has suffered recurring losses and requires significant cash resources to execute its business plans. These losses are expected to continue for an extended period of time. The aforementioned factors raise substantial doubt about the Company’s ability to continue as a going concern within one year from the date of filing. The accompanying financial statements have been prepared on a going concern basis, which contemplates the realization of assets and the satisfaction of liabilities in the normal course of business. The financial statements do not include any adjustments relating to the recoverability and classification of asset amounts or the classification of liabilities that might be necessary should the Company be unable to continue as a going concern within one year after the date the financial statements are issued.

Historically, the major source of our cash has been from proceeds from various public and private offerings of our common stock. Management’s plans to mitigate an expected shortfall of capital, to support future operations, include raising additional funds. The actual amount of cash that it will need to operate is subject to many factors.

The Company also recognizes it will need to raise additional capital in order to continue to execute its business plan in the future. There is no assurance that additional financing will be available when needed or that management will be able to obtain financing on terms acceptable to the Company or whether the Company will become profitable and generate positive operating cash flow. If the Company is unable to raise sufficient additional funds, it will have to scale back its operations.

Risks Related to New Ayala’s Business, Industry and Strategy

New Ayala is currently operating in a period of economic uncertainty and capital markets disruption, which has been significantly impacted by geopolitical instability, an ongoing military conflict between Russia and Ukraine, and record inflation. New Ayala’s business, financial condition and results of operations could be materially adversely affected by any negative impact on the global economy and capital markets resulting from the conflict in Ukraine, geopolitical tensions, or record inflation.

U.S. and global markets are experiencing volatility and disruption following the escalation of geopolitical tensions and the start of the military conflict between Russia and Ukraine. On February 24, 2022, a full-scale military invasion of Ukraine by Russian troops was reported. Although the length and impact of the ongoing military conflict is highly unpredictable, the conflict in Ukraine has led to market disruptions, including significant volatility in commodity prices, credit and capital markets, as well as supply chain interruptions, which has caused record inflation globally. New Ayala is continuing to monitor the situation in Ukraine and globally and assessing its potential impact on New Ayala’s business.

Although, to date, New Ayala’s business has not been materially impacted by the ongoing military conflict between Russian and Ukraine, geopolitical tensions, or record inflation, it is impossible to predict the extent to which its operations will be impacted in the short and long term, or the ways in which the conflict in Ukraine, geopolitical tensions, or record inflation may impact New Ayala’s business. The extent and duration of the conflict in Ukraine, geopolitical tensions, record inflation and resulting market disruptions are impossible to predict, but could be substantial.

New Ayala is a clinical stage company.

New Ayala is a clinical stage biotechnology company with a history of losses and can provide no assurance as to future operating results. As a result of losses that will continue throughout New Ayala’s clinical stage, it may exhaust its financial resources and be unable to complete the development of its products. New Ayala anticipates that it will continue to incur significant operational costs as New Ayala executes its clinical development strategy. New Ayala’s deficit will continue to grow during its drug development period.

New Ayala has sustained losses from operations in each fiscal year since its inception, and it expects losses to continue for the foreseeable future due to its substantial investment in research and development. As of October 31, 2022, New Ayala had an accumulated deficit of approximately $443 million and stockholders’ equity of approximately $23.6 million. New Ayala expects to spend substantial additional sums on the continued administration and research and development of proprietary products and technologies with no certainty that its immunotherapies will become commercially viable or profitable as a result of these expenditures. If New Ayala fails to raise a significant amount of capital, it may need to significantly curtail operations or cease operations in the near future. If any of New Ayala’s product candidates fail in clinical trials or does not gain regulatory approval, New Ayala may never become profitable. Even if New Ayala achieves profitability in the future, it may not be able to sustain profitability in subsequent periods.

New Ayala is significantly dependent on the success of its Lm Technology platform and its product candidates based on this platform.

New Ayala is invested, and it expects to continue to invest, significant efforts and financial resources in the development of product candidates based on its Lm Technology. New Ayala’s ability to generate meaningful revenue, which may not occur for the foreseeable future, if ever, will depend heavily on the successful development, regulatory approval and commercialization of one or more of these product candidates, and such regulatory approval and commercialization may never occur.

The successful development of immunotherapies is highly uncertain.

Successful development of immunotherapies is highly uncertain and is dependent on numerous factors, many of which are beyond New Ayala’s control. Immunotherapies that appear promising in the early phases of development may fail to reach, or be delayed in reaching, the market for several reasons including:

● preclinical study results that may show the immunotherapy to be less effective than desired (e.g., the study failed to meet its primary objectives) or to have harmful or problematic side effects; ● clinical study results that may show the immunotherapy to be less effective than expected (e.g., the study failed to meet its primary endpoint) or to have unacceptable side effects; ● failure to receive the necessary regulatory approvals or a delay in receiving such approvals. Among other things, such delays may be caused by slow enrollment in clinical studies, length of time to achieve study endpoints, delays in receiving the necessary products or supplies for the conduct of clinical or pre-clinical trials, additional time requirements for data analysis, or Biologics License Application (“BLA”) preparation, discussions with the FDA, an FDA request for additional preclinical or clinical data, FDA delays in inspecting manufacturing establishments, failure to receive FDA approval for manufacturing processes or facilities, or unexpected safety or manufacturing issues;

● manufacturing costs, formulation issues, pricing or reimbursement issues, or other factors that make the immunotherapy uneconomical; and ● the proprietary rights of others and their competing products and technologies that may prevent the immunotherapy from being commercialized.

Success in preclinical and early clinical studies does not ensure that large-scale clinical studies will be successful. Clinical results are frequently susceptible to varying interpretations that may delay, limit or prevent regulatory approvals. The length of time necessary to complete clinical studies and to submit an application for marketing approval for a final decision by a regulatory authority varies significantly from one immunotherapy to the next and may be difficult to predict.

Even if New Ayala’s product candidates are approved, they may be subject to limitations on the indicated uses and populations for which they may be marketed. They may also be subject to other conditions of approval, may contain significant safety warnings, including boxed warnings, contraindications, and precautions, may not be approved with label statements necessary or desirable for successful commercialization, or may contain requirements for costly post-market testing and surveillance, or other requirements, including the submission of risk evaluation and mitigation strategies, or REMS, to monitor the safety or efficacy of the products. If New Ayala does not receive FDA approval for, and successfully commercialize its product candidates, it will not be able to generate revenue from these product candidates in the United States in the foreseeable future, or at all. Any significant delays in obtaining approval for and commercializing New Ayala’s product candidates will have a material adverse impact on its business and financial condition.

New Ayala must rely upon third parties for manufacturing.

New Ayala currently has agreements with third party manufacturing facilities for production of many of its immunotherapies for research and development and testing purposes. New Ayala depends on third-party manufacturers to supply all of its clinical materials, but it does not have direct control over their personnel or operations. Third-party manufacturers must be able to meet New Ayala’s deadlines as well as adhere to quality standards and specifications. New Ayala’s reliance on third parties for the manufacturing of its drug substance, investigational new drugs and, in the future, any approved products, creates a dependency that could severely disrupt New Ayala’s research and development, its clinical testing, and ultimately its sales and marketing efforts if the source of such supply proves to be unreliable or unavailable. For instance, manufacturers may experience unforeseen problems, such as material or personnel shortages, temporary or permanent facility closures, or scale up challenges. If any contracted manufacturing operation is unreliable or unavailable, New Ayala may not be able to manufacture clinical drug supplies of its immunotherapies, and its preclinical and clinical testing programs may not be able to move forward and its entire business plan could fail. If New Ayala is able to commercialize its products in the future, there is no assurance that any third-party manufacturers will be able to meet commercialized scale production requirements in a timely manner.

There is also no guarantee that New Ayala’s third-party manufacturers will be able to manufacture its product candidates in accordance with current Good Manufacturing Practices, or cGMPs. Poor control of production processes can lead to the introduction of adventitious agents or other contaminants, or to inadvertent changes in the properties or stability of a product candidate that may not be detectable in final product testing. If these third-party manufacturers are not able to comply with cGMPs, New Ayala may not be able to conduct clinical trials, may need to conduct additional studies, and may not, eventually, receive and maintain FDA approval for those products. Deviations from manufacturing requirements may also require remedial measures that may be costly and/or time-consuming for a third party to implement and that may include the temporary or permanent suspension of a clinical trial or commercial sales or the temporary or permanent closure of a facility. Any such remedial measures imposed upon or by third parties with whom New Ayala contracts could materially harm its business. A failure to comply with the applicable regulatory requirements may also result in regulatory enforcement actions against New Ayala’s manufacturers.

While New Ayala is ultimately responsible for the manufacturing of its product candidates, other than through its contractual arrangements, New Ayala has little control over its manufacturers’ compliance with these regulations and standards. If New Ayala’s manufacturers encounter manufacturing difficulties, including cGMP compliance, it may need to find alternative manufacturing facilities, which it may not be able to on favorable terms or at all, and which would significantly impact New Ayala’s ability to develop, obtain and maintain regulatory approval for or market its product candidates, if approved. Any new manufacturers would need to either obtain or develop the necessary manufacturing know-how, and obtain the necessary equipment and materials, which may take substantial time and investment. New Ayala must also receive FDA approval for the use of any new manufacturers for commercial supply.

If New Ayala is unable to establish, manage or maintain strategic collaborations in the future, its revenue and drug development may be limited.

New Ayala’s strategy includes eventual substantial reliance upon strategic collaborations for marketing and commercialization of its clinical product candidates, and it may rely even more on strategic collaborations for research, development, marketing and commercialization for some of New Ayala’s immunotherapies. To date, New Ayala has been heavily reliant upon third party outsourcing for its clinical trials execution and production of drug supplies for use in clinical trials. Establishing strategic collaborations is difficult and time-consuming. New Ayala’s discussions with potential collaborators may not lead to the establishment of collaborations on favorable terms, if at all. For example, potential collaborators may reject collaborations based upon their assessment of New Ayala’s financial, clinical, regulatory or intellectual property position. New Ayala’s current collaborations, as well as any future new collaborations, may never result in the successful development or commercialization of its immunotherapies or the generation of sales revenue. To the extent that New Ayala has entered or will enter into co-promotion or other collaborative arrangements, its product revenues are likely to be lower than if it directly marketed and sold any products that New Ayala may develop.

Management of New Ayala’s relationships with its collaborators will require:

● significant time and effort from New Ayala’s management team; ● financial funding to support said collaboration; ● coordination of New Ayala’s research and development programs with the research and development priorities of its collaborators; and ● effective allocation of New Ayala’s resources to multiple projects.

If New Ayala continues to enter into research and development collaborations at the early phases of drug development, its success will in part depend on the performance of its corporate collaborators. New Ayala will not directly control the amount or timing of resources devoted by its corporate collaborators to activities related to its immunotherapies and its collaborations may terminate at any time. New Ayala’s corporate collaborators may not commit sufficient resources to its research and development programs or the commercialization, marketing or distribution of its immunotherapies. If any corporate collaborator fails to commit sufficient resources or terminate their collaborations with New Ayala, its preclinical or clinical development programs related to this collaboration could be delayed or terminated.

Further, New Ayala’s collaborators may pursue existing or other development-stage products or alternative technologies in preference to those being developed in collaboration with New Ayala. Collaborators may also fail to comply with the applicable regulatory requirements, which may subject them or New Ayala to regulatory enforcement actions. Finally, if New Ayala fails to make required milestone or royalty payments to its collaborators or to observe other obligations in its agreements with them, New Ayala’s collaborators may have the right to terminate those agreements.

Changes in product candidate manufacturing or formulation may result in additional costs or delay.

In an effort to optimize processes and results, it is common that various aspects of the development program, such as manufacturing methods, manufacturing sites, and formulation, are altered as product candidates are developed from preclinical studies to late-stage clinical trials toward approval and commercialization. Any of these changes could cause New Ayala’s product candidates to perform differently and affect the results of planned clinical trials or other future clinical trials conducted with the altered materials. Such changes may also require additional testing, regulatory disclosure, or prior approval from the FDA. For instance, the FDA may require that New Ayala conducts a comparability study that evaluates the potential differences in the product candidate resulting from the change. Delays in designing and completing such a study to the satisfaction of the FDA could delay or preclude New Ayala’s development and commercialization plans, and the regulatory approval of its product candidates. It may also require the repetition of one or more clinical trials, increase clinical trial costs, delay approval of New Ayala’s product candidates and jeopardize its ability to commence product sales and generate revenue. Any of the foregoing could limit New Ayala’s future revenues and growth. Any changes would also require that New Ayala devotes time and resources to manufacturing development, including with third-party manufacturers, and would also likely require additional testing and regulatory actions on its part, which may delay the development of its product candidates.

New Ayala may incur significant costs complying with environmental laws and regulations.

New Ayala and its contracted third parties use hazardous materials, including chemicals and biological agents and compounds that could be dangerous to human health and safety or the environment. As appropriate, New Ayala stores these materials and wastes resulting from their use at New Ayala or its outsourced laboratory facility pending their ultimate use or disposal. New Ayala contract with a third party to properly dispose of these materials and wastes. New Ayala is subject to a variety of federal, state and local laws and regulations governing the use, generation, manufacture, storage, handling and disposal of these materials and wastes. Compliance with such laws and regulations may be costly.

Additional laws and regulations governing international operations could negatively impact or restrict New Ayala’s operations.

If New Ayala further expands its operations outside of the United States, it must dedicate additional resources to comply with numerous laws and regulations in each jurisdiction in which it plans to operate. The U.S. Foreign Corrupt Practices Act, or FCPA, prohibits any U.S. individual or business from paying, offering, authorizing payment or offering anything of value, directly or indirectly, to any foreign official, political party or candidate for the purpose of influencing any act or decision of the foreign entity in order to assist the individual or business in obtaining or retaining business. The FCPA also obligates companies whose securities are listed in the United States to comply with certain accounting provisions requiring New Ayala to maintain books and records that accurately and fairly reflect all transactions of the corporation, including international subsidiaries, and to devise and maintain an adequate system of internal accounting controls for international operations.

Compliance with the FCPA is expensive and difficult, particularly in countries in which corruption is a recognized problem. In addition, the FCPA presents particular challenges in the pharmaceutical industry, because, in many countries, hospitals are operated by the government, and doctors and other hospital employees are considered foreign officials. Certain payments to hospitals in connection with clinical trials and other work have been deemed to be improper payments to government officials and have led to FCPA enforcement actions.

Various laws, regulations and executive orders also restrict the use and dissemination outside of the United States, or the sharing with certain non-U.S. nationals, of information classified for national security purposes, as well as certain products and technical data relating to those products. If New Ayala expands its presence outside of the United States, it will require New Ayala to dedicate additional resources to comply with these laws, and these laws may preclude it from developing, manufacturing or selling certain products and product candidates outside of the United States, which could limit its growth potential and increase New Ayala’s development costs.

The failure to comply with laws governing international business practices may result in substantial civil and criminal penalties and suspension or debarment from government contracting. The SEC also may suspend or bar issuers from trading securities on U.S. exchanges for violations of the FCPA’s accounting provisions.

New Ayala is subject to certain U.S. and foreign anti-corruption, anti-money laundering, export control, sanctions and other trade laws and regulations. New Ayala can face serious consequences for violations.

Among other matters, U.S. and foreign anti-corruption, anti-money laundering, export control, sanctions and other trade laws and regulations, which are collectively referred to as Trade Laws, prohibit companies and their employees, agents, clinical research organizations, legal counsel, accountants, consultants, contractors and other partners from authorizing, promising, offering, providing, soliciting or receiving, directly or indirectly, corrupt or improper payments or anything else of value to or from recipients in the public or private sector. Violations of Trade Laws can result in substantial criminal fines and civil penalties, imprisonment, the loss of trade privileges, debarment, tax reassessments, breach of contract and fraud litigation, exclusion from public tenders, reputational harm and other consequences. New Ayala has direct or indirect interactions with officials and employees of government agencies or government-affiliated hospitals, universities and other organizations. New Ayala plans to engage third parties for clinical trials and/or to obtain necessary permits, licenses, patent registrations and other regulatory approvals and it can be held liable for the corrupt or other illegal activities of its personnel, agents or partners, even if New Ayala does not explicitly authorize or have prior knowledge of such activities.

If New Ayala uses biological materials in a manner that causes injury, it may be liable for damages.

New Ayala’s research and development activities involve the use of biological and hazardous materials. Although New Ayala believes its safety procedures for handling and disposing of these materials complies with federal, state and local laws and regulations, it cannot entirely eliminate the risk of accidental injury or contamination from the use, storage, handling or disposal of these materials. New Ayala does not carry specific biological waste or pollution liability or remediation insurance coverage, nor do its workers’ compensation, general liability, and property and casualty insurance policies provide coverage for damages and fines/penalties arising from biological exposure or contamination. Accordingly, in the event of contamination or injury, New Ayala could be held liable for damages or penalized with fines in an amount exceeding its resources, and its clinical trials or regulatory approvals could be suspended or terminated.

New Ayala needs to attract and retain highly skilled personnel; it may be unable to effectively manage growth with its limited resources.

As of October 31, 2022 New Ayala had 15 employees, 14 of which were full time employees. New Ayala’s ability to attract and retain highly skilled personnel is critical to its operations and expansion. New Ayala faces competition for these types of personnel from other technology companies and more established organizations, many of which have significantly larger operations and greater financial, technical, human and other resources than it has. New Ayala may not be successful in attracting and retaining qualified personnel on a timely basis, on competitive terms, or at all. If New Ayala is not successful in attracting and retaining these personnel, or integrating them into its operations, business, prospects, financial condition and results of operations will be materially adversely affected. In such circumstances New Ayala may be unable to conduct certain research and development programs, unable to adequately manage its clinical trials and other products, unable to commercialize any products, and unable to adequately address its management needs.

New Ayala depends upon its senior management and key consultants and their loss or unavailability could put it at a competitive disadvantage.

New Ayala depends upon the efforts and abilities of its senior executives, as well as the services of several key consultants. The loss or unavailability of the services of any of these individuals for any significant period of time could have a material adverse effect on New Ayala’s business, prospects, financial condition and results of operations. New Ayala has not obtained, does not own, nor is it the beneficiary of, key-person life insurance.

The biotechnology and immunotherapy industries are characterized by rapid technological developments and a high degree of competition. New Ayala may be unable to compete with more substantial enterprises.

The biotechnology and biopharmaceutical industries are characterized by rapid technological developments and a high degree of competition. As a result, New Ayala’s actual or proposed immunotherapies could become obsolete before it recoups any portion of its related research and development and commercialization expenses. Competition in the biopharmaceutical industry is based significantly on scientific and technological factors. These factors include the availability of patent and other protection for technology and products, the ability to commercialize technological developments and the ability to obtain governmental approval for testing, manufacturing and marketing. New Ayala competes with specialized biopharmaceutical firms in the United States, Europe and elsewhere, as well as a growing number of large pharmaceutical companies that are applying biotechnology to their operations. Many biopharmaceutical companies have focused their development efforts in the human therapeutics area, including cancer. Many major pharmaceutical companies have developed or acquired internal biotechnology capabilities or made commercial arrangements with other biopharmaceutical companies. These companies, as well as academic institutions and governmental agencies and private research organizations, also compete with New Ayala in recruiting and retaining highly qualified scientific personnel and consultants. New Ayala’s ability to compete successfully with other companies in the pharmaceutical field will also depend to a considerable degree on the continuing availability of capital to New Ayala.

New Ayala is aware of certain investigational new products under development or approved products by competitors that are used for the prevention, diagnosis, or treatment of certain diseases it has targeted for product development. Various companies are developing biopharmaceutical products that have the potential to directly compete with New Ayala’s immunotherapies even though their approach may be different. The biotechnology and biopharmaceutical industries are highly competitive, and this competition comes from both biotechnology firms and major pharmaceutical companies, including companies like: Gritstone, Moderna, Bristol-Myers Squibb Company (“BMS”), Merck and Neon Therapeutics, among others, each of which is pursuing cancer vaccines and/or immunotherapies. Many of these companies have substantially greater financial, marketing, and human resources than New Ayala does (including, in some cases, substantially greater experience in clinical testing, manufacturing, and marketing of pharmaceutical products). New Ayala also experiences competition in the development of its immunotherapies from universities and other research institutions and compete with others in acquiring technology from such universities and institutions.

In addition, certain of New Ayala’s immunotherapies may be subject to competition from investigational new drugs and/or products developed using other technologies, some of which have completed numerous clinical trials.

Risks Related to the Development and Regulatory Approval of New Ayala Product Candidates

New Ayala can provide no assurance that its clinical product candidates will obtain regulatory approval or that the results of clinical studies will be favorable.

New Ayala is currently evaluating the safety and efficacy of its product candidates in clinical trials. However, even though the initiation and conduct of the clinical trials is in accordance with the governing regulatory authorities in each country, as with any investigational new drug (under an Investigational New Drug Application, or IND, in the United States, or the equivalent in countries outside of the United States), New Ayala is at risk of a clinical hold at any time based on the evaluation of the data and information submitted to the governing regulatory authorities.

There can be delays in obtaining FDA and/or other necessary regulatory approvals in the United States and in countries outside the United States for any investigational new drug and failure to receive such approvals would have an adverse effect on the investigational new drug’s potential commercial success and on New Ayala’s business, prospects, financial condition and results of operations. The time required to obtain approval by the FDA and non-U.S. regulatory authorities is unpredictable but typically takes many years following the commencement of clinical trials and depends upon numerous factors, including the substantial discretion of the regulatory authorities. For example, the FDA or non-U.S. regulatory authorities may disagree with the design or implementation of New Ayala’s clinical trials or study endpoints; or it may be unable to demonstrate that a product candidate’s clinical and other benefits outweigh its safety risks. In addition, the FDA or non-U.S. regulatory authorities may disagree with New Ayala’s interpretation of data from preclinical studies or clinical trials or the data collected from clinical trials of its product candidates may not be sufficient to support the submission of a BLA or New Drug Application (“NDA”) or other submission or to obtain regulatory approval in the United States or elsewhere. The FDA or non-U.S. regulatory authorities may fail to approve the manufacturing processes or facilities of third-party manufacturers with which New Ayala contracts for clinical and commercial supplies; and the approval policies or regulations of the FDA or non-U.S. regulatory authorities may significantly change in a manner rendering New Ayala’s clinical data insufficient for approval.

In addition to the foregoing, approval policies, regulations, or the type and amount of clinical data necessary to gain approval may change during the course of a product candidate’s clinical development and may vary among jurisdictions. New Ayala has not submitted for nor obtained regulatory approval for any product candidate in-humans (US & EU) and it is possible that none of its existing product candidates or any product candidates New Ayala may seek to develop in the future will ever obtain regulatory approval.

Drug discovery and development is a complex, time-consuming and expensive process that is fraught with risk and a high rate of failure.

Product candidates are subject to extensive pre-clinical testing and clinical trials to demonstrate their safety and efficacy in humans. Conducting pre-clinical testing and clinical trials is a lengthy, time-consuming and expensive process that takes many years. New Ayala cannot be sure that pre-clinical testing or clinical trials of any of its product candidates will demonstrate the safety, efficacy and benefit-to-risk profile necessary to obtain marketing approvals. In addition, product candidates that experience success in pre-clinical testing and early-stage clinical trials will not necessarily experience the same success in larger or late-stage clinical trials, which are required for marketing approval.

Even if New Ayala is successful in advancing a product candidate into the clinical development stage, before obtaining regulatory and marketing approvals, it must demonstrate through extensive human clinical trials that the product candidate is safe and effective for its intended use. Human clinical trials must be carried out under protocols that are acceptable to regulatory authorities and to the independent committees responsible for the ethical review of clinical studies. There may be delays in preparing protocols or receiving approval for them that may delay the start or completion of the clinical trials. In addition, clinical practices vary globally, and there is a lack of harmonization among the guidance provided by various regulatory bodies of different regions and countries with respect to the data that is required to receive marketing approval, which makes designing global trials increasingly complex. There are a number of additional factors that may cause New Ayala’s clinical trials to be delayed, prematurely terminated or deemed inadequate to support regulatory approval, such as:

● safety issues up to and including patient death (whether arising with respect to trials by third parties for compounds in a similar class as tour product or product candidate), inadequate efficacy, or an unacceptable risk-benefit profile observed at any point during or after completion of the trials; ● slower than expected rates of patient enrollment, which could be due to any number of factors, including failure of New Ayala’s third-party vendors, including its CROs, to effectively perform their obligations to New Ayala, a lack of patients who meet the enrollment criteria or competition from clinical trials in similar product classes or patient populations, or onerous treatment administration requirements; ● subjects may drop out of New Ayala’s clinical trials, be lost to follow-up at a higher rate than it anticipates, or not comply with the required clinical trial procedures; ● New Ayala may experience delays in reaching, or fail to reach, agreement on acceptable clinical trial contracts or clinical trial protocols with prospective trial sites and its CROs; ● the cost of clinical trials may be greater than New Ayala anticipates or it may have insufficient funds for a clinical trial or to pay the substantial FDA user fees;

● the FDA or comparable foreign regulatory authorities may disagree with New Ayala’s study design, including endpoints, its intended indications, or its interpretation of data; ● the risk of failure of New Ayala’s clinical investigational sites and related facilities, including its suppliers and CROs, to maintain compliance with the FDA’s cGMP and Good Clinical Practices, or GCP, regulations or similar regulations in countries outside of the U.S., including the risk that these sites fail to pass inspections by the appropriate governmental authority, which could invalidate the data collected at that site or place the entire clinical trial at risk; ● any inability to reach agreement or lengthy discussions with the FDA, equivalent regulatory authorities, or ethical review committees on trial design that New Ayala is able to execute or it may be required to modify its trial design such that studies are impracticable; ● regulators may require New Ayala to perform additional or unanticipated clinical trials to obtain approval or it may be subject to additional post-marketing testing, surveillance, or REMS requirements to maintain regulatory approval; ● FDA refusal to accept the data from foreign clinical trial sites to the extent New Ayala uses such sites; ● changes in laws, regulations, regulatory policy or clinical practices, especially if they occur during ongoing clinical trials or shortly after completion of such trials; and ● clinical trial record keeping or data quality and accuracy issues.

Any deficiency in the design, implementation or oversight of New Ayala’s development programs could cause it to incur significant additional costs, conduct additional trials, experience significant delays, prevent it from obtaining marketing approval for any product candidate or abandon development of certain product candidates, any of which could harm its business and cause its stock price to decline.

New Ayala may face legal claims; legal disputes are expensive and it may not be able to afford the costs.

New Ayala may face legal claims involving stockholders, consumers, clinical trial subjects, competitors, regulators and other parties. New Ayala is engaged in legal proceedings. Litigation and other legal proceedings are inherently uncertain, and adverse rulings could occur, including monetary damages, or an injunction stopping New Ayala from engaging in business practices, or requiring other remedies, including, but not limited to, compulsory licensing of patents.

The costs of litigation or any proceeding, including, but not limited to, those relating to New Ayala’s intellectual property or contractual rights, could be substantial, even if resolved in its favor. Some of New Ayala’s competitors or financial funding sources have far greater resources than it does and may be better able to afford the costs of complex litigation. Also, a lawsuit, even if frivolous, will require considerable time commitments on the part of management, New Ayala’s attorneys and consultants. Defending these types of proceedings or legal actions involve considerable expense and could negatively affect New Ayala’s financial results. Legal claims may also adversely impact New Ayala in other ways, such as the withdrawal or slower enrollment in or from its clinical trials, regulatory enforcement actions, and negative media attention, any of which could materially and negatively harm New Ayala and its operations.

New Ayala can provide no assurance of the successful and timely development of new products.

New Ayala immunotherapies are at various stages of development. Further development and extensive testing will be required to determine their technical feasibility and commercial viability. New Ayala will need to complete significant additional clinical trials demonstrating that its product candidates are safe and effective to the satisfaction of the FDA and other non-U.S. regulatory authorities. The drug approval process is time-consuming, involves substantial expenditures of resources, and depends upon a number of factors, including the severity of the illness in question, the availability of alternative treatments, and the risks and benefits demonstrated in the clinical trials. New Ayala’s success will depend on its ability to achieve scientific and technological advances and to translate such advances into licensable, FDA-approvable, commercially competitive products on a timely basis. Failure can occur at any stage of the process. If such programs are not successful, New Ayala may invest substantial amounts of time and money without developing revenue-producing products. As New Ayala enters a more extensive clinical program for its product candidates, the data generated in these studies may not be as compelling as the earlier results.

The proposed development schedules for New Ayala immunotherapies may be affected by a variety of factors, including technological difficulties, clinical trial failures, regulatory hurdles, clinical holds, competitive products, intellectual property challenges and/or changes in governmental regulation, many of which will not be within its control. Any delay in the development, introduction or marketing of New Ayala products could result either in such products being marketed at a time when their cost and performance characteristics would not be competitive in the marketplace or in the shortening of their commercial lives. In light of the long-term nature of New Ayala’s projects, the unproven technology involved, and the other factors described elsewhere in this section, there can be no assurance that New Ayala will be able to successfully complete the development or marketing of any new products which could materially harm its business, results of operations and prospects.

New Ayala research and development expenses are subject to uncertainty.

Factors affecting New Ayala research and development expenses include, but are not limited to:

● competition from companies that have substantially greater assets and financial resources than New Ayala has; ● need for market acceptance of New Ayala’s immunotherapies if it receives regulatory approval; ● ability to anticipate and adapt to a competitive market and rapid technological developments; ● ability to raise sufficient capital to fund New Ayala research and development activities; ● amount and timing of operating costs and capital expenditures relating to expansion of New Ayala business, operations and infrastructure; ● need to rely on multiple levels of outside funding due to the length of drug development cycles and governmental approved protocols associated with the pharmaceutical industry; and ● dependence upon key personnel including key independent consultants and advisors.

There can be no guarantee that New Ayala research and development expenses will be consistent from period to period. New Ayala may be required to accelerate or delay incurring certain expenses depending on the results of its studies and the availability of adequate funding.

New Ayala may be required to suspend or discontinue clinical trials for a number of reasons, which could preclude approval of any of its product candidates.

New Ayala clinical trials may be suspended at any time for a number of reasons. A clinical trial may be suspended or terminated by New Ayala, an Institutional Review Board (“IRB”), the FDA or other regulatory authorities due to a failure to conduct the clinical trial in accordance with regulatory requirements or its clinical protocols, presentation or identification of unforeseen safety signals or issues, failure to demonstrate a benefit from using the investigational drug, changes in governmental regulations or administrative actions, lack of adequate funding to continue the clinical trial, or for other business-related reasons. For example, in June 2019, New Ayala announced that it was closing its AIM2CERV Phase 3 clinical trial with AXAL in cervical cancer due to the delays New Ayala incurred as a result of the recent FDA partial clinical hold on the trial, as well as the estimated cost and time to completion of the trial. Furthermore, New Ayala has completed the clinical study report from Part A of the ADXS-NEO study and plans to close its ADXS-NEO program IND as next step. In addition, clinical trials for New Ayala’s product candidates could be suspended due to adverse side effects. Drug-related side effects could affect patient recruitment or the ability of enrolled patients to complete the trial or result in potential product liability claims. New Ayala may also voluntarily suspend or terminate its clinical trials if at any time it believes that they present an unacceptable risk to patients or do not demonstrate clinical benefit. If New Ayala elects or is forced to suspend or terminate any clinical trial of any product candidates that it develops, the commercial prospects of such product candidates will be harmed and its ability to generate product revenues from any of these product candidates will be delayed or eliminated. Any of these occurrences may significantly harm New Ayala’s business, financial condition, results of operations and prospects.

Preliminary or interim results of a clinical trial are not necessarily predictive of future or final results.

Interim or preliminary data from clinical trials that New Ayala may conduct may not be indicative of the final results of the trial and are subject to the risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient data become available. Interim or preliminary data also remain subject to audit and verification procedures that may result in the final data being materially different from the interim or preliminary data. As a result, interim or preliminary data should be viewed with caution until the final data are available. Even if New Ayala’s clinical trials are completed as planned, it cannot be certain that their results will support its proposed indications.

New Ayala is subject to numerous risks inherent in conducting clinical trials.

New Ayala outsources the management of its clinical trials to third parties. Agreements with CROs, clinical investigators and medical institutions for clinical testing and data management services, place substantial responsibilities on these parties that, if unmet, could result in delays in, or termination of, New Ayala’s clinical trials. For example, if any of New Ayala’s clinical trial sites or CROs fail to comply with FDA-approved good clinical practices, New Ayala may be unable to use the data gathered at those sites. If these clinical investigators, medical institutions or other third parties do not carry out their contractual duties or regulatory obligations or fail to meet expected deadlines, or if the quality or accuracy of the clinical data they obtain is compromised due to their failure to adhere to New Ayala’s clinical protocols or for other reasons, its clinical trials may be extended, delayed or terminated, and New Ayala may be unable to obtain regulatory approval for, or successfully commercialize, its agents. New Ayala is not certain that it will successfully recruit enough patients to complete its clinical trials nor that it will reach its primary endpoints. Delays in recruitment, lack of clinical benefit or unacceptable side effects would delay or prevent the initiation of future development of New Ayala’s agents.

While New Ayala has agreements governing the activities of such third parties and are responsible for its third-party service provider’s activities and regulatory compliance, it has limited influence and control over their actual performance and activities and cannot control whether or not they devote sufficient time and resources to New Ayala’s ongoing clinical, non-clinical, and preclinical programs and cannot control whether they maintain regulatory compliance. New Ayala’s third-party service providers may also have relationships with other entities, some of which may be its competitors, for whom they may also be conducting trials or other therapeutic development activities that could harm New Ayala’s competitive position.

Agreements with third parties conducting or otherwise assisting with New Ayala’s clinical or preclinical studies might terminate for a variety of reasons, including a failure to perform by the third parties. If any of New Ayala’s relationships with these third parties terminate, it may not be able to enter into arrangements with alternative providers or to do so on commercially reasonable terms. Switching or adding additional third parties involve additional cost and requires management time and focus. In addition, there is a natural transition period when a new third party commences work. As a result, if New Ayala needs to enter into alternative arrangements, it could delay its product development activities and adversely affect its business. Though New Ayala carefully manages its relationships with third parties, there can be no assurance that it will not encounter challenges or delays in the future or that these delays or challenges will not have a material adverse impact on New Ayala’s business, financial condition and prospects, and results of operations.

New Ayala or its regulators may suspend or terminate its clinical trials for a number of reasons. New Ayala may voluntarily suspend or terminate its clinical trials if at any time it believes they present an unacceptable risk to the patients enrolled in its clinical trials or do not demonstrate clinical benefit. In addition, regulatory agencies may order the temporary or permanent discontinuation of New Ayala’s clinical trials, or place its products on temporary or permanent hold, at any time if they believe that the clinical trials are not being conducted in accordance with applicable regulatory requirements or that they present an unacceptable safety risk to the patients enrolled in New Ayala’s clinical trials.

New Ayala’s clinical trial operations are subject to regulatory inspections at any time. If regulatory inspectors conclude that New Ayala or its clinical trial sites are not in compliance with applicable regulatory requirements for conducting clinical trials, it may receive reports of observations or warning letters detailing deficiencies, and it will be required to implement corrective actions. If regulatory agencies deem New Ayala’s responses to be inadequate or are dissatisfied with the corrective actions it or its clinical trial sites have implemented, New Ayala’s clinical trials may be temporarily or permanently discontinued, may be fined, New Ayala or its investigators may be precluded from conducting any ongoing or any future clinical trials, the government may refuse to approve its marketing applications or allow it to manufacture or market its products, and New Ayala may be criminally prosecuted.

The lengthy approval process as well as the unpredictability of future clinical trial results may result in New Ayala failing to obtain regulatory approval for its product candidates, which would materially harm its business, results of operations and prospects.

New Ayala employees, independent contractors, consultants, commercial partners, principal investigators, or CROs may engage in misconduct or other improper activities, including noncompliance with regulatory standards and requirements, which could have a material adverse effect on its business.

New Ayala is exposed to the risk of employee and third-party fraud or other misconduct. Misconduct by employees, independent contractors, consultants, commercial partners, manufacturers, investigators, or CROs could include intentional, reckless, negligent, or unintentional failures to comply with FDA regulations, comply with applicable fraud and abuse laws, provide accurate information to the FDA, properly calculate pricing information required by federal programs, comply with federal procurement rules or contract terms, report financial information or data accurately or disclose unauthorized activities to New Ayala. This misconduct could also involve the improper use or misrepresentation of information obtained in the course of clinical trials, which could result in regulatory sanctions and serious harm to New Ayala’s reputation. It is not always possible to identify and deter this type of misconduct, and the precautions New Ayala takes to detect and prevent this activity may not be effective in controlling unknown or unmanaged risks or losses or in protecting it from governmental investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws or regulations. Moreover, it is possible for a whistleblower to pursue a federal False Claims Act, or FCA, case against New Ayala even if the government considers the claim unmeritorious and declines to intervene, which could require New Ayala to incur costs defending against such a claim. Further, due to the risk that a judgment in an FCA case could result in exclusion from federal health programs or debarment from government contracts, whistleblower cases often result in large settlements. If any such actions are instituted against New Ayala, and it is not successful in defending itself or asserting its rights, those actions could have a significant impact on its business, financial condition, and results of operations, including the imposition of significant fines or other sanctions.

New Ayala must comply with significant government regulations.

The research and development, manufacturing and marketing of human therapeutic and diagnostic products are subject to regulation, primarily by the FDA in the United States and by comparable authorities in other countries. These national agencies and other federal, state, local and foreign entities regulate, among other things, research and development activities (including testing in animals and in humans) and the testing, manufacturing, handling, labeling, storage, record keeping, approval, distribution, advertising and promotion of the products that New Ayala is developing. If New Ayala obtains approval for any of its product candidates, its operations will be directly or indirectly through its customers, subject to various federal and state fraud and abuse laws, including, without limitation, the federal Anti-Kickback Statue and the FCA, and privacy laws. New Ayala, its product candidates, and its products, if it receives marketing approval are and will continue to be subject to extensive governmental regulation and regulatory authorities do and will continue to closely monitor New Ayala and its contractor’s compliance through, among other methods, inspections. Noncompliance with applicable laws and requirements can result in various adverse consequences and regulatory enforcement actions, including delay in approving or refusal to approve product licenses or other applications, suspension or termination of clinical investigations, revocation of approvals previously granted, fines, criminal prosecution, civil and criminal penalties, restitution or disgorgement of profits, recall or seizure of products, exclusion from having its products reimbursed by federal health care programs, the curtailment or restructuring of New Ayala’s operations, corporate integrity agreements or consent decrees, refusal to permit product import or export, modifications to labeling or promotional materials, issuance of corrective information, regulatory authority public statements, warning, untitled, or cyber letters, requirements for post-market studies or REMS, injunctions against shipping products and total or partial suspension of production and/or refusal to allow a company to enter into governmental supply contracts. Any of these events could prevent New Ayala from achieving or maintaining product approval and market acceptance of the particular product candidate, if approved, or could substantially increase the costs and expenses of developing and commercializing such product, which in turn could delay or prevent New Ayala from generating significant revenues from its sale. Any of these events could further have other material and adverse effects on New Ayala’s operations and business and could adversely impact its stock price and could significantly harm New Ayala’s business, financial condition, results of operations, and prospects.

The process of obtaining requisite FDA approval has historically been costly and time-consuming. Current FDA requirements for a new human biological product to be marketed in the United States include: (1) the successful conclusion of preclinical laboratory and animal tests, if appropriate, to gain preliminary information on the product’s safety; (2) filing with the FDA of an IND to conduct human clinical trials for drugs or biologics; (3) the successful completion of adequate and well-controlled human clinical trials to establish the safety and efficacy of the investigational new drug for its recommended use; and (4) filing by a company and acceptance and approval by the FDA of a BLA for marketing approval of a biologic, to allow commercial distribution of a biologic product. The FDA also requires that any drug or formulation to be tested in humans be manufactured in accordance with its cGMP regulations. This has been extended to include any drug that will be tested for safety in animals in support of human testing. The cGMPs set certain minimum requirements for procedures, record-keeping and the physical characteristics of the laboratories used in the production of these drugs. A delay in one or more of the procedural steps outlined above could be harmful to New Ayala in terms of getting its immunotherapies through clinical testing and to market.

New Ayala may not obtain or maintain the benefits associated with Orphan Drug Designation, including market exclusivity.

Although New Ayala has been granted a designation from the FDA under the Orphan Drug Act, or ODA, intended to treat a rare disease or condition (Orphan Drug Designation, or “ODD”) for AXAL for use in the treatment of anal cancer, HPV-associated head and neck cancer, Stage II-IV invasive cervical cancer and for ADXS-HER2 for the treatment of osteosarcoma in the United States, as well as the European Medicines Agency, or EMA, ODD for AXAL for the treatment of anal cancer and for ADXS-HER2 for the treatment of osteosarcoma in the EU, New Ayala may not receive the benefits associated with ODD. This may result from a failure to maintain orphan drug status or result from a competing product reaching the market that has an orphan designation for the same disease indication. Moreover, while ODD does provide New Ayala with certain advantages, it neither shortens the development time or regulatory review time of a product candidate nor gives the product candidate any advantage in the regulatory review or approval process.

Under U.S. rules for orphan drugs, if such a competing product reaches the market before New Ayala does, if such product is considered by FDA to be the same as New Ayala’s, and if such product is intended for the same orphan indication, the competing product could potentially obtain a scope of market exclusivity that limits or precludes its product from being sold in the United States for seven years unless New Ayala can demonstrate that its product is clinically superior. Even if New Ayala obtains exclusivity, the FDA could subsequently approve the same drug for the same condition if the FDA concludes that the later drug is clinically superior to New Ayala in that it is shown to be safer, more effective or makes a major contribution to patient care. A competitor also may receive approval of different products for the same indication for which New Ayala’s orphan product has exclusivity or obtain approval for the same product but for a different indication for which the orphan product has exclusivity. Moreover, New Ayala may not be able to maintain its ODD or exclusivity and its product candidates would not be eligible for exclusivity if the approved indication is broader than the ODD.

In addition, if and when New Ayala requests ODD in Europe, the European exclusivity period is ten years but can be reduced to six years if the drug no longer meets the criteria for ODD or if the drug is sufficiently profitable so that market exclusivity is no longer justified. Orphan drug exclusivity may be lost if the FDA or EMA determines that the request for designation was materially defective or if the manufacturer is unable to assure sufficient quantity of the drug to meet the needs of patients with the rare disease or condition.

New Ayala may incur substantial liabilities from any product liability claims if its insurance coverage for those claims is inadequate.

New Ayala faces an inherent risk of product liability exposure related to the testing of its immunotherapies in human clinical trials and will face an even greater risk if the approved products are sold commercially. An individual may bring a liability claim against New Ayala if one of the immunotherapies causes, or merely appears to have caused, an injury. If New Ayala cannot successfully defend itself against the product liability claim, it will incur substantial liabilities. Regardless of merit or eventual outcome, liability claims may result in:

● decreased demand for New Ayala’s immunotherapies; ● damage to New Ayala’s reputation; ● withdrawal of clinical trial participants; ● costs of related litigation; ● substantial monetary awards to patients or other claimants; ● loss of revenues; ● the inability to commercialize immunotherapies; and ● increased difficulty in raising required additional funds in the private and public capital markets.

New Ayala has product liability and clinical trial liability insurance coverage for each clinical trial. New Ayala does not have product liability insurance for sold commercial products because it does not have products on the market. New Ayala plans to expand such coverage to include the sale of commercial products if marketing approval is obtained for any of its immunotherapies. However, insurance coverage is increasingly expensive and New Ayala may not be able to maintain insurance coverage at a reasonable cost. Further, New Ayala may not be able to obtain insurance coverage that will be adequate to satisfy any liability that may arise.

New Ayala may not receive Fast Track designation, Breakthrough Therapy Designation or any other designation that it may apply for from the FDA and, if granted, such designations may not actually lead to a faster development or regulatory review or approval process.

The FDA has granted a designation to facilitate development and expedite the review of therapies with the potential to treat a serious condition where there is an unmet medical need (the “Fast Track” designation) for AXAL for adjuvant therapy for high-risk locally advanced cervical cancer patients, and has granted Fast Track designation for ADXS-HER2 for patients with newly-diagnosed, non-metastatic, surgically-resectable osteosarcoma. New Ayala may seek Breakthrough Therapy Designation for its product candidates or Fast Track designation for certain of its other product candidates. There is no guarantee, however, that New Ayala will be able to obtain or maintain such designations.

The FDA has broad discretion whether or not to grant any special designation, so even if New Ayala believes one of its product candidates is eligible for this designation, it cannot assure you that the FDA would decide to grant it. Additionally, even if New Ayala receives a special designation, it may not experience a faster development process, review or approval compared to conventional FDA procedures. The FDA may also withdraw the designation if it believes that the designation is no longer supported by data from New Ayala’s clinical development program.

The results of clinical trials conducted at clinical trial sites outside the United States might not be accepted by the FDA, and data developed outside of a foreign jurisdiction similarly might not be accepted by such foreign regulatory authority.

Some of the clinical trials for New Ayala product candidates that are being or will be conducted through its partnerships and collaborations may be conducted outside the United States, and it intends in the future to conduct additional clinical trials outside the United States. Although the FDA, EMA or comparable foreign regulatory authorities may accept data from clinical trials conducted outside the relevant jurisdiction, acceptance of these data is subject to certain conditions. For example, the FDA requires that the clinical trial must be well designed and conducted and performed by qualified investigators in accordance with ethical principles such as IRB or ethics committee approval and informed consent, the trial population must adequately represent the U.S. population, and the data must be applicable to the U.S. population and U.S. medical practice in ways that the FDA deems clinically meaningful. In addition, while these clinical trials are subject to the applicable local laws, acceptance of the data by the FDA will be dependent upon its determination that the trials were conducted consistent with all applicable U.S. laws and regulations. There can be no assurance that the FDA will accept data from trials conducted outside of the United States as adequate support of a marketing application. Similarly, New Ayala must also ensure that any data submitted to foreign regulatory authorities adheres to their standards and requirements for clinical trials and there can be no assurance a comparable foreign regulatory authority would accept data from trials conducted outside of its jurisdiction.

New Ayala’s relationships with healthcare providers and physicians and third-party payors will be subject to applicable anti-kickback, fraud and abuse and other healthcare laws and regulations, which could expose it to criminal sanctions, civil penalties, contractual damages, reputational harm and diminished profits and future earnings.

Healthcare providers, physicians and third-party payors in the United States and elsewhere play a primary role in the recommendation and prescription of pharmaceutical products. Arrangements with third-party payors and customers can expose pharmaceutical manufacturers to broadly applicable fraud and abuse and other healthcare laws and regulations, including, without limitation, the federal Anti-Kickback Statute (the “AKS”) and the FCA which may constrain the business or financial arrangements and relationships through which such companies sell, market and distribute pharmaceutical products. In particular, the research of New Ayala’s product candidates, as well as the promotion, sales and marketing of healthcare items and services, as well as certain business arrangements in the healthcare industry, are subject to extensive laws designed to prevent fraud, kickbacks, self-dealing and other abusive practices. These laws and regulations may restrict or prohibit a wide range of pricing, discounting, marketing and promotion, structuring and commission(s), certain customer incentive programs and other business arrangements generally. Activities subject to these laws also involve the improper use of information obtained in the course of patient recruitment for clinical trials. The applicable federal, state and foreign healthcare laws and regulations that may affect New Ayala’s ability to operate include, but are not limited to:

● the AKS, which prohibits, among other things, knowingly and willfully soliciting, receiving, offering or paying any remuneration (including any kickback, bribe or rebate), directly or indirectly, overtly or covertly, in cash or in kind, to induce, or in return for, either the referral of an individual, or the purchase, lease, order or recommendation of any good, facility, item or service for which payment may be made, in whole or in part, under a federal healthcare program, such as the Medicare and Medicaid programs. A person or entity can be found guilty of violating the statute without actual knowledge of the statute or specific intent to violate it. In addition, a claim including items or services resulting from a violation of the AKS constitutes a false or fraudulent claim for purposes of the FCA. The AKS has been interpreted to apply to arrangements between pharmaceutical manufacturers on the one hand and prescribers, purchasers, and formulary managers on the other. There are a number of statutory exceptions and regulatory safe harbors protecting some common activities from prosecution;

● the federal civil and criminal false claims laws and civil monetary penalty laws, including the FCA, which prohibit, among other things, individuals or entities from knowingly presenting, or causing to be presented, false or fraudulent claims for payment to, or approval by Medicare, Medicaid or other federal healthcare programs, knowingly making, using or causing to be made or used a false record or statement material to a false or fraudulent claim or an obligation to pay or transmit money to the federal government, or knowingly concealing or knowingly and improperly avoiding or decreasing or concealing an obligation to pay money to the federal government. Manufacturers can be held liable under the FCA even when they do not submit claims directly to government payors if they are deemed to “cause” the submission of false or fraudulent claims. The government may deem manufacturers to have “caused” the submission of false or fraudulent claims by, for example, providing inaccurate billing or coding information to customers or promoting a product off-label. The FCA also permits a private individual acting as a “whistleblower” to bring actions on behalf of the federal government alleging violations of the FCA and to share in any monetary recovery; ● the federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, which created additional federal criminal statutes that prohibit knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or fraudulent pretenses, representations or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program, regardless of the payor (e.g., public or private) and knowingly and willfully falsifying, concealing or covering up by any trick or device a material fact or making any materially false statements in connection with the delivery of, or payment for, healthcare benefits, items or services relating to healthcare matters. Similar to the AKS, a person or entity can be found guilty of violating HIPAA without actual knowledge of the statute or specific intent to violate it; ● HIPAA, as amended by HITECH, and their respective implementing regulations, which impose, among other things, requirements on certain healthcare providers, health plans and healthcare clearinghouses, known as covered entities, as well as their respective business associates, independent contractors that perform services for covered entities that involve the use, or disclosure of, individually identifiable health information, relating to the privacy, security and transmission of individually identifiable health information. HITECH also created new tiers of civil monetary penalties, amended HIPAA to make civil and criminal penalties directly applicable to business associates, and gave state attorneys general new authority to file civil actions for damages or injunctions in federal courts to enforce the federal HIPAA laws and seek attorneys’ fees and costs associated with pursuing federal civil actions;

● the federal Physician Payments Sunshine Act, created under the Patient Protection and Affordable Care Act, as amended, or ACA, and its implementing regulations, which require some manufacturers of drugs, devices, biologicals and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program (with certain exceptions) to report annually to the Centers for Medicare & Medicaid Services, or CMS, of the U.S. Department of Health and Human Services, or HHS, information related to payments or other transfers of value made to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors) and teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members; and ● analogous state and foreign laws and regulations, such as state anti-kickback and false claims laws, which may apply to sales or marketing arrangements and claims involving healthcare items or services reimbursed by non-governmental third-party payors, including private insurers, and may be broader in scope than their federal equivalents; state and foreign laws that require pharmaceutical companies to comply with the pharmaceutical industry’s voluntary compliance guidelines and the relevant compliance guidance promulgated by the federal government or otherwise restrict payments that may be made to healthcare providers; state and foreign laws that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers, marketing expenditures or drug pricing; state and local laws that require the registration of pharmaceutical sales representatives; and state and foreign laws governing the privacy and security of health information in certain circumstances, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.

The distribution of pharmaceutical products is subject to additional requirements and regulations, including extensive record-keeping, licensing, storage and security requirements intended to prevent the unauthorized sale of pharmaceutical products. Pharmaceutical companies may also be subject to federal consumer protection and unfair competition laws, which broadly regulate marketplace activities and activities that potentially harm consumers.

It is possible that governmental and enforcement authorities will conclude that New Ayala’s business practices may not comply with current or future statutes, regulations or case law interpreting applicable fraud and abuse or other healthcare laws and regulations. If any such actions are instituted against New Ayala, and it is not successful in defending itself or asserting its rights, those actions could have a significant impact on its business, including the imposition of civil, criminal and administrative penalties, damages, fines, disgorgement, imprisonment, exclusion from participation in federal and state funded healthcare programs, contractual damages and the curtailment or restricting of New Ayala’s operations, as well as additional reporting obligations and oversight if it becomes subject to a corporate integrity agreement or other agreement to resolve allegations of non-compliance with these laws. Further, if any of the physicians or other healthcare providers or entities with whom New Ayala expects to do business is found to be not in compliance with applicable laws, they may be subject to significant criminal, civil or administrative sanctions, including exclusions from government funded healthcare programs. Any action for violation of these laws, even if successfully defended, could cause a biopharmaceutical manufacturer to incur significant legal expenses and divert management’s attention from the operation of the business. Prohibitions or restrictions on sales or withdrawal of future marketed products could materially affect business in an adverse way.

Obtaining and maintaining regulatory approval of New Ayala’s product candidates in one jurisdiction does not mean that it will be successful in obtaining regulatory approval of its product candidates in other jurisdictions.

Obtaining and maintaining regulatory approval of New Ayala’s product candidates in one jurisdiction does not guarantee that it will be able to obtain or maintain regulatory approval in any other jurisdiction, while a failure or delay in obtaining regulatory approval in one jurisdiction may have a negative effect on the regulatory approval process in others. For example, even if the FDA grants marketing approval of a product candidate, the EMA or comparable foreign regulatory authorities must also approve the manufacturing, marketing and promotion of the product candidate in those countries. Approval procedures vary among jurisdictions and can involve requirements and administrative review periods different from, and greater than, those in the United States, including additional preclinical studies or clinical trials, as clinical trials conducted in one jurisdiction may not be accepted by regulatory authorities in other jurisdictions. In many jurisdictions outside the United States, a product candidate must be approved for reimbursement before it can be approved for sale in that jurisdiction. In some cases, the price that New Ayala intends to charge for its products are also subject to approval.

New Ayala may also submit marketing applications in other countries. Regulatory authorities in jurisdictions outside of the United States have requirements for approval of product candidates with which it must comply prior to marketing in those jurisdictions. Obtaining foreign regulatory approvals and compliance with foreign regulatory requirements could result in significant delays, difficulties and costs for New Ayala and could delay or prevent the introduction of its products in certain countries. If New Ayala fails to comply with the regulatory requirements in international markets and/or receive applicable marketing approvals, its target market will be reduced and its ability to realize the full market potential of its product candidates will be harmed.

Even if New Ayala receives regulatory approval of any product candidates, it will be subject to ongoing regulatory obligations and continued regulatory review, which may result in significant additional expense and it may be subject to penalties if it fails to comply with regulatory requirements or experience unanticipated problems with its product candidates.

If any of New Ayala’s product candidates are approved, they will be subject to ongoing regulatory requirements for manufacturing, labeling, packaging, storage, advertising, promotion, distribution, sampling, record-keeping, conduct of post-marketing studies and submission of safety, efficacy and other post-market information, including both federal and state requirements in the United States and requirements of comparable foreign regulatory authorities. In addition, New Ayala will be subject to continued compliance with cGMP and GCP requirements for any clinical trials that it conducts post-approval.

Manufacturers and manufacturers’ facilities are required to comply with extensive FDA, EMA and comparable foreign regulatory authority requirements, including ensuring that quality control and manufacturing procedures conform to cGMP regulations. As such, New Ayala and its contract manufacturers will be subject to continual review and inspections to assess compliance with cGMP and adherence to commitments made in any BLA, other marketing application and previous responses to inspection observations. Accordingly, New Ayala and others with whom it works must continue to expend time, money and effort in all areas of regulatory compliance, including manufacturing, production and quality control.

Any regulatory approvals that New Ayala receives for its product candidates may be subject to limitations on the approved indicated uses for which the product may be marketed or to the conditions of approval, or contain requirements for potentially costly post-marketing testing, including Phase 4 clinical trials and surveillance to monitor the safety and efficacy of the product candidate. Certain endpoint data New Ayala hopes to include in any approved product labeling also may not make it into such labeling, including exploratory or secondary endpoint data such as patient-reported outcome measures. The FDA may also require a REMS program as a condition of approval of New Ayala’s product candidates, which could entail requirements for long-term patient follow-up, a medication guide, physician communication plans or additional elements to ensure safe use, such as restricted distribution methods, patient registries and other risk minimization tools. In addition, if the FDA, EMA or a comparable foreign regulatory authority approves New Ayala’s product candidates, it will have to comply with requirements including submissions of safety and other post-marketing information and reports and registration.

The FDA may impose consent decrees or withdraw approval if compliance with regulatory requirements and standards is not maintained or if problems occur after the product reaches the market. Later discovery of previously unknown problems with New Ayala’s product candidates, including adverse events of unanticipated severity or frequency, or with its third-party manufacturers or manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved labeling to add new safety information, imposition of post-market studies or clinical trials to assess new safety risks or imposition of distribution restrictions or other restrictions under a REMS program. Other potential consequences include, among other things:

● restrictions on the marketing or manufacturing of New Ayala’s products, withdrawal of the product from the market or voluntary or mandatory product recalls; ● fines, warning letters or holds on clinical trials; ● refusal by the FDA to approve pending applications or supplements to approved applications filed by New Ayala or suspension or revocation of license approvals; ● product seizure or detention or refusal to permit the import or export of New Ayala’s product candidates; and ● injunctions or the imposition of civil or criminal penalties.

The FDA strictly regulates marketing, labeling, advertising and promotion of products that are placed on the market. Products may be promoted only for the approved indications and in accordance with the provisions of the approved label. The policies of the FDA, EMA and comparable foreign regulatory authorities may change and additional government regulations may be enacted that could prevent, limit or delay regulatory approval of New Ayala’s product candidates. New Ayala cannot predict the likelihood, nature or extent of government regulation that may arise from future legislation or administrative action, either in the United States or abroad. If New Ayala is slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if New Ayala is not able to maintain regulatory compliance, it may lose any marketing approval that it may have obtained and it may not achieve or sustain profitability.

Coverage and reimbursement may be limited or unavailable in certain market segments for New Ayala’s product candidates, if approved, which could make it difficult for New Ayala to sell any product candidates profitably.

The success of New Ayala’s product candidates, if approved, depends on the availability of coverage and adequate reimbursement from third-party payors. New Ayala cannot be sure that coverage and reimbursement will be available for, or accurately estimate the potential revenue from, its product candidates or assure that coverage and reimbursement will be available for any product that it may develop.

Patients who are provided medical treatment for their conditions generally rely on third-party payors to reimburse all or part of the costs associated with their treatment. Coverage and adequate reimbursement from governmental healthcare programs, such as Medicare and Medicaid, and commercial payors is critical to new product acceptance.

Government authorities and other third-party payors, such as private health insurers and health maintenance organizations, decide which drugs and treatments they will cover and the amount of reimbursement. Coverage and reimbursement by a third-party payor may depend upon a number of factors, including the third-party payor’s determination that use of a product is:

● a covered benefit under its health plan; ● safe, effective and medically necessary; ● appropriate for the specific patient; ● cost-effective; and ● neither experimental nor investigational.

In the United States, no uniform policy of coverage and reimbursement for products exists among third-party payors. As a result, obtaining coverage and reimbursement approval of a product from a government or other third-party payor is a time-consuming and costly process that could require New Ayala to provide to each payor supporting scientific, clinical and cost-effectiveness data for the use of its products on a payor-by-payor basis, with no assurance that coverage and adequate reimbursement will be obtained. Even if New Ayala obtains coverage for a given product, the resulting reimbursement payment rates might not be adequate for it to achieve or sustain profitability or may require co-payments that patients find unacceptably high. Additionally, third-party payors may not cover, or provide adequate reimbursement for, long-term follow-up evaluations required following the use of product candidates, once approved. Patients are unlikely to use New Ayala’s product candidates, once approved, unless coverage is provided and reimbursement is adequate

Ongoing healthcare legislative and regulatory reform measures may have a material adverse effect on New Ayala’s business and results of operations.

Changes in regulations, statutes or the interpretation of existing regulations could impact New Ayala’s business in the future by requiring, for example: (i) changes to its manufacturing arrangements; (ii) additions or modifications to product labeling; (iii) the recall or discontinuation of its products; or (iv) additional record-keeping requirements. If any such changes were to be imposed, they could adversely affect the operation of New Ayala’s business.

In the United States, there have been and continue to be a number of legislative initiatives to contain healthcare costs. For example, in March 2010, the ACA was passed, which substantially changed the way healthcare is financed by both governmental and private insurers, and significantly impacted the U.S. biopharmaceutical industry. The ACA, among other things, addressed a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, implanted or injected, increased the minimum Medicaid rebates owed by manufacturers under the Medicaid Drug Rebate Program and extended the rebate program to individuals enrolled in Medicaid managed care organizations, established annual fees and taxes on manufacturers of certain branded prescription drugs and created a new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer 70% point-of-sale discounts off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for the manufacturer’s outpatient drugs to be covered under Medicare Part D.

Some of the provisions of the ACA have yet to be fully implemented, while certain provisions have been subject to judicial and Congressional challenges to repeal or replace certain aspects of the ACA. For example, Congress has considered legislation that would repeal or repeal and replace all or part of the ACA. While Congress has not passed repeal legislation, the Tax Reform Act includes a provision that repealed, effective January 1, 2019, the tax-based shared responsibility payment imposed by the ACA on certain individuals who fail to maintain qualifying health coverage for all or part of a year that is commonly referred to as the “individual mandate.” As a result of the individual mandate repeal, subsequent litigation challenged the validity of the ACA. On December 14, 2018, a U.S. District Court judge in the Northern District of Texas ruled that the individual mandate portion of the ACA is an essential and inseverable feature of the ACA, and therefore because the mandate was repealed as part of the Tax Cuts and Jobs Act, or TCJA, the remaining provisions of the ACA are invalid as well. The Trump administration and CMS have both stated that the ruling will have no immediate effect, and on December 30, 2018 the same judge issued an order staying the judgment pending appeal. A Fifth Circuit U.S. Court of Appeals hearing to determine whether certain states and the House of Representatives have standing to appeal the lower court decision was held on July 9, 2019, but it is unclear when the court will render its decision on this hearing, and what effect it will have on the status of the ACA. Litigation and legislation over the ACA are likely to continue, with unpredictable and uncertain results. New Ayala will continue to evaluate the effect that the ACA and its possible repeal and replacement has on its business.

Since January 2017, President Trump has signed two Executive Orders designed to delay the implementation of certain provisions of the ACA or otherwise circumvent some of the requirements for health insurance mandated by the ACA. Further, the Trump administration has concluded that cost-sharing reduction, or CSR, payments to insurance companies required under the ACA have not received necessary appropriations from Congress and announced that it will discontinue these payments immediately until those appropriations are made. The loss of the CSR payments is expected to increase premiums on certain policies issued by qualified health plans under the ACA. Bipartisan bills to appropriate funds for CSR payments were proposed in 2017 and 2018, but the proposals have not been enacted into law. Multiple state Attorneys General filed suit to stop the administration from terminating the subsidies, but their case was dismissed by a federal judge in California on July 18, 2018. Furthermore, on June 14, 2018, the U.S. Court of Appeals for the Federal Circuit ruled that the federal government was not required to pay more than $12 billion in ACA risk corridor payments to third-party payors who argued were owed to them. The effects of this gap in reimbursement on third-party payors, the viability of the ACA marketplace and providers, and the potential effect on New Ayala’s business, are not yet known.

Inadequate funding for the FDA and other government agencies could hinder their ability to hire and retain key leadership and other personnel, prevent new products and services from being developed or commercialized in a timely manner or otherwise prevent those agencies from performing normal business functions on which the operation of New Ayala’s business may rely, which could negatively impact its business.

The ability of the FDA to review and approve new products can be affected by a variety of factors, including government budget and funding levels, ability to hire and retain key personnel and accept the payment of user fees, and statutory, regulatory, and policy changes. Average review times at the agency have fluctuated in recent years as a result.

Disruptions at the FDA and other agencies may also slow the time necessary for new drugs to be reviewed and/or approved by necessary government agencies, which would adversely affect New Ayala’s business. For example, over the last several years, the U.S. government has shut down several times and certain regulatory agencies, such as the FDA, have had to furlough critical employees and stop critical activities. If a prolonged government shutdown occurs, it could significantly impact the ability of the FDA to timely review and process New Ayala’s regulatory submissions, which could have a material adverse effect on its business. Further, upon completion of this offering and in New Ayala’s operations as a public company, future government shutdowns could impact its ability to access the public markets and obtain necessary capital in order to properly capitalize and continue its operations.

Approval of New Ayala’s product candidates does not ensure successful commercialization and reimbursement.

New Ayala is not currently marketing its product candidates, nor can it until they are approved; however, New Ayala is seeking partnering and commercial opportunities for its products. New Ayala cannot assure you that it will be able to commercialize any of its product candidates itself or find a commercialization partner or that it will be able to agree to acceptable terms with any partner to launch and commercialize its products.

The commercial success of New Ayala’s product candidates is subject to risks in both the United States and European countries. In addition, in European countries, pricing and payment of prescription pharmaceuticals is subject to more extensive governmental control than in the United States. Pricing negotiations with European governmental authorities can take six to 12 months or longer after the receipt of regulatory approval and product launch. If reimbursement is unavailable in any country in which reimbursement is sought, limited in scope or amount, or if pricing is set at or reduced to unsatisfactory levels, New Ayala’s ability or any potential partner’s ability to successfully commercialize in such a country would be impacted negatively. Furthermore, if these measures prevent New Ayala or any potential partner from selling on a profitable basis in a particular country, they could prevent the commercial launch or continued sale in that country and could adversely impact the commercialization market opportunity in other countries.

Moreover, as a condition of approval, the regulatory authorities may require that New Ayala conduct post-approval studies. Those studies may reveal new safety or efficacy findings regarding New Ayala’s drug that could adversely impact the continued commercialization or future market opportunity in other countries.

In addition, New Ayala predominantly relies on a network of suppliers and vendors to manufacture its products. Should a regulatory authority make any significant findings on an inspection of New Ayala’s own operations or the operations of those companies, the ability for it to continue producing its products could be adversely impacted and further production could cease. Regulatory GMP requirements are extensive and can present a risk of injury or recall, among other risks, if not manufactured or labeled properly under GMPs.

New Ayala’s potential revenues from the commercialization of its product candidates are subject to these and other factors, and therefore it may never reach or maintain profitability.

Even if New Ayala is successful in obtaining market approval, commercial success of any of its product candidates will also depend in large part on the availability of coverage and adequate reimbursement from third-party payers, including government payers such as the Medicare and Medicaid programs and managed care organizations, which may be affected by existing and future health care reform measures designed to reduce the cost of health care. Third-party payers could require New Ayala to conduct additional studies, including post-marketing studies related to the cost effectiveness of a product, to qualify for reimbursement, which could be costly and divert its resources. If government and other health care payers were not to provide adequate coverage and reimbursement levels for one any of New Ayala’s products once approved, market acceptance and commercial success would be reduced.

In addition, if one of New Ayala’s products is approved for marketing, it will be subject to significant regulatory obligations regarding product promotion, the submission of safety and other post-marketing information and reports and registration, and will need to continue to comply (or ensure that New Ayala’s third-party providers comply) with cGMPs, and GCPs for any clinical trials that it conducts post-approval. In addition, there is always the risk that New Ayala or a regulatory authority might identify previously unknown problems with a product post-approval, such as adverse events of unanticipated severity or frequency. Compliance with these requirements is costly, and any failure to comply or other issues with New Ayala product candidates’ post-market approval could have a material adverse effect on its business, financial condition and results of operations.

Risks Related to New Ayala’s Intellectual Property

New Ayala relies on patents to protect its technology. New Ayala may be unable to protect its intellectual property rights and it may be liable for infringing the intellectual property rights of others.

New Ayala’s ability to compete effectively will depend on its ability to maintain the proprietary nature of its technologies, including the Lm-LLO based immunotherapy platform technology, and the proprietary technology of others with whom New Ayala has entered into collaboration and licensing agreements.

Currently, New Ayala owns or have rights to several hundred patents and applications, which are owned, licensed from, or co-owned with Penn and Merck. New Ayala has obtained the rights to all future patent applications in this field originating in the laboratories of Dr. Yvonne Paterson and Dr. Fred Frankel, at the University of Pennsylvania.

New Ayala owns or hold licenses to a number of issued patents and U.S. pending patent applications, as well as foreign patents and foreign counterparts. New Ayala’s success depends in part on its ability to obtain patent protection both in the United States and in other countries for its product candidates, as well as the methods for treating patients in the product indications using these product candidates. Such patent protection is costly to obtain and maintain, and New Ayala cannot guarantee that sufficient funds will be available. New Ayala’s ability to protect its product candidates from unauthorized or infringing use by third parties depends in substantial part on its ability to obtain and maintain valid and enforceable patents. Due to evolving legal standards relating to the patentability, validity and enforceability of patents covering pharmaceutical inventions and the scope of claims made under these patents, New Ayala’s ability to obtain, maintain and enforce patents is uncertain and involves complex legal and factual questions. Even if New Ayala’s product candidates, as well as methods for treating patients for prescribed indications using these product candidates are covered by valid and enforceable patents and have claims with sufficient scope, disclosure and support in the specification, the patents will provide protection only for a limited amount of time. Accordingly, rights under any issued patents may not provide New Ayala with sufficient protection for its product candidates or provide sufficient protection to afford it a commercial advantage against competitive products or processes.

In addition, New Ayala cannot guarantee that any patents will issue from any pending or future patent applications owned by or licensed to New Ayala. Even if patents have issued or will issue, New Ayala cannot guarantee that the claims of these patents are or will be valid or enforceable or will provide it with any significant protection against competitive products or otherwise be commercially valuable to New Ayala. The laws of some foreign jurisdictions do not protect intellectual property rights to the same extent as in the United States and many companies have encountered significant difficulties in protecting and defending such rights in foreign jurisdictions. Furthermore, different countries have different procedures for obtaining patents, and patents issued in different countries offer different degrees of protection against use of the patented invention by others. If New Ayala encounters such difficulties in protecting or are otherwise precluded from effectively protecting its intellectual property rights in foreign jurisdictions, its business prospects could be substantially harmed.

The patent positions of biotechnology and pharmaceutical companies, including New Ayala’s patent position, involve complex legal and factual questions, and, therefore, validity and enforceability cannot be predicted with certainty. Patents may be challenged, deemed unenforceable, invalidated, or circumvented as a result of laws, rules and guidelines that are changed due to legislative, judicial or administrative actions, or review, which render New Ayala’s patents unenforceable or invalid. New Ayala’s patents can be challenged by its competitors who can argue that its patents are invalid, unenforceable, lack utility, sufficient written description or enablement, or that the claims of the issued patents should be limited or narrowly construed. Patents also will not protect New Ayala’s product candidates if competitors devise ways of making or using these product candidates without infringing its patents.

New Ayala will be able to protect its proprietary rights from unauthorized use by third parties only to the extent that its technologies, methods of treatment, product candidates, and any future products are covered by valid and enforceable patents or are effectively maintained as trade secrets and New Ayala has the funds to enforce its rights, if necessary.

The expiration of New Ayala’s owned or licensed patents before completing the research and development of its product candidates and receiving all required approvals in order to sell and distribute the products on a commercial scale can adversely affect New Ayala’s business and results of operations.

Litigation regarding patents, patent applications and other proprietary rights may be expensive and time consuming. If New Ayala is involved in such litigation, it could cause delays in bringing product candidates to market and harm its ability to operate.

New Ayala’s success will depend in part on its ability to operate without infringing the proprietary rights of third parties. The pharmaceutical industry is characterized by extensive litigation regarding patents and other intellectual property rights. Other parties may obtain patents in the future and allege that the products or use of New Ayala’s technologies infringe these patent claims or that it is employing their proprietary technology without authorization.

In addition, third parties may challenge or infringe upon New Ayala’s existing or future patents. Proceedings involving New Ayala’s patents or patent applications or those of others could result in adverse decisions regarding:

● the patentability of New Ayala’s inventions relating to its product candidates; and/or ● the enforceability, validity or scope of protection offered by New Ayala’s patents relating to its product candidates.

Even if New Ayala is successful in these proceedings, it may incur substantial costs and divert management time and attention in pursuing these proceedings, which could have a material adverse effect on New Ayala. If New Ayala is unable to avoid infringing the patent rights of others, it may be required to seek a license, defend an infringement action or challenge the validity of the patents in court. Patent litigation is costly and time consuming. New Ayala may not have sufficient resources to bring these actions to a successful conclusion. In addition, if New Ayala does not obtain a license, develop or obtain non-infringing technology, fail to defend an infringement action successfully or have infringed patents declared valid, New Ayala may:

● incur substantial monetary damages; ● encounter significant delays in bringing New Ayala product candidates to market; and/or ● be precluded from participating in the manufacture, use or sale of New Ayala product candidates or methods of treatment requiring licenses.

New Ayala may be unable to adequately prevent disclosure of trade secrets and other proprietary information.

New Ayala also relies on trade secrets to protect its proprietary technologies, especially where it does not believe patent protection is appropriate or obtainable. However, trade secrets are difficult to protect. New Ayala relies in part on confidentiality agreements with its employees, consultants, outside scientific collaborators, sponsored researchers, and other advisors to protect its trade secrets and other proprietary information. These agreements may not effectively prevent disclosure of confidential information and may not provide an adequate remedy in the event of unauthorized disclosure of confidential information. In addition, others may independently discover New Ayala’s trade secrets and proprietary information. Costly and time-consuming litigation could be necessary to enforce and determine the scope of New Ayala’s proprietary rights, and failure to obtain or maintain trade secret protection could adversely affect its competitive business position.

Some of New Ayala’s products are dependent upon its license agreement with Penn; if New Ayala breaches the license agreement and/or fail to make payments due and owing to Penn under its license agreement, its business may be materially and adversely affected.

Pursuant to the terms of New Ayala’s license agreement with Penn, which has been amended from time to time, it has acquired exclusive worldwide licenses for patents and patent applications related to its proprietary Listeria vaccine technology. The license provides New Ayala with the exclusive commercial rights to the patent portfolio developed at Penn as of the effective date of the license, in connection with Dr. Paterson and requires New Ayala to pay various milestone, legal, filing and licensing payments to commercialize the technology. As of October 31, 2022, New Ayala did not have outstanding payables to Penn. New Ayala can provide no assurance that it will be able to make all future payments due and owing thereunder, that such licenses will not be terminated or expire during critical periods, that it will be able to obtain licenses from Penn for other rights that may be important to New Ayala, or, if obtained, that such licenses will be obtained on commercially reasonable terms. The loss of any current or future licenses from Penn or the exclusivity rights provided therein could materially harm New Ayala’s business, financial condition and operating results.

If New Ayala is unable to obtain licenses needed for the development of its product candidates, or if it breaches any of the agreements under which New Ayala licenses rights to patents or other intellectual property from third parties, it could lose license rights that are important to its business.

If New Ayala is unable to maintain and/or obtain licenses needed for the development of its product candidates in the future, it may have to develop alternatives to avoid infringing on the patents of others, potentially causing increased costs and delays in drug development and introduction or precluding the development, manufacture, or sale of planned products. Some of New Ayala’s licenses provide for limited periods of exclusivity that require minimum license fees and payments and/or may be extended only with the consent of the licensor. New Ayala can provide no assurance that it will be able to meet these minimum license fees in the future or that these third parties will grant extensions on any or all such licenses. This same restriction may be contained in licenses obtained in the future.

Additionally, New Ayala can provide no assurance that the patents underlying any licenses will be valid and enforceable. To the extent any products developed by New Ayala are based on licensed technology, royalty payments on the licenses will reduce its gross profit from such product sales and may render the sales of such products uneconomical. In addition, the loss of any current or future licenses or the exclusivity rights provided therein could materially harm New Ayala’s business, financial condition and its operations.

Risks Related to Ownership of New Ayala’s Securities

Because New Ayala is quoted on the OTCQX instead of an exchange or national quotation system, its investors find it more difficult to trade in its stock or might experience volatility in the market price of New Ayala’s Common Stock.

New Ayala’s Common Stock is quoted on the OTCQX. The OTCQX is often highly illiquid, in part because it does not have a national quotation system by which potential investors can follow the market price of shares except through information received and generated by a limited number of broker-dealers that make markets in particular stocks. There is a greater chance of volatility for securities that are quoted on the OTCQX as compared to a national exchange or quotation system. This volatility may be caused by a variety of factors, including the lack of readily available price quotations, the absence of consistent administrative supervision of bid and ask quotations, lower trading volume, and market conditions. Investors in New Ayala’s Common Stock may experience high fluctuations in the market price and volume of the trading market for its securities. These fluctuations, when they occur, have a negative effect on the market price for New Ayala’s securities. Accordingly, New Ayala stockholders may not be able to realize a fair price from their shares when they determine to sell them or may have to hold them for a substantial period of time until the market for its Common Stock improves.

New Ayala’s stock is quoted on the OTCQX, if it fails to remain current on its reporting requirements, New Ayala could be removed from the OTCQX which would limit the ability of broker-dealers to sell its securities in the secondary market.

Companies trading on the OTCQX, must be reporting issuers under Section 12 of the Exchange Act, and must be current in their reports under Section 13, in order to maintain price quotation privileges on the OTCQX. As a result, the market liquidity for New Ayala’s securities could be severely adversely affected by limiting the ability of broker-dealers to sell its securities and the ability of stockholders to sell their securities in the secondary market. In addition, it may be unable to get requoted on the OTCQX, which may have an adverse material effect on New Ayala.

On January 10, 2023, New Ayala, was notified by the OTC Markets Group Inc., that its market capitalization has stayed below $5 million for the past 30 consecutive calendar days and no longer meets the Standards for Continued Qualification for the OTCQX U.S. tier as per the OTCQX Rules for U.S. Companies section 3.2.b.2. If the Company’s market capitalization has not stayed at or above $5 million for ten consecutive trading days by July 10, 2023, then its common stock will be moved from OTCQX to the OTCQB market.

New Ayala could issue additional “blank check” preferred stock without stockholder approval with the effect of diluting then current stockholder interests and impairing their voting rights, and provisions in its charter documents and under Delaware law could discourage a takeover that stockholders may consider favorable.

New Ayala’s certificate of incorporation, as amended, provides that it may authorize and issue up to 5,000,000 shares of “blank check” preferred stock with designations, rights, and preferences as may be determined from time to time by New Ayala’s Board. New Ayala’s Board is empowered, without stockholder approval, to issue one or more series of preferred stock with dividend, liquidation, conversion, voting, or other rights, which could dilute the interest of or impair the voting power of its holders of Common Stock. The issuance of a series of preferred stock could be used as a method of discouraging, delaying, or preventing a change in control. For example, it would be possible for New Ayala’s Board to issue preferred stock with voting or other rights or preferences that could impede the success of any attempt to change control of New Ayala.

Sales of additional equity securities may adversely affect the market price of New Ayala’s Common Stock and your rights may be reduced.

New Ayala expects to continue to incur drug development and selling, general and administrative costs, and to satisfy its funding requirements, it will need to sell additional equity securities, which may be subject to registration rights and warrants with anti-dilutive protective provisions. The sale or the proposed sale of substantial amounts of New Ayala’s Common Stock or other equity securities in the public markets may adversely affect the market price of its Common Stock and stock price may decline substantially. New Ayala shareholders may experience substantial dilution and a reduction in the price that they are able to obtain upon sale of their shares. Also, new equity securities issued may have greater rights, preferences or privileges than New Ayala’s existing Common Stock.

The price of New Ayala’s Common Stock and warrants may be volatile.

The trading price of New Ayala’s Common Stock and warrants may fluctuate substantially. The price of New Ayala’s Common Stock and warrants that will prevail in the market may be higher or lower than the price you have paid, depending on many factors, some of which are beyond New Ayala’s control and may not be related to its operating performance. These fluctuations could cause you to lose part or all of your investment in New Ayala’s Common Stock and warrants. Those factors that could cause fluctuations include, but are not limited to, the following:

● price and volume fluctuations in the overall stock market from time to time; ● fluctuations in stock market prices and trading volumes of similar companies; ● actual or anticipated changes in New Ayala’s net loss or fluctuations in its operating results or in the expectations of securities analysts; ● the issuance of new equity securities pursuant to a future offering, including issuances of preferred stock; ● general economic conditions and trends; ● positive and negative events relating to healthcare and the overall pharmaceutical and biotech sector; ● major catastrophic events; ● sales of large blocks of New Ayala stock; ● significant dilution caused by the anti-dilutive clauses in New Ayala’s financial agreements; ● departures of key personnel; ● changes in the regulatory status of New Ayala’s immunotherapies, including results of its clinical trials; ● events affecting Penn or any current or future collaborators; ● announcements of new products or technologies, commercial relationships or other events by New Ayala or its competitors; ● regulatory developments in the United States and other countries; ● failure of New Ayala’s Common Stock or warrants to be listed or quoted on the OTCQX® Best Market or on a national market system;

● changes in accounting principles; and ● discussion of New Ayala or its stock price by the financial and scientific press and in online investor communities.

In the past, following periods of volatility in the market price of a company’s securities, securities class action litigation has often been brought against that company. Due to the potential volatility of New Ayala’s stock price, it may therefore be the target of securities litigation in the future. Securities litigation could result in substantial costs and divert management’s attention and resources from its business.

The market prices for New Ayala’s Common Stock may be adversely impacted by future events.

New Ayala’s Common Stock began trading on the over-the-counter-markets on July 28, 2005 and is currently quoted on the OTCQX under the symbol ADXS. Market prices for New Ayala’s Common Stock and warrants will be influenced by a number of factors, including:

● the issuance of new equity securities pursuant to a future offering, including issuances of preferred stock; ● changes in interest rates; ● significant dilution caused by the anti-dilutive clauses in New Ayala’s financial agreements; ● competitive developments, including announcements by competitors of new products or services or significant contracts, acquisitions, strategic partnerships, joint ventures or capital commitments; ● variations in quarterly operating results; ● change in financial estimates by securities analysts; ● the depth and liquidity of the market for New Ayala’s Common Stock and warrants; ● investor perceptions of New Ayala and the pharmaceutical and biotech industries generally; and ● general economic and other national conditions.

So long as New Ayala’s Common Stock continues to be quoted on the OTCQX, it could be subject to the so-called “penny stock” rules that impose restrictive sales practice requirements.

As New Ayala’s Common Stock has been de-listed from the Nasdaq Capital Market and is now quoted on the OTCQX, which is not a “national securities exchange” as defined by the Exchange Act, and thus its Common Stock will be become subject to the so-called “penny stock” rules if the shares have a market value of less than $5.00 per share. The SEC has adopted regulations that define a penny stock to include any stock that has a market price of less than $5.00 per share, subject to certain exceptions, including an exception for stock traded on a national securities exchange. The SEC regulations impose restrictive sales practice requirements on broker-dealers who sell penny stocks to persons other than established customers and accredited investors. An accredited investor generally is a person whose individual annual income exceeded $200,000, or whose joint annual income with a spouse exceeded $300,000 during the past two years and who expects their annual income to exceed the applicable level during the current year, or a person with net worth in excess of $1.0 million, not including the value of the investor’s principal residence and excluding mortgage debt secured by the investor’s principal residence up to the estimated fair market value of the home, except that any mortgage debt incurred by the investor within 60 days prior to the date of the transaction shall not be excluded from the determination of the investor’s net worth unless the mortgage debt was incurred to acquire the residence. For transactions covered by this rule, the broker-dealer must make a special suitability determination for the purchaser and must have received the purchaser’s written consent to the transaction prior to sale. This means that so long as New Ayala’s Common Stock is not listed on a national securities exchange, the ability of stockholders to sell their Common Stock in the secondary market could be adversely affected.

If a transaction involving a penny stock is not exempt from the SEC’s rule, a broker-dealer must deliver a disclosure schedule relating to the penny stock market to each investor prior to a transaction. The broker-dealer also must disclose the commissions payable to both the broker-dealer and its registered representative, current quotations for the penny stock, and, if the broker-dealer is the sole market-maker, the broker-dealer must disclose this fact and the broker-dealer’s presumed control over the market. Finally, monthly statements must be sent disclosing recent price information for the penny stock held in the customer’s account and information on the limited market in penny stocks.

New Ayala may be at an increased risk of securities litigation, which is expensive and could divert management attention.

The market price of New Ayala’s Common Stock may be volatile, and in the past companies that have experienced volatility in the market price of their stock have been subject to securities class action litigation. New Ayala may be the target of this type of litigation in the future. Securities litigation against New Ayala could result in substantial costs and divert its management’s attention from other business concerns, which could seriously harm its business.

New Ayala does not intend to pay cash dividends.

New Ayala has not declared or paid any cash dividends on its Common Stock, and it does not anticipate declaring or paying cash dividends for the foreseeable future. Any future determination as to the payment of cash dividends on New Ayala’s Common Stock will be at its Board of Directors’ discretion and will depend on its financial condition, operating results, capital requirements and other factors that its Board of Directors considers to be relevant.

New Ayala’s certificate of incorporation, bylaws and Delaware law have anti-takeover provisions that could discourage, delay or prevent a change in control, which may cause New Ayala’s stock price to decline.

New Ayala’s certificate of incorporation, Bylaws and Delaware law contain provisions which could make it more difficult for a third party to acquire New Ayala, even if closing such a transaction would be beneficial to its shareholders. New Ayala is authorized to issue up to 5,000,000 shares of preferred stock. This preferred stock may be issued in one or more series, the terms of which may be determined at the time of issuance by New Ayala’s Board of Directors without further action by shareholders. The terms of any series of preferred stock may include voting rights (including the right to vote as a series on particular matters), preferences as to dividend, liquidation, conversion and redemption rights and sinking fund provisions. The issuance of any preferred stock could materially adversely affect the rights of the holders of New Ayala’s Common Stock, and therefore, reduce the value of its Common Stock. In particular, specific rights granted to future holders of preferred stock could be used to restrict New Ayala’s ability to merge with, or sell its assets to, a third party and thereby preserve control by the present management.

Provisions of New Ayala’s certificate of incorporation, Bylaws and Delaware law also could have the effect of discouraging potential Acquisition Proposals or making a tender offer or delaying or preventing a change in control, including changes a shareholder might consider favorable. Such provisions may also prevent or frustrate attempts by New Ayala shareholders to replace or remove its management. In particular, the certificate of incorporation, Bylaws and Delaware law, as applicable, among other things; provide the Board of Directors with the ability to alter the By-laws without shareholder approval and provide that vacancies on the Board of Directors may be filled by a majority of directors in office, and less than a quorum.

These provisions are expected to discourage certain types of coercive takeover practices and inadequate takeover bids and to encourage persons seeking to acquire control of New Ayala to first negotiate with its board. These provisions may delay or prevent someone from acquiring or merging with New Ayala, which may cause the market price of its Common Stock to decline.

Item 1B: Unresolved Staff Comments.

None.

Item 1C. Cybersecurity.

As a regular part of our ordinary business operations, we collect and store data, including information necessary for our operations, information from our customers, employees, and our business partners. We recognize these networks and systems may be subject to increasing and continually evolving cybersecurity risks. Our Audit Committee is responsible for overseeing risk management and cybersecurity is an integral part of the Company’s overall risk management program. Our risk management process is designed to identify, prioritize, and monitor risks that could affect our ability to execute our corporate strategy and fulfill our business objectives and to appropriately mitigate such risks.

Our management team is involved in assessing and managing the Company’s material risks from cybersecurity threats, including by hiring appropriate personnel, considering cybersecurity risk in our enterprise risk management strategy, helping prepare for cybersecurity incidents, and participating in the cybersecurity incident response and remediation process for incidents escalated to it including determining materiality. Our management that is involved in these processes includes our Chief Financial Officer, our VP of regulatory affairs as well as an external IT company, who collectively share risk management, compliance and technical experience. Management also escalates, as appropriate, reports relating to cybersecurity incidents or threats to our Board or to its Audit Committee.

While we have not yet experienced any material impacts from a cyber-attack, any one or more future cyber-attacks could materially adversely impact the Company, including a loss of trust among our customers, departures of key employees, general diminishment of our reputation and financial losses from remediation actions, loss of business or potential litigation or regulatory liability. Further, evolving market dynamics are increasingly driving heightened cybersecurity protections and mandating cybersecurity standards for our products, and we may incur additional costs to address these increased risks and to comply with such demands.

Item 2. Properties.

Our ~~corporate~~principal ~~offices~~office ~~are~~is located at 9Oppenheimer ~~Deer~~4, ~~Park~~Rehovot ~~Drive~~7670104, ~~Suite K-1~~Israel, ~~Monmouth~~where ~~Junction,~~we NJlease ~~08852 which~~office isand ~~occupied~~laboratory ~~pursuant~~space tounder a lease agreement that ~~expires~~terminates onin ~~March~~2025. 31Our principal U.S. office is located at 9 Deer Park Drive, ~~2023~~Suite K-1, Monmouth Junction, New Jersey 08852.

We believe that our facilities are sufficient to meet our current needs and that suitable additional space will be available as and when needed.

Item 3. Legal Proceedings.

~~Atachbarian~~See the matters set forth in note 7, “Commitment and Contingent Liabilities – Purported Stockholder Claims” in the Notes to Consolidated Financial Statements included herein.

On November 15, 2021, a purported stockholder of the Company commenced an action against the Company and certain of its directors in the U.S. District Court for the District of New Jersey, entitled Atachbarian v. Advaxis, Inc., et al., No. 3:21-cv-20006. The plaintiff alleges that the defendants breached their fiduciary duties and violated Section 14(a) and Rule 20(a) of the Securities Exchange Act of 1934 and Rule 14a-9 promulgated thereunder by allegedly failing to disclose certain matters in its Registration Statement on Form S-4 (Commission File No. 333-259065 (the “Registration Statement”) filed in connection with a proposed merger with Biosight Ltd. (the “Previously Proposed Merger”). On December 15, 2021, pursuant to an understanding reached with the plaintiff, the Company made certain other additional disclosures that mooted the demands asserted in the complaint. On December 17, 2021, the plaintiff filed a notice of voluntary dismissal with prejudice. On February 7, 2022, the Company and the plaintiff reached a settlement agreement, which is recorded in general and administrative expenses in the consolidated statement of operations.

Purported Stockholder Claims Related to Biosight Transaction

Between September 16, 2021, and November 4, 2021, the Company received demand letters on behalf of six purported stockholders of the Company, alleging that the Company failed to disclose certain matters in the Registration Statement, and demanding that the Company disclose such information in a supplemental disclosure filed with the SEC. On October 14, 2021, the Company filed an amendment to the Registration Statement and on November 8, 2021, the Company made certain other additional disclosures that mooted the demands asserted in the above-referenced letters. The six plaintiffs have made settlement demands. On May 20, 2022, the Company and one of the plaintiffs have reached a settlement agreement, which is recorded in general and administrative expenses in the consolidated statement of operations. At this time, the Company is unable to predict the likelihood of an unfavorable outcome.

In addition, the Company received certain additional demands from stockholders asserting that the proxy materials filed by the Company in connection with the Previously Proposed Merger contained alleged material misstatements and/or omissions. Certain stockholders also demanded books and records of the Company pursuant to Delaware law. In response to these demands, the Company agreed to make, and did make, certain supplemental disclosures to the proxy materials. The stockholders have made settlement demands. On July 18, 2022, the Company and the plaintiffs consummated settlement agreements, which is recorded in general and administrative expenses in the consolidated statement of operations.

Purported Stockholder Claims Related to Series D Convertible Preferred Stock Offering

On February 17, 2022, the Company received a letter on behalf of purported stockholders of the Company, demanding certain books and records pursuant to Delaware law regarding the proposed issuance of super voting preferred stock. The Company agreed to provide certain books and records to the stockholders and agreed to make, and did make, a supplemental disclosure to the proxy materials. The stockholders have made settlement demands. On July 18, 2022, the Company and the plaintiffs consummated settlement agreements, which is recorded in general and administrative expenses in the consolidated statement of operations.

Purported Stockholder Claims Related to Merger with Old Ayala

On December 15, 2022, a purported stockholder of Old Ayala filed a complaint in the U.S. District Court for the Southern District of New York against Old Ayala and the members of its Board, captioned Stephen Bushansky v. Ayala Pharmaceuticals, Inc., Case No.1:22-cv-10621 (S.D.N.Y.) (the “Complaint”).

The Complaint asserts claims against all defendants under Section 14(a) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and Rule 14a-9 promulgated thereunder for omitting or misrepresenting material information from Old Ayala’s Proxy Statement and against the individual defendants under Section 20(a) of the Exchange Act for alleged “control person” liability with respect to such alleged omissions and misrepresentations. The allegations in the Complaint include that the Proxy Statement omitted material information regarding Old Ayala’s financial projections and the financial analyses of Old Ayala’s financial advisor for the Merger. The Complaint seeks, among other relief, (1) to enjoin defendants from consummating the Merger; (2) to enjoin a vote on the Merger; (3) to rescind the Merger Agreement or recover damages, if the Merger is completed; (4) a declaration that defendants violated Sections 14(a) or 20(a) and Rule 14a-9 of the Exchange Act; and (5) attorneys’ fees and costs.

In addition, approximately nine purported stockholders of Old Ayala sent letters to those noted in the above-referenced Complaint alleging similar deficiencies in Old Ayala’s Proxy Statement (collectively, the “Demand Letters”).

At this time, the Company is unable to predict the likelihood of an unfavorable outcome with respect to the Complaint and the Demand Letters.

Item 4. Mine Safety Disclosures.

~~None~~Not applicable.

59INFORMATION ABOUT OUR EXECUTIVE OFFICERS AND DIRECTORS

The following table sets forth information regarding our executive officers and directors as of the filling date of this Annual Report on Form 10-K.

Name	Age	Position
*Executive Officers*
Kenneth A. Berlin	59	President and Chief Executive Officer, Director
Roy Golan, CPA, LLM	50	Chief Financial Officer

Executive Officers

Kenneth Berlin has served as our President and Chief Executive Officer and a member of our Board of Directors since April 2018. Mr. Berlin served as our Interim Chief Financial Officer from September 2020 to May 2022. Prior to joining the Company, Mr. Berlin served as President and Chief Executive Officer of Rosetta Genomics from November 2009 until April 2018. Prior to Rosetta Genomics, Mr. Berlin was Worldwide General Manager at cellular and molecular cancer diagnostics developer Veridex, LLC, a Johnson & Johnson company. At Veridex he grew the organization to over 100 employees, launched three cancer diagnostic products, led the acquisition of its cellular diagnostics partner, and delivered significant growth in sales as Veridex transitioned from an R&D entity to a commercial provider of oncology diagnostic products and services. Mr. Berlin joined Johnson & Johnson in 1994 and served as corporate counsel for six years. From 2001 until 2004 he served as Vice President, Licensing and New Business Development in the pharmaceuticals group, and from 2004 until 2007 served as Worldwide Vice President, Franchise Development, Ortho-Clinical Diagnostics. Mr. Berlin holds an A.B. degree from Princeton University and a J.D. from the University of California Los Angeles School of Law. Mr. Berlin’s experience in life science companies, as well as his business experience in general, qualify him to service as our director.

Roy Golan, CPA, LLM, has served as our Chief Financial Officer since October 2023. Mr. Golan is a registered CPA with a broad experience in aspects of Nasdaq, IPOs and M&As. Prior to joining Ayala, Mr. Golan served in several financial management positions in the biotech industry, including as the EVP and CFO of Biosight from 2019 until the merger with Ayala in October 2023. From 2014 to 2018 Mr. Golan served as CFO of Neuroderm, where he had a pivotal role in their successful Nasdaq IPO, two Follow-On Offerings, and Neuroderm’s acquisition by Mitsubishi Tanabe Pharmaceutical Corporation for a total of $1.1 billion. Mr. Golan started his career at PriceWaterhouseCoopers (PWC). Mr. Golan is a registered CPA, holds a B.A. in Accounting and Business from the Israeli College of Management School of Business and an LL.M. in Law from Bar Ilan University.

PART II

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

Market Information and Holders

Our common stock is quoted on the OTCQX under the symbol “ADXS”.

As of ~~October~~December 31, ~~2022~~2023 there were approximately 80117 holders of record of our common stock. The actual number of holders of our common stock is greater than this number of record holders, and includes stockholders who are beneficial owners, but whose shares are held in street name by brokers or held by other nominees.

We have not declared or paid any cash dividends on our common stock, and we do not anticipate declaring or paying cash dividends for the foreseeable future.

Recent Sales of Unregistered Securities

~~None~~All information required by Item Furnish the information required by Item 201 of Regulation S-K and Item 701 of Regulation S-K as to all equity securities that we sold during the period covered by this Annual Report on Form 10-K that were not registered under the Securities Act has been included in our previously filed Quarterly Reports on Form 10-Q or Current Reports on Form 8-K and is thus not furnished here.

~~ITEM~~Item 6. ~~Selected Financial Data~~[Reserved].

~~[Reserved]~~Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.

~~ITEM~~You 7.should ~~Management’s~~read ~~Discussion~~the following discussion and ~~Analysis~~analysis of ~~Financial~~our ~~Condition~~financial condition and ~~Results~~results of ~~Operations~~operations together with our consolidated financial statements and the related notes included elsewhere in this Annual Report on Form 10-K. Some of the information contained in this discussion and analysis or set forth elsewhere in this Annual Report on Form 10-K, including information with respect to our plans and strategy for our business and related financing, includes forward-looking statements that involve risks and uncertainties. As a result of many factors, our actual results could differ materially from the results described in or implied by the forward-looking statements contained in the following discussion and analysis.

~~This~~A ~~Management’s~~discussion ~~Discussion and Analysis~~ of ~~Financial~~the ~~Conditions~~fiscal ~~and~~year ~~Results~~ended ofDecember ~~Operations~~31, ~~and~~2022 ~~other~~compared ~~portions~~to ofthe ~~this~~fiscal ~~report~~year ~~contain forward-looking~~ended ~~information~~December ~~that~~31, ~~involves~~2021, ~~risks~~which ~~and~~constitute ~~uncertainties.~~our ~~Our actual results could differ materially from those anticipated~~financial bystatements ~~the~~for ~~forward-looking~~such ~~information.~~periods, ~~Factors~~has ~~that~~been ~~may~~reported ~~cause~~previously ~~such~~in ~~differences~~Old ~~include,~~Ayala’s ~~but~~Annual ~~are~~Report ~~not~~on ~~limited~~Form ~~to,~~10-K ~~availability~~for ~~and~~the ~~cost~~year ~~of financial~~ended ~~resources~~December 31, ~~product demand~~2022, ~~market~~filed ~~acceptance~~with ~~and~~the ~~other~~SEC ~~factors~~on ~~discussed~~March in31, ~~this~~2023, ~~report~~ under the heading “~~Risk Factors”. This~~ Management’s Discussion and Analysis of Financial ~~Conditions~~ Condition and Results of Operations ~~should be read in conjunction with our financial statements and the related notes included elsewhere in this report~~.”

Overview

~~Ayala~~See ~~Pharmaceuticals, Inc. (~~“~~New~~Introductory ~~Ayala~~Note” beginning ~~or the “Company”) is a clinical-stage biotechnology company focused~~ on ~~the~~page ~~development~~3 ~~and commercialization~~ of ~~proprietary~~this LmAnnual ~~Technology~~Report ~~antigen delivery products based~~ on aForm ~~platform technology that utilizes live attenuated Listeria monocytogenes, or Lm, bioengineered to secrete antigen/adjuvant fusion proteins. These Lm~~10-~~based~~K ~~strains~~for ~~are believed to be~~ a ~~significant~~description ~~advancement~~of incertain ~~immunotherapy~~transactions asthat ~~they~~have ~~integrate~~occurred ~~multiple~~since ~~functions into a single immunotherapy by accessing and directing antigen presenting cells to stimulate anti-tumor T cell immunity, stimulate and activate~~ the ~~innate immune system with the equivalent~~ beginning of ~~multiple~~our ~~adjuvants,~~fiscal ~~and~~year ~~simultaneously~~ended ~~reduce~~December ~~tumor protection in the Tumor Microenvironment~~31, ~~or TME, to enable the T cells to attack tumor cells~~2023.

~~The Company~~Because ~~believes~~the ~~that~~Asset LmSale ~~Technology~~was ~~immunotherapies~~consummated following ~~can~~the ~~complement~~end ~~and~~of ~~address~~our ~~significant~~fiscal ~~unmet~~year ~~needs~~ended inDecember ~~the~~31, ~~current~~2023, ~~oncology treatment~~the ~~landscape.~~financial ~~Specifically,~~results ~~our~~discussed ~~product~~in ~~candidates~~this ~~(i.e.,~~Management’s ~~ADXS-PSA~~Discussion and Analysis ~~ADXS-504)~~of ~~have~~Financial ~~the~~Condition ~~potential~~and toResults ~~optimize,~~of ~~enhance~~Operations ~~checkpoint performance~~describe ofour ~~other~~business ~~oncology~~as ~~treatments,~~it ~~while~~existed ~~having~~during that period. For a ~~generally~~description ~~well-tolerated~~of this ~~safety~~business, ~~profile.~~please refer to:

~~New~~● the description of the business of Old Ayala is ~~currently~~set ~~winding~~forth ~~down~~in orpages ~~has~~233-273 ~~wound~~of ~~down~~the ~~clinical~~Definitive ~~studies~~Proxy Statement of LmOld ~~Technology~~Ayala ~~immunotherapies~~for the Special Meeting of Stockholders of Old Ayala held on January 13, 2023, which was filed with the Commission on December 12, 2022 and which pages are set forth on Exhibit 99.1 to this Annual Report on Form 10-K, and are, in ~~three~~accordance ~~program~~with ~~areas:~~Rule 12b-23 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), incorporated by reference herein.

●Following ~~Human~~the ~~Papilloma~~completion ~~Virus~~of the Asset Sale on March 25, 2024, the Company is a clinical-stage oncology company whose primary clinical assets currently include aspacytarabine (~~“HPV”~~BST-236), a novel proprietary anti-~~associated~~metabolite ~~cancers~~for ●first ~~Personalized~~line ~~neoantigen~~treatment in unfit acute myeloid leukemia (AML). BST-~~directed~~236 ~~therapies~~is ●a ~~Human~~novel ~~epidermal~~prodrug of ~~growth~~cytarabine, ~~factor~~enabling ~~receptor~~delivery of high cytarabine doses with reduced systemic toxicity, creating a potential new backbone for AML combination regimens. We believe that our novel product candidates, if approved, have the potential to transform treatment outcomes for patients suffering from solid and hematological cancers. We also continue to conduct certain operations relating to former Advaxis’ operations as clinical-2stage biotechnology company focused on the development and commercialization of proprietary Listeria monocytogenes (~~HER-2~~“Lm”)-based antigen ~~associated~~delivery ~~cancers~~products. These efforts are primarily focused on the development of ADXS-504, an Lm-based therapy for early-stage prostate cancer.

60We were originally incorporated in the State of Colorado on June 5, 1987 under the name Great Expectations, Inc. We were a publicly-traded “shell” company without any business until November 12, 2004 when we acquired New Ayala, a Delaware corporation, through a Share Exchange and Reorganization Agreement, dated as of August 25, 2004, which we refer to as the Share Exchange, by and among New Ayala, the stockholders of New Ayala and us. As a result of the Share Exchange, New Ayala became our wholly-owned subsidiary and our sole operating company. On December 23, 2004, we amended and restated our articles of incorporation and changed our name to New Ayala. On June 6, 2006, our stockholders approved the reincorporation of our company from Colorado to Delaware by merging the Colorado entity into our wholly-owned Delaware subsidiary. Our date of inception, for financial statement purposes, is March 1, 2002 and the Company was listed on The Nasdaq Capital Market (“Nasdaq”) in 2014. In December 2021, the Company was delisted from Nasdaq and accepted onto the OTCQX. Shares of New Ayala’s common stock are currently quoted on the OTCQX under the symbol “ADXS.” Our operations to date have been limited to organizing and staffing our company, business planning, raising capital and conducting research and development activities for our product candidates. To date, we have funded our operations primarily through the sales of common stock convertible notes, warrants and convertible preferred stock.

All these clinical program areas are anchored in the Company’s Lm TechnologyTM, a unique platform designed for its ability to safely and effectively target various cancers in multiple ways. While we are currently winding down clinical studies of Lm Technology immunotherapies in these three program areas, our license agreements continue with OS Therapies, LLC for ADXS-HER2 and with Global BioPharma, or GBP, for the exclusive license for the development and commercialization of ADXS-HPV, or AXAL, in Asia, Africa, and the former USSR territory, exclusive of India and certain other countries.21

~~Recent~~We ~~Developments~~have incurred significant net operating losses in every year since our inception and expect to continue to incur significant expenses and increasing operating losses for the foreseeable future. Our net losses may fluctuate significantly from quarter to quarter and year to year and could be substantial. Our net losses were $48.1 million and $38.0 million for the years ended December 31, 2023 and 2022, respectively. As of December 31, 2023, we had an accumulated deficit of $197.2 million. We anticipate that our expenses will increase significantly as we:

Merger with Ayala Pharmaceuticals, Inc.

	●	Continue to conduct certain operations related to advancing the development of BST-236
	●	Satisfy certain debts and obligations remaining from our operations prior to the consummation of the Asset Sale

OnWe ~~October~~do ~~18,~~not ~~2022,~~expect ~~the~~to ~~Company~~generate ~~entered~~revenue ~~into~~from aproduct ~~Merger~~sales ~~Agreement~~unless ~~(the~~and ~~“Merger~~until ~~Agreement”),~~we ~~subject~~successfully tocomplete ~~shareholder~~clinical ~~approval,~~development and obtain regulatory ~~with~~approval ~~Ayala~~for ~~Pharmaceuticals,~~a ~~Inc~~product candidate. ~~(“Old~~Additionally, ~~Ayala”)~~we ~~and~~currently ~~Doe~~use ~~Merger~~contract ~~Sub~~research organizations, ~~Inc.~~or ~~(“Merger Sub”)~~CROs, ato ~~direct,~~carry ~~wholly-owned subsidiary~~out ofour ~~New~~clinical development ~~Ayala~~activities. ~~Under~~Furthermore, ~~the~~we ~~terms~~incur ofadditional ~~the~~costs ~~agreement,~~associated ~~the~~with ~~Merger~~operating ~~Sub~~as ~~merged~~a ~~with~~public ~~and~~company. ~~into~~As ~~Old~~a ~~Ayala~~result, ~~with~~we ~~Old~~will ~~Ayala~~need substantial additional funding to support our continuing ~~as the~~operations, ~~surviving~~pursue ~~company~~our growth strategy and continue as a ~~wholly-owned~~going ~~subsidiary~~concern. ofUntil such ~~New~~time ~~Ayala~~as ~~(the~~we ~~“Merger”).~~can ~~Immediately~~generate ~~after~~significant ~~the~~revenue ~~Merger,~~from ~~New~~product ~~Ayala~~sales, ~~stockholders as~~if ofever, ~~immediately~~we ~~prior~~expect to ~~the~~fund ~~Merger~~our ~~owned~~operations ~~approximately~~through ~~37.5%~~public ofor ~~the~~equity offerings ~~outstanding~~or ~~shares~~debt offinancings, ~~the~~marketing ~~combined~~and ~~company~~distribution arrangements and ~~former Old~~other ~~Ayala~~collaborations, ~~shareholders~~strategic ~~owned~~alliances ~~approximately~~and 62licensing arrangements or other sources.5% ofWe ~~the~~may, ~~outstanding~~however, ~~shares~~be ofunable ~~the~~to ~~combined~~raise ~~company.~~additional ~~The~~funds ~~Merger~~or ~~was~~enter ~~accounted~~into such other arrangements when needed on favorable ~~for~~terms or at all. Our failure to raise capital or enter into such other arrangements as and when needed would have a ~~reverse~~negative ~~acquisition~~impact ~~pursuant~~on our financial condition and our ability to ~~ASC~~develop ~~805-40~~our current or any future product candidates.

AtBecause of the ~~effective~~numerous ~~time~~risks ofand ~~the~~uncertainties ~~Merger~~associated ~~(the~~with ~~“Effective~~therapeutics ~~Time”)~~product development, ~~each~~we ~~share~~are ofunable ~~share~~to ~~capital~~predict accurately the timing or amount of ~~Old~~increased ~~Ayala~~expenses ~~issued~~or ~~and~~when ~~outstanding immediately~~or ~~prior~~if we will be able to ~~the~~achieve ~~Effective~~or ~~Time~~maintain ~~was~~profitability. ~~converted~~Even ~~into~~if ~~the~~we ~~right~~are able to ~~receive~~generate arevenue from ~~number~~product ofsales, ~~shares~~we ofmay ~~New~~not ~~Ayala~~become ~~common~~profitable. ~~stock,~~If ~~par~~we ~~value $0.001~~fail ~~per~~to ~~share,~~become ~~equal~~profitable or are unable to ~~the~~sustain ~~exchange~~profitability ~~ratio~~on a continuing basis, ~~0.1874~~then ~~shares~~we ofmay ~~New~~be ~~Ayala~~unable ~~common~~to ~~stock~~continue ~~per~~our ~~Old~~operations ~~Ayala~~at ~~share~~planned levels and be forced to reduce or terminate our operations.

~~Results~~The Company has incurred ofrecurring ~~Operations~~losses ~~for~~since ~~the~~inception ~~Fiscal~~as ~~Year~~a ~~Ended~~research ~~October~~and development organization. For the year ended December 31, ~~2022~~2023, ~~Compared~~the toCompany ~~the~~used approximately ~~Fiscal~~$29.5 ~~Year~~million ~~Ended~~of ~~October~~cash in operations and incurred a net loss of $48.1 million. As of December 31, ~~2021~~2023, the Company had $4.9 million in cash and cash equivalents, $25.0 million in current liabilities and an accumulated deficit of $197.2 million.

Due to the uncertainty in securing additional funding, and the insufficient amount of cash and cash equivalent resources at December 31, 2023, we have concluded that substantial doubt exists with respect to our ability to continue as a going concern through May 2024. See “—Liquidity and Capital Resources.” Substantial doubt about our ability to continue as a going concern may materially and adversely affect the price per share of our common stock, and it may be more difficult for us to obtain financing. If potential collaborators decline to do business with us or potential investors decline to participate in any future financings due to such concerns, our ability to increase our cash position may be limited. We will need to generate significant revenues to achieve profitability, and we may never do so. Because of the numerous risks and uncertainties associated with the development of our current and any future product candidates, and because the extent to which we may enter into collaborations with third parties for the development of any of our product candidates is unknown, we are unable to estimate the amounts of increased capital outlays and operating expenses required for completing the research and development of our product candidates.

License Agreements

Bristol-Myers Squibb

Our financial results for the periods ended December 31, 2023 and 2022, as discussed in this Management’s Discussion and Analysis of Financial Condition and Results of Operations, largely related to our AL101 and AL102 programs, which we sold to Immunome on March 25, 2024. We had licensed those assets pursuant to an exclusive worldwide license agreement with Bristol-Myers Squibb Company, or BMS, which we describe herein. We transferred this license agreement to Immunome as part of the Asset Sale.

We entered into the license agreement with BMS in November 2017. Under the terms of the license agreement, we licensed the exclusive worldwide development and commercialization rights for AL101 (previously known as BMS-906024) and AL102 (previously known as BMS-986115).

Under the license agreement, we were responsible for all future development and commercialization of AL101 and AL102. In consideration for the rights granted under the agreement, we paid BMS a payment of $6 million and issued to BMS 1,125,929 shares of Series A preferred stock valued at approximately $7.3 million. We were obligated under the license agreement to pay BMS up to approximately $142 million in the aggregate upon the achievement of certain clinical development or regulatory milestones and up to $50 million in the aggregate upon the achievement of certain commercial milestones by each product containing the licensed BMS compounds. In addition, we were obligated under the license agreement to pay BMS tiered royalties ranging from a high single-digit to a low teen percentage on worldwide net sales of all products containing the licensed BMS compounds. Both we and BMS had the right to terminate the BMS License Agreement in its entirety upon written notice to the licensee under certain circumstances described therein.

Components of Results of Operations

Revenue Recognition

We recognize revenue in accordance with ASC Topic 606, Revenue from Contracts with Customers, which applies to all contracts with customers. Under Topic 606, an entity recognizes revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration that the entity expects to receive in exchange for those goods or services.

In December 2018, we entered into an agreement with Novartis Agreement for which we paid for its research and development costs. This agreement was terminated in 2022.

We concluded that there is one distinct performance obligation under the Novartis Agreement: Research and development services, an obligation which is satisfied over time.

Revenue associated with the research and development services in the amount of $13 thousand was recognized in the year ended December 31, 2023, compared to $0.7 million in fiscal year 2022.

We concluded that progress towards completion of the research and development performance obligation related to the Novartis Agreement is best measured in an amount proportional to the expenses incurred from the total estimated expenses. We periodically review and update our estimates, when appropriate, which may adjust revenue recognized for the period. The transaction price to be recognized as revenue under the Novartis Agreement consists of the reimbursable research and development costs.

Operating Expenses

Our operating expenses since inception have consisted solely of research and development expenses and general and administrative expenses.

Research and Development Expenses

Research and development expenses consist primarily of costs incurred for our research activities, including the development of and pursuit of regulatory approval of our lead product candidates, including AL101 and AL102 (which were disposed of in early 2024), Lm-based products and BST-236, which include:

	●	employee-related expenses, including salaries, benefits and stock-based compensation expense for personnel engaged in research and development functions;
	●	expenses incurred in connection with the preclinical and clinical development of our product candidates, including under agreements with CROs, investigative sites and consultants;
	●	costs of manufacturing our product candidates for use in our preclinical studies and clinical trials, as well as manufacturers that provide components of our product candidates for use in our preclinical and current and potential future clinical trials;
	●	costs associated with our bioinformatics platform;
	●	consulting and professional fees related to research and development activities;
	●	costs related to compliance with clinical regulatory requirements; and
	●	facility costs and other allocated expenses, which include expenses for rent and maintenance of our facility, utilities, depreciation and other supplies.

We expense research and development costs as incurred. Our external research and development expenses consist primarily of costs such as fees paid to consultants, contractors and CROs in connection with our preclinical and clinical development activities. We typically use our employee and infrastructure resources across our development programs and we do not allocate personnel costs and other internal costs to specific product candidates or development programs with the exception of the costs to manufacture our product candidates.

The following table summarizes our research and development expenses by product candidate or development program for the years ended December 31, 2023 and 2022:

	Years Ended December 31,
	2023		2022
Program-specific costs:
AL101
ACC	$	395	$	3,601
TNBC		509		3,747
General Expenses		322		2,533
AL102
General Expenses		282		295
Desmoid		20,458		17,675
Other R&D expenses (Mainly Lm -based products and BST-236)		2,115		-
Total research and development expenses	$	24,081	$	27,851

Research and development activities are central to our business model. Product candidates in later stages of clinical development generally have higher development costs than those in earlier stages of clinical development, primarily due to the increased size and duration of later-stage clinical trials. We expect that our research and development expenses will continue to be significant in the future to the extent that we initiate additional clinical trials, scale our manufacturing processes, continue to develop additional product candidates and hire additional clinical and scientific personnel.

The successful development of Lm-based products and BST-236 and any future product candidate is highly uncertain. Accordingly, at this time, we cannot reasonably estimate or know the nature, timing and costs of the efforts that will be necessary to complete the development of these product candidates. We are also unable to predict when, if ever, we will generate revenue and material net cash inflows from the commercialization and sale of any of our product candidates for which we may obtain marketing approval. We may never succeed in achieving regulatory approval for any of our product candidates. The duration, costs and timing of preclinical studies, clinical trials and development of our product candidates will depend on a variety of factors, including:

	●	successful completion of clinical trials with adequate safety, tolerability and efficacy profiles for any potential future product candidates that are satisfactory to the FDA or any comparable foreign regulatory authority;
	●	approval of INDs for Lm-based products and BST-236 and any potential future product candidate to commence planned or future clinical trials in the United States or foreign countries;
	●	significant and changing government regulation and regulatory guidance;
	●	timing and receipt of marketing approvals from applicable regulatory authorities;
	●	establishing arrangements with contract manufacturing organizations, or CMOs, for third-party clinical and commercial manufacturing to obtain sufficient supply of our product candidates;
	●	obtaining, maintaining, protecting and enforcing patent and other intellectual property rights and regulatory exclusivity for our product candidates;
	●	commercializing the product candidates, if and when approved, whether alone or in collaboration with other organizations;
	●	acceptance of the product, if and when approved, by patients, the medical community and third-party payors;
	●	competition with other therapies; and
	●	maintenance of a continued acceptable safety profile of the products following approval

A change in the outcome of any of these variables with respect to the development, manufacture or commercialization enabling activities of any of our product candidates would significantly change the costs, timing and viability associated with the development of that product candidate. For example, if the FDA or another regulatory authority were to require us to conduct clinical trials beyond those that we anticipate will be required for the completion of clinical development of a product candidate, or if we experience significant delays in our clinical trials due to patient enrollment or other reasons, we would be required to expend significant additional financial resources and time on the completion of clinical development.

General and Administrative Expenses

General and administrative expenses consist primarily of salaries and other related costs, including stock-based compensation, for personnel in executive, finance and administrative functions. General and administrative expenses also include direct and allocated facility-related costs as well as professional fees for legal, patent, consulting, investor and public relations, accounting, auditing, tax services and insurance costs.

We expect to continue to incur expenses associated with being a public company, including the costs of personnel, accounting, audit, legal, regulatory and tax-related services associated with maintaining compliance with Securities and Exchange Commission, or SEC, requirements, director and officer insurance costs, and investor and public relations costs.

Financial Income, Net

Financial income, net primarily consists of an immediate loss and a revaluation of Convertible Note and Warrant Liability offset by interest income earned on our cash and cash equivalents and restricted bank deposits.

Critical Accounting Policies and Use of Estimates

Our management’s discussion and analysis of financial condition and results of operations is based on our consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States, or GAAP. The preparation of these financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities and expenses and the disclosure of contingent assets and liabilities in our consolidated financial statements 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, known trends and events, 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 described in more detail in the notes to our consolidated financial statements appearing elsewhere in this Annual Report on Form 10-K, we believe the following accounting policies used in the preparation of our consolidated financial statements require the most significant judgments and estimates.

Warrant Liabilities

The Company analyzes warrants issued to determine whether they meet the classification as liabilities or equity under US GAAP. Warrant liabilities are adjusted to reflect fair value at each reporting period, with any increase or decrease in the fair value recorded as finance expenses (income) in the statement of operations. The Company uses a fair valuation specialist to estimate the value of these instruments using numerous iterations using the Black–Scholes option price model.

The key assumptions used in the models are the expected future volatility in the price of the Company’s shares and the expected life of the warrants.

Convertible Notes

The Company analyzes convertible notes issued to determine whether they meet the classification as liabilities or equity under US GAAP. Convertible notes are adjusted to reflect fair value at each reporting period, with any increase or decrease in the fair value recorded as finance expenses (income) in the statement of operations. The Company uses a fair valuation specialist to estimate the value of these instruments using numerous iterations using the Monte Carlo Simulation.

The key assumptions used in the models are the expected future outcome as well as volatility in the price of the Company’s shares and the expected life of the notes.

Business Combination

We account for business combinations in accordance with ASC 805, “Business Combinations”. ASC 805 requires recognition of assets acquired and liabilities assumed at the acquisition date, measured at their fair values as of that date. The Company determines the recognition of intangible assets based on the following criteria: (i) the intangible asset arises from contractual or other rights; or (ii) the intangible asset is separable or divisible from the acquired entity and capable of being sold, transferred, licensed, returned or exchanged. The excess of the fair value of the purchase price over the fair values of the identifiable assets and liabilities is recorded as goodwill. Determining the fair value of the identifiable assets and liabilities requires management to use significant judgment and estimates including the forecasted revenue and revenues growth rates, discount rates, customer contract renewal rates and customer attrition rates.

The process of estimating the fair values requires significant estimates, especially with respect to intangible assets. Critical estimates in valuing certain intangible assets include, but are not limited to, future expected cash flows and discount rates. The Company estimates fair value based upon assumptions that are believed to be reasonable, but which are inherently uncertain and unpredictable and, as a result, actual results may differ from estimates.

Impairment of long-lived assets

Long-lived assets, including property and equipment and finite-lived intangible assets, are reviewed for impairment whenever facts or circumstances either internally or externally may indicate that the carrying value of an asset may not be recoverable. If there are indications of an impairment, the Company tests for recoverability by comparing the estimated undiscounted future cash flows expected to result from the use of the asset to the carrying amount of the asset or asset group. If the asset or asset group is determined to be impaired, any excess of the carrying value of the asset or asset group over its estimated fair value is recognized as an impairment loss.

Goodwill and intangible assets

Goodwill and acquired intangible assets have been recorded in the Company’s financial statements resulting from the a business combinations. Goodwill represents the excess of the purchase price in a business combination over the fair value of identifiable tangible and intangible assets acquired and liabilities assumed. Goodwill is subject to an annual impairment test.

Reporting units are evaluated when changes in the Company’s operating structure occur, and if necessary, goodwill would be reassigned using a relative fair value allocation approach. The Company operates in one operating segment, and this segment is the only reporting unit.

ASC 350, Intangibles—Goodwill and Other (“ASC 350”) requires goodwill to be tested for impairment at least annually and, in certain circumstances, between annual tests. The accounting guidance gives the option to perform a qualitative assessment to determine whether further impairment testing is necessary. The qualitative assessment considers events and circumstances that might indicate that a reporting unit’s fair value is less than its carrying amount. If it is determined, as a result of the qualitative assessment, that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, a quantitative test is performed.

The Company elects to perform an annual impairment test of goodwill as of December 31 of each year, or more frequently if impairment indicators are present. The Company performed its annual goodwill impairment test on December 31, 2023, and the Company concluded that no additional goodwill impairment should be recorded. There were no impairments of goodwill during the year ended December 31, 2023.

In process technology are amortized on a straight-line basis over the estimated useful life of the assets: approximately four years from the start of revenue which is estimated to start in 2030. Amortization of in process technology is presented within Research and Development in the consolidated statement of operations.

Income Taxes

We calculate income tax provisions based on our results in each jurisdiction in which we operate. The calculation is based on estimated tax consequences and on assumptions as to our entitlement to various benefits under the applicable local tax laws.

Significant judgment is required in evaluating our uncertain tax positions. We establish reserves for uncertain tax positions based on the evaluation of whether or not our uncertain tax position is “more likely than not” to be sustained upon examination based on our technical merits. We record estimated interest pertaining to our uncertain tax positions in the financial statements as income tax expense.

Deferred tax assets are recognized for unused tax losses, unused tax credits, and deductible temporary differences to the extent that it is probable that future taxable profits will be available, against which they can be used. Deferred taxes for each jurisdiction are presented as a net asset or liability, net of any valuation allowances. We estimate the need for any valuation allowance by applying significant judgment and considering all available evidence including past results and future projections. We reassess our estimates periodically and record a partial or full valuation allowance release if needed.

We cannot assure that future final tax outcomes will not be different than our tax provisions and reserves for uncertain tax positions. To the extent that the final tax outcome of these matters is different than the amounts recorded, such differences will impact the provision for income taxes in the period in which such determination is made.

Stock-Based Compensation

We measure stock options and other stock-based awards granted to employees, directors, consultants or advisors of the company or its affiliates based on their fair value on the date of the grant and recognize compensation expense of those awards, over the requisite service period, which is generally the vesting period of the respective award. We apply the accelerated method of expense recognition to all awards with only service-based vesting conditions.

For stock-based awards granted to non-employees, compensation expense is recognized over the period during which services are rendered by such non-employees until completed.

We estimate the fair value of each stock option grant on the date of grant using the Black-Scholes option-pricing model, which uses as inputs the fair value of our common stock and assumptions we make for the volatility of our common stock, the expected term of our stock options, the risk-free interest rate for a period that approximates the expected term of our stock options and our expected dividend yield.

Previously, as a private company with no active public market for our common stock, our board of directors historically determined the fair value of our common stock on each date of grant, with input from management. Our board of directors periodically determined the estimated per share fair value of our common stock at various dates using valuations performed by third parties. All options to purchase shares of our common stock were intended to be granted with an exercise price per share no less than the fair value per share of our common stock underlying those options on the date of grant, based on the information known to us on the date of grant. Our determinations of the fair value of our common stock were made using methodologies, approaches and assumptions consistent with the American Institute of Certified Public Accountants Audit and Accounting Practice Aid Series: Valuation of Privately Held Company Equity Securities Issued as Compensation, or the Practice Guide.

Our board of directors considered various objective and subjective factors, along with input from management, to determine the fair value of our common stock, including:

	●	the lack of an active public market for our common stock;
	●	our results of operations and financial condition, including cash on hand;
	●	the material risks related to our business;
	●	our stage of development and business strategy;
	●	the composition of, and changes to, our management team and board of directors;
	●	the market performance of publicly traded companies in the life sciences and biotechnology sectors, as well as recently completed initial public offerings, or IPOs, of companies in the life sciences and biotechnology sectors; and
	●	the likelihood of achieving a liquidity event given prevailing market conditions.

There are significant judgments and estimates inherent in the determination of the fair value of our common stock. These judgments and estimates are management’s best estimates and include assumptions regarding our future operating performance, the time to completing an initial public offering or other liquidity event, the related company valuations associated with such events and the determinations of the appropriate valuation methods. If we had made different assumptions, our stock-based compensation expense, net loss and net loss per common share could have been different.

Results of Operations

Comparison of the year ended December 31, 2023 and 2022

The following table summarizes our results of operations for the year ended December 31, 2023 and 2022 (in thousands):

	Years Ended December 31,
	2023			2022			Change
Revenue from license agreement	$	13		$	692			(679	)
Cost of revenue		(13	)		(602	)		589
Gross profit		-			90			(90	)
Operating expenses:
Research and development		24,081			27,851			(3,770	)
General and administrative		12,185			9,742			2,443
Operating loss		(36,266	)		(37,503	)		(1,327	)
Financial income (expense), net		(15,718	)		74			(15,792	)
Loss before income tax		(51,984	)		(37,429	)		(14,555	)
Taxes on income		3,912			(584	)		4,496
Net loss	$	(48,072	)	$	(38,013	)		(10,059	)

Revenue

Revenue ~~was~~associated ~~$250,000~~with ~~for~~ the ~~year~~research ~~ended~~and ~~October~~development ~~31,~~services ~~2022~~mainly ~~compared~~under tothe Novartis Agreement in the amount of $~~3,240,000~~13 ~~for~~thousand was recognized in the year ended ~~October~~December 31, ~~2021.~~2023, ~~In the~~compared ~~prior~~to ~~period,~~$0.7 wemillion recognized ~~royalty~~in ~~payments~~fiscal ~~from~~year ~~OST~~2022.

Research and Development Expenses

WeResearch ~~invest in research~~ and development toexpenses ~~advance~~were ~~our~~$24.1 Lmmillion ~~technology~~for ~~through~~the ~~our~~year ~~preclinical~~ended ~~and~~December ~~clinical~~31, ~~development~~2023 ~~programs.~~compared ~~Research and~~to ~~development~~$27.9 ~~expenses~~million for the ~~years~~year ended ~~October~~ December 31, 2022, a decrease of $3.8 million. The decrease was due to the termination of the TENACITY trial and ~~2021~~winding ~~were~~down ~~categorized~~of asthe ~~follows~~ACCURACY trial ~~(in~~offset ~~thousands):~~by expenses incurred by the programs of former Advaxis and Biosight.

	Fiscal Years Ended October 31,				Increase (Decrease)
	2022		2021		$			%
Hotspot/Off-the-Shelf therapies	$	4,323	$	4,261	$	62			1	%
Prostate cancer		94		30		64			213	%
HPV-associated cancers		263		2,069		(1,806	)		(87	)%
Personalized neoantigen-directed therapies		11		495		(484	)		(98	)%
Other expenses		2,925		3,707		(782	)		(21	)%
Total research & development expense	$	7,616	$	10,562	$	(2,946	)		(28	)%
Stock-based compensation expense included in research and development expense	$	47	$	164	$	(117	)		(71	)%

Hotspot/Off-the-Shelf Therapies (ADXS-HOT)

Research and development costs associated with our hotspot mutation-based therapy for the fiscal year ended October 31, 2022 increased approximately 1% to $4,323,000 compared to the same period in 2021. The increase is attributable to patient recruitment costs and manufacturing costs pertaining to the HOT-503 study incurred in the current period and partially offset by a slowdown in patient enrollment. On October 18, 2022, we announced that we are conducting an orderly wind down of our HOT-503 study.

Prostate Cancer (ADXS-PSA)

Research and development costs associated with our prostate cancer therapy for the year ended October 31, 2022 increased approximately $64,000, or 213%, compared to the same period in 2021. The increase is not significant. The Phase 1/2 study of our ADXS-PSA compound in combination with KEYTRUDA® (pembrolizumab), Merck’s humanized monoclonal antibody, has been completed and we do not anticipate that we will continue to incur significant costs associated with the wind down of the study.

HPV-Associated Cancers (AXAL)

The majority of the HPV-associated research and development costs include clinical trial and other related costs associated with our AXAL programs in cervical and head and neck cancers. HPV-associated costs for the year ended October 31, 2022 decreased approximately $1,806,000, or 87%, compared to the same period in 2021. The decrease is attributable to wind down costs associated with the closure of our Phase 3 AIM2CERV study in high-risk locally advanced cervical cancer. We do not anticipate that we will continue to incur significant costs associated with the wind down of our Phase 3 AIM2CERV study.

Personalized Neoantigen-Directed Therapies (ADXS-NEO)

Research and development costs associated with personalized neoantigen-directed therapies for the year ended October 31, 2022 decreased approximately $484,000, or 98%, compared to the same period in 2021. The study has been completed and we do not anticipate that we will continue to incur significant costs associated with the wind down of the study.

Other Expenses

Other expenses include salary and benefit costs, stock-based compensation expense, professional fees, laboratory costs and other internal and external costs associated with our research & development activities. Other expenses for the year ended October 31, 2022 decreased approximately $782,000, or 21%, compared to the same period in 2021. The decrease is attributable to (1) prior period losses on disposal of property and equipment in connection with the termination of our office lease at our former location, (2) decrease in personnel costs due to decreases in headcount, stock compensation and bonus accruals, and (3) decrease in depreciation expense. The decreases were partially offset by increases in (1) clinical trial expenses due to credit memos issued by vendors in the prior year and (2) consulting expenses.

General and Administrative Expenses

General and administrative expenses ~~primarily~~were ~~include~~$12.2 ~~salary~~million ~~and~~for ~~benefit~~the ~~costs~~year ~~and~~ended ~~stock-based~~December ~~compensation~~31, ~~expense~~2023 compared to $9.7 million for ~~employees~~the ~~included~~year inended ~~our~~December ~~finance~~31, ~~legal~~2022, ~~and~~an ~~administrative~~increase ~~organizations,~~of ~~outside~~$2.4 ~~legal~~million. ~~and~~The ~~professional~~increase ~~services,~~was ~~and~~mainly ~~facilities~~due ~~costs.~~to ~~General~~severance ~~and~~agreement ~~administrative expenses~~obligations ~~for~~recognized in the period ~~years~~to ~~ended~~former ~~October~~executives ~~31,~~of ~~2022~~$0.9 million in salary compensation and ~~2021~~$0.9 ~~were~~million in stock-based compensation due to acceleration of options as ~~follows~~part ~~(in~~of ~~thousands):~~severance agreement.

	Years Ended October 31,				Increase (Decrease)
	2022		2021		$			%
General and administrative expense	$	8,891	$	11,464	$	(2,573	)		(22	)%
Stock-based compensation expense included in general and administrative expense	$	50	$	402	$	(352	)		(88	)%

Financial Income (expense), net

62Financial expense, net was $15.7 million for the year ended December 31, 2023 compared to financial income, net of $74 thousand for the year ended December 31, 2022. The increase in financial expenses was mainly due to revaluation of convertible notes side letter agreements and warrants issued.

General and administrative expenses for the year ended October 31, 2022 decreased approximately $2,573,000, or 22%, compared to the same period in 2021. This decrease primarily relates to (1) legal and consulting fees related to the Previously Proposed Merger in the prior period, (2) prior period losses on disposal of property and equipment in connection with the termination of our office lease at our former location, (3) prior period sublicense fees paid to the University of Pennsylvania for the OST milestones reached, (4) decrease in personnel costs due to decreases in stock compensation and bonus accruals, (5) decreases in rent, utilities and depreciation due to the termination of our office lease at our former location and (6) decreases in Director and Officer insurance. These decreases were partially offset by (1) an increase in proxy solicitation fees related to the Previously Proposed Merger and the reverse stock split and (2) an increase in amounts paid in settlement of shareholder demand letters in the current period.28

Intangible Asset Impairment

During the year ended October 31, 2022, the Company recorded an impairment charge under ASC 350 for its patents owned and in-licensed intellectual property of approximately $3,053,000.

Changes in Fair Values

For the year ended October 31, 2022, we recorded non-cash income from changes in the fair value of derivative liabilities of approximately $4,853,000. The decrease in the derivative liabilities was attributable to a decrease in our share price from $38.77 at October 31, 2021 to $1.86 at October 31, 2022.

For the year ended October 31, 2021, we recorded non-cash income from changes in the fair value of the warrant liability of approximately $970,000. The decrease in the fair value of liability warrants resulted primarily from the issuance of warrants in the April 2021 Private Placement. The warrants issued in the April 2021 Private Placement decreased in fair value from date of issuance to October 31, 2021 due to a decrease in our share price from $45.36 at April 14, 2021 to $38.77 at October 31, 2021.

Liquidity and Capital Resources

~~Going~~Sources ~~Concern~~of ~~and Management’s Plans~~Liquidity

~~Similar~~The toCompany ~~other~~has ~~development~~incurred ~~stage~~recurring ~~biotechnology~~losses ~~companies,~~since ~~our~~inception ~~products~~as ~~that are being developed have not generated significant revenue. As~~ a ~~result,~~research ~~we have historically suffered recurring losses~~ and wedevelopment ~~have required significant cash resources to execute our business plans~~organization. ~~These~~For ~~losses are expected to continue for~~ the ~~foreseeable~~year ~~future.~~ended ~~Additionally,~~December ~~due to the Merger~~31, ~~we will need additional~~2023, ~~cash resources to properly integrate and implement~~ the ~~operations~~Company ofused ~~Old~~approximately ~~Ayala~~$29.5 ~~The~~million ~~aforementioned~~of ~~factors~~cash ~~raise~~in ~~substantial~~operations ~~doubt about~~and ~~our~~incurred ~~ability~~a tonet ~~continue~~loss asof a$48.1 ~~going concern~~million. ~~The~~As ~~accompanying~~of ~~financial~~December ~~statements~~31, ~~have been prepared on a going concern basis~~2023, ~~which contemplates~~ the ~~realization~~Company ofhad ~~assets~~$4.9 ~~and~~million ~~the satisfaction of liabilities~~ in ~~the~~cash ~~normal~~and ~~course~~cash ofequivalents, ~~business~~$25.0 ~~The~~million ~~financial statements~~in docurrent ~~not~~liabilities ~~include any adjustments relating to the recoverability~~ and ~~classification~~an ofaccumulated ~~asset~~deficit ~~amounts or the classification~~ of ~~liabilities that might be necessary should we be unable to continue as a going concern within twelve months after the date the~~$197.2 ~~financial statements are issued~~million.

~~Historically,~~Upon closing of the Asset Sale, on March 25, 2024, the Company received $13.0 million in cash, and Immunome paid $3.0 million of the Company’s liabilities ~~major~~directly ~~sources~~to vendors of ~~cash~~the ~~have~~Company. ~~comprised~~In ~~proceeds~~addition, ~~from~~under ~~various~~the ~~public~~Asset ~~and~~Sale ~~private~~Agreement ~~offerings~~the ofCompany ~~its~~received ~~securities~~2,175,489 ~~(including~~shares of Immunome’s common stock (the “Immunome Shares”),. ~~debt~~The ~~financings,~~Asset ~~clinical~~Sale ~~collaborations,~~Agreement ~~option~~prohibits ~~and~~the ~~warrant~~Company ~~exercises,~~from ~~income~~selling ~~earned~~more onthan 50% ~~investments~~of ~~and~~the ~~grants,~~Immunome ~~and~~Shares ~~interest income.~~in ~~From~~the ~~October~~first ~~2013~~six ~~through~~months ~~October~~following 31the closing of the Asset Sale. In addition, ~~2022~~on March 1, 2024, the Company issued ~~raised~~additional ~~approximately~~convertible notes and warrants in exchange for $~~339~~2.40 million in ~~gross~~funding ~~proceeds~~ from ~~various~~the ~~public and~~Convertible ~~private~~Notes ~~offerings~~investors. As of the ~~our~~date ~~common~~of ~~stock.~~this ~~The~~filing, ~~Company~~the ~~has~~cash ~~sustained~~proceeds ~~losses~~received from ~~operations~~the inAsset ~~each~~Sale ~~fiscal~~and ~~year~~the ~~since~~convertible ~~our~~notes ~~inception~~sold on March 1, ~~and~~ we2024 ~~expect~~were ~~losses~~not sufficient to ~~continue~~pay ~~for~~ the ~~indefinite~~Company’s ~~future~~existing liabilities. AsTherefore, ofthe ~~October~~Company ~~31,~~has ~~2022~~limited available cash resources and ~~October~~requires 31additional financing, ~~2021,~~through the ~~Company~~sale ~~had~~of ana ~~accumulated deficit~~portion of ~~approximately~~the ~~$443~~Immunome ~~million~~Shares ~~and~~or ~~$428.6 million~~otherwise, ~~respectively,~~in ~~and~~order ~~stockholders’~~to ~~equity~~continue ofto ~~approximately~~fund ~~$23.6~~its ~~million and~~current ~~$38.9~~operations ~~million,~~beyond May ~~respectively~~2024.

~~The~~Raising ~~COVID-19~~additional ~~pandemic~~funds ~~has~~or ~~created~~the ~~significant~~satisfactory ~~volatility~~sale ~~and~~of ~~disruption~~a portion of ~~financial~~the ~~markets.~~Immunome AnShares ~~extended~~prior ~~period~~to the end of ~~economic~~May ~~disruption~~2024 ~~could~~is essential to provide sufficient ~~negatively~~cash ~~affect~~flow ~~the~~to ~~Company’s~~meet ~~business,~~future ~~financial~~liabilities ~~condition~~and other obligations, ~~and~~such ~~access~~as totax ~~sources~~payments ofarising ~~liquidity.~~from Asthe ofAsset ~~October~~Sale. 31Furthermore, ~~2022,~~even if the Company ~~had~~is ~~approximately~~successful ~~$25.2~~in ~~million~~selling ina ~~cash~~portion ~~and~~of ~~cash~~the ~~equivalents.~~Immunome ~~The~~Shares ~~actual~~or ~~amount~~raising ofadditional ~~cash~~funds ~~that~~through other means, the Company cannot give any assurance that it will, ~~need~~in the future, be able to ~~continue operating~~achieve isa ~~subject~~level of profitability from the sale of its products to ~~many~~sustain its ~~factors~~operations.

63If the Company is unable to obtain funding, or able to receive sufficient funds from the sale of a portion of the Immunome Shares, the Company would be forced to delay, reduce, or eliminate its research and development programs, or the Company may be unable to continue operations. As such, those factors raise substantial doubt about the Company’s ability to continue as a going concern.

~~The~~As ~~Company~~part ~~recognizes~~of ~~that~~a itcost ~~will~~reduction ~~need~~plan, toduring ~~raise~~the ~~additional~~year ~~capital~~ended inDecember ~~order~~31, to2023, ~~continue~~the toCompany ~~execute~~had ~~its~~a ~~business~~reduction ~~plan~~in workforce in which the ~~future. There~~employment isof noapproximately ~~assurance~~50% ~~that~~of ~~additional~~the ~~financing~~Company’s ~~will~~employees bewas ~~available~~terminated. ~~when~~During ~~needed~~the orfirst ~~that~~quarter of 2024, the Company ~~will~~gave benotice ~~able~~of termination to ~~obtain~~18 ~~financing~~additional onemployees ~~terms acceptable~~and totwo itofficers or(including ~~whether~~ the ~~Company~~Chief ~~will~~Financial ~~become~~Officer, ~~profitable~~whose ~~and~~employment ~~generate~~will ~~positive~~terminate ~~operating~~on ~~cash~~June ~~flow~~25, 2024). After If the ~~Company~~effectiveness isof ~~unable~~such ~~to raise~~terminations, ~~sufficient~~the ~~additional~~Chief ~~funds,~~Executive itOfficer will ~~have~~be tothe ~~further~~only ~~scale~~employee ~~back~~of ~~its~~the ~~operations~~Company. The Company ~~based~~expects ~~this estimate on assumptions that may prove~~ to be ~~incorrect,~~able ~~and~~to wemeet ~~could~~its ~~use~~financial ~~available~~obligations ~~capital~~to ~~resources~~its ~~sooner than currently expected~~employees.

On February 19, 2021, Old Ayala entered into a Securities Purchase Agreement (the “2021 Purchase Agreement”) with the purchasers named therein (the “Investors”). Pursuant to the 2021 Purchase Agreement, Old Ayala agreed to sell (i) an aggregate of 62,467 shares of Old Ayala’s common stock (the “Private Placement Shares”), par value $0.01 per share, together with warrants to purchase an aggregate of 21,863 shares of Old Ayala’s common stock with an exercise price of $96.58 per share (the “Common Warrants”), for an aggregate purchase price of $4,999,995.00 and (ii) pre-funded warrants to purchase an aggregate of 249,867 shares of our common stock with an exercise price of $0.05 per share (the “Pre-Funded Warrants” and collectively with the Common Warrants, the “Private Placement Warrants”), together with an aggregate of 87,453 Common Warrants, for an aggregate purchase price of $19,986,661.67 (collectively, the “Private Placement”). The Private Placement closed on February 23, 2021.

The exercise price and the number of shares of common stock issuable upon exercise of each Private Placement Warrant are subject to adjustment in the event of certain stock dividends and distributions, stock splits, stock combinations, reclassifications or similar events affecting the common stock. In addition, in certain circumstances, upon a fundamental transaction, a holder of Common Warrants will be entitled to receive, upon exercise of the Common Warrants, the kind and amount of securities, cash or other property that such holder would have received had they exercised the Private Placement Warrants immediately prior to the fundamental transaction. The Pre-Funded Warrants will be automatically exercised on cashless basis upon the occurrence of a fundamental transaction. Each Common Warrant is exercisable from the date of issuance and has a term of three years and each Pre-Funded Warrant is exercisable from the date of issuance and has a term of ten years. Pursuant to the 2021 Purchase Agreement, Old Ayala registered the Private Placement Shares and Private Placement Warrants for resale by the Investors on a registration statement on Form S-3 (the “Private Placement Registration Statement”).

In June 2021, Old Ayala entered into an Open Market Sales Agreement, or the Sales Agreement, with Jefferies LLC, or Jefferies, as sales agent, pursuant to which Old Ayala was able to, from time to time, issue and sell common stock with an aggregate value of up to $200.0 million in “at-the-market” offerings (the “ATM”), under a registration statement on Form S-3 filed with the SEC. Sales of common stock, if any, pursuant to the Sales Agreement, could be made in sales deemed to be an “at the market offering” as defined in Rule 415(a) of the Securities Act, including sales made directly through The Nasdaq Global Market or on any other existing trading market for our common stock. During the year ended December 31, 2022, Old Ayala sold a total of 310,417 shares of its common stock for total gross proceeds of approximately $526 thousand. The Sales Agreement was terminated in January 2023.

On October 18, 2022, the Company, which at the time was named Advaxis, Inc., entered into a Merger Agreement (the “Merger Agreement”), with an entity then known as Ayala Pharmaceuticals, Inc. (which shortly prior to the closing of the merger in January 2023 changed its name to Old Ayala, Inc., (“Old Ayala”) and Doe Merger Sub, Inc. (“Merger Sub”), a direct, wholly-owned subsidiary of the Company. Under the terms of the Merger Agreement, Merger Sub merged with and into Old Ayala, with Old Ayala continuing as the surviving company and a wholly-owned subsidiary of the Company (the “January 2023 Merger”). Immediately after the January 2023 Merger, former Advaxis stockholders as of immediately prior to the Merger own approximately 37.5% of the outstanding shares of the combined Company and former Old Ayala shareholders own approximately 62.5% of the outstanding shares of the combined Company.

At the effective time of the January 2023 Merger (the “Effective Time”), each share of share capital of Old Ayala issued and outstanding immediately prior to the Effective Time was converted into the right to receive a number of shares of the Company’s common stock, par value $0.001 per share, equal to the exchange ratio, 0.1874 shares of the Company’s common stock per Old Ayala share.

On August 7, 2023, the Company entered into an agreement for the issuance of Senior Secured Convertible Promissory Notes (the “Secured Notes”) to Israel Biotech Fund I, L.P. The Secured Notes provided for the borrowing by the Company of up to $2.0 million dollars, which borrowings which the Company received on September 1, 2023.

On November 17, 2023, the Company issued Senior Convertible Promissory Notes (collectively, the “Senior Convertible Notes”), in an aggregate amount of $4.0 million, to several existing lenders and investors in the Company, including Israel Biotech Fund I, L.P., Israel Biotech Fund II, L.P., Arkin Bio Ventures L.P. and Biotel Limited. The amounts borrowed by the Company under the Senior Convertible Notes were funded to the Company on November 20, 2023. The Senior Convertible Notes were convertible into shares of the Company’s common stock, par value $0.001 per share (the “Common Stock”) at any time at the option of the noteholders, and were subject to mandatory conversion upon certain events, including a change of control transaction and certain financing transactions involving the Company, at a conversion price equal to the lower of (i) 50% of the Common Stock’s price per share as of market close on November 16, 2023 and (ii) 50% of the Common Stock’s price per share as of the close of market on the Trading Day immediately prior to the date of the Notice of Conversion, subject to certain adjustments. In connection with the issuance of the Senior Convertible Notes, the Company issued to the noteholders warrants to purchase an aggregate of 15,000,000 shares of the Common Stock with an exercise price equal to the lower of (A) 50% of the Common Stock’s price per share as of market close on November 16, 2023 and (ii) 50% of the Common Stock’s price per share as of the close of market on the Trading Day immediately prior to the date of the Notice of Exercise of the warrant, subject to adjustment, which exercise may be on a cashless basis.

The noteholders also had the right, pursuant to a Side Letter Agreement between the noteholders and the Company, to lend an additional $4.0 million dollars to the Company on the same terms.

The Company and Israel Biotech Fund I, L.P. and Israel Biotech Fund II, L.P. also agreed to amend and restate the terms of Secured Notes to conform to the terms of the Senior Convertible Notes, and issued to the holders of the Secured Notes warrants to purchase an aggregate of 7,500,000 shares of the Common Stock on the terms of the above-described warrants.

In February 2024, the Secured Notes and the Senior Convertible Notes, and the warrants issued in connection with all of them, were converted into shares of the Company’s common stock under the terms described in such notes and warrants.

Cash Flows

~~Operating~~The ~~Activities~~following table provides information regarding our total cash and cash equivalents and restricted bank cash at December 31, 2023 and 2022 (in thousands):

Net cash used in operating activities was approximately $15,284,000 for the fiscal year ended October 31, 2022 compared to $15,439,000, for the fiscal year ended October 31, 2021. Net cash used in operating activities includes reduced spending associated with our clinical trial programs and general and administrative activities. The variance is insignificant.

	As of December 31,
	2023		2022
Cash and cash equivalents and restricted cash	$	5,212	$	2,724

~~Investing~~Cash ~~Activities~~Flows

~~Net~~The ~~cash~~following ~~used~~table inprovides ~~investing~~information ~~activities~~regarding ~~was~~our ~~approximately~~cash ~~$166,000~~flows for the ~~fiscal~~years ~~year~~ ended ~~October~~December 31, ~~2022~~2023 ~~compared to $11,000 for the fiscal year ended October 31, 2021. The decrease is the result of proceeds on a prior period disposal of property~~ and ~~equipment~~2022 ~~partially offset by reductions~~ (in ~~purchases for intangible assets.~~thousands):

Financing Activities

	Years Ended December 31,
	2023			2022
Net cash used in operating activities	$	(29,485	)	$	(34,510	)
Net cash provided by (used in) investing activities		5,946			(2	)
Net cash provided by financing activities		26,001			103
Effect of exchange rate changes on cash, cash equivalents and restricted cash		26			-
Net increase (decrease) in cash and cash equivalents and restricted cash	$	2,488		$	(34,615	)

Net ~~cash~~ ~~used~~Cash inUsed financing activities was approximately $956,000 for the fiscal year ended October 31, 2022 as compared to net cash provided by financing activities of $31,886,000 for the fiscal year ended October 31, 2021. On January 31, 2022, the Company closed on an offering with certain institutional investors for the private placement of 1,000,000 shares of Series D Preferred Stock. The shares sold had an aggregate stated value of $5,000,000. Each share of the Series D Preferred Stock was sold for a purchase price of $4.75, representing an original issue discount of 5% of the stated value. Total net proceeds from the offering, after deducting the financial advisor’s fees and other estimated offering expenses, were approximately $4.3 million. The Series D preferred stock also had a liquidation preference over the shares of common stock, and could be redeemed by the investors, in ~~accordance~~Operating with certain terms, for a redemption price equal to 105% of the stated value, or in certain circumstances, 110% of the stated value. On April 6, 2022, the holders of all 1,000,000 outstanding shares of the Series D Preferred Stock exercised their right to cause the Company to redeem all of such shares at a price per share equal to 105% of the stated value per share of $5.00, and such shares were redeemed accordingly.Activities

~~In November~~The ~~2020,~~cash ~~the~~used ~~Company~~in ~~closed~~operating ~~on a public offering of 383,333 shares of its common stock at a public offering price of $24.00 per~~activities ~~share.~~resulted ~~After~~primarily ~~deducting~~from ~~the underwriting discounts and commissions and other offering~~ expenses, ~~the~~associated ~~net~~with ~~proceeds~~our ~~from~~clinical ~~the~~development ~~offering~~programs ~~were approximately~~and ~~$8.5~~early-stage ~~million.~~research Inand ~~addition,~~general the Company also undertook a concurrent private placement of warrants to purchase up to 191,674 shares of common stock. The warrants have an exercise price per share of $28.00, are exercisable immediately and ~~will expire five years~~administrative ~~from the date of issuance~~expenses.

~~On April~~Net ~~12,~~cash ~~2021,~~used ~~the~~in ~~Company~~operating ~~completed~~activities during anthe ~~offering~~year ofended ~~(i)~~December ~~219~~31,~~718~~ ~~shares~~2023 of ~~common~~$29.5 ~~stock,~~million ~~(ii)~~was ~~95,899~~primarily ~~pre-funded~~attributable ~~warrants~~ to ~~purchase 95,899~~our ~~shares~~net loss of ~~common~~$48.1 ~~stock and (iii) registered common share purchase warrants to purchase 140~~million,~~552~~ ~~shares~~adjusted offor ~~common stock with two~~non-cash ~~healthcare~~expenses ~~focused,~~of ~~institutional investors~~$17.5 ~~The Company also issued to the investors~~million, inwhich aincludes ~~concurrent~~revaluation ~~private~~of ~~placement, unregistered common share purchase~~ warrants toand ~~purchase~~convertible ~~175,065~~notes ~~shares~~ of ~~the~~$15.7 ~~Company’s~~and ~~common~~ stock.-based Wecompensation ~~received gross proceeds~~ of ~~approximately~~ $20 1.2 million, ~~before deducting the fees~~ and ~~expenses~~a ~~payable~~net byincrease us in ~~connection~~working ~~with~~capital ~~the~~of ~~offering~~$1.1 million.

~~During~~Net cash used in operating activities during the year ended ~~October~~December 31, ~~2021,~~2022 ~~warrant~~of ~~holders~~$34.5 ~~from~~million ~~the~~was ~~Company’s~~primarily ~~November~~attributable ~~2020~~to ~~and~~our ~~April~~net ~~2021~~loss ~~offerings~~of ~~exercised~~$38.0 ~~230~~million,~~343~~ ~~warrants~~adjusted for non-cash inexpenses ~~exchange~~of ~~for~~$2.7 ~~230~~million,~~343~~ ~~shares~~which ofincludes ~~the~~stock-based ~~Company’s~~compensation ~~common~~of ~~stock~~$2.2 ~~Pursuant~~million toand ~~these~~a ~~warrant~~net ~~exercises,~~increase ~~the~~in ~~Company~~working ~~received~~capital ~~aggregate proceeds~~ of ~~approximately~~ $30.8 million.

64Net Cash Provided by (Used in) Investing Activities

~~Off-Balance~~Net cash provided by investing ~~Sheet~~activities ~~Arrangements~~of $5.9 million during the year ended December 31, 2023 was mainly attributable to $4.0 million in proceeds from the sale of our AL 101 and AL 102 assets and $1.9 million of proceeds received in connection with the merger with Biosight.

AsNet cash used in investing activities ofduring ~~October~~the year ended December 31, 2022, weof ~~had~~$2 nothousand ~~off-balance~~was ~~sheet~~attributable ~~arrangements~~to purchases of property and equipment.

~~Critical Accounting~~Net ~~Estimates~~Cash Provided by Financing Activities

~~The preparation~~Net ofcash ~~financial~~provided ~~statements~~by ~~and related disclosures in conformity with accounting principles generally accepted in~~financing ~~the~~activities ~~United~~during ~~States of America requires management to make estimates and assumptions that affect~~ the ~~reported~~year ~~amounts~~ended ofDecember ~~assets and liabilities~~31, ~~disclosure~~ 2023 of ~~contingent~~$26.0 ~~assets~~million ~~and~~was ~~liabilities~~primarily atattributable ~~the~~to ~~date of~~ the ~~financial~~January ~~statements,~~2023 ~~and~~Merger ~~income~~ and ~~expenses during~~ the ~~periods reported.~~Convertible ~~Actual results could materially differ from those estimates~~Loans. ~~We have identified the following critical accounting estimates:~~

~~Warrant~~Net cash provided by financing ~~Liabilities~~activities during the year ended December 31, 2022, of $0.1 million was primarily attributable to our issuance of shares at market, net of issuance costs.

We account for our warrants as either equity-classified or liability-classified instruments based on an assessment of the warrant’s specific terms and applicable authoritative guidance in ASC 480, Distinguishing Liabilities from Equity (“ASC 480”) and ASC 815, Derivatives and Hedging (“ASC 815”). The assessment considers whether the warrants are freestanding financial instruments pursuant to ASC 480, meet the definition of a liability pursuant to ASC 480, and whether the warrants meet all of the requirements for liability classification under ASC 815, including whether the warrants are indexed to the Company’s own ordinary shares, among other conditions for equity classification. This assessment, which requires the use of professional judgment, is conducted at the time of warrant issuance and as of each subsequent quarterly period end date while the warrants are outstanding.30

~~Some~~Funding ofRequirements ~~our warrants meet the criteria as liability classified derivative instruments~~ and ~~are~~Going recorded at fair value on the grant date and re-valued at each reporting date, with changes in the fair value reported in the statements of operations. Warrant liabilities are classified on the balance sheet as current or non-current based on whether or not net-cash settlement or conversion of the instrument could be required within 12 months of the balance sheet date. Volatility in our common stock may result in significant changes in the value of the warrant liabilities and resulting gains and losses on our consolidated statement of operations.Concern

~~Intangible~~Our ~~Assets~~future capital requirements are difficult to forecast and will depend on many factors, including our ability to raise additional funding. To the extent that we continue the research and development for, initiate later-stage clinical trials for, and seek marketing approval for, our product candidates, we expect our expenses would increase. In addition, if we obtain marketing approval for any of our product candidates, we expect to incur significant commercialization expenses related to product sales, marketing, manufacturing, and distribution. Furthermore, we incur additional costs associated with operating as a public company. Accordingly, we will need to obtain substantial additional funding in connection with our continuing operations. If we are unable to raise capital when needed or on attractive terms, we would be forced to delay, reduce or eliminate our research and development programs or future commercialization efforts.

~~Intangible~~The ~~assets~~Company ~~primarily~~has ~~consist~~incurred ofrecurring ~~legal~~losses ~~and~~since ~~filing~~inception ~~costs~~as ~~associated~~a ~~with~~research ~~obtaining~~and ~~patents~~development ~~and~~organization. ~~licenses~~For ~~and~~the ~~are~~year ~~amortized~~ended onDecember a31, ~~straight-line~~2023, ~~basis~~the ~~over~~Company ~~their~~used ~~remaining~~approximately ~~useful~~$29.5 ~~lives~~million ~~which~~of ~~are~~cash ~~estimated~~in tooperations beand ~~twenty~~incurred ~~years~~a ~~from~~net ~~the~~loss ~~effective dates~~ of ~~the~~$48.1 ~~University~~million. As of ~~Pennsylvania (Penn)~~December ~~License~~31, ~~Agreements~~2023, the ~~beginning~~Company inhad ~~July 1, 2002~~$4.9 ~~These~~million ~~legal~~in cash and ~~filing~~cash ~~costs~~equivalents, ~~are~~$25.0 ~~invoiced~~million toin ~~the~~current ~~Company~~liabilities ~~through~~and ~~Penn~~an ~~and~~accumulated ~~its~~deficit ~~patent~~of $197.2 ~~attorneys~~million.

~~Critical~~Upon ~~Accounting~~closing ~~Policies~~of the Asset Sale, on March 25, 2024, the Company received $13.0 million in cash, and Immunome paid $3.0 million of the Company’s liabilities directly to vendors of the Company. In addition, under the Asset Sale Agreement the Company received 2,175,489 shares of Immunome’s common stock (the “Immunome Shares”). The Asset Sale Agreement prohibits the Company from selling more than 50% of the Immunome Shares in the first six months following the closing of the Asset Sale. In addition, on March 1, 2024, the Company issued additional convertible notes and warrants in exchange for $2.0 million in funding from the Convertible Notes investors. As of the date of this filing, the cash proceeds received from the Asset Sale and the convertible notes sold on March 1, 2024 were not sufficient to pay the Company’s existing liabilities. The Company does not believe it has sufficient capital to fund its current obligations, as they become due, as the Company has limited available cash resources and requires additional funds in order to continue to fund its current operations , and to pay existing and future liabilities and other obligations. Our future capital requirements will depend on many factors, including:

~~Revenue Recognition~~● the ability to successfully sale a portion of the Immunome Shares received in the Asset Sale;. ● The cost of conducting and completing clinical trials of BST-236; ● the scope, progress, results and costs of discovery, preclinical development, laboratory testing and clinical trials for other potential product candidates we may develop or acquire, if any; ● the costs, timing and outcome of regulatory review of our product candidates; ● the achievement of milestones or occurrence of other developments that trigger payments under any current or future license, collaboration or other agreements; ● the costs and timing of future commercialization activities, including product sales, marketing, manufacturing and distribution, for any of our product candidates for which we receive marketing approval; ● the amount of revenue, if any, received from commercial sales of our product candidates, should any of our product candidates receive marketing approval; ● the costs of preparing, filing and prosecuting patent applications, obtaining, maintaining, protecting and enforcing our intellectual property rights and defending intellectual property-related claims; ● the costs of operating as a public company.

~~Under~~Conducting ~~ASC~~preclinical ~~606,~~testing anand ~~entity~~clinical ~~recognizes~~trials ~~revenue~~is ~~when~~a ~~its customer obtains control of promised goods or services~~time-consuming, inexpensive anand ~~amount~~uncertain process that ~~reflects~~takes ~~the consideration~~years ~~which the entity expects~~ to ~~receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606~~complete, ~~the~~and ~~entity~~we ~~performs the following five steps: (i) identify the contract(s)~~may ~~with~~never agenerate ~~customer; (ii) identify~~ the ~~performance~~necessary ~~obligations~~data inor ~~the~~results ~~contract;~~required ~~(iii) determine the transaction price; (iv) allocate the transaction price~~ to ~~the~~obtain ~~performance~~marketing ~~obligations~~approval inand ~~the~~achieve ~~contract;~~product ~~and~~sales. ~~(v)~~In ~~recognize~~addition, ~~revenue~~our ~~when~~product candidates, ~~(or~~if ~~as)~~approved, ~~the~~may ~~entity~~not ~~satisfies~~achieve acommercial ~~performance obligation~~success. ~~The~~Our ~~Company~~commercial ~~only~~revenues, ~~applies~~if ~~the~~any, ~~five-step~~will ~~model~~be toderived ~~contracts~~from ~~when~~sales itof ~~is probable~~ products that ~~the~~we ~~entity~~do ~~will~~not ~~collect~~expect ~~the consideration it is entitled~~ to inbe ~~exchange~~commercially available for ~~the~~many ~~goods~~years, orif ~~services~~at ~~it transfers to the customer~~all. ~~At contract inception~~Accordingly, ~~once~~we ~~the~~will ~~contract~~need ~~is determined~~ to becontinue ~~within~~to ~~the~~rely ~~scope~~on ~~of ASC 606, the Company assesses the goods or services promised within each contract, determines those that are~~additional ~~performance~~financing ~~obligations~~to ~~and~~achieve ~~assesses~~our ~~whether~~business ~~each promised good or service is distinct~~objectives. ~~The~~Adequate ~~Company~~additional ~~then~~financing ~~recognizes~~may asnot ~~revenue~~be ~~the~~available ~~amount of the transaction price that is allocated~~ to ~~the~~us ~~respective~~on ~~performance~~acceptable ~~obligation~~terms, ~~when (~~or ~~as)~~at ~~the performance obligation is satisfied~~all.

65Until such time, if ever, as we can generate substantial product revenues, we expect to finance our cash needs through a combination of equity offerings, debt financings, collaborations, strategic alliances and licensing arrangements. We do not have any committed external source of funds. To the extent that we raise additional capital through the sale of equity or convertible debt securities, your ownership interests may be diluted.. Any debt financing, if available, may involve agreements that include restrictive covenants that limit our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends, that could adversely impact our ability to conduct our business.

The Company enters into licensing agreements that are within the scope of ASC 606, under which it may exclusively license rights to research, develop, manufacture and commercialize its product candidates to third parties. The terms of these arrangements typically include payment to the Company of one or more of the following: non-refundable, upfront license fees; reimbursement of certain costs; customer option exercise fees; development, regulatory and commercial milestone payments; and royalties on net sales of licensed products.

In determining the appropriate amount of revenue to be recognized as it fulfills its obligations under its agreements, the Company performs the following steps: (i) identification of the promised goods or services in the contract; (ii) determination of whether the promised goods or services are performance obligations including whether they are distinct in the context of the contract; (iii) measurement of the transaction price, including the constraint on variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue when (or as) the Company satisfies each performance obligation. As part of the accounting for these arrangements, the Company must use significant judgment to determine: (a) the number of performance obligations based on the determination under step (ii) above; (b) the transaction price under step (iii) above; and (c) the stand-alone selling price for each performance obligation identified in the contract for the allocation of transaction price in step (iv) above. The Company uses judgment to determine whether milestones or other variable consideration, except for royalties, should be included in the transaction price as described further below. The transaction price is allocated to each performance obligation on a relative stand-alone selling price basis, for which the Company recognizes revenue as or when the performance obligations under the contract are satisfied.

Amounts received prior to revenue recognition are recorded as deferred revenue. Amounts expected to be recognized as revenue within the 12 months following the balance sheet date are classified as current portion of deferred revenue in the accompanying consolidated balance sheets. Amounts not expected to be recognized as revenue within the 12 months following the balance sheet date are classified as deferred revenue, net of current portion.

Exclusive Licenses. If the license to the Company’s intellectual property is determined to be distinct from the other performance obligations identified in the arrangement, the Company recognizes revenue from non-refundable, upfront fees allocated to the license when the license is transferred to the customer and the customer is able to use and benefit from the license. In assessing whether a performance obligation is distinct from the other performance obligations, the Company considers factors such as the research, development, manufacturing and commercialization capabilities of the collaboration partner and the availability of the associated expertise in the general marketplace. In addition, the Company considers whether the collaboration partner can benefit from a performance obligation for its intended purpose without the receipt of the remaining performance obligation, whether the value of the performance obligation is dependent on the unsatisfied performance obligation, whether there are other vendors that could provide the remaining performance obligation, and whether it is separately identifiable from the remaining performance obligation. For licenses that are combined with other performance obligation, the Company utilizes judgment to assess the nature of the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time and, if over time, the appropriate method of measuring progress for purposes of recognizing revenue. The Company evaluates the measure of progress each reporting period and, if necessary, adjusts the measure of performance and related revenue recognition. The measure of progress, and thereby periods over which revenue should be recognized, are subject to estimates by management and may change over the course of the research and development and licensing agreement. Such a change could have a material impact on the amount of revenue the Company records in future periods.

Milestone Payments. At the inception of each arrangement that includes research or development milestone payments, the Company evaluates whether the milestones are considered probable of being achieved and estimates the amount to be included in the transaction price using the most likely amount method. If it is probable that a significant revenue reversal would not occur, the associated milestone value is included in the transaction price. An output method is generally used to measure progress toward complete satisfaction of a milestone. Milestone payments that are not within the control of the Company or the licensee, such as regulatory approvals, are not considered probable of being achieved until those approvals are received. The Company evaluates factors such as the scientific, clinical, regulatory, commercial, and other risks that must be overcome to achieve the particular milestone in making this assessment. There is considerable judgment involved in determining whether it is probable that a significant revenue reversal would not occur. At the end of each subsequent reporting period, the Company re-evaluates the probability of achievement of all milestones subject to constraint and, if necessary, adjusts its estimate of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis, which would affect revenue and earnings in the period of adjustment.

Stock Based Compensation

The Company has an equity plan which allows for the granting of stock options to its employees, directors and consultants for a fixed number of shares with an exercise price equal to the fair value of the shares at date of grant. The Company measures the cost of services received in exchange for an award of equity instruments based on the fair value of the award. The fair value of the award is measured on the grant date and is then recognized over the requisite service period, usually the vesting period, in both research and development expenses and general and administrative expenses on the consolidated statement of operations, depending on the nature of the services provided by the employees or consultants.

The process of estimating the fair value of stock-based compensation awards and recognizing stock-based compensation cost over their requisite service period involves significant assumptions and judgments. The Company estimates the fair value of stock option awards on the date of grant using the Black Scholes Model (“BSM”) for the remaining awards, which requires that the Company makes certain assumptions regarding: (i) the expected volatility in the market price of its common stock; (ii) dividend yield; (iii) risk-free interest rates; and (iv) the period of time employees are expected to hold the award prior to exercise (referred to as the expected holding period). As a result, if the Company revises its assumptions and estimates, stock-based compensation expense could change materially for future grants.

The Company accounts for stock-based compensation using fair value recognition and records forfeitures as they occur. As such, the Company recognizes stock-based compensation cost only for those stock-based awards that vest over their requisite service period, based on the vesting provisions of the individual grants.

Warrant Liabilities

Some of our warrants meet the criteria as liability classified derivative instruments and are recorded at fair value on the grant date and re-valued at each reporting date, with changes in the fair value reported in the statements of operations. Warrant liabilities are classified on the balance sheet as current or non-current based on whether or not net-cash settlement or conversion of the instrument could be required within 12 months of the balance sheet date. Volatility in our common stock may result in significant changes in the value of the warrant liabilities and resulting gains and losses on our consolidated statement of operations.

Intangible Assets

Intangible assets primarily consist of legal and filing costs associated with obtaining patents and licenses and are amortized on a straight-line basis over their remaining useful lives which are estimated to be twenty years from the effective dates of the University of Pennsylvania (Penn) License Agreements, beginning in July 1, 2002. These legal and filing costs are invoiced to the Company through Penn and its patent attorneys.

Management reviews its long-lived assets for impairment whenever events and circumstances indicate that the carrying value of an asset might not be recoverable. Net assets are recorded on the balance sheet for patents related to ADXS-HER2 and the Lm technology licensed from the University of Pennsylvania. There are various scenarios under which an impairment charge may be recorded, which include if a competitor were to gain FDA approval for a similar treatment before the Company, if future clinical trials fail to meet the targeted endpoints, or if a drug application is rejected or fails to be issued. Lastly, if the Company is unable to raise enough capital to continue funding its studies and developing its intellectual property, the Company would likely record an impairment to these assets.

Leases

At the inception of an arrangement, the Company determines whether an arrangement is or contains a lease based on the facts and circumstances present in the arrangement. An arrangement is or contains a lease if the arrangement conveys the right to control the use of an identified asset for a period of time in exchange for consideration. Most leases with a term greater than one year are recognized on the consolidated balance sheet as operating lease right-of-use assets and current and long-term operating lease liabilities, as applicable. The Company has elected not to recognize on the consolidated balance sheet leases with terms of 12 months or less. The Company typically only includes the initial lease term in its assessment of a lease arrangement. Options to extend a lease are not included in the Company’s assessment unless there is reasonable certainty that the Company will renew.

Operating lease liabilities and their corresponding right-of-use assets are recorded based on the present value of lease payments over the expected remaining lease term. Certain adjustments to the right-of-use asset may be required for items such as prepaid or accrued rent. The interest rate implicit in the Company’s leases is typically not readily determinable. As a result, the Company utilizes its incremental borrowing rate, which reflects the fixed rate at which the Company could borrow on a collateralized basis the amount of the lease payments in the same currency, for a similar term, in a similar economic environment. In transition to ASC 842, the Company utilized the remaining lease term of its leases in determining the appropriate incremental borrowing rates.

New Accounting Standards

See Note 2 to our financial statements that discusses new accounting standards.

Item 7A. Quantitative and Qualitative Disclosures About Market Risk.

~~At October 31, 2022, we had approximately $25~~Omitted.2 million in cash and cash equivalents, which consisted primarily of bank deposits and money market funds. Our investment policy and strategy are focused on preservation of capital and supporting our liquidity requirements. We use a combination of internal and external management to execute our investment strategy and achieve our investment objectives. We typically invest in highly-rated securities (such as money market funds), and our investment policy generally limits the amount of credit exposure to any one issuer. The policy requires investments generally to be investment grade, with the primary objective of minimizing the potential risk of principal loss. Such interest-earning instruments carry a degree of interest rate risk; however, historical fluctuations of interest income have not been significant.

We have not been exposed nor do we anticipate being exposed to material risks due to changes in interest rates. A hypothetical 10% change in interest rates during any of the periods presented would not have had a material impact on our financial statements.31

Item 8. Financial Statements and Supplementary Data.

The information required by this Item 8 is incorporated by reference to our financial statements and the related notes and the report of our independent registered public accounting firm beginning at page F-1 of this report.

Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure.

None.

Item 9A: Controls and Procedures.

Evaluation of Disclosure Controls and Procedures

We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our Exchange Act reports is recorded, processed, summarized, and reported within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our management, including our Chief Executive Officer and our Interim Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. In designing and evaluating the disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and procedures reflects the fact that there are resource constraints and that management is required to apply its judgment in evaluating the benefits of possible controls and procedures relative to their costs.

As required by Rule 13a-15(b) under the Exchange Act, our management, under the supervision and with the participation of our Chief Executive Officer and our Interim Chief Financial Officer, conducted an evaluation of the effectiveness of our disclosure controls and procedures as of October 31, 2022. Based on such evaluation, our Chief Executive Officer and our Interim Chief Financial Officer concluded that, as of October 31, 2022, our disclosure controls and procedures were effective.

Management’s Annual Report on Internal Control over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as defined in Rule 13a-15(f) under the Exchange Act. With the participation of our Chief Executive Officer and our Interim Chief Financial Officer, our management conducted an evaluation of the effectiveness of our internal control over financial reporting as of October 31, 2022. In conducting such evaluation, management used the criteria set forth in the report entitled “Internal Control — Integrated Framework” published by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) to evaluate the effectiveness of our internal control over financial reporting. Based on this evaluation, management has concluded that our internal control over financial reporting was effective as of October 31, 2022, based on those criteria.

This report does not include an attestation report of our independent registered public accounting firm regarding our internal control over financial reporting, in accordance with applicable SEC rules that permit us to provide only management’s report in this report.

Changes in Internal Control Over Financial Reporting

There was no change in our internal control over financial reporting during the fiscal year ended October 31, 2022, that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

Internal control over financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements prepared for external purposes in accordance with generally accepted accounting principles. Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

Item 9B. Other Information

None.

Item 9C. Disclosure Regarding Foreign Jurisdictions That Prevent Inspections.

None.

PART III

Item 10. Directors, Executive Officers and Corporate Governance.

Legal Proceedings Involving Directors

None.

Board Leadership Structure

On May 27, 2015, David Sidransky was appointed Chairman of the Board of Directors (the “Board”) and continues to serve as Chairman. Dr. Sidransky’s experience in life science companies, as well as his scientific knowledge, his history with our Company and his own history of innovation and strategic thinking, qualify him to serve as our Chairman. Additionally, on April 23, 2018, Kenneth Berlin was appointed President and Chief Executive Officer and named a member of the Board of Directors. Mr. Berlin’s knowledge of industry standards and his experience in industry operations, and his leadership experience complements Dr. Sidransky’s scientific knowledge.

While we do not have a formal policy regarding the separation of our principal executive officer and chairman of our Board, we believe the current structure is in the best interest of the Company at this time. Further, this structure demonstrates to our employees and stockholders that we are under strong leadership, with multiple skills and sets the tone for managing our operations. This leadership structure promotes strategic development and execution, timely decision-making and effective management of our resources. We believe that we are well-served by this structure.

New Ayala’s directors are elected annually by the stockholders and serve for one-year terms until his/her successor is elected and qualified or until such director’s earlier death, resignation or removal. The executive officers and key personnel are appointed by and serve at the discretion of the Board of Directors. The executive officers and directors of New Ayala and their respective ages as of October 31, 2022 were as follows:

Name	Age	Position
Dr. David Sidransky (2) (3) (4)	62	Chairman of our Board of Directors
Dr. James P. Patton (1) (3) (4)	65	Vice Chairman of our Board of Directors
Roni A. Appel (1) (3)	56	Director
Kenneth A. Berlin	58	President and Chief Executive Officer, Director
Richard J. Berman (1) (2)	80	Director
Dr. Samir N. Khleif (2) (4)	59	Director
Andres Gutierrez	62	Chief Medical Officer and Executive Vice President
Igor Gitelman	47	Interim Chief Financial Officer, VP of Finance

	(1)	Member of the Audit Committee
	(2)	Member of the Compensation Committee
	(3)	Member of the Nominating and Corporate Governance Committee
	(4)	Member of the Research & Development Committee

In connection with the Merger, Dr. Patton and Mr. Berman stepped down from the Board and were replaced by Dr. Vered Bisker-Leib, Murray A. Goldberg, and Dr. Robert Spiegel.

Dr. David Sidransky

Dr. Sidransky currently serves as the Chairman of our Board of Directors and has served as a member of our Board of Directors since July 2013. He is a renowned oncologist and research scientist named and profiled by TIME magazine in 2001 as one of the top physicians and scientists in America, recognized for his work with early detection of cancer. Since 1994, Dr. Sidransky has been the Director of the Head and Neck Cancer Research Division and Professor of Oncology, Otolaryngology, Genetics, and Pathology at Johns Hopkins University School of Medicine. He has served as Chairman or Lead of the Board of Directors of Champions Oncology since October 2007 and was a director and Vice-Chairman of ImClone Systems until its merger with Eli Lilly Inc. He is the Chairman of Tamir Biotechnology and Ayala and serves on the Board of Directors of Galmed and Orgenesis. He has served on scientific advisory boards of MedImmune, Roche, Amgen, and Veridex, LLC (a Johnson & Johnson diagnostic company), among others. Dr. Sidransky served as Director (2005-2008) of the American Association for Cancer Research (AACR). He earned his B.S. from Brandeis University and his Medical Doctorate from Baylor College of Medicine. Dr. Sidransky’s experience in life science companies, as well as his scientific knowledge, qualify him to service as our director and non-executive chairman.

Roni A. Appel

Mr. Appel has served as a member of our Board of Directors since November 2004. He was our President and Chief Executive Officer from January 1, 2006 until December 2006 and Secretary and Chief Financial Officer from November 2004 to September 2006. From December 15, 2006 to December 2007, Mr. Appel served as a consultant to us. Mr. Appel currently is a self-employed consultant and the Co-Founder and President of Spirify Pharma Inc. Previously, he served as Chief Executive Officer of Anima Biotech Inc., from 2008 through January 31, 2013. From 1999 to 2004, he was a partner and managing director of LV Equity Partners (f/k/a LibertyView Equity Partners). From 1998 until 1999, he was a director of business development at Americana Financial Services, Inc. From 1994 to 1996, he worked as an attorney. Mr. Appel holds an M.B.A from Columbia University (1998) and an LL.B. from Haifa University (1994). Mr. Appel’s longstanding service with us and his entrepreneurial investment career in early stage biotech businesses qualify him to serve as our director.

Kenneth Berlin

Mr. Berlin has served as our President and Chief Executive Officer and a member of our Board of Directors since April 2018. Mr. Berlin served as our Interim Chief Financial Officer from September 2020 to May 2022. Prior to joining New Ayala, Mr. Berlin served as President and Chief Executive Officer of Rosetta Genomics from November 2009 until April 2018. Prior to Rosetta Genomics, Mr. Berlin was Worldwide General Manager at cellular and molecular cancer diagnostics developer Veridex, LLC, a Johnson & Johnson company. At Veridex he grew the organization to over 100 employees, launched three cancer diagnostic products, led the acquisition of its cellular diagnostics partner, and delivered significant growth in sales as Veridex transitioned from an R&D entity to a commercial provider of oncology diagnostic products and services. Mr. Berlin joined Johnson & Johnson in 1994 and served as corporate counsel for six years. From 2001 until 2004 he served as Vice President, Licensing and New Business Development in the pharmaceuticals group, and from 2004 until 2007 served as Worldwide Vice President, Franchise Development, Ortho-Clinical Diagnostics. Mr. Berlin holds an A.B. degree from Princeton University and a J.D. from the University of California Los Angeles School of Law. Mr. Berlin’s experience in life science companies, as well as his business experience in general, qualify him to service as our director.

Dr. Samir Khleif

Dr. Khleif has served as a member of our Board of Directors since October 2014. He currently serves as the Director of the State of Georgia Cancer Center, Georgia Regents University Cancer Center and the Cancer Service Line. Dr. Khleif was formerly Chief of the Cancer Vaccine Section at the NCI, and also served as a Special Assistant to the Commissioner of the FDA leading the Critical Path Initiative for oncology. Dr. Khleif is a Georgia Research Alliance Distinguished Cancer Scientist and Clinician and holds a professorship in Medicine, Biochemistry and Molecular Biology, and Graduate Studies at Georgia Regents University. Dr. Khleif’s research program at Georgia Regents University Cancer Center focuses on understanding the mechanisms of cancer-induced immune suppression, and utilizing this knowledge for the development of novel immune therapeutics and vaccines against cancer. His research group designed and performed some of the first cancer vaccine clinical trials targeting specific genetic changes in cancer cells. He led many national efforts and committees on the development of biomarkers and integration of biomarkers in clinical trials, including the AACR-NCI-FDA Cancer Biomarker Collaborative and the ASCO Alternative Clinical Trial Design. Dr. Khleif is the author of many book chapters and scientific articles on tumor immunology and biomarkers process development, and he is the editor for two textbooks on cancer therapeutics, tumor immunology, and cancer vaccines. Dr. Khleif was inducted into the American Society for Clinical Investigation, received the National Cancer Institute’s Director Golden Star Award, the National Institutes of Health Award for Merit, the Commendation Medal of the US Public Health Service, and he was recently appointed to the Institute of Medicine National Cancer Policy Forum. Dr. Khleif’s distinguished career as well as his extensive expertise in vaccines and immunotherapies qualify him to serve as our director.

Vered Bisker-Leib, Ph.D., M.B.A.

Dr. Bisker-Leib has served as a member of the Old Ayala Board of Directors since January 2023. Dr. Bisker-Leib is the President and Chief Operating Officer of Compass Therapeutics, Inc. where she has been a member of the executive leadership team since November 2017. Prior to Compass, Dr. Bisker-Leib advised Atlas Ventures portfolio companies as an entrepreneur-in-residence from November 2016 to November 2017. Previously, as the Chief Business Officer of Cydan Development, Inc. from October 2014 to October 2016, Dr. Bisker-Leib founded biotech companies focused on therapies addressing rare diseases, including Imara Inc. Dr. Bisker-Leib was a member of BMS’ strategic transactions group where she assumed roles of increasing responsibility across five therapeutic areas, most recently as an Executive Director and Global Head of business development for the cardiovascular and metabolic franchises. Dr. Bisker-Leib received a Ph.D. in Chemical Engineering and an M.B.A. from the University of Massachusetts, Amherst. Dr. Bisker-Leib has a B.Sc. in Chemical Engineering from the Israel Institute of Technology, Haifa. We believe that Dr. Bisker-Leib’s extensive experience in the life-science industry qualifies her to serve on our board of directors.

Murray A. Goldberg, M.B.A.

Mr. Goldberg has served as a member of the Old Ayala Board of Directors since January 2023. Mr. Goldberg held various management positions at Regeneron Pharmaceuticals, Inc., a biopharmaceutical company, from March 1995 to March 2015, including as Senior Vice President of Administration and Assistant Secretary from October 2013 to March 2015, as Chief Financial Officer and Senior Vice President, Finance and Administration and Assistant Secretary from March 1995 to October 2013 and as Treasurer from March 1995 to October 2012. Mr. Goldberg previously served on the boards of directors of Aerie Pharmaceuticals Inc., a biopharmaceutical company, from August 2013 to June 2020, where he also served as the chairman of its audit committee, and Teva Pharmaceuticals Industries Ltd. from July 2017 to June 2020. Mr. Goldberg received a B.S. in Engineering from New York University, a Master’s degree in International Economics from the London School of Economics and an M.B.A. from the University of Chicago. We believe that Mr. Goldberg is qualified to serve on our board of directors because of his broad financial, operational and transactional experience in the industry.

Robert Spiegel, M.D., F.A.C.P.

Dr. Spiegel has served as a member of the Old Ayala Board of Directors since January 2023. Since 2012, Dr. Spiegel has served as an Associate Professor at the Weill Cornell Medical School. In addition, Dr. Spiegel has served as a Senior Advisor to Warburg Pincus, a private equity firm, and an Advisor to the Israel Biotech Fund, a venture investment fund since 2010 and 2016, respectively. Prior to these positions, Dr. Spiegel served as Chief Medical Officer of PTC Therapeutics, Inc., a biopharmaceutical company, from March 2011 to April 2016. Prior to his time at PTC Therapeutics, Dr. Spiegel held various management positions at Schering-Plough Corporation, a global healthcare company, including as Chief Medical Officer and Senior Vice President of the Schering-Plough Research Institute, the pharmaceutical research arm of the Schering-Plough Corporation from 1998 to 2009. Dr. Spiegel is currently a member of the board of directors of Geron Corporation and Cyclacel Pharmaceuticals, Inc., biopharmaceutical company, since 2010 and 2018, respectively. Dr. Spiegel has previously served as a member of the board of directors for Sucampo Pharmaceuticals, Inc., a biopharmaceutical company, Edge Therapeutics, Inc., a biotechnology company, Avior Computing Corporation, a privately-held governance risk and compliance process technology company, Talon Therapeutics, Inc., a biopharmaceutical company, Capstone Therapeutics Corp., a biotechnology company, the Cancer Institute of New Jersey and Cancer Care New Jersey. Dr. Spiegel received a B.A. in 1971 from Yale University and an M.D. from the University of Pennsylvania in 1975. Following his residency in internal medicine, Dr. Spiegel completed a fellowship in medical oncology at the National Cancer Institute. We believe that Dr. Spiegel’s extensive medical and scientific knowledge as well as his experience in the life science industry qualifies him to serve on our board of directors.

Igor Gitelman

Mr. Gitelman has served as our Interim Chief Financial Officer since May of 2022, VP of Finance since November 2020 and Chief Accounting Officer since February 2021. Before joining the Company, Mr. Gitelman served as CFO Executive Financial Consultant for Accu Reference Medical Labs, a clinical diagnostic laboratory. Before that, from February 2017 through November 2018, Mr. Gitelman served as a chief accounting officer of Cancer Genetics, Inc., a drug discovery, preclinical oncology, and immuno-oncology services company. Prior to that, Mr. Gitelman served as an Assistant to Vice President (AVP) of Finance and Tax at clinical diagnostic laboratory, BioReference Laboratories, Inc., from October 2005 to October 2016. During this time at BioReference Laboratories, Inc., Mr. Gitelman held various positions of increasing responsibility managing the company’s internal audit function, SEC financial reporting, tax, and corporate finance functions.

Andres Gutierrez, M.D., Ph.D.

Dr. Gutierrez has served as our Executive Vice President and Chief Medical Officer since April 2018. Prior to joining New Ayala, Dr. Gutierrez served as Chief Medical Officer for Oncolytics Biotech, Inc. from November 2016 to April 2018. Prior to Oncolytics, Dr. Gutierrez was Chief Medical Officer at SELLAS Life Sciences Group from November 2015 to September 2016 and was Medical Director, Early Development Immuno-Oncology at BMS from October 2012 to November 2015, where he oversaw the development of translational and clinical development of immuno-oncology programs in solid tumors and hematological malignancies. Earlier, Dr. Gutierrez was Medical Director for several biotechnology companies, including Sunesis Pharmaceuticals, BioMarin Pharmaceutical, Proteolix and Oculus Innovative Sciences, leading key programs with talazoparib and carfilzomib, among others. Prior to Oculus, he served as Director of the Gene & Cell Therapy Unit at the National Institutes of Health in Mexico City and as a consultant physician at the Hospital Angeles del Pedregal.

Director Independence

Each of our incumbent non-employee directors is independent in accordance with the definition set forth in the rules of the Nasdaq Stock Market LLC, though our common stock is not currently listed on that exchange. Each nominated member of each of our Board committees is an independent director under the Nasdaq standards applicable to such committees. The Board considered the information included in transactions with related parties as outlined below along with other information the Board considered relevant, when considering the independence of each director.

Board Meetings and Committee Meetings; Attendance

All directors who served as directors at the time attended our 2022 Annual Meeting of Stockholders. Directors are expected, but not required, to attend the annual meeting of stockholders. Our Board holds meetings at least quarterly. Our Board held 20 meetings during fiscal year 2022.

Audit Committee

The Audit Committee of our Board of Directors is currently composed of three directors, all of whom satisfy the independence and other standards for Audit Committee members under the Nasdaq rules and the Exchange Act rules. The Audit Committee is responsible for recommending the engagement of auditors to the full Board, reviewing the results of the audit engagement with the independent registered public accounting firm, identifying irregularities in the management of our business in consultation with our independent accountants, and suggesting an appropriate course of action, reviewing the adequacy, scope, and results of the internal accounting controls and procedures, reviewing the degree of independence of the auditors, as well as the nature and scope of our relationship with our independent registered public accounting firm, and reviewing the auditors’ fees. For fiscal year 2022, the Audit Committee was composed of Messrs. Berman and Appel and Dr. Patton, with Mr. Berman serving as the Audit Committee’s financial expert as defined under Item 407 of Regulation S-K. The Audit Committee held five meetings during the most recent fiscal year.

Following the Merger, the Audit Committee is comprised of Mr. Goldberg, Mr. Appel and Dr. Bisker-Leib.

The Audit Committee operates under a written Audit Committee Charter, which is available to stockholders on our website at https://www.ayalapharma.com/corporate-governance/governance-overview.

Compensation Committee

The Compensation Committee of our Board of Directors as of October 31, 2022 consisted of Mr. Berman, and Drs. Khleif and Sidransky. The Compensation Committee determines the salaries, bonuses, and incentive and equity compensation of our officers subject to applicable employment agreements, provides recommendations for the salaries and incentive compensation of our other employees and consultants, and reviews and oversees our compensation programs and policies generally. For executives other than the Chief Executive Officer, the Compensation Committee receives and considers performance evaluations and compensation recommendations submitted to the Committee by the Chief Executive Officer. In the case of the Chief Executive Officer, the evaluation of his performance is conducted by the Compensation Committee, which determines any adjustments to his compensation as well as awards to be granted. The agenda for meetings of the Compensation Committee is usually determined by its Chairman, with the assistance of the Company’s Chief Executive Officer. The Compensation Committee held one meeting and acted by unanimous written consent once during the 2022 fiscal year.

Following the Merger, the Compensation Committee is comprised of Mr. Appel, Dr. Bisker-Leib and Dr. Sidransky.

The Compensation Committee operates under a written Compensation Committee Charter, which is available to stockholders on our website at https://www.ayalapharma.com/corporate-governance/governance-overview.

Nominating and Corporate Governance Committee

The Nominating and Corporate Governance Committee of our Board of Directors as of October 31, 2022 consisted of Mr. Berman, and Drs. Patton, Khleif and Sidransky. The functions of the Nominating and Corporate Governance Committee include identifying and recommending to the Board individuals qualified to serve as members of the Board and on the committees of the Board, advising the Board with respect to matters of board composition, procedures and committees, developing and recommending to the Board a set of corporate governance principles applicable to us and overseeing corporate governance matters generally including review of possible conflicts and transactions with persons affiliated with directors or members of management, and overseeing the annual evaluation of the Board and our management. The Nominating and Governance Committees held 1 meeting during the 2022 fiscal year.

Following the Merger, the Nominating and Governance Committee is comprised of Drs. Sidransky, Spiegel and Khleif.

The Nominating and Corporate Governance Committee operates under a written Nominating and Corporate Governance Committee Charter, which is available to stockholders on our website at https://www.ayalapharma.com/corporate-governance/governance-overview.

Research and Development Committee

The Research and Development Committee was established in August 2013 with the purpose of providing advice and guidance to the Board on scientific and medical matters and development. The Research and Development Committee as of October 31, 2022 consisted of Drs. Sidransky, Khleif and Patton. The functions of the Research and Development Committee include providing advice and guidance to the Board on scientific matters and providing advice and guidance to the Board on medical matters. The Research and Development Committee held 1 meeting during the 2021 fiscal year.

Following the Merger, the Nominating and Governance Committee is comprised of Drs. Khleif, Sidransky and Spiegel.

Code of Ethics

We have adopted a Code Business Conduct and Ethics that applies to our employees, senior management and Board of Directors, including the Chief Executive Officer and Chief Financial Officer. The Code of Business Conduct and Ethics is available on our website at https://www.ayalapharma.com/corporate-governance/governance-overview.

Item 11: Executive Compensation.

The following table sets forth the compensation of our chief executive officer and chief financial officer, and our “named executive officers,” for the fiscal years ended October 31, 2022 and 2021:

Summary Compensation Table

Name and Principal Position	Fiscal Year		Salary		Bonus		Stock Award(s)		Option Award(s) (1)		All Other Compensation (2)		Total
Kenneth Berlin		2022	$	643,427	$	-		-	$	-	$	60,341	$	703,768
President, Chief Executive Officer		2021	$	569,670	$	-		-	$	-	$	55,728	$	625,398
Igor Gitelman (3)		2022	$	299,985	$	-		-	$	-	$	42,224	$	342,209
Executive VP, Interim Chief Finance Officer		2021	$	259,135	$	-		-	$	15,777	$	38,733	$	313,645
Andres Gutierrez		2022	$	494,944	$	-		-	$	-	$	38,683	$	533,627
Senior VP, Chief Medical Officer		2021	$	438,208	$	-		-	$	-	$	33,824	$	472,032

	(1)	Reflects the aggregate grant date fair value of stock options determined in accordance with FASB ASC Topic 718. The assumptions used in determining the grant date fair values of the stock options are set forth in Note 7 to the Company’s financial statements.
	(2)	All Other Compensation is more fully described in the table under “All Other Compensation – Supplemental” below.
	(3)	Mr. Gitelman began his employment with the Company as VP of Finance in November 2020 and as Chief Accounting Officer since February 2021, and was named Interim Chief Financial Officer on May 1, 2022.

All Other Compensation – Supplemental

	Fiscal		Health Insurance Premiums		Life and AD&D Insurance		Matching Contributions to 401(k) Plan		Other		Total
Name and Principal Position	Year		$		$		$		$		$
Kenneth Berlin		2022		35,179		536		24,026		600		60,341
President, Chief Executive Officer		2021		32,526		696		21,906		600		55,728
Igor Gitelman		2022		35,179		536		5,909		600		42,224
Chief Accounting Officer, VP of Finance		2021		29,442		665		8,049		577		38,733
Andres Gutierrez		2022		35,179		536		2,368		600		38,683
Senior VP, Chief Medical Officer		2021		32,526		698		-		600		33,824

Employment Agreements with Named Executive Officers

The Company appointed Mr. Berlin as President and Chief Executive Officer, effective April 23, 2018. The Company and Mr. Berlin entered into an employment agreement, effective April 23, 2018, which provides for an initial three-year term, after which it will be automatically renewed for one-year periods, unless otherwise terminated by either party upon ninety (90) days’ written notice. The employment agreement provides that Mr. Berlin will receive a base salary of $696,115 per year, as adjusted for annual increases by the Compensation Committee since entry of the agreement, and he is eligible for an annual bonus targeted at 55% of his base salary based on achievement of performance goals in the discretion of the Compensation Committee. Mr. Berlin also received a one-time lump-sum bonus equal to $150,000 that was paid within fifteen (15) days following the effective date of the agreement. Mr. Berlin also received 625 stock options and 208 restricted stock units, which vest in equal instalments over the first three years of his employment. In May 2020, Mr. Berlin received an additional 625 stock options.

The Company appointed Mr. Gitelman as Chief Accounting Officer, effective February 11, 2021. Mr. Gitelman does not have an employment agreement with the Company. In November 2020, Mr. Gitelman received 625 stock options.

The Company appointed Mr. Gutierrez as Executive Vice President and Chief Medical Officer, effective April 23, 2018. The Company and Mr. Gutierrez entered into an employment agreement, effective April 23, 2018, which provides for an initial three-year term, after which it will be automatically renewed for one-year periods, unless otherwise terminated by either party upon ninety (90) days’ written notice. The employment agreement provides that Mr. Gutierrez will receive a base salary of $535,473 per year, as adjusted for annual increases by the Compensation Committee since entry of the agreement, and eligible for an annual bonus based on achievement of performance goals at the discretion of the Compensation Committee. Mr. Gutierrez also received a one-time lump-sum bonus equal to $40,000 that was paid within the first ninety (90) days following the effective date of the agreement. Mr. Gutierrez also received 208 stock options, which vest annually on the first three anniversaries of his employment as an equity incentive award. In May 2020, Mr. Gutierrez received an additional 625 stock options.

In the event Mr. Gutierrez employment is terminated without Just Cause, or if he voluntarily resigns with Good Reason, or if his employment is terminated due to disability (all as defined in their respective employment agreements), and so long as he executes a confidential separation and release agreement, in addition to the applicable base salary, plus any accrued but unused vacation time and unpaid expenses that have been earned as of the date of such termination, he is entitled to the following severance benefits: (i) twelve months of base salary payable in in equal monthly installments, (ii) a bonus payment for the year in which the employment is terminated equal to the target bonus percentage, multiplied by the base salary in effect at the time of termination, (iii) continued health and welfare benefits for 12 months, and (iv) full vesting of all stock options and stock awards (with extension of the exercise period for stock options by two years).

On September 12, 2022, the Company and Mr. Berlin entered into Amendment No. 1 to his employment agreement to revise certain terms related to if he was terminated without Just Cause or he terminated his employment for Good Reason. In the event Mr. Berlin’s employment is terminated without Just Cause during the period beginning three months prior to a Change in Control and ending after the CIC Protection Period, or if Mr. Berlin voluntarily resigns with Good Reason, during the CIC Protection Period, and provided that Mr. Berlin continues to comply with certain covenants set forth in his employment agreement, in addition to the applicable base salary and any earned but unpaid bonus for the prior fiscal year, plus any accrued but unused vacation time and unpaid expenses that have been earned as of the date of such termination, Mr. Berlin is entitled to the following severance benefits: (i) an amount equal to 2 times the sum of the applicable base salary plus an amount equal to Mr. Berlin’s target bonus, payable in a single lump sum within sixty (60) days of the termination, (ii) a bonus payment for the year in which the employment is terminated equal to the target bonus percentage, multiplied by the base salary in effect at the time of termination, multiplied by a fraction, the numerator of which is the number of calendar days Mr. Berlin was employed during such year and the denominator is 365, (iii) continued health and welfare benefits for 24 months, and (iv) full vesting and exercisability of all stock options and stock awards. Amendment No. 1 further provides, that in the event Mr. Berlin’s employment were terminated without Just Cause, or he terminated his employment for Good Reason, other than during the CIC Protection Period, he would receive equal monthly installments of 1.25 times his applicable Base Salary (increased from 1.0 times), and that he would receive this amount for 15 months rather than 12. In addition, the number of months for which he would receive continued health and welfare benefits in this circumstance is increased from 12 months to 15 months. Mr. Berlin is also entitled to a bonus payment for the year in which his employment is terminated equal to the target bonus percentage, multiplied by the base salary in effect at the time of termination.

The named executive officer employment agreements contain customary covenants regarding non-solicitation, non-compete, confidentiality and works for hire.

Potential Payments Upon Termination or Change-in-Control

Termination of Employment

As described above under “Employment Agreements with Named Executive Officers,” the Company has entered into employment agreements with two of the named executive officers that provide for certain severance payments and benefits in the event the named executive officer’s employment with the Company is terminated under certain circumstances.

In addition, upon a Change in Control of the Company, unvested equity awards held by two of the executive officers will be accelerated as follows: (i) outstanding stock options and other awards in the nature of rights that may be exercised shall become fully vested and exercisable, (ii) time-based restrictions on restricted stock, restricted stock units and other equity awards shall lapse and the awards shall become fully vested, and (iii) performance-based equity awards, if any, shall become vested and shall be deemed earned based on an assumed achievement of all relevant performance goals at “target” levels, and shall payout pro rata to reflect the portion of the performance period that had elapsed prior to the Change in Control.

The table below shows the estimated value of benefits to each of the named executive officers if their employment had been terminated under various circumstances as of October 31, 2022. The amounts shown in the table exclude accrued but unpaid base salary, unreimbursed employment-related expenses, accrued but unpaid vacation pay, and the value of equity awards that were vested by their terms as of October 31, 2022.

	Involuntary Termination without a Change in Control ($)			Involuntary Termination in connection with a Change in Control ($)			Death ($)			Disability ($)			Termination for Cause; Voluntary Resignation ($)
Kenneth Berlin
Cash severance		870,144	(1)		2,157,996	(5)		-			870,144	(1)		-
Bonus		382,863	(7)		382,863	(2)		382,863	(2)		382,863	(7)		-
Health benefits		45,813	(3)		73,701	(6)		-			45,813	(3)		-
Value of equity Acceleration		-	(4)		-	(4)		-	(4)		-	(4)		-
Total		1,298,820			2,614,120			382,863			1,298,820			-
Andres Gutierrez
Cash severance		535,473	(1)		535,473	(5)		-			535,473	(1)		-
Bonus		214,189	(7)		214,189	(2)		214,189	(7)		214,189	(7)		-
Health benefits		36,651	(3)		36,651	(6)		-			36,651	(3)		-
Value of equity Acceleration		-	(4)		-	(4)		-	(4)		—	(4)		-
Total		786,313			786,313			214,189			786,313			-
Igor Gitelman
Cash severance		-			-			-			-			-
Bonus		-			-			-			-			-
Health benefits		-			-			-			-			-
Value of equity Acceleration		-			-			-			-			-
Total		-			-			-			-			-

	(1)	For Mr. Berlin, reflects severance payment equal to 1.25 times base salary payable in equal monthly instalments for 15 months. For Mr. Gutierrez, reflects severance payment equal to one times base salary payable in equal monthly instalments for 12 months.
	(2)	Reflects pro rata bonus determined by multiplying the target bonus amount for the year in which the termination occurs by a fraction, the numerator of which is the number of calendar days the executive is employed during such year and the denominator of which is 365. Because the amounts reflected in the table assume the named executive officer’s employment was terminated on October 31, 2022 (the last day of the 2022 fiscal year), the amounts reflected are not pro-rated.
	(3)	For Mr. Berlin, reflects the Company’s cost of continued health coverage at active employee rates for 15 months. For Mr. Gutierrez, reflects the Company’s cost of continued health coverage at active employee rates for 12 months.
	(4)	Reflects the value of unvested in-the-money stock options that vest upon the designated event.
	(5)	For Mr. Berlin, reflects two times the sum of his base salary and target bonus, payable in equal monthly installments for 24 months. For Mr. Gutierrez, equals one times base salary, payable in equal monthly installments for 12 months.
	(6)	Reflects the full cost of continued health coverage for 24 months for Mr. Berlin and 12 months for Mr. Gutierrez.
	(7)	Represents a bonus payment equal to the executive’s target bonus.

Outstanding Equity Awards at 2022 Fiscal Year-End

The following table summarizes all outstanding equity awards held by our named executive officers at fiscal year-end. The market or payout value of unearned shares, units or rights that have not vested equals $1.86, which was the closing price of New Ayala’s common shares on Nasdaq on October 31, 2022 and for performance based restricted stock units presumes that the target performance goals are met.

Name	Number of Securities Underlying Unexercised Options (#) Exercisable		Number of Securities Underlying Unexercised Options (#) Unexercisable			Option Exercise Price ($)		Option Expiration Date	Number of Shares or Units of Stock That Have Not Vested (#)		Value of Shares or Units of Stock That Have Not Vested ($)
Kenneth Berlin		625		-	(1)		1,944.00	4/23/2028		-		-
		267		-	(2)		648.00	11/5/2028		-		-
		625		-	(3)		24.80	10/24/2029		-		-
		417		208	(4)		52.80	5/4/2030		-		-
Igor Gitelman		209		416	(6)		31.20	11/16/2030		-		-
Andres Gutierrez		208		-	(5)		1,944.00	4/23/2028		-		-
		104		-	(2)		648.00	11/05/2028		-		-
		313		-	(3)		24.80	10/24/2029		-		-
		417		208	(4)		52.80	5/4/2030		-		-

	(1)	Of these options, one-third vested on December 31, 2018, one-third vested on April 23, 2020, and the award was fully vested on April 23, 2021.
	(2)	Of these options, one-third vested on November 5, 2019, one-third vested on November 5, 2020, and the award was fully vested on November 5, 2021.
	(3)	Of these options, one-third vested on October 24, 2020, one-third vested on October 24, 2021, and the award was fully vested on October 24, 2022.
	(4)	Of these options, one-third vested on May 4, 2021, one-third will vest on May 4, 2022, and the award will be fully vested on May 4, 2023.
	(5)	Of these options, one-third vested on April 23, 2019, one-third vested on April 23, 2020, and the award was fully vested on April 23, 2021.
	(6)	Of these options, one-third vested on November 16, 2021, one-third was vested on November 16, 2022, and the award will be fully vested on November 16, 2023.

The table below summarizes the compensation that was earned by our non-employee directors for fiscal year 2022:

Name	Fees Earned or Paid in Cash ($) (1)		Option Awards ($) (2)		Total ($)
Dr. David Sidransky		105,000		-		105,000
Dr. James Patton		87,500		-		87,500
Roni A. Appel		62,500		-		62,500
Richard J. Berman		72,500		-		72,500
Dr. Samir N. Khleif		67,500		-		67,500

	(1)	Represents the annual retainers paid in cash for director services in fiscal year 2022.
	(2)	Reflects the aggregate grant date fair value of stock options determined in accordance with FASB ASC Topic 718. The assumptions used in determining the grant date fair values of the stock options are set forth in Note 7 to the Company’s financial statements.

Item 12: Security Ownership of Certain Beneficial Owners and Management and Related Shareholder Matters.

The following table sets forth information regarding the beneficial ownership of our common stock by (a) each person who is known to us to be the owner of more than five percent (5%) of our common stock, (b) each of our directors, (c) each of the named executive officers, and (d) all directors and executive officers and executive employees as a group. For purposes of the table, a person or group of persons is deemed to have beneficial ownership of any shares that such person has the right to acquire within 60 days of October 31, 2022. The percentage of ownership is based on 1,815,951 shares outstanding as of October 31, 2022. Unless otherwise indicated by footnote, the address for each of the beneficial owners set forth in the table below is c/o Ayala Pharmaceuticals, Inc., 9 Deer Park Drive, Suite K-1, Monmouth Junction, NJ 08852.

Name of Beneficial Owner	Total # of Shares Beneficially Owned		Percentage of Ownership
Kenneth Berlin (1)		2,205		*	%
Igor Gitelman (2)		417		*	%
David Sidransky (3)		461		*	%
Roni Appel (4)		508		*	%
Richard Berman (5)		399		*	%
Samir Khleif (6)		448		*	%
James Patton (7)		598		*	%
Andres Gutierrez (8)		1,089		*	%
All Current Directors and Officers as a Group (8 People) (9)		6,125		*	%

*	Constitutes less than 1% of our outstanding Common Stock.
(1)	Represents 271 issued shares of our Common Stock, and options to purchase 1,934 shares of our Common Stock exercisable within 60 days.
(2)	Represents options to purchase 417 shares of our Common Stock exercisable within 60 days.
(3)	Represents 93 issued shares of our Common Stock and options to purchase 368 shares of our Common Stock exercisable within 60 days.
(4)	Represents 133 issued shares of our Common Stock, options to purchase 351 shares of our Common Stock exercisable within 60 days and warrants to purchase 24 shares of our Common Stock exercisable within 60 days.
(5)	Represents 47 issued shares of our Common Stock and options to purchase 352 shares of our Common Stock exercisable within 60 days.
(6)	Represents 59 issued shares of our Common Stock and options to purchase 389 shares of our Common Stock exercisable within 60 days.
(7)	Represents 241 issued shares of our Common Stock and options to purchase 357 shares of our Common Stock exercisable within 60 days.
(8)	Represents 47 issued shares of our Common Stock and options to purchase 1,042 shares of our Common Stock exercisable within 60 days.
(9)	Represents 891 issued shares of our Common Stock and options to purchase 5,210 shares of our Common Stock exercisable within 60 days and warrants to purchase 24 shares of our Common Stock exercisable within 60 days.

Securities Authorized for Issuance under Equity Compensation Plans

Equity Compensation Plan Information

The following table includes information related to shares available and outstanding awards under our equity incentive plans as of October 31, 2022:

Plan Category	Number of Securities to be issued upon Exercise of outstanding Options, Warrants and Rights (#)		Weighted-average Exercise Price of Outstanding Options, Warrants and Rights ($)		Number of Securities Remaining Available for Future Issuance Under Equity Compensation Plans (#)
Equity Compensation Plans approved by security holders		11,118		1,412.82		66,191
Equity Compensation Plans not approved by security holders		-		-		-
TOTAL:		11,118		1,412.82		66,191

Compensation Committee Interlocks and Insider Participation

The members of the Compensation Committee during the 2022 fiscal year were Mr. Berman, and Drs. Khleif and Sidransky. During the 2022 fiscal year, no member of our Compensation Committee was an officer, former officer or employee of the Company or had any direct or indirect material interest in a transaction with us or in a business relationship with the Company that would require disclosure under the applicable rules of the SEC. In addition, no interlocking relationship existed between any member of our Compensation Committee, any member of our Board, or one of our executive officers, and any member of the board of directors or compensation committee of any other company.

Compensation Committee Report

Our Compensation Committee has reviewed and discussed the Compensation Discussion and Analysis with management. Based on this review and discussion, our Compensation Committee recommended to our Board of Directors that the Compensation Discussion and Analysis be included in our Annual Report on Form 10-K.

The Compensation Committee Dr. David Sidransky – Chair Dr. Samir Khleif Richard Berman

Item 13: Certain Relationships and Related Transactions, and Director Independence.

Certain Relationships and Related Transactions

Our policy is to enter into transactions with related parties on terms that, on the whole, are no more favorable, or no less favorable, than those available from unaffiliated third parties. Based on our experience in the business sectors in which we operate and the terms of our transactions with unaffiliated third parties, we believe that all transactions that we enter will meet this policy standard at the time they occur. Presently, we have no such related party transactions.

Director Independence

In accordance with the disclosure requirements of the SEC, we have adopted the Nasdaq listing standards for independence. Each of our non-employee directors is independent in accordance with the definition set forth in the Nasdaq rules. Each nominated member of each of our Board committees is an independent director under the Nasdaq standards applicable to such committees. The Board considered the information included in transactions with related parties as outlined below along with other information the Board considered relevant, when considering the independence of each director.

Item 14: Principal Accountant Fees and Services.

In December 2012, we engaged Marcum, LLP (“Marcum”) as our independent registered public accounting firm to audit our financial statements. Beginning with the fiscal year ended October 31, 2012, Marcum has audited our financial statements. The following table presents fees for professional services rendered by Marcum for the fiscal years ended October 31, 2022 and 2021:

	Fiscal 2022		Fiscal 2021
Audit Fees (1)	$	232,879	$	153,770
Tax Fees (2)		-		-
All Other Fees (3)		69,010		103,766
Total	$	301,889	$	257,536

	(1)	Audit Fees consisted primarily of annual audit fees and reviews of the Company’s quarterly reports on Form 10-Q.
	(2)	Tax Fees consisted primarily of services related to tax compliance, including the preparation, review and filing of tax returns.
	(3)	All Other Fees consisted primarily of services related to the review of securities registration documents and other non-audit reviews.

Policy on Audit Committee Pre-Approval of Audit and Permissible Non-Audit Services of Independent Auditors

The Audit Committee will pre-approve all auditing services and the terms thereof (which may include providing comfort letters in connection with securities underwriting) and non-audit services (other than non-audit services prohibited under Section 10A(g) of the Exchange Act or the applicable rules of the SEC or the Public Company Accounting Oversight Board) to be provided to us by the independent auditor; provided, however, the pre-approval requirement is waived with respect to the provisions of non-audit services for us if the “de minimis” provisions of Section 10A(i)(1)(B) of the Exchange Act are satisfied. This authority to pre-approve non-audit services may be delegated to one or more members of the Audit Committee, who shall present all decisions to pre-approve an activity to the full Audit Committee at its first meeting following such decision. The Audit Committee may review and approve the scope and staffing of the independent auditors’ annual audit plan.

PART IV

Item 15. Exhibits and Financial Statements Schedules.

(a) 1. Financial Statements.

For a list of the financial statements included herein, see Index to the Financial Statements on page F-1 of this Form 10-K.

2. Financial Statement Schedules.

No financial statement schedules have been submitted because they are not required or are not applicable or because the information required is included in the financial statements or the notes thereto.

3. List of Exhibits.

See the Exhibit Index in Item 15(b) below.

Exhibit Number		Description of Exhibits
2.1		Agreement and Plan of Merger and Reorganization, by and among the Company, Merger Sub, and Ayala, dated as of October 18, 2022. Incorporated by reference to Exhibit 2.1 to Current Report on Form 8-K filed with the SEC on October 19, 2022.
3.1*		Restated Certificate of Incorporation of Ayala Pharmaceuticals, Inc., dated as of [January 27], 2023.

3.2		Second Amended and Restated By-Laws of Advaxis, Inc. Incorporated by reference to Exhibit 3.1 of the Current Report on Form 8-K filed with the SEC on March 5, 2021.
3.3		Amendment No. 1 to the Second Amended and Restated By-Laws of Advaxis, Inc. Incorporated by reference to Exhibit 3.1 of the Current Report on Form 8-K filed with the SEC on September 20, 2021.
4.1		Form of Warrant Agency Agreement, dated as of September 11, 2018 between Advaxis, Inc. and Continental Stock Transfer and Trust Company (and Form of Warrant contained therein), Incorporated by reference to Exhibit 4.1 to Current Report on Form 8-K filed with the SEC on September 11, 2018.
4.2		Form of Common Warrant dated July 25, 2019 Incorporated by reference to Exhibit 4.2 to the Current Report on Form 8-K filed with the SEC on July 25, 2019.
4.3		Form of Common Stock Warrant dated November 27, 2020. Incorporated by reference to Exhibit 4.1 to the Current Report on Form 8-K filed with the SEC on November 27, 2020.
4.4		Form of Pre-Funded Warrant. Incorporated by reference to Exhibit 4.1 to the Current Report on Form 8-K filed with the SEC on April 12, 2021.
4.5		Form of Accompanying Warrant. Incorporated by reference to Exhibit 4.2 to the Current Report on Form 8-K filed with the SEC on April 12, 2021.
4.6		Form of Private Placement Warrant. Incorporated by reference to Exhibit 4.3 to the Current Report on Form 8-K filed with the SEC on April 12, 2021.

4.7		Description of each class of securities registered under Section 12 of the Securities Exchange Act of 1934
10.1		License Agreement, between the Trustees of the University of Pennsylvania and the registrant dated as of June 17, 2002, as Amended and Restated on February 13, 2007. Incorporated by reference to Exhibit 10.11 to Annual Report on Form 10-KSB filed with the SEC on February 13, 2007.
10.2		Second Amendment to the Amended and Restated Patent License Agreement between the registrant and the Trustees of the University of Pennsylvania dated as of May 10, 2010. Incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q filed with the SEC on June 3, 2010.
10.3		2011 Omnibus Incentive Plan of registrant. Incorporated by reference to Annex A to DEF 14A Proxy Statement filed with the SEC on August 29, 2011.
10.4		Amendment No. 1, dated as of March 26, 2007, to the License Agreement, between the Trustees of the University of Pennsylvania and Advaxis, Inc. dated as of June 17, 2002, as amended and restated on February 13, 2007. Incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q filed with the SEC on June 14, 2012.
10.5		Amendment No. 3, dated as of December 12, 2011, to the License Agreement, between the Trustees of the University of Pennsylvania and Advaxis, Inc. dated as of June 17, 2002, as amended and restated on February 13, 2007. Incorporated by reference to Exhibit 10.5 to Quarterly Report on Form 10-Q filed with the SEC on June 14, 2012.
10.6		Amendment No. 1 to 2011 Omnibus Incentive Plan of registrant. Incorporated by reference to Annex B to DEF 14A Proxy Statement filed with the SEC on July 19, 2012.
10.7		Indemnification Agreement. Incorporated by reference to Exhibit 10.3 to Current Report on Form 8-K filed with the SEC on August 20, 2013.
10.8		Exclusive License and Technology Transfer Agreement by and between Advaxis, Inc. and Global BioPharma, Inc., dated December 9, 2013. Incorporated by reference to Exhibit 10.79 to Annual Report on Form 10-K/A filed with the SEC on February 6, 2014.
10.9		Distribution and Supply Agreement, dated as of January 20, 2014, by and between Advaxis, Inc. and Biocon, Limited. Incorporated by reference to Exhibit 10.7 to Quarterly Report on Form 10-Q filed with the SEC on March 17, 2014.
10.10		Exclusive License Agreement, dated March 19, 2014, by and between Advaxis, Inc. and Aratana Therapeutics, Inc. Incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q filed with the SEC on June 10, 2014.
10.11		Clinical Trial Collaboration Agreement, dated July 21, 2014, by and between Advaxis, Inc. and MedImmune, LLC. Incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q filed with the SEC on September 9, 2014.
10.12		5th Amendment to the Amended & Restated License Agreement, dated July 25, 2014, by and between Advaxis, Inc. and University of Pennsylvania. Incorporated by reference to Exhibit 10.2 to Quarterly Report on Form 10-Q filed with the SEC on September 9, 2014.

10.13		Amendment No. 2 to the Advaxis, Inc. 2011 Omnibus Incentive Plan, effective July 9, 2014. Incorporated by reference to Annex A to Current Report on Schedule 14A filed with the SEC on May 20, 2014.
10.14		Amended and Restated 2011 Omnibus Incentive Plan, dated September 8, 2014. Incorporated by reference to Exhibit 10.4 to Quarterly Report on Form 10-Q filed with the SEC on September 9, 2014.
10.15		Master Services Agreement for Technical Transfer and Clinical Supply, dated February 5, 2014, by and between Advaxis, Inc. and SynCo Bio Partners B.V. Incorporated by reference to Exhibit 10.1 to Current Report to Form 8-K filed with the SEC on February 11, 2014.
10.16		Clinical Trial Collaboration and Supply Agreement by and between Advaxis, Inc. and Merck & Co. dated August 22, 2014. Incorporated by reference to Exhibit 10.101 to Annual Report on Form 10-K filed with the SEC on January 6, 2015
10.17		Co-Development and Commercialization Agreement between Advaxis, Inc. and Especificos Stendhal SA de CV dated February 3, 2016. Incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q filed with the SEC on February 26, 2016.
10.18		2015 Incentive Plan of registrant. Incorporated by reference to Annex A to DEF 14A Proxy Statement filed with the SEC on April 7, 2015.
10.19		Amendment to the Advaxis, Inc. 2015 Incentive Plan. Incorporated by reference to Exhibit B to DEF 14A Proxy Statement filed with the SEC on February 11, 2016.
10.20		Amendment to the Advaxis, Inc. 2015 Incentive Plan. Incorporated by reference to Exhibit A to DEF 14A Proxy Statement filed with the SEC on February 10, 2017.
10.21		Amendment to the Advaxis, Inc. 2015 Incentive Plan. Incorporated by reference to Exhibit A to DEF 14A Proxy Statement filed with the SEC on March 20, 2020.
10.22		Sales Agreement, dated May 8, 2020, by and between Advaxis, Inc. and A.G.P./Alliance Global Partners. Incorporated by reference to Exhibit 1.1 to the Company’s Current Report on Form 8-K filed with the SEC on May 8, 2020)
10.23		Purchase Agreement, dated July 30, 2020, by and between Advaxis, Inc. and Lincoln Park Capital Fund, LLC. Incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed with the SEC on August 3, 2020)
10.24		Lease Agreement, dated March 25, 2021, by and between Advaxis, Inc. and Princeton Corporate Plaza, LLC. Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on March 30, 2021.
10.25		Lease Termination and Surrender Agreement, dated March 26, 2021, by and between Advaxis, Inc. and 300 CR LLC. Incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed with the SEC on March 30, 2021
10.26		Securities Purchase Agreement dated April 12, 2021, by and among Advaxis, Inc. and the purchasers identified on the signature pages thereto. Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on April 12, 2021.
10.27		Form of Investor Agreement. Incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed with the SEC on April 12, 2021.

10.28		Amendment to the Advaxis, Inc. 2015 Incentive Plan, dated as of February 11, 2021. Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on June 4, 2021.
10.29		Employment Agreement between Advaxis, Inc. and Kenneth A. Berlin, dated April 23, 2018. Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on April 23, 2018.
10.30		Employment Agreement between Advaxis, Inc. and Andres Gutierrez, M.D., dated April 23, 2018. Incorporated by reference to Exhibit 10.33 to the Annual Report on Form 10-K/A filed with the SEC on February 26, 2021.
10.31		Amended 2017 Stock Incentive Plan and form of agreements thereunder. Incorporated by reference to Exhibit 10.01 of the Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) Annual Report on Form 10-K filed with the SEC on March 28, 2022 (File No. 333-236942).
10.32		Lease Agreement, dated January 24, 2019, between Ayala-Oncology Israel Ltd. and Ogen Real Estate Maniv Ltd. Incorporated by reference to Exhibit 10.08 of the Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) Annual Report on Form 10-K filed with the SEC on March 28, 2022 (333-236942).
10.33		License Agreement, dated November 29, 2017, between the Registrant and Bristol-Myers Squibb Company, as amended. Incorporated by reference to Exhibit 10.01 of the Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) Annual Report on Form 10-K filed with the SEC on March 28, 2022 (File No. 333-236942).
10.34		Evaluation, Option and License Agreement, dated December 19, 2018, between the Registrant and Novartis International Pharmaceutical Limited. Incorporated by reference to Exhibit 10.09 of the Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) Annual Report on Form 10-K filed with the SEC on March 28, 2022 (File No. 333-236942).
10.35		Securities Purchase Agreement, dated February 19, 2021, by and among Ayala Pharmaceuticals, Inc. and the Investors named therein. Incorporated by reference to Exhibit 10.10 of the Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) Annual Report on Form 10-K filed with the SEC on March 28, 2022 (File No. 001-39279).
10.36		Amendment No. 1 to the employment agreement between Advaxis, Inc. and Kenneth A. Berlin, dated September 12, 2022. Incorporated by reference to Exhibit 10.1 to the Quarterly Report on Form 10-Q filed with the SEC on September 12, 2022.
14.1		Code of Business Conduct and Ethics dated July 9, 2014. Incorporated by reference to Exhibit 14.1 to Current Report on Form 8-K filed with the SEC on July 10, 2014.
23.1*		Consent of Independent Registered Public Accounting Firm
31.1*		Certification of Chief Executive Officer pursuant to section 302 of the Sarbanes-Oxley Act of 2002
31.2*		Certification of interim Chief Financial Officer pursuant to section 302 of the Sarbanes-Oxley Act of 2002
32.1*		Certification of Chief Executive Officer pursuant to section 906 of the Sarbanes-Oxley Act of 2002
32.2*		Certification of interim Chief Financial Officer pursuant to section 906 of the Sarbanes-Oxley Act of 2002
99.1		Definitive Proxy Statement of Old Ayala (f/k/a Ayala Pharmaceuticals, Inc.). Incorporated by reference to the description of the business of Old Ayala set forth in pages 233-273 of the Definitive Proxy Statement of Old Ayala for the Special Meeting of Stockholders of Old Ayala held on January 13, 2023, filed with the SEC on December 12, 2022 (File No. 001-39279).
99.2		Definitive Proxy Statement of Old Ayala (f/k/a Ayala Pharmaceuticals, Inc.). Incorporated by reference to description of the risk factors relating to Old Ayala set forth in pages 64-131 of the Old Ayala Merger Proxy, filed with the SEC on December 12, 2022 (File No. 001-39279).

101.INS**		Inline XBRL Instance Document
101.SCH**		Inline XBRL Taxonomy Extension Schema Document
101.CAL**		Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF**		Inline XBRL Taxonomy Extension Definitions Linkbase Document
101.LAB**		Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE**		Inline XBRL Taxonomy Extension Presentation Linkbase Document
104		Cover Page Interactive Data File (embedded within the Inline XBRL document)

* Filed herewith. ** Furnished herewith. ‡ Denotes management contract or compensatory plan or arrangement.

ITEM 16. Form 10-K Summary

None.

SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this Annual Report to be signed on its behalf by the undersigned, thereunto duly authorized, in Princeton, Mercer County, State of New Jersey, on this 9th day of February 2023.

AYALA PHARMACEUTICALS, INC. By: /s/ Kenneth Berlin President, Chief Executive Officer By: /s/ Igor Gitelman Interim Chief Financial Officer

KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Kenneth Berlin (with full power to act alone), as his true and lawful attorney-in-fact and agents, with full powers of substitution and resubstitution, for him and in his name, place and stead, in any and all capacities, to sign any and all amendments to this Annual Report on Form 10-K and to file the same, with all exhibits thereto, and other documents in connection therewith, with the Securities and Exchange Commission, granting unto said attorney-in-fact and agent full power and authority to do and perform each and every act and thing requisite or necessary to be done in and about the premises, as fully to all intents and purposes as he might or could do in person, hereby ratifying and confirming all that said attorney-in-fact and agent, or his substitute or substitutes, lawfully do or cause to be done by virtue hereof.

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, this report has been signed by the following persons on behalf of the registrant and in the capacities and on the dates indicated:

SIGNATURE	Title	DATE
/s/ Kenneth Berlin	President, Chief Executive Officer, Director	February 9, 2023
Kenneth Berlin	(Principal Executive Officer)
/s/ Igor Gitelman	Interim Chief Financial Officer	February 9, 2023
Igor Gitelman	(Principal Financial Officer)
/s/ David Sidransky	Chairman of the Board	February 9, 2023
David Sidransky
/s/ Vered Bisker-Leib	Director	February 9, 2023
Vered Bisker-Leib
/s/ Murray A. Goldberg	Director	February 9, 2023
Murray A. Goldberg
/s/ Robert Spiegel	Director	February 9, 2023
Robert Spiegel
/s/ Samir Khleif	Director	February 9, 2023
Samir Khleif
/s/ Roni Appel	Director	February 9, 2023
Roni Appel

AYALA PHARMACEUTICALS, INC.

~~FINANCIAL~~INDEX TO FINANCIAL STATEMENTS

INDEX

Report of Independent Registered Public Accounting Firm (PCAOB ID: 1281)	F-2
Consolidated Balance Sheets	F-3
Consolidated Statements of Operations	F-4
Statement of Changes in Stockholders’ equity	F-5
Statements of Consolidated Cash Flows	F-6
Notes to Consolidated Financial Statements	F-7

		Page
Report of Independent Registered Public Accounting Firm PCAOB ID: 688		F-2
Consolidated Balance Sheets		F-3
Consolidated Statements of Operations		F-4
Consolidated Statements of Shareholders’ Equity		F-5
Consolidated Statements of Cash Flows		F-6
Notes to the Consolidated Financial Statements		F-8

F-1

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

	Kost Forer Gabbay & Kasierer	Tel: +972-3-6232525
	144 Menachem Begin Road, Building A	Fax: +972-3-5622555

	Tel-Aviv 6492102, Israel	ey.com

ToReport ~~the~~of ~~Shareholders~~Independent ~~and~~Registered ~~Board~~Public ofAccounting ~~Directors of~~Firm

~~Ayala~~To ~~Pharmaceuticals,~~the ~~Inc.~~Shareholders ~~(formerly~~and ~~known~~the asBoard ~~Advaxis,~~of ~~Inc.)~~Directors of

AYALA PHARMACEUTICALS, INC.

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of Ayala Pharmaceuticals, Inc. (~~formerly known as Advaxis, Inc.) (~~the “Company”) as of ~~October~~December 31, ~~2022~~2023 and ~~2021~~2022, the related consolidated statements of operations, changes in stockholders’ equity and cash flows for each of the two years in the period ended ~~October~~December 31, ~~2022~~2023, and the related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company at asDecember ~~of October~~ 31, ~~2022~~2023 and ~~2021~~2022, and the results of its operations and its cash flows for each of the two years in the period ended ~~October~~ December 31, ~~2022~~2023, in conformity with ~~accounting~~U.S. ~~principles~~ generally accepted inaccounting ~~the United States of America~~principles.

~~Explanatory~~The ~~Paragraph~~Company’s –Ability to Continue as a Going Concern

The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a going concern. As ~~more~~discussed ~~fully described~~ in Note 1 to the financial statements, the Company has ~~incurred~~suffered ~~significant~~recurring losses ~~and~~from ~~needs~~operations, tohas ~~raise~~a ~~additional~~negative ~~funds~~cash toflows ~~meet~~from ~~its~~operating activities, ~~obligations~~ and ~~sustain~~ ~~its~~has ~~operations.~~stated ~~These~~that ~~conditions raise~~ substantial doubt exists about the Company’s ability to continue as a going concern. Management’s ~~plans~~evaluation inof ~~regard~~the toevents and conditions and management’s plans regarding these matters are also described in Note 1. The consolidated financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and are required to be independent with respect to the Company in accordance with the U.S. federal ~~securities~~ securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the ~~audits~~audit to obtain reasonable assurance about whether the financial statements are free of material ~~misstatement~~misstatements, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.

Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.

~~Critical~~KOST ~~Audit~~FORER ~~Matters~~GABBAY & KASIERER

~~Critical~~A ~~audit~~Member ~~matters are matters arising from the current period audit~~ of ~~the~~EY financial statements that were communicated or required to be communicated to the audit committee and that: (1) relate to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective, or complex judgments. We determined that there are no critical audit matters.Global

~~/s/ Marcum LLP Marcum llp~~ We have served as the Company’s auditor since ~~2012~~2017. ~~New York, NY February 9, 2023~~

Tel-Aviv, Israel

April 16, 2024

F-2

AYALA PHARMACEUTICALS, INC.

(formerly known as Advaxis, Inc.)

CONSOLIDATED BALANCE SHEETS

~~(In~~U.S. dollars in thousands, (except share and per share data)

	2022			2021
	December 31,			December 31,
	October 31,
	2023			2022
	2022			2021
Assets
ASSETS
Current Assets:
Current assets:
Cash and Cash Equivalents	$	4,882		$	2,408
Cash and cash equivalents	$	25,208		$	41,614
Trade Receivables		-			234
Prepaid expenses and other current assets		551			1,643
Prepaid Expenses and Other Current Assets		2,646			546
Total current assets		25,759			43,257
Total Current Assets		7,528			3,188
Property and equipment (net of accumulated depreciation)		38			118
Long-Term Assets:
Intangible assets (net of accumulated amortization)		110			3,354
Deferred issuance costs		-			1,953
Operating right-of-use asset (net of accumulated amortization)		12			40
Intangible assets, net		3,898			-
Other assets		11			11
Goodwill		4,500			-
Total assets	$	25,930		$	46,780
Operating lease right of use asset		102			1,462
LIABILITIES AND STOCKHOLDERS’ EQUITY
Property and Equipment, Net		540			960
Current liabilities:
Other Assets		11			206
Accounts payable	$	22		$	87
Total Long-Term Assets		9,051			4,581
Accrued expenses		2,150			2,836
Total Assets	$	16,579		$	7,769
Current portion of operating lease liability		12			28
Liabilities and Stockholders’ Equity:
Common stock warrant liability		119			4,929
Current Liabilities:
Total current liabilities		2,303			7,880
Trade Payables	$	6,076		$	4,080
Operating lease liability, net of current portion		-			12
Operating lease liabilities		166			419
Total liabilities		2,303			7,892
Accrued expenses and other payables		5,554			708
Contingencies – Note 8		-			-
Side Agreement and reinvestment rights**		8,436
Series D convertible preferred stock- $0.001 par value; 0 shares authorized, 0 shares issued and outstanding at October 31, 2022 and October 31, 2021.		-			-
Accrued payroll and employee benefits		786			994
Stockholders’ equity:
Proceed from Asset Sale		4,000			-
Preferred stock, $0.001 par value; 5,000,000 shares authorized, 0 shares issued and outstanding at October 31, 2022 and October 31, 2021.		-			-
Total Current Liabilities		25,018			6,201
Common stock - $0.001 par value; 170,000,000 shares authorized, 1,815,951 and 1,820,452 shares issued and outstanding at October 31, 2022 and 2021.		2			2
Long-Term Liabilities:
Additional paid-in capital		466,584			467,486
Long-term warrant liability**		6,057			-
Accumulated deficit		(442,959	)		(428,600	)
Convertible Note**		8,141			-
Total stockholders’ equity		23,627			38,888
Uncertain tax position		1,771			1,335
Total liabilities and stockholders’ equity	$	25,930		$	46,780
Long-term operating lease liabilities		9			1,332
Total Long-Term Liabilities	$	15,978		$	2,667
Stockholders’ Equity:
Common Stock of $0.001 par value per share; 170,000,000 and 37,480,000* shares authorized at December 31, 2023 and 2022, respectively; 11,896,845 and 2,695,067* shares issued at December 31, 2023 and 2022, respectively; 11,857,393 and 2,638,663* shares outstanding at December 31, 2023 and 2022, Respectively.	$	12		$	3
Additional Paid-in Capital		172,797			148,052
Accumulated Deficit		(197,226	)		(149,154	)
Total Stockholders’ Equity		(24,417	)		(1,099	)
Total Liabilities and Stockholders’ Equity	$	16,579		$	7,769

The accompanying notes ~~should~~are bean ~~read~~integral inpart ~~conjunction~~of ~~with~~ the consolidated financial statements.

*	All of the Common Stock, additional paid-in capital and per share data have been retroactively adjusted for the impact of the January 2023 merger between Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) and Ayala Pharmaceutical, Inc.(f/k/a Advaxis, Inc.). See note 1.

**	Received from related party see note 14.

F-3

AYALA PHARMACEUTICALS, INC.

(formerly known as Advaxis, Inc.)

CONSOLIDATED STATEMENTS OF OPERATIONS

~~(In~~U.S. dollars in thousands, (except ~~share~~shares and per ~~share~~shares data)

	2022			2021
	Year ended			Year ended
	Year Ended October 31,
	December 31,			December 31,
	2022			2021
	2023			2022
Revenue	$	~~250~~13		$	~~3,240~~692
Operating expenses:
Cost of Revenue		(13	)		(602	)
Research and development expenses		7,616			10,562
Gross Profit		-			90
General and administrative expenses		8,891			11,464
Research and Development	$	24,081		$	27,851
Intangible asset impairment		3,053			-
General and Administrative		12,185			9,742
Total operating expenses		19,560			22,026
Operating Loss		(36,266	)		(37,503	)
Loss from operations		(19,310	)		(18,786	)
Financial income (expenses), net		(15,718	)		74
Other income (expense):
Loss before taxes on income		(51,984	)		(37,429	)
Interest income		157			5
Taxes on Income		3,912			(584	)
Net changes in fair value of derivative liabilities		4,853			970
Net Loss	$	(48,072	)	$	(38,013	)
Other expense		(9	)		(1	)
Net Loss per Share attributable to Common Stockholders, Basic and Diluted	$	(7.99	)	$	(13.13	)
Net loss before income taxes		(14,309	)		(17,812	)
Weighted Average Shares Used to Compute Net Loss per Share, Basic and Diluted		6,019,063			2,895,130
Income tax expense		50			50
Net loss		(14,359	)		(17,862	)
Accretion of discount and redemption feature of convertible preferred stock		(1,025	)		-
Income available to common stockholders	$	(15,384	)	$	(17,862	)
Net loss per common share, basic and diluted	$	(8.46	)	$	(11.07	)
Weighted average number of common shares outstanding, basic and diluted		1,818,639			1,613,634

The accompanying notes ~~should~~are bean ~~read~~integral inpart ~~conjunction~~of ~~with~~ the consolidated financial statements.

F-4

AYALA PHARMACEUTICALS, INC.

~~(formerly known~~STATEMENT asOF ~~Advaxis,~~CHANGES ~~Inc.)~~IN STOCKHOLDERS’ EQUITY

~~CONSOLIDATED~~U.S. ~~STATEMENTS~~dollars OFin ~~STOCKHOLDERS’~~thousands ~~EQUITY~~(except share amounts)

(In thousands, except share and per share data)

			^**		^**
	Common Stock**				Additional paid-in		Accumulated			Total Stockholders’ (Deficit)
	Number		Amount		Capital**		Deficit			Equity

Balance as of December 31, 2021		2,615,360	$	3	$	145,296	$	(111,141	)	$	34,158
Proceeds from Issuance of common stock, net of issuance cost of $14		58,172		-*		512		—			512
Stock Based Compensation		21,535		-*		2,244		—			2,244
Net Loss		—		—		—		(38,013	)		(38,013	)
Balance as of December 31, 2022		2,695,067	$	3	$	148,052	$	(149,154	)	$	(1,099	)
Balance		2,695,067	$	3	$	148,052	$	(149,154	)	$	(1,099	)
exercise of warrants		246,192		-*		-		-			-
Issuance of shares upon January 2023 Merger, net of issuance costs of $3,153		1,815,951		2		16,947		-			16,949
Issuance of shares upon Bio sight Merger		5,913,480		6		5,508		-			5,514
Conversion of SAFE		1,145,053		1		1,067		-			1,068
Share based compensation		41,650		-		1,223		-			1,223
Net Loss		-		-		-		(48,072	)		(48,072	)
Balance as of December 31, 2023		11,857,393		12		172,797		(197,226	)		(24,417	)
Balance		11,857,393		12		172,797		(197,226	)		(24,417	)

		Shares		Amount		Shares			Amount		Capital			Deficit				Equity
*	Represents an amount lower than $1.
		Preferred Stock				Common Stock					Additional Paid-In			Accumulated				Total Shareholders’
**	All of the Common Stock and per share data have been retroactively adjusted and Additional paid in Capital to adjust for common stock amount, for the impact of the January 2023 merger between Old Ayala, Inc. (f/k/a Ayala Pharmaceuticals, Inc.) and Ayala Pharmaceutical, Inc.(f/k/a Advaxis, Inc.). See note 1
		Shares		Amount		Shares			Amount		Capital			Deficit				Equity
Balance at October 31, 2020			-	$	-		975,897		$	1	$	440,917		$	(410,738	)		$	30,180
Stock-based compensation			-		-		69			-		566			-				566
Stock option exercises			-		-		4			-		-			-				-
Issuance of shares to employees under ESPP Plan			-		-		12			-		-			-				-
Warrant exercises			-		-		230,343			-		3,771			-				3,771
Public offerings, net of offering costs			-		-		614,127			1		22,232			-				22,233
Net Loss			-		-		-			-		-			(17,862	)			(17,862	)
Balance at October 31, 2021			-		-		1,820,452			2		467,486			(428,600	)			38,888
Balance value			-		-		1,820,452			2		467,486			(428,600	)			38,888
Stock-based compensation			-		-		-			-		97			-				97
Accretion of discount and redemption feature of convertible preferred stock			-		-		-			-		(1,025	)		-				(1,025	)
Convertible preferred stock redemption			-		-		-			-		44			-				44
Fractional shares cashed out			-		-		(4,501	)		-		(18	)		-				(18	)
Net Loss			-		-		-			-		-			(14,359	)			(14,359	)
Balance at October 31, 2022			-	$	-		1,815,951		$	2	$	466,584		$	(442,959	)		$	23,627
Balance value			-	$	-		1,815,951		$	2	$	466,584		$	(442,959)		$	23,627

The accompanying notes ~~should~~are bean ~~read~~integral inpart ~~conjunction~~of ~~with~~ the consolidated financial statements.

F-5

AYALA PHARMACEUTICALS, INC.

~~(formerly known~~STATEMENTS asOF ~~Advaxis,~~CONSOLIDATED ~~Inc.)~~CASH FLOWS

U.S. ~~CONSOLIDATED~~dollars ~~STATEMENT~~in ~~OF CASH FLOWS~~thousands

(In thousands, except share and per share data)

	Year Ended			Year Ended
	December 31,			December 31,
	2023			2022
Cash Flows from Operating Activities:
Net Loss	$	(48,072	)	$	(38,013	)
Adjustments to reconcile Net Loss to Net Cash used in Operating Activities:
Shared Based Compensation		1,223			2,244

Depreciation and Amortization		369			162
Asset write-downs		145			-
Remeasurement of long-term warrant liability		5,854			-
Remeasurement of Side Letter Agreements		7,751			-
Remeasurement of convertible note		2,141			-
(Increase) Decrease in Prepaid Expenses and other Assets		(1,491	)		2,232
Decrease (Increase) in Trade Receivables		234			(234	)
Decrease in Trade Payables		(724	)		(472	)
Decrease in operating lease right-of-use assets		1,429			288
Decrease in operating lease liabilities		(1,641	)		(536	)
Increase (decrease) in accrued expenses and other payables		3,123			121
Increase (decrease) in accrued payroll and employee benefits		(248	)		(767	)
Changes in uncertain tax position		448			465
Other		(26	)		-
Net Cash used in Operating Activities		(29,485	)		(34,510	)
Cash Flows from Investing Activities:
Proceed from Asset Sale		4,000			-
Cash acquired from the Biosight Merger		1,909			-
Other		37			(2	)
Net Cash used in Investing Activities		5,946			(2	)
Cash Flows from Financing Activities:
Proceeds from issuance of convertible note from related party		6,000			-
Proceeds from issuance of shares, net of issuance cost of $14		-			512
Issuance of shares upon January 2023 Merger, net of issuance costs		20,001			(615	)
Net Cash used in Financing Activities		26,001			(103	)
Effect of exchange rate changes on cash, cash equivalents and restricted cash		26
Increase (decrease)in Cash and Cash Equivalents and Restricted Cash		2,488			(34,615	)
Cash and Cash Equivalents and Restricted Cash at Beginning of the Year		2,724			37,339
Cash and Cash Equivalents and Restricted Cash at End of the Year	$	5,212		$	2,724
Supplemental Disclosure of investing and financing Activities
Lease liabilities arising from new right-of-use assets	$	-		$	537
Deferred issuance costs accrued but not yet paid	$	-		$	1,338
Supplemental Disclosures of Cash Flow Information
Cash Paid for Income Taxes	$	371		$	244

	2022			2021
	Year Ended			Year Ended
	Year Ended October 31,
	December 31,			December 31,
	2022			2021
	2023			2022
OPERATING ACTIVITIES
Cash and Cash Equivalents	$	4,882		$	2,408
Net loss	$	(14,359	)	$	(17,862	)
Restricted Cash in Prepaid Expenses and Other Current Assets		330			110
Adjustments to reconcile net loss to net cash used in operating activities:
Restricted Cash in Other Assets		-			206
Share based compensation		97			566
Cash and Cash Equivalents and Restricted Cash at End of the Year	$	5,212		$	2,724
Gain on change in value of warrants		(4,810	)		(970	)
Gain on change in value of preferred stock redemption liability		(43	)		-
(Gain) loss on disposal of property and equipment		(8	)		1,439
Abandonment of intangible assets		159			94
Impairment charges on intangible assets		3,053			-
Depreciation expense		53			387
Amortization expense of intangible assets		233			273
Amortization of right-of-use assets		28			330
Net gain on write-off of right-of-use asset and lease liability		-			(116	)
Change in operating assets and liabilities:
Prepaid expenses, other current assets and deferred expenses		1,092			1,030
Other assets		-			171
Accounts payable and accrued expenses		(751	)		776
Deferred revenue		-			(165	)
Operating lease liabilities		(28	)		(1,392	)
Net cash used in operating activities		(15,284	)		(15,439	)
INVESTING ACTIVITIES
Proceeds from disposal of property and equipment		35			449
Cost of intangible assets		(201	)		(460	)
Net cash used in investing activities		(166	)		(11	)
FINANCING ACTIVITIES
Net proceeds of issuance of Series D preferred stock		4,312			-
Net proceeds of issuance of common stock and warrants		-			28,115
Fractional shares cashed out		(18	)		-
Redemption of Series D preferred stock		(5,250	)		-
Warrant exercises		-			3,771
Net cash provided by (used in) financing activities		(956	)		31,886
Net (decrease) increase in cash and cash equivalents		(16,406	)		16,436
Cash and cash equivalents at beginning of year		41,614			25,178
Cash and cash equivalents at end of year	$	25,208		$	41,614

The accompanying notes ~~should~~are bean ~~read~~integral inpart ~~conjunction~~of ~~with~~ the consolidated financial statements.

F-6

Supplemental Disclosures of Cash Flow Information

	Year Ended October 31,
	2022		2021
Supplemental Disclosures of Cash Flow Information
Cash paid for taxes	$	50	$	50

Supplemental Schedule of Noncash Investing and Financing Activities

	Year Ended October 31,
	2022		2021
Supplemental Schedule of Noncash Investing and Financing Activities
Reclassification of preferred stock redemption liability into equity upon redemption of preferred stock	$	44	$	-
Accretion of discount and redemption feature of convertible preferred stock		1,025		-
Reassessment of the lease term		-		43

The accompanying notes should be read in conjunction with the financial statements.

F-7

AYALA PHARMACEUTICALS, INC.

(formerly known as Advaxis, Inc.)

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

1. ~~NATURE OF OPERATIONS AND BASIS OF PRESENTATION~~General

In these financial statements, unless otherwise stated or the context otherwise indicates, references to “New Ayala,” ~~“Advaxis,”~~ and the “Company,” ~~“we,” “us,” “our” and similar references refer~~ refers to Ayala Pharmaceuticals, Inc., a Delaware corporation, which prior to the change of its name effected on January 19, 2023, was known as Advaxis, Inc. The name change was affected in connection with the January 2023 Merger, as described below. References to “former Advaxis” refer to the Company solely in the period prior to the January 2023 Merger.

~~New~~Prior to the January 2023 Merger, ~~Ayala~~the Company was a clinical-stage biotechnology company focused on the development and commercialization of proprietary Listeria monocytogenes (“Lm”)-based antigen delivery products. ~~The~~These ~~Company~~efforts isutilized ~~using~~the ~~its~~Company Lm platform directed against tumor-specific targets in order to engage the patient’s immune system to destroy tumor cells. Through a license from the University of Pennsylvania, ~~New~~ ~~Ayala~~the Company has exclusive access to this proprietary formulation of attenuated Lm called Lm TechnologyTM. ~~New Ayala’s proprietary approach is designed to deploy a mechanism of action that redirects the immune system to attack cancer in three distinct ways:~~

●Following ~~Alerting~~the ~~and~~January ~~training~~2023 Merger, the ~~immune~~Company ~~system~~became byprimarily ~~activating~~a ~~multiple~~clinical-stage ~~pathways~~oncology company focused on developing and commercializing small molecule therapeutics for patients suffering from rare and aggressive cancers, primarily in ~~Antigen-Presenting~~genetically ~~Cells~~defined ~~(“APCs”)~~patient ~~with~~populations. ~~the~~The ~~equivalent~~Company ofdifferentiated development ~~multiple~~approach ~~adjuvants;~~is ●predicated ~~Attacking~~on ~~the~~identifying ~~tumor~~and byaddressing ~~generating~~tumorigenic adrivers ~~strong,~~of cancer~~-specific~~, Tthrough ~~cell~~a ~~response;~~combination of the Company’s bioinformatics platform and ●next-generation ~~Breaking~~sequencing ~~down~~to ~~tumor~~deliver ~~protection~~targeted ~~through~~therapies ~~suppression~~to underserved patient populations. The Company’s portfolio of product candidates following the ~~protective~~January ~~cells~~2023 inMerger, AL101 and AL102, targets the ~~tumor~~aberrant ~~microenvironment~~activation ~~(“TME”)~~of ~~that~~the ~~shields~~Notch pathway using gamma secretase inhibitors. All of the ~~tumor~~Company’s ~~from~~assets relating to AL 101 and AL 102 were sold on March 25, 2024 in the ~~immune~~Asset Sale ~~system~~(as defined below). ~~This~~Following ~~enables~~the January 2023 Merger, the ~~activated~~Company Talso ~~cells~~continued to ~~begin~~conduct ~~working~~certain operations relating to ~~attack~~former Advaxis’ operations as a clinical-stage biotechnology company focused on the ~~tumor~~development ~~cells~~and commercialization of proprietary Listeria monocytogenes (“Lm”)-based antigen delivery products. These efforts are primarily focused on the development of ADXS-504, a Lm-based therapy for early-stage prostate cancer. See note 3.

~~New Ayala’s~~On ~~proprietary~~July Lm26, ~~platform~~2023, ~~technology~~the ~~has~~Company and ~~demonstrated~~its ~~clinical~~wholly ~~activity~~owned insubsidiary ~~several~~organized under the laws of ~~its~~the ~~programs~~State ~~and~~of ~~has~~Israel, ~~been~~Advaxis ~~dosed in~~Israel ~~over~~Ltd. ~~470~~(“Biosight ~~patients~~Merger ~~across~~Sub”), entered ~~multiple~~into ~~clinical~~an ~~trials~~Agreement and inPlan ~~various~~of ~~tumor~~Merger ~~types.~~and ~~The~~Reorganization ~~Company~~(the ~~believes~~“Merger ~~that~~Agreement”) Lmwith ~~Technology~~Biosight ~~immunotherapies~~Ltd. (“Biosight”), ~~can~~a ~~complement~~privately-held ~~and~~Israeli ~~address~~pharmaceutical ~~significant~~company ~~unmet~~developing ~~needs~~innovative intherapeutics ~~the~~for ~~current~~hematological ~~oncology~~malignancies ~~treatment~~and ~~landscape~~disorders. ~~Specifically,~~Under the ~~its~~terms ~~product~~of ~~candidates have~~ the ~~potential~~Merger toAgreement, ~~work~~on ~~synergistically~~October ~~with~~18, ~~other immunotherapies~~2023, ~~including~~Merger ~~checkpoint~~Sub ~~inhibitors~~merged with and into Biosight, ~~while~~which ~~having~~is now a ~~generally~~wholly ~~well-tolerated~~owned subsidiary ~~safety~~of ~~profile~~the Company (the “Biosight Merger”). See note 3.

~~Merger with~~Based ~~Ayala~~on the agreement, Ayala Pharmaceuticals, Inc. was the legal acquirer in the Biosight Merger. In addition, the Company considered ASC 805-10-55 to determine the accounting acquirer in the Biosight Merger. As the Company holds a majority of the members of the governing body of the combined Company and the Company’s former management dominates the majority of the senior management of the combined Company, and after considering all other factors according to ASC 805-10-55, the Company was identified as the accounting acquirer in the Biosight Merger. The Company has accounted for the Biosight Merger as a business combination according to ASC 805 “Business Combinations”.

On ~~October~~ 18February 5, ~~2022~~2024, the Company ~~entered into a Merger Agreement (the “Merger Agreement”), subject to shareholder approval,~~ ~~with~~and ~~Ayala Pharmaceuticals~~Immunome, Inc. (“~~Old Ayala~~Immunome”), ~~and~~entered ~~Doe~~into ~~Merger~~an ~~Sub,~~Asset ~~Inc.~~Purchase Agreement (the “~~Merger~~Asset ~~Sub~~Purchase Agreement”), ~~a direct,~~pursuant ~~wholly-owned~~to ~~subsidiary~~which ofImmunome ~~New~~agreed ~~Ayala.~~to ~~Under~~acquire ~~the~~certain ~~terms~~ of the ~~agreement,~~Company’s ~~the~~assets ~~Merger Sub merged with~~ and ~~into~~liabilities ~~Old~~related ~~Ayala,~~to ~~with~~its ~~Old Ayala~~AL101 ~~continuing as the surviving company~~ and aAL102 ~~wholly-owned~~programs ~~subsidiary of New Ayala~~ (the “~~Merger~~Asset Sale”)~~. Immediately after the Merger~~, ~~New~~which ~~Ayala~~constitute ~~stockholders~~substantially asall of ~~immediately prior to~~ the ~~Merger~~Company’s ~~own approximately 37~~assets.5% of the outstanding shares of the combined company and former Old Ayala shareholders own approximately 62.5% of the outstanding shares of the combined company. The Merger was accounted for as a reverse acquisition pursuant to ASC 805-40.

At On March 25, 2024, the ~~effective~~Company and ~~time~~Immunome ofconsummated the ~~Merger~~Asset (Sale pursuant to the ~~“Effective~~Asset ~~Time”),~~Purchase ~~each~~Agreement. ~~share~~Immunome ofpaid ~~share~~to ~~capital~~the ofCompany ~~Ayala~~an ~~issued~~aggregate ~~and~~purchase price ~~outstanding~~of ~~immediately~~$20.0 ~~prior~~in tocash ~~the~~(of ~~Effective~~which ~~Time~~$4.0 had ~~was~~been ~~converted~~paid upon entering into the ~~right~~Asset Purchase Agreement), subject to ~~receive~~certain aadjustments, ~~number~~and ofissued to the Company 2,175,489 shares of(the ~~New~~“Shares”) ~~Ayala~~of Immunome’s common stock, $0.0001 par value. The Asset Purchase Agreement further provides that Immunome may pay the Company up to $037.~~001~~5 ~~per~~million ~~share~~in cash due upon the Immunome’s achievement of certain development and commercial milestone events set forth in the Asset Purchase Agreement. At the March 25, ~~equal~~2023 toclosing of the ~~exchange~~Asset ~~ratio~~Sale, ~~0.1874~~Immunome ~~shares~~paid the remaining $16.0 million of ~~New~~cash ~~Ayala~~consideration ~~common~~to ~~stock~~the ~~per~~Company ~~Old~~and, ~~Ayala~~at ~~share~~the Company’s direction, to certain vendors of the Company.

OnThe Asset Purchase Agreement ~~January~~contains 13customary representations, ~~2023~~warranties, conditions and covenants, including covenants (i) concerning the ~~Ayala~~conduct ~~stockholders~~of ~~approved~~business by the ~~Merger~~Company ~~Agreement~~prior to the closing of the Asset Sale, (ii) prohibiting the Company and its representatives from soliciting, initiating or knowingly inducing, encouraging or facilitating any competing acquisition proposal, (iii) prohibiting the ~~Merger~~Company ~~closed~~and onits ~~January~~controlled affiliates 19from competing with Immunome for five years following the closing of the Asset Sale in certain fields, ~~2023.~~and ~~See~~(iv) ~~Note~~restricting the ~~16.~~Company’s ability to make distributions to stockholders, dissolve or wind up its business or file for bankruptcy for six months following the closing of the Asset Sale.

In the Asset Sale, the Company disposed of the assets relating to AL102, an oral gamma secretase inhibitor in Phase 3 clinical development, and AL 101, and as such, the Company’s clinical assets currently include aspacytarabine (BST-236), a novel proprietary anti-metabolite for first line treatment in unfit acute myeloid leukemia (AML).

During the year ended December 31, 2023, the Company had a reduction in workforce in which the employment of approximately 50% of the Company’s employees was terminated. This reduction in workforce has not yet required the Company to cease any major development efforts. Following the reduction in workforce, the Company had 21 employees. See note 17 for information regarding the additional reduction of 18 employees and one officer during the first quarter of 2024, with the employment of a second officer to terminate on June 25, 2024.

Going Concern

F-7

2. Significant Accounting Policies

Basis of Presentation

The consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”). The significant accounting policies followed in the preparation of the consolidated financial statements, are as follows:

Use of Estimates:

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates, judgments and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. The Company’s management believes that the estimates, judgment and assumptions used are reasonable based upon information available at the time they are made. These estimates, judgments and assumptions can affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the dates of the consolidated financial statements. Actual results could differ from those estimates.

Consolidated Financial Statements in U.S. Dollars

A substantial portion of the Company’s financing activities, including equity transactions and cash investments, are incurred in U.S. dollars. The Company’s management believes that the U.S. dollar is the currency of the primary economic environment in which the Company operates. Thus, the functional and reporting currency of the Company is the U.S. dollar.

A subsidiary’s functional currency is the currency of the primary economic environment in which the subsidiary operates; normally, that is the currency of the environment in which a subsidiary primarily generates and expends cash. In making the determination of the appropriate functional currency for a subsidiary, the Company considers cash flow indicators, local market indicators, financing indicators and the subsidiary’s relationship with both the parent company and other subsidiaries. For subsidiaries that are primarily a direct and integral component or extension of the parent entity’s operations, the U.S. dollar is the functional currency.

F-8

~~Going~~The ~~Concerns,~~Company ~~Liquidity,~~has determined the functional currency of its foreign subsidiary is the U.S. Dollar. The foreign operation is considered a direct and ~~Management~~integral part or extension of the Company’s ~~Plans~~operations. The day-to-day operations of the foreign subsidiary are dependent on the economic environment of the U.S. Dollar.

~~Similar~~Accordingly, tomonetary ~~other~~accounts ~~development~~maintained ~~stage~~in ~~biotechnology~~currencies ~~companies,~~other ~~the~~than ~~Company’s products that are being developed have not generated significant revenue. As a result,~~ the ~~Company has suffered recurring losses and requires significant cash resources to execute its business plans~~U. ~~These~~S. ~~losses~~dollar are ~~expected~~remeasured tointo ~~continue for the foreseeable future~~U.S. ~~The~~dollars ~~aforementioned~~in ~~factors~~accordance ~~raise~~with ~~substantial~~Statement ~~doubt about~~ of the ~~Company’s ability~~Accounting toStandard ~~continue~~Codification as(“ASC”) aNo. ~~going~~830 ~~concern~~“Foreign ~~within~~Currency ~~one~~Matters” ~~year~~(“ASC ~~from the date of filing~~No. ~~The accompanying financial statements have been prepared~~830”). onAll atransaction ~~going~~gains ~~concern~~and ~~basis,~~losses ~~which~~of ~~contemplates~~ the ~~realization~~remeasured ofmonetary ~~assets~~balance ~~and~~sheet ~~the~~items ~~satisfaction~~are ofreflected ~~liabilities~~ in the ~~normal course of business. The financial~~ statements ~~do not include any adjustments relating to the recoverability and classification~~ of ~~asset~~operations ~~amounts~~as ~~or the classification~~financial ofincome ~~liabilities~~or ~~that~~expenses ~~might be necessary should the Company be unable to continue~~ as ~~a going concern within one year after the date the financial statements are issued~~appropriate.

As of October 31, 2022, the Company had approximately $25.2 million in cash and cash equivalents. The Company does not believe it has sufficient capital to fund its obligations after the closing of the Merger, as they become due, in the ordinary course of business until at least one year from the issuance of these consolidated financial statements but will need to raise additional funds.

The Company recognizes it will need to raise additional capital in order to continue to execute its business plan in the future. There is no assurance that additional financing will be available when needed or that management will be able to obtain financing on terms acceptable to the Company or whether the Company will become profitable and generate positive operating cash flow. If the Company is unable to raise sufficient additional funds, it will have to further scale back its operations.

2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Estimates

The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”) requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Estimates are used when accounting for such items as the fair value and recoverability of the carrying value of property and equipment and intangible assets (patents and licenses), determining the Incremental Borrowing Rate (“IBR”) for calculating Right-Of-Use (“ROU”) assets and lease liabilities, deferred expenses, the fair value of options, warrants and related disclosure of contingent assets and liabilities. The Company bases its estimates on historical experience and on various other assumptions that it believes are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. On an ongoing basis, the Company reviews its estimates to ensure that they appropriately reflect changes in the business or as new information becomes available. Actual results may differ from these estimates.

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and ~~its~~the ~~wholly-owned subsidiary~~Subsidiary. ~~All~~Intercompany ~~significant~~balances ~~intercompany accounts~~ and transactions have been eliminated upon consolidation.

~~Revenue~~Cash ~~Recognition~~and Cash Equivalents and Short-term restricted Cash and Cash Equivalents

~~Under~~The ~~ASC~~Company ~~606,~~considers anall ~~entity~~highly ~~recognizes~~liquid ~~revenue~~certificates ~~when~~of ~~its~~deposits ~~customer~~with ~~obtains~~original ~~control~~maturities of ~~promised~~three ~~goods~~months or ~~services,~~less infrom ~~an amount that reflects~~ the ~~consideration~~ ~~which~~purchase ~~the entity expects~~ date to ~~receive~~be incash ~~exchange for those goods or services~~equivalents. ToCash ~~determine~~equivalents ~~revenue~~consist ~~recognition~~primarily ~~for arrangements that an entity determines are within the scope~~ of ~~ASC~~amounts ~~606,~~invested ~~the~~in ~~entity~~money ~~performs~~market ~~the~~accounts ~~following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations~~ in the ~~contract;~~United ~~(iii)~~States ~~determine~~and ~~the~~are stated ~~transaction~~at ~~price;~~carrying ~~(iv)~~value ~~allocate~~which ~~the transaction~~approximate ~~price~~their tofair ~~the~~values. ~~performance~~Restricted ~~obligations~~Cash ~~in the contract;~~ and ~~(v)~~Cash ~~recognize~~Equivalents ~~revenue~~consist ~~when~~of ~~(or as) the entity satisfies~~ a ~~performance obligation.~~bank ~~The~~deposit ~~Company only applies the five-step model to contracts when it is probable~~ accounts that ~~the~~serves ~~entity~~as ~~will~~collateral ~~collect the consideration it is entitled to in exchange~~ for ~~the~~a ~~goods~~credit orcard ~~services~~agreement itand ~~transfers~~lease toagreements ~~the~~at ~~customer.~~one ~~At contract inception, once the contract is determined to be within the scope~~ of ~~ASC 606,~~ the Company’s ~~assesses~~financial ~~the goods or services promised within each contract, determines those that are performance obligations and assesses whether each promised good or service is distinct~~institutions. ~~The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when (or as) the performance obligation is satisfied.~~

Property and Equipment, Net

Property and equipment are stated at cost, less accumulated depreciation. Depreciation is calculated on a straight-line basis over the estimated useful lives of the related assets, at the following annual rates:

Computers and Software	33	%
Lab Equipment	15	%
Office Furniture and Equipment	7-9	%

Leasehold improvements are amortized on a straight-line basis over the shorter of the assets’ estimated useful life (10%) or the remaining term of the lease (10-50%).

Maintenance and repair costs are expensed as incurred.

Impairment of Long-Lived Assets

The Company’s long-lived assets are reviewed for impairment in accordance with ASC No. 360, “Property, Plant and Equipment,” whenever events or changes in circumstances indicate that the carrying amount of an asset (assets group) may not be recoverable. If indicators of impairment exist and the undiscounted future cash flows that the assets (assets group) are expected to generate are less than the carrying value of the assets (assets group), the Company reduces the carrying amount of the assets through an impairment charge, to their estimated fair values. During the years ended December 31, 2023, and 2022, no impairment loss have been recorded.

Accrued Post-Employment Benefit

Under Israeli employment laws, employees of the Company are included under Section 14 of the Severance Compensation Act, 1963 (“Section 14”) for a portion of their salaries. According to Section 14, these employees are entitled to monthly payments made by the Company on their behalf with insurance companies.

Payments in accordance with Section 14 release the Company from any future severance payments with respect to those employees. The obligation to make the monthly deposits is expensed as incurred. In addition, the aforementioned deposits are not recorded as an asset in the consolidated balance sheet, and there is no liability recorded as the Company does not have a future obligation to make any additional payments. Severance costs amounted to approximately $0.2 million and $0.3 million for the years ended December 31, 2023 and 2022, respectively.

The Company maintains a 401(k) retirement savings plan for its U.S. employees. Each eligible employee may elect to contribute a portion of the employee’s compensation to the plan. As of December 31, 2023, and 2022, the Company has matched 100% of all employee contributions, up to 6% of the employee’s base salary.

F-9

InThe ~~determining~~Company’s ~~the~~leases ~~appropriate~~include ~~amount~~offices offor ~~revenue~~its tofacilities, beas ~~recognized~~well as itcar ~~fulfills its obligations under its agreements~~leases, ~~the~~which ~~Company performs the following steps: (i) identification of the promised goods or services in the contract; (ii) determination of whether the promised goods or services~~ are ~~performance~~all ~~obligations~~classified including whether they are distinct in the context of the contract; (iii) measurement of the transaction price, including the constraint on variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue when (or as) ~~the~~operating ~~Company satisfies each performance obligation~~leases. ~~As part of the accounting~~Short-term ~~for~~leases ~~these~~with ~~arrangements, the Company must use significant judgment to determine: (~~a) ~~the~~term ~~number~~ of ~~performance~~12 ~~obligations~~months ~~based~~or onless ~~the determination~~are ~~under~~not ~~step~~recorded ~~(ii)~~on ~~above; (b)~~ the ~~transaction~~balance ~~price under step (iii) above; and (c) the stand-alone selling price for each performance obligation identified in the contract for the allocation of transaction price in step (iv) above~~sheet. The Company ~~uses~~does ~~judgment to~~not ~~determine~~separate ~~whether~~lease ~~milestones~~components orfrom other variable consideration, except for royalties, should be included in the transaction price as described further below. The transaction price is allocated to each performance obligation on a relative standnon-~~alone selling price basis,~~lease ~~for which the Company recognizes revenue as or when the performance obligations under the contract are satisfied~~components.

~~Amounts~~At ~~received~~the ~~prior~~inception toof ~~revenue~~an ~~recognition~~arrangement, ~~are~~the ~~recorded~~Company asdetermines ~~deferred~~whether ~~revenue.~~the ~~Amounts~~arrangement ~~expected~~is toor becontains ~~recognized~~a aslease. ~~revenue~~Operating ~~within~~lease ~~the~~liabilities ~~12 months~~and ~~following~~their ~~the~~corresponding ~~balance~~right-of-use ~~sheet~~assets are recorded at commencement date. ~~are~~The ~~classified~~Company asrecords ~~current~~lease ~~portion~~liabilities based on the present value of ~~deferred~~lease ~~revenue~~payments inover the ~~accompanying~~lease ~~consolidated~~term. ~~balance~~The ~~sheets~~ROU asset also includes any lease payments made and excludes lease incentives. The Company ~~Amounts~~generally ~~not~~uses ~~expected~~an incremental borrowing rate to bediscount ~~recognized~~its aslease ~~revenue~~liabilities, ~~within~~as the 12rate ~~months~~implicit ~~following~~in the ~~balance~~lease ~~sheet~~is ~~date~~typically not readily determinable. Certain lease agreements include renewal options that are ~~classified~~under asthe ~~deferred~~Company’s ~~revenue,~~control. The Company includes optional ~~net~~renewal ofperiods ~~current~~in ~~portion~~the lease term only when it is reasonably certain that The Company will exercise its option.

~~Exclusive~~Certain ~~Licenses.~~lease Ifagreements ~~the~~contain ~~license~~variable ~~to the Company’s intellectual property is determined to be distinct from the other performance obligations identified in the arrangement~~payments, ~~the~~which ~~Company~~are ~~recognizes~~expensed revenue from non-refundable, upfront fees allocated to the license when the license is transferred to the customer and the customer is able to use and benefit from the license. In assessing whether a performance obligation is distinct from the other performance obligations, the Company considers factors such as ~~the~~incurred ~~research, development, manufacturing~~ and ~~commercialization~~ ~~capabilities~~not ofincluded ~~the collaboration partner and the availability of the associated expertise~~ in the ~~general~~operating ~~marketplace. In~~lease ~~addition, the Company considers whether the collaboration partner can benefit from a performance obligation for its intended purpose without the receipt~~ right-of-use ~~the remaining performance obligation, whether the value of the performance obligation is dependent on the unsatisfied~~(“ROU”) ~~performance~~assets ~~obligation, whether there are other vendors that could provide the remaining performance obligation,~~ and ~~whether it is separately identifiable from the remaining performance obligation~~liabilities. For licenses that are combined with other performance obligation, the Company utilizes judgment to assess the nature of the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time and, if over time, the appropriate method of measuring progress for purposes of recognizing revenue. The Company evaluates the measure of progress each reporting period and, if necessary, adjusts the measure of performance and related revenue recognition. The measure of progress, and thereby periods over which revenue should be recognized, are subject to estimates by management and may change over the course of the research and development and licensing agreement. Such a change could have a material impact on the amount of revenue the Company records in future periods.

~~Milestone~~Fair ~~Payments.~~Value ~~At the inception~~ of ~~each~~Financial arrangement that includes research or development milestone payments, the Company evaluates whether the milestones are considered probable of being achieved and estimates the amount to be included in the transaction price using the most likely amount method. If it is probable that a significant revenue reversal would not occur, the associated milestone value is included in the transaction price. An output method is generally used to measure progress toward complete satisfaction of a milestone. Milestone payments that are not within the control of the Company or the licensee, such as regulatory approvals, are not considered probable of being achieved until those approvals are received. The Company evaluates factors such as the scientific, clinical, regulatory, commercial, and other risks that must be overcome to achieve the particular milestone in making this assessment. There is considerable judgment involved in determining whether it is probable that a significant revenue reversal would not occur. At the end of each subsequent reporting period, the Company re-evaluates the probability of achievement of all milestones subject to constraint and, if necessary, adjusts its estimate of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis, which would affect revenue and earnings in the period of adjustment.Instruments:

The Company measures and discloses the fair value of financial assets and liabilities in accordance with ASC Topic 820, “Fair Value Measurement.” Fair value is based on the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date.

Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs.

The accounting standard establishes a fair value hierarchy that prioritizes observable and unobservable inputs used to measure fair value into three broad levels, which are described below:

Level 1: Quoted prices (unadjusted) in active markets that are accessible at the measurement date for assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs.

Level 2: Observable inputs that are based on inputs not quoted on active markets but corroborated by market data.

Level 3: Unobservable inputs are used when little or no market data are available.

Restricted Cash and Cash Equivalent, trade receivables, trade payables are stated at their carrying value, which approximates fair value due to the short time to the expected receipt or payment date.

Research and Development

Research and development costs are expensed as incurred. Research and development costs include payroll and personnel expenses, consulting costs, external contract research and development expenses, raw materials, drug product manufacturing costs, and allocated overhead including depreciation, rent, and utilities. Research and development costs that are paid in advance of performance are classified as a prepaid expense and amortized over the service period as the services are provided.

Clinical Trial Costs

Clinical trial costs are a component of research and development expenses. The Company bases its expenses related to Clinical Research Organization (“CRO”) on the services received, and efforts expanded pursuant to agreements with them. The financial terms of these agreements are subject to negotiation, vary from contract to contract and may result in uneven payment flows. For reoccurring services fees, the Company records the services over the time period which services will are based on inputs received from CRO. If the actual timing of the performance of services varies from the calculation, the Company adjusts the accrual or amount of prepaid expenses accordingly to adjust for such changes in time.

F-10

~~Collaborative~~Patent ~~Arrangements~~Costs

~~The~~Legal ~~Company~~and ~~analyzes~~related ~~its~~patent ~~collaboration~~costs ~~arrangements to assess whether such arrangements involve joint operating activities performed by parties that~~ are ~~both~~expensed ~~active~~as ~~participants~~incurred inas ~~the~~their ~~activities~~realization and exposed to significant risks and rewards dependent on the commercial success of such activities and therefore within the scope of ASC Topic 808, Collaborative Arrangements (ASC 808). This assessment is ~~performed throughout the life of the arrangement based on changes in the responsibilities of all parties in the arrangement~~uncertain. ~~For~~Costs ~~collaboration arrangements~~related ~~within the scope of ASC 808 that contain multiple elements, the Company first determines which elements of the collaboration are deemed~~ to bepatent ~~within~~registration ~~the scope of ASC 808 and which elements of the collaboration~~ are ~~more~~classified as ~~reflective~~general ~~of a vendor-customer relationship~~ and ~~therefore~~administrative ~~within the scope of ASC 606. For elements of collaboration arrangements that are accounted for pursuant to ASC 808~~expenses, ~~an appropriate recognition method is determined~~ and ~~applied~~costs ~~consistently,~~related ~~generally by analogy~~ to ~~ASC~~acquired ~~606.~~patents ~~Amounts that~~ are ~~owed~~classified ~~to collaboration partners are recognized~~ as anresearch ~~offset~~and todevelopment ~~collaboration~~expenses ~~revenue as such amounts are incurred by~~ in the ~~collaboration~~accompanying ~~partner.~~consolidated ~~For~~statements ~~those elements~~ of ~~the arrangement that are accounted for pursuant to ASC 606, the Company applies the five-step model described above under ASC 606~~operations.

~~Cash~~Contingent ~~and Cash Equivalents~~Liabilities

The Company ~~considers~~accounts ~~all~~for ~~highly~~its ~~liquid~~contingent ~~investments~~liabilities in accordance with anASC ~~original~~No. ~~maturity~~450, of“Contingencies”. ~~three~~A ~~months~~provision oris ~~less~~recorded when ~~from~~it is both probable that a liability has been incurred and the ~~date~~amount of ~~purchase~~the toloss can be ~~cash equivalents~~reasonably estimated. AsWith ofrespect ~~October~~to 31legal matters, ~~2022~~provisions are reviewed and ~~2021,~~adjusted to reflect the ~~Company~~impact ~~had~~of ~~cash~~negotiations, ~~equivalents~~estimated settlements, legal rulings, advice of legal ~~approximately~~counsel ~~$12.3~~and ~~million~~other information and ~~$17~~events pertaining to a particular matter.2 ~~million,~~See ~~respectively~~Note 7.

~~Restricted~~Income ~~Cash~~Taxes

OnThe ~~January~~Company ~~31,~~accounts ~~2022~~for income taxes in accordance with ASC 740, “Income Taxes”. This standard prescribes the ~~Company~~use ~~transferred~~of ~~$5,250,000~~the ~~into~~liability method anwhereby ~~escrow~~deferred ~~fund~~tax toasset ~~fund~~and aliability ~~potential~~account ~~Series~~balances Dare ~~preferred~~determined ~~stock~~based ~~redemption.~~on Ondifferences between financial reporting and ~~April~~tax 6bases of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. The Company provides a valuation allowance, ~~2022~~if necessary, ~~the~~to ~~Series~~reduce Ddeferred ~~convertible~~tax ~~preferred~~assets ~~stock~~to ~~was~~their ~~redeemed~~estimated ~~utilizing~~realizable value, if it is more likely than not that some portion of the entire ~~amount~~deferred ~~held~~tax inasset ~~the~~will ~~escrow~~not ~~fund~~be realized.

~~Concentration~~The Company accounts for uncertain tax positions in accordance with the provisions of ~~Credit~~ASC ~~Risk~~740-10, “Income Taxes”. Accounting guidance addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements, under which a Company may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position.

The tax benefits recognized in the consolidated financial statements from such a position should be measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. Although the Company ~~maintains~~believes ~~its~~that ~~cash~~it inhas ~~bank~~adequately ~~deposit~~reserved ~~accounts~~for its uncertain tax positions (~~checking~~including net interest and penalties), it can provide no assurance that atthe ~~times~~final ~~exceed~~tax ~~federally~~outcome ~~insured~~of ~~limits.~~these ~~Approximately~~matters ~~$25~~will not be materially different.0 ~~million~~The Company ismakes ~~subject~~adjustments to ~~credit~~these ~~risk~~reserves atwhen ~~October~~facts 31and circumstances change, ~~2022~~such as the closing of a tax audit or the refinement of an estimate. To ~~The~~the ~~Company~~extent ~~has~~that ~~not~~the ~~experienced~~final ~~any~~tax ~~losses~~outcome of these matters is different from the amounts recorded, such differences will affect the income tax expense in the period in which such ~~accounts~~determination is made.

~~Deferred~~Concentrations ~~Expenses~~of Credit Risk

~~Deferred~~Financial ~~expenses~~instruments ~~consist~~that potentially subject the Company to a concentration of ~~advanced~~credit ~~payments~~risk ~~made~~consist onprimarily ~~research~~of cash and ~~development~~cash ~~projects~~equivalents. ~~Expense~~Bank deposits isare ~~recognized~~held by accredited financial institutions and these deposits may at times be in ~~the~~excess ~~consolidated~~of ~~statement~~insured limits. Money Market funds are of ~~operations~~Prime asA ~~the~~and ~~research~~only invested in government issued securities. The Company limits its credit risk associated with cash and ~~development~~cash ~~activity~~equivalents by isplacing ~~performed~~them with financial institutions that it believes are of high-quality credit rating. The Company has not experienced any losses on its deposits of cash or cash equivalents.

~~Property~~The Company did not have ~~and~~any ~~Equipment~~customers as of December 31, 2023. The Company’s trade receivables as of December 31, 2022 were from one customer. In addition, the potential risk of loss with any one counterparty resulting from this type of credit risk is monitored on an ongoing basis.

Property and equipment are stated at cost. Additions and improvements that extend the lives of the assets are capitalized, while expenditures for repairs and maintenance are expensed as incurred. Leasehold improvements are amortized on a straightStock-~~line basis over the shorter~~Based ~~of the asset’s estimated useful life or the remaining lease term. Depreciation is calculated on a straight-line basis over the estimated useful lives of the assets ranging from three to ten years.~~Compensation

~~When~~The ~~depreciable~~Company ~~assets~~measures ~~are~~its ~~retired~~stock-based orpayment ~~sold~~awards ~~the~~made ~~cost~~to employees, directors, and ~~related~~non-employee ~~accumulated~~service ~~depreciation~~providers ~~are~~based ~~removed~~on ~~from~~estimated fair values. The fair value of each option award is estimated on the ~~accounts~~grant ~~and~~date ~~any~~using ~~resulting~~the Black-Scholes option pricing model. The Company ~~gain~~recognizes orcompensation ~~loss~~expenses isbased ~~recognized~~on inthe ~~operations~~accelerated method over the requisite service period. The Company recognizes forfeitures of awards as they occur.

~~Intangible~~The ~~Assets~~Black-Scholes option pricing model requires a number of assumptions, of which the most significant are share price, expected volatility, expected option term (the time from the grant date until the options are exercised or expire), risk-free rate, and expected divided rate. After the IPO, the fair value of each ordinary share was based on the closing price of the Company’s publicly traded ordinary shares as reported on the date of the grant.

Intangible assets are recorded at cost and include patents and patent application costs, licenses and software. Intangible assets are amortized on a straight-line basis over their estimated useful lives ranging from three to 20 years. Patent application costs are written-off if the application is rejected, withdrawn or abandoned.

F-11

~~Impairment~~Expected ~~of Long-Lived Assets~~volatility

~~The~~As the Company ~~periodically~~has ~~assesses~~a ~~the~~short ~~carrying~~trading ~~value~~history offor ~~intangible~~its ~~and~~ordinary ~~other long-lived assets~~shares, ~~and~~the ~~whenever~~expected ~~events~~volatility oris ~~changes~~derived infrom ~~circumstances indicate that~~ the ~~carrying~~average ~~amount~~historical share volatilities of anseveral ~~asset~~unrelated ~~might~~public ~~not~~companies bewithin ~~recoverable. The assets are considered to be impaired if~~ the Company’s ~~determines~~ industry that the ~~carrying~~Company ~~value~~considers ~~may~~to ~~not~~ be ~~recoverable~~comparable ~~based~~to its ~~upon~~own ~~its~~business ~~assessment,~~over ~~which~~a ~~includes~~period ~~consideration~~equivalent ofto the ~~following~~option’s ~~events~~expected ~~or changes in circumstances:~~term.

●Expected Dividend the asset’s ability to continue to generate income from operations and positive cash flow in future periods; ● loss of legal ownership or title to the asset(s); ● significant changes in the Company’s strategic business objectives and utilization of the asset(s); and ● the impact of significant negative industry or economic trends.Yield

IfThe ~~the~~Company ~~assets~~has ~~are~~historically ~~considered~~not topaid bedividends ~~impaired,~~and ~~the~~has ~~impairment~~no ~~recognized~~foreseeable isplans ~~the amount by which the carrying value of the assets exceeds the fair value of the assets. Fair value is determined by the application of discounted cash flow models~~ to ~~project~~pay ~~cash flows from the assets. In addition~~dividends, ~~the Company bases estimates of the useful lives~~ and ~~related~~therefore ~~amortization or depreciation expense on its subjective estimate of~~ the ~~period the assets will generate revenue or otherwise be used by it. Assets to be disposed of are reported at the lower of the carrying amount or fair value, less selling costs. The~~ Company ~~also~~uses ~~periodically reviews the lives assigned to long-lived assets to ensure~~an ~~that~~expected ~~the~~dividend ~~initial~~yield ~~estimates~~of ~~do not exceed any revised estimated periods from which the Company expects to realize cash flows from its assets~~0%.

~~Leases~~Risk-Free Interest Rate

AtThe ~~the~~risk-free ~~inception~~interest ofrate ~~an arrangement, the Company determines whether an arrangement~~ is ~~or contains a lease~~ based on the ~~facts~~yield ~~and~~from ~~circumstances present in the arrangement~~U. ~~An arrangement is or contains a lease if the arrangement conveys the right to control the use of an identified asset for a period of time in exchange for consideration~~S. ~~Most~~Treasury ~~leases with a term greater than one year are recognized on the consolidated balance sheet as operating lease right~~zero-~~of-use~~coupon ~~assets~~bonds ~~and current and long-term operating lease liabilities, as applicable. The Company has elected not to recognize on the consolidated balance sheet leases~~ with ~~terms~~an ofequivalent 12expected ~~months or less. The Company typically only includes the initial lease~~ term ~~in its assessment of a lease arrangement~~. ~~Options to extend a lease are not included in the Company’s assessment unless there is reasonable certainty that the Company will renew.~~

~~Operating~~Expected ~~lease~~Term ~~liabilities~~The ~~and~~expected ~~their~~option ~~corresponding~~term ~~right-of-use~~is ~~assets~~calculated ~~are~~for ~~recorded~~options ~~based~~granted onto ~~the~~employees ~~present~~and ~~value~~directors ofusing ~~lease~~the ~~payments~~“simplified” ~~over~~method. Under this approach, the expected ~~remaining~~ ~~lease~~ term. ~~Certain~~is ~~adjustments~~presumed to be the ~~right-of-use~~midpoint ~~asset~~between ~~may~~the beweighted ~~required~~average ~~for~~vesting ~~items~~term ~~such~~and asthe ~~prepaid~~contractual orterm of ~~accrued~~the ~~rent~~option. The ~~interest rate~~simplified ~~implicit~~method inmakes the ~~Company’s~~assumption ~~leases~~that isthe ~~typically~~employee ~~not~~will ~~readily~~exercise ~~determinable.~~share Asoptions aevenly ~~result,~~over the ~~Company~~period ~~utilizes~~when ~~its incremental~~the ~~borrowing~~share ~~rate,~~options ~~which~~are ~~reflects~~vested ~~the~~and ~~fixed~~ending ~~rate~~on atthe ~~which~~date when the ~~Company~~share ~~could~~options ~~borrow~~expire. The expected option term for options granted to non-employees is based on athe ~~collateralized~~contractual ~~basis~~term. Changes in the ~~amount~~determination of each of the ~~lease~~inputs ~~payments in~~can affect the ~~same~~fair ~~currency,~~value ~~for~~of athe ~~similar~~share ~~term,~~options ingranted and athe ~~similar~~results ~~economic~~of ~~environment~~operations of the Company.

~~Net~~Restricted ~~Income~~shares ~~(Loss)~~are ~~per~~valued ~~Share~~at the fair value of shares on the date of grant.

Basic ~~net~~and ~~income or loss per common share is computed by dividing net income or loss available to common stockholders by the weighted average number of common shares outstanding during the period.~~ Diluted ~~earnings~~Net ~~per~~Loss share give effect to dilutive options, warrants, restricted stock units and other potential common stock outstanding during the period. In the case of a net loss, the impact of the potential common stock resulting from warrants, outstanding stock options and convertible debt are not included in the computation of diluted loss per ~~share,~~ as the effect would be anti-dilutive. In the case of net income, the impact of the potential common stock resulting from these instruments that have intrinsic value are included in the diluted earnings per share. The table sets forth the number of potential shares of common stock that have been excluded from diluted net loss per share:Share

~~SCHEDULE~~Basic loss OFper ~~ANTI-DILUTIVE~~share ~~SECURITIES~~is ~~EXCLUDED~~computed ~~FROM~~by ~~DILUTED~~dividing ~~NET~~the ~~LOSS~~net ~~PER~~loss ~~SHARE~~by the weighted average number of shares of Common Stock outstanding during the period. Diluted loss per share is computed by dividing the net loss by the weighted average number of shares of Common Stock outstanding together with the number of additional shares of Common Stock that would have been outstanding if all potentially dilutive shares of Common Stock had been issued. Diluted net loss per share is the same as basic net loss per share in periods when the effects of potentially dilutive shares of Common Stock are anti-dilutive.

	As of October 31,
	2022		2021
Warrants		377,818		377,818
Stock options		11,118		11,192
Total		388,936		389,010

Business combinations

The Company accounts for business combinations by applying the provisions of ASC 805, Business Combination (“ASC 805”) and allocates the fair value of the purchase consideration to the tangible and intangible assets acquired and liabilities assumed based on their estimated fair values. The excess of the fair value of purchase consideration over the fair value of these identifiable assets and liabilities is recorded as goodwill. When determining the fair value of assets acquired and liabilities assumed, management makes significant estimates and assumptions, especially with respect to intangible assets.

Acquisition-related expenses are expensed as incurred.

Goodwill and acquired intangible assets

Goodwill and acquired intangible assets recorded in the Company’s financial statements result from both business combinations. Goodwill represents the excess of the purchase price in a business combination over the fair value of identifiable tangible and intangible assets acquired and liabilities assumed. Goodwill is not amortized as it is estimated to have an indefinite life. As such, goodwill is subject to an annual impairment test.

The Company allocates goodwill to reporting units based on the expected benefit from the business combination. Reporting units are evaluated when changes in the Company’s operating structure occur, and if necessary, goodwill is reassigned using a relative fair value allocation approach. The Company operates in one operating segment, and this segment is the only reporting unit.

ASC 350, Intangibles—Goodwill and Other (“ASC 350”) requires goodwill to be tested for impairment at least annually or more frequently if events or changes in circumstances indicate that goodwill may be impaired. The Company elects to perform an annual impairment test of goodwill as of December 31 of each year. The accounting guidance gives the option to perform a qualitative assessment to determine whether further impairment testing is necessary. The qualitative assessment considers events and circumstances that might indicate that a reporting unit’s fair value is less than its carrying amount. If it is determined, as a result of the qualitative assessment, that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, a quantitative test is performed.

During the last quarter of 2023, the Company experienced a significant decline in the stock price, which might suggest the fair value of the reporting unit is less than its carrying amount. However, when the Company performed its annual goodwill impairment test on December 31, 2023, it was noted that the reporting unit have a negative carrying amount. The Company concluded that no goodwill impairment should be recorded since after performing a quantitative test, the reporting unit’s fair value is not less than its carrying amount.

Separately acquired intangible assets are measured on initial recognition at cost including directly attributable costs. Intangible assets acquired in a business combination are measured at fair value at the acquisition date. Acquired identifiable finite-lived intangible assets are amortized on a straight-line basis over the estimated useful life of the respective asset. Each period the Company evaluates the estimated remaining useful lives of its intangible assets and whether events or changes in circumstances warrant a revision to the remaining period of amortization. Acquired indefinite-lived intangible assets are not amortized but are tested for impairment at least annually or more frequently if events or changes in circumstances indicate that the intangible asset may be impaired.

F-12

~~Research~~Segment ~~and Development Expenses~~Information

~~Research~~Financial information is available for evaluation by the chief operating decision maker, the Company’s Chief Executive Officer, in making decisions regarding resource allocation and ~~development~~assessing ~~costs~~performance. ~~are~~The ~~expensed~~Company asviews ~~incurred~~its operations and ~~include~~manages ~~but~~its business in one operating segment. Operating segments are ~~not~~defined ~~limited~~as tocomponents ~~clinical~~of ~~trial~~an ~~and~~enterprise ~~related~~in ~~manufacturing~~which ~~costs,~~separate ~~payroll~~financial information is evaluated regularly ~~and~~by ~~personnel~~the ~~expenses,~~chief ~~lab~~operating ~~expenses,~~decision ~~and~~maker ~~related~~in ~~overhead~~deciding ~~costs~~how to allocate resources and assessing performance.

~~Stock~~The ~~Based~~geographical ~~Compensation~~regions of the Company’s intangible assets are as follows:

~~The~~ Schedule ~~Company has an equity plan which allows for the granting~~ of ~~stock~~Geographical ~~options~~Region ~~to its employees, directors and consultants for a fixed number~~ of ~~shares~~Long-Lived with an exercise price equal to the fair value of the shares at date of grant. The Company measures the cost of services received in exchange for an award of equity instruments based on the fair value of the award. The fair value of the award is measured on the grant date and is then recognized over the requisite service period, usually the vesting period, in both research and development expenses and general and administrative expenses on the consolidated statement of operations, depending on the nature of the services provided by the employees or consultants.Assets

The process of estimating the fair value of stock-based compensation awards and recognizing stock-based compensation cost over their requisite service period involves significant assumptions and judgments. The Company estimates the fair value of stock option awards on the date of grant using the Black Scholes Model for the remaining awards, which requires that the Company makes certain assumptions regarding: (i) the expected volatility in the market price of its common stock; (ii) dividend yield; (iii) risk-free interest rates; and (iv) the period of time employees are expected to hold the award prior to exercise (referred to as the expected holding period). As a result, if the Company revises its assumptions and estimates, stock-based compensation expense could change materially for future grants.

	2023		2022
	Year ended
	December 31,		December 31,
	2023		2022
Israel		3,800		-
United States		98		-
Total		3,898		-
Total intangible assets		3,898		-

The ~~Company~~ ~~accounts~~geographical ~~for~~regions ~~stock-based~~of ~~compensation using fair value recognition and records forfeitures as they occur. As such,~~ the ~~Company~~ ~~recognizes~~Company’s ~~stock-based~~long ~~compensation~~lived ~~cost~~asset ~~only~~including ~~for~~rights ~~those stock-based awards that vest over their requisite service period, based on the vesting provisions~~ of ~~the~~use ~~individual~~are ~~grants.~~as follows:

Fair Value of Financial Instruments

	Year ended		Year ended
	December 31,		December 31,
	2023		2022
Israel		600		2,392
United States		42		30
Total		642		2,422
Total rights of use of assets and property and equipment		642		2,422

~~The carrying value~~ All of ~~financial~~the ~~instruments,~~Company’s ~~including~~revenues ~~cash~~are ~~and~~generated ~~cash~~in ~~equivalents and accounts payable, approximated fair value as of~~ the ~~balance~~ ~~sheet~~United ~~date presented, due to their short maturities~~States.

~~Convertible~~Schedule of Geographical ~~Preferred~~Region ~~Stock~~of Revenues

~~Preferred~~Revenue shares subject to mandatory redemption are classified as liability instruments and are measured at fair value. The Company classifies conditionally redeemable preferred shares, which includes preferred shares that feature redemption rights that are either within the control of the holder or subject to redemption upon the occurrence of uncertain events not solely within the Company’s control, as temporary equity (“mezzanine”) until such time as the conditions are removed or lapse.Recognition

~~Derivative~~The ~~Financial~~Company ~~Instruments~~recognizes revenue in accordance with ASC Topic 606, Revenue from Contracts with Customers, which applies to all contracts with customers. Under Topic 606, an entity recognizes revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration that the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of Topic 606, the entity performs the following five steps:

~~The Company~~(i) ~~does~~identify not use derivative instruments to hedge exposures to cash flow, market or foreign currency risks. The Company evaluates all of its financial instruments to determine if such instruments are derivatives or contain features that qualify as embedded derivatives. For derivative financial instruments that are accounted for as liabilities, the ~~derivative~~contract(s) ~~instrument is initially recorded at its fair value and is then re-valued at each reporting date,~~ with ~~changes in the fair value reported in the statements of operations. For share-based derivative financial instruments, the Company used the Monte Carlo simulation model, the Black Scholes model and~~ a binomial model to value the derivative instruments at inception and on subsequent valuation dates. The classification of derivative instruments, including whether such instruments should be recorded as liabilities or as equity, is evaluated at the end of each reporting period. Derivative liabilities are classified in the consolidated balance sheet as current or non-current based on whether or not net-cash settlement of the instrument could be required within 12 months after the balance sheet date.customer;

(ii)	identify the performance obligations in the contract;

(iii)

determine the transaction price;

(iv)	allocate the transaction price to the performance obligations in the contract; and

(v)	recognize revenue when (or as) the entity satisfies a performance obligation.

At contract inception, once the contract is determined to be within the scope of Topic 606, the Company assesses the goods or services promised within the contract and determines those that are performance obligations and assesses whether each promised good or service is distinct.

Customer option to acquire additional goods or services gives rise to a performance obligation in the contract only if the option provides a material right to the customer that it would not receive without entering into that contract.

In a contract with multiple performance obligations, the Company develop estimates and assumptions that require judgment to determine the underlying stand-alone selling price for each performance obligation, which determines how the transaction price is allocated among the performance obligations.

The Company evaluates each performance obligation to determine if it can be satisfied at a point in time or over time.

Revenue is recognized when control of the promised goods or services is transferred to the customers, in an amount that reflects the consideration the Company expect to be entitled to receive in exchange for those goods or services.

F-13

~~Income~~Recently ~~Taxes~~Adopted Accounting Pronouncements

~~The Company~~In ~~uses~~June 2016, the ~~asset~~FASB ~~and~~issued ~~liability~~ASU ~~method~~No. of2016-13 ~~accounting for income taxes in accordance with ASC~~ (Topic ~~740~~ 326), ~~“Income~~Financial ~~Taxes.” Under~~Instruments—Credit ~~this~~Losses: ~~method,~~Measurement ~~income~~of ~~tax~~Credit ~~expense~~Losses oron ~~benefit~~Financial isInstruments, ~~recognized~~which ~~for~~replaces the ~~amount~~existing ~~of:~~incurred loss ~~(i)~~impairment ~~taxes~~model ~~payable~~with oran ~~refundable~~expected ~~for~~credit ~~the~~loss ~~current year~~model and ~~(ii)~~requires ~~deferred~~a ~~tax consequences of temporary differences resulting from matters that have been recognized in an entity’s~~ financial ~~statements~~asset ~~or tax returns. Deferred tax assets and liabilities are~~ measured ~~using~~at ~~enacted~~amortized ~~tax~~cost ~~rates expected~~ to ~~apply~~be topresented ~~taxable~~at ~~income in~~ the ~~years~~net inamount ~~which those temporary differences are~~ expected to be ~~recovered or settled~~collected. The ~~effect~~new onguidance ~~deferred~~was ~~tax~~effective ~~assets~~for ~~and liabilities of a change in tax rates is recognized in~~ the ~~results~~Company ofon ~~operations~~January in1, ~~the~~2023 ~~period~~and ~~that includes~~ the ~~enactment~~adoption ~~date.~~did Anot ~~valuation~~have ~~allowance~~a ismaterial ~~provided~~impact ~~to reduce the deferred tax assets reported if based~~ on the ~~weight~~Company’s ofconsolidated ~~the~~financial ~~available positive and negative evidence, it is more likely than not some portion or all of the deferred tax assets will not be realized~~statements.

OnRecently ~~August~~Issued ~~16,~~Accounting ~~2022,~~Pronouncements ~~the~~Not ~~Inflation~~Yet Reduction Act (IRA) was signed into law. The legislation imposes new taxes, including a 15% corporate alternative minimum tax (CAMT) on adjusted financial statement income of corporations with profits over $1 billion, which is effective for tax years beginning after December 31, 2022, and a 1% surcharge on corporate stock buybacks of public US companies, which applies to repurchases of stock after December 31, 2022. The tax provisions of the Inflation Reduction Act do not have a material impact on the Company’s financial statements.Adopted

~~Reverse~~In ~~Stock~~November ~~Split~~2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, which requires public entities to disclose information about their reportable segments’ significant expenses and other segment items on an interim and annual basis. Public entities with a single reportable segment are required to apply the disclosure requirements in ASU 2023-07, as well as all existing segment disclosures and reconciliation requirements in ASC 280 on an interim and annual basis. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of adopting ASU 2023-07.

~~On March~~In ~~31,~~December ~~2022~~2023, the ~~Company’s~~FASB ~~stockholders voted to approve an amendment to allow the Company to execute a reverse stock split~~issued ofASU ~~common~~2023-09, Income ~~stock~~Taxes ~~within~~(Topic a740): ~~range~~Improvements ~~of 1 for 20~~ to 1Income ~~for~~Tax 80Disclosures, ~~without~~which ~~reducing~~requires ~~the~~public ~~authorized~~entities, ~~number~~on ofan ~~shares~~annual ~~of the common stock~~basis, ~~at the~~ ~~discretion~~to ofprovide ~~the~~disclosure ~~Board~~ of ~~Directors.~~specific Oncategories ~~June~~in ~~3, 2022,~~ the ~~Board~~rate ofreconciliation, ~~Directors~~as ~~approved~~well aas 1disclosure ~~for~~of 80income ~~reverse~~taxes ~~stock~~paid ~~split,~~disaggregated ~~which~~by ~~became effective~~jurisdiction. onASU ~~June~~2023-09 6,is ~~2022.~~effective ~~All~~for ~~references~~fiscal inyears ~~this~~beginning ~~Report~~after toDecember ~~number~~15, ~~of shares~~2024, ~~price~~with ~~per~~early ~~share~~adoption ~~and~~permitted. ~~weighted~~The ~~average~~Company ~~number~~is ofcurrently ~~shares of common stock~~evaluating ~~outstanding prior to this reverse stock split have been adjusted to reflect~~ the ~~reverse~~impact ~~stock~~of ~~split~~adopting onASU ~~a retroactive basis, unless otherwise noted~~2023-09.

~~Recent Accounting~~3. ~~Standards~~Mergers

~~Business~~Merger ~~Combinations~~with Ayala Pharmaceuticals, Inc.

InOn October ~~2021~~18, 2022, the ~~FASB~~Company, ~~issued~~which ~~ASU~~at ~~2021-08,~~the ~~Business~~time ~~Combinations~~was ~~(Topic~~named ~~805):~~Advaxis, ~~Accounting~~Inc., ~~for~~entered ~~Contract~~into ~~Assets~~a ~~and~~Merger ~~Contract~~Agreement ~~Liabilities from~~(the ~~Contracts~~“Merger Agreement”), with ~~Customers~~an ~~which~~entity ~~amended~~then ~~guidance~~known onas ~~accounting~~Ayala ~~for~~Pharmaceuticals, ~~contract~~Inc. ~~assets~~(which ~~and~~shortly ~~contract~~prior ~~liabilities~~to ~~from~~the ~~contracts~~closing ~~with~~of ~~customers in~~the amerger ~~business~~in ~~combination.~~January ~~The~~2023 ~~guidance~~changed isits name ~~intended~~ to ~~address~~Old ~~inconsistency~~Ayala, ~~related~~Inc., to(“Old ~~recognition~~Ayala”) ofand anDoe ~~acquired~~Merger ~~contract~~Sub, ~~liability and~~Inc. ~~payment~~(“Merger ~~terms~~Sub”), ~~and~~a ~~their~~direct, ~~effect~~wholly-owned onsubsidiary of ~~subsequent~~the ~~revenue recognized~~Company. AtUnder the ~~acquisition~~terms ~~date,~~of anthe ~~entity~~Merger ~~should~~Agreement, ~~account~~Merger ~~for~~Sub ~~the~~merged ~~related revenue~~with ~~contracts~~and ininto ~~accordance~~Old Ayala, with ~~existing~~Old ~~revenue~~Ayala ~~recognition~~continuing ~~guidance~~as ~~generally~~the surviving bycompany ~~assessing~~and ~~how~~a ~~the~~wholly-owned ~~acquiree~~subsidiary ~~applied~~of ~~recognition and~~the ~~measurement~~Company in(the ~~their~~“January ~~financial~~2023 ~~statements~~Merger”). ~~The~~Immediately ~~amended~~after ~~guidance~~the isJanuary 2023 ~~effective~~Merger, ~~for~~former ~~the~~Advaxis ~~Company~~stockholders as of ~~November~~immediately 1,prior ~~2023~~to onthe aMerger ~~prospective approach~~own approximately 37.5% ~~Early~~of ~~adoption~~the isoutstanding ~~permitted.~~shares ~~This~~of ~~guidance~~the combined isCompany ~~not~~and ~~expected~~former toOld ~~have~~Ayala ashareholders ~~material~~own ~~effect~~approximately on62.5% of the ~~Company’s~~outstanding ~~financial~~shares ~~statements~~of the combined Company.

~~Management~~At ~~does~~the ~~not~~effective ~~believe~~time ~~that~~of ~~any~~the ~~recently~~January ~~issued~~2023 Merger (the “Effective Time”), ~~but~~each ~~not~~share ~~yet~~of ~~effective~~share ~~accounting~~capital ~~pronouncements,~~of ifOld ~~adopted,~~Ayala ~~would~~issued ~~have~~and outstanding immediately prior to the Effective Time was converted into the right to receive a ~~material~~number ~~impact~~of shares of the Company’s oncommon stock, par value $0.001 per share, equal to the ~~accompanying~~exchange ~~consolidated~~ratio, ~~financial~~0.1874 ~~statements~~shares of the Company’s common stock per Old Ayala share.

The January 2023 Merger has been accounted for as a reverse merger with Old Ayala as the accounting acquirer and former Advaxis as the accounting acquiree. In identifying Old Ayala as the accounting acquirer, the companies considered ASC 805-10-55 including the structure of the January 2023 Merger, relative outstanding share ownership at closing and the composition of the combined Company’s board of directors and senior management. The financial reporting reflects the accounting from the perspective of Old Ayala (“accounting acquirer”), except for the legal capital, which has been retroactively adjusted to reflect the capital of former Advaxis (“accounting acquiree”) in accordance with ASC 805-40-45. As such, the historical financial information presented is that of Old Ayala as the accounting acquirer in the January 2023 Merger.

Because most of the value of the assets of former Advaxis was in cash and cash equivalents, the January 2023 Merger is treated primarily as a financing transaction for accounting purposes with a small component as a business acquisition. Therefore, no gain or loss is recorded as a result of the January 2023 Merger. Old Ayala’s transaction costs were capitalized and offset against the shareholder’s equity upon the January 2023 Merger, and former Advaxis’ transaction costs were expensed as merger costs. The consolidated financial statements from the closing date of the January 2023 Merger include the assets, liabilities, and results of operations of the combined company.

F-14

3.Fair ~~PROPERTY~~Value ~~AND EQUIPMENT~~Allocation

~~Property~~The following sets forth the fair value of acquired identifiable assets and ~~equipment~~assumed ~~consist~~liabilities of former Advaxis which includes adjustments to reflect the ~~following~~fair value of intangible assets acquired (in thousands) as of January 19, 2023:

~~SCHEDULE~~ Schedule OFof ~~PROPERTY~~fair ~~AND~~value ~~EQUIPMENT~~ of Intangible Assets Acquired

	2022			2021
	Amounts
	October 31,
Cash and cash equivalents	$	22,539
	2022			2021
Prepaid expenses and other current assets		300
Laboratory Equipment	$	94		$	179
Property and equipment, net		34
Computer equipment		24			241
Intangible assets		130
Total property and equipment		118			420
Operating right-of-use asset		5
Accumulated depreciation and amortization		(80	)		(302	)
Other assets		11
Net property and equipment	$	38		$	118
Goodwill
Total assets		23,019
SAFE liability
Common stock warrant liability		(203	)
Other current liabilities and trade payables		(2,714	)
Total liabilities		(2,917	)
Net assets acquired	$	20,102

~~Depreciation~~The ~~expense~~fair ~~for~~value ~~the~~estimate ~~years~~for ~~ended~~all ~~October~~identifiable ~~31,~~assets ~~2022~~ and ~~2021~~liabilities ~~was~~assumed ~~approximately~~is ~~$53,000~~preliminary and ~~$387,000,~~is ~~respectively.~~based ~~During~~on ~~the~~assumptions ~~year~~that ~~ended~~market ~~October~~participants ~~31,~~would ~~2022,~~use ~~the~~in ~~Company~~pricing ~~incurred~~an aasset, ~~gain~~based on ~~disposal of equipment of approximately $8,000, all of which is reflected in~~ the ~~research~~most ~~and development~~advantageous ~~expenses~~market infor the ~~consolidated~~asset ~~statement of operations~~(i.e., ~~During~~its ~~the~~highest ~~year~~and ~~ended~~best ~~October~~use). ~~31,~~This ~~2021,~~fair ~~the~~value ~~Company~~estimate ~~incurred~~could ainclude ~~loss on~~assets ~~disposal~~that ofare ~~equipment~~not ofintended ~~approximately~~to ~~$1,439,000,~~be ~~$891~~used,~~000~~ ofmay ~~which~~be ~~is reflected in the research and development expenses and $548~~sold,~~000 of~~ ~~which~~or isare ~~reflected~~intended into ~~the~~be ~~general~~used ~~and administrative expenses~~ in ~~the~~a ~~consolidated~~manner ~~statement~~other than oftheir ~~operations~~best use.

4The Company recognized intangible assets related to the January 2023 Merger, which consist of the Patents and License agreements valued at $130 thousand with an estimated useful life of four years. Acquired identifiable finite-lived intangible assets are amortized on a straight-line ~~INTANGIBLE~~basis ~~ASSETS~~over the estimated useful lives of the assets. The basis of amortization approximates the pattern in which the assets are utilized, over their estimated useful lives. The Company routinely reviews the remaining estimated useful lives of finite-lived intangible assets. In case the Company reduces the estimated useful life for any asset, the remaining unamortized balance is amortized or depreciated over the revised estimated useful life.

~~Intangible~~The ~~assets~~results ~~consist~~of operations of ~~the~~Advaxis ~~following~~have (been included in ~~thousands):~~the consolidated financial statements since the acquisition date of January 19, 2023.There is no practical way to determine net income attributable to the former Advaxis due to integration.

~~SUMMARY~~Merger OFwith ~~INTANGIBLE~~Biosight ~~ASSETS~~Ltd.

	2022		2021
	October 31,
	2022		2021
Patents	$	95	$	4,836
License		15		777
Software		-		98
Total intangibles		110		5,711
Accumulated amortization		-		(2,357	)
Net intangible assets	$	110	$	3,354

On July 26, 2023, the Company and its wholly owned subsidiary organized under the laws of the State of Israel, Advaxis Israel Ltd. (“Biosight Merger Sub”), entered into an Agreement and Plan of Merger and Reorganization (the “Merger Agreement”) with Biosight Ltd. (“Biosight”), a privately-held Israeli pharmaceutical company developing innovative therapeutics for hematological malignancies and disorders. Under the terms of the Merger Agreement, on October 18, 2023, Merger Sub merged with and into Biosight, which is now a wholly owned subsidiary of the Company (the “Biosight Merger”). At completion of the Biosight Merger, Ayala’s then-current equity holders own approximately 45% and the former Biosight equity holders own approximately 55% of Ayala’s common stock.

~~The~~Based ~~expiration~~on ~~dates~~the ofagreement, the ~~existing~~Company ~~patents~~was ~~range~~the ~~from~~legal ~~2022~~acquirer toin ~~2039 but~~ the ~~expiration~~Biosight ~~dates~~Merger. ~~can~~In beaddition, ~~extended~~the ~~based~~Company onconsidered ~~market~~ASC ~~approval~~805-10-55 ifto ~~granted~~determine ~~and/or~~the ~~based~~accounting onacquirer ~~existing~~in ~~laws~~the ~~and~~Biosight ~~regulations~~Merger. ~~Capitalized~~As ~~costs~~the ~~associated~~Company ~~with~~holds ~~patent~~a ~~applications~~majority ~~that~~of ~~are abandoned without future value are charged to expense when~~ the ~~determination~~members isof ~~made not to further pursue~~ the ~~application.~~governing ~~Patent~~body ~~applications having~~of athe ~~net~~combined ~~book~~Company ~~value of approximately $159,000~~ and ~~$94,000~~the ~~were~~Company’s ~~abandoned~~former ~~and~~management ~~were~~dominates ~~charged~~the tomajority ~~general~~of ~~and~~the ~~administrative~~senior ~~expenses~~management inof the ~~consolidated~~ ~~statement~~combined ofCompany, and ~~operations~~after ~~for~~considering ~~the~~all ~~years~~other ~~ended~~factors ~~October~~according ~~31,~~to ~~2022~~ASC ~~and 2021~~805-10-55, ~~respectively.~~the ~~Amortization~~Company ~~expense for intangible assets that~~ was ~~charged~~identified toas ~~general~~the ~~and~~accounting ~~administrative~~acquirer ~~expense~~ in the Biosight ~~consolidated~~Merger. ~~statement~~The ofCompany ~~operations~~has ~~aggregated~~accounted ~~approximately~~for ~~$233,000 and~~the ~~$273,000~~Biosight ~~for~~Merger ~~the~~as ~~years~~a ~~ended~~business ~~October~~combination ~~31,~~according ~~2022~~to ~~and~~ASC ~~2021,~~805 ~~respectively~~“Business Combinations”.

During the year ended October 31, 2022, the Company identified the following indicators of impairment under ASC 360 indicating that the patents and license carrying amounts might not be recoverable:

	●	Adverse changes in the business climate for biotechnology companies, particularly raising capital; and
	●	A significant reduction in the Company’s market capitalization during the year ended October 31, 2022.

The Company performed an impairment test under ASC 350 on its patents owned and in-licensed intellectual property. Under this test a fair value of the relevant asset is compared with the carrying amount of such asset. Fair value is calculated using a discounted cash flow analysis. Cash flows are discounted using a weighted average cost of capital derived from comparable companies, which reflects the costs of borrowing as well as the associated risk. The results of the impairment test indicated that the carrying value of the patents owned and in-licensed intellectual property exceeded the fair value. During the year ended October 31, 2022, the Company recorded an impairment charge for patents owned and in-licensed intellectual property of approximately $3,052,000 in its consolidated statement of operations.

F-15

AtFair ~~October~~Value ~~31, 2022, the estimated amortization expense by fiscal year based on the current carrying value of intangible assets is as follows (in thousands):~~Allocation

~~SCHEDULE~~The OFfollowing ~~CARRYING~~sets ~~VALUE~~forth OFthe ~~INTANGIBLE~~fair ~~ASSETS~~value of acquired identifiable assets and assumed liabilities of Biosight which includes to reflect the fair value of intangible assets acquired (in thousands) as of October 18, 2023:

		1
2023	$	66
2024		44
Total	$	110

5. ACCRUED EXPENSES:

	Amounts
Cash and cash equivalents	$	1,909
Fixed Assets, net		64
Prepaid expenses and other current assets		89
Intangible assets		3,800
Goodwill		4,500
Total assets		10,363
Side Letter Agreement Liability		(685	)
SAFE liability		(1,068	)
Other current liabilities and trade payables		(3,096	)
Total liabilities		(4,849	)
Net assets acquired	$	5,514

The ~~following~~fair ~~table~~value ~~represents~~estimate for all identifiable assets and liabilities assumed and is based on assumptions that market participants would use in pricing an asset, based on the ~~major~~most ~~components~~advantageous ofmarket ~~accrued~~for ~~expenses~~the asset (ini.e., ~~thousands~~its highest and best use):. This preliminary fair value estimate could include assets that are not intended to be used, may be sold, or are intended to be used in a manner other than their best use. Such estimates are subject to change during the measurement period, which is not expected to exceed one year. Any adjustments identified during the measurement period will be recognized in the period in which the adjustments are determined.

~~SUMMARY~~The OFCompany ~~ACCRUED~~recognized ~~EXPENSES~~intangible assets related to the Biosight Merger, consisting of certain patents and license agreements (“In Process Technology”) valued at $3.8 million. Such assets were fair valued using the discounted cash flow method. Acquired indefinite-lived intangible assets will remain indefinite-lived assets until the completion or abandonment of these assets. The Company also recognized goodwill assets related to the Biosight Merger, valued at $4.5 million with an estimated indefinite useful life. The Company did not recognize any changes as of December 31, 2023, in the value of the Biosight that suggested impairment to both intangible asset and goodwill. The goodwill is not deductible for tax purposes

	2022		2021
	October 31,
	2022		2021
Salaries and other compensation	$	92	$	55
Vendors		1,151		1,968
Professional fees		707		613
Other		200		200
Total accrued expenses	$	2,150	$	2,836

Acquisition-related transaction costs are not included as components of consideration transferred but are accounted for as expenses in the period in which the costs are incurred. The Company incurred transaction costs of $1.0 million during the year ended December 31, 2023 which were included in general and administrative expenses in the consolidated statements of operations (loss).

6.The ~~LEASES~~results of operations of Biosight have been included in the consolidated financial statements since the acquisition date of October 18, 2023. There is no practical way to determine net income attributable to Biosight due to integration.

The ~~Company~~following ~~previously~~unaudited ~~leased~~table aprovides ~~corporate~~certain ~~office~~pro ~~and~~forma ~~manufacturing~~financial ~~facility~~information infor ~~Princeton, New Jersey under an operating lease that was set to expire in November 2025. On March 26, 2021,~~ the Company ~~entered~~as ~~into~~if athe ~~Lease~~January ~~Termination~~2023 ~~and~~Merger ~~Surrender Agreement with respect to this lease agreement. The Lease Termination~~ and ~~Surrender Agreement provides for~~ the ~~early~~Biosight Merger ~~termination~~occurred ~~of the lease, which became effective~~ on ~~March~~January ~~31, 2021. In connection with the early termination of the lease, the Company was required to pay a $~~1,~~000,000~~ ~~termination~~2022 ~~payment. The~~(in ~~unapplied~~thousands ~~security~~except ~~deposit~~per ~~totaling~~share approximately $182,000 was credited against the termination fee for a net payment of approximately $818,000. The Company wrote off of the remaining right-of-use asset of approximately $4,512,000 and lease liability of approximately $5,628,000. After consideration of the termination payment and write off the remaining right-of-use asset and lease liability, the Company recorded a net gain of approximately $116,000.amounts):

~~On March~~ Schedule ~~25, 2021, the Company entered into a new one-year lease agreement for its corporate office/lab with base rent~~ of ~~approximately $29,000~~Pro ~~per~~Forma ~~year,~~Financial plus other expenses. This lease was accounted for as a short-term lease at inception, and the Company elected not to recognize a right-of-use asset and lease liability. In September 2021, the Company exercised its option to renew the lease, extending the lease term until March 25, 2023. Since the renewed lease term exceeded one-year, the lease no longer qualified for the short-term lease exception, resulting in the recognition of a right-of-use asset and operating lease liability of approximately $43,000.Information

Supplemental balance sheet information related to leases was as follows (in thousands):

	Year			Year
	ended			ended
	December 31,			December 31,
	2023			2022*
	Unaudited			Unaudited
Revenue	$	13		$	942
Net loss	$	(57,344	)	$	(63,011	)

~~SCHEDULE~~* OFThe ~~SUPPLEMENTAL~~pro ~~BALANCE~~forma ~~SHEET~~amounts ~~RELATED~~above TOare ~~LEASES~~ derived from historical numbers of the Company, Old Ayala and Biosight. The results of operations for the year ended December 31, 2022 include the operations of the Company for the period from November 1, 2022 to October 31, 2023 which was the fiscal year 2022 prior to the change in the Company’s fiscal year end from October 31 to December 31, which change was effected in January 2023. There are no such adjustments for Biosight as the fiscal year ended on December 31, 2023.

	October 31, 2022		October 31, 2021
Operating leases:
Operating lease right-of-use assets	$	12	$	40
Operating lease liability	$	12	$	28
Operating lease liability, net of current portion		-		12
Total operating lease liabilities	$	12	$	40

The unaudited pro forma results have been prepared based on estimates and assumptions, which we believe are reasonable; however, they are not necessarily indicative of the consolidated results of operations had the acquisition occurred on January 1, 2022, or of future results of operations.

F-16

~~Supplemental~~4. ~~lease~~Property ~~expense~~and ~~related~~Equipment, ~~to leases was as follows (in thousands):~~net

~~SCHEDULE~~Property and OFEquipment, ~~LEASE~~net ~~EXPENSES~~ consists of the following:

Lease Cost (in thousands)	Statements of Operations Classification	For the Fiscal Year Ended October 31, 2022		For the Fiscal Year Ended October 31, 2021
Operating lease cost	General and administrative	$	29	$	1,302
Short-term lease cost	General and administrative		-		14
Variable lease cost	General and administrative		47		180
Total lease expense		$	76	$	1,496

Schedule of Property and Equipment, Net

Other information related to leases where the Company is the lessee is as follows:

	December 31,		December 31,
	2023		2022
	(in thousands)
Cost:
Computers and Software	$	60	$	73
Lab Equipment		95		296
Office Furniture and Equipment		92		146
Leasehold Improvements		1,105		1,105
Property and Equipment, Gross		1,352		1,620
Less: Accumulated Depreciation		812		660
Property and Equipment, Net	$	540	$	960

~~SCHEDULE~~Depreciation expenses OFfor ~~OTHER~~the ~~INFORMATION~~years ~~RELATED~~ended TODecember ~~LEASES~~ 31, 2023, and 2022 was approximately $334 thousand and $162 thousand, respectively.

	October 31, 2022			October 31, 2021
Weighted-average remaining lease term		0.4 years			1.4 years
Weighted-average discount rate		3.79	%		3.79	%

During the year ended December 31, 2023 the Company recorded a write down to assets due to inactivity of lab equipment and intention to dispose or sell all of them of $145 thousand.

~~Supplemental~~5. ~~cash flow information related to operating leases was as follows:~~Leases

~~SCHEDULE~~The OFCompany ~~CASH~~adopted ~~FLOW~~ASC ~~INFORMATION~~842, ~~RELATED~~relating to TOlease ~~LEASES~~ accounting, in the first quarter of 2022 using the modified retrospective method. Results for reporting periods beginning after December 31, 2021, have been presented in accordance with the standard. The cumulative effect of initially applying the new leases standard was recognized as an adjustment to the opening consolidated balance sheet as of January 1, 2022.

		For the Fiscal Year Ended October 31, 2022				For the Fiscal Year Ended October 31, 2021
Cash paid for operating lease liabilities		$	29			$	547

The Company elected a package of practical expedients for leases that commenced prior to January 1, 2022, and did not reassess historical conclusions on: (i) whether any expired or existing contracts are or contain leases; (ii) lease classification for any expired or existing leases; and (iii) initial direct costs capitalization for any existing leases.

~~Future~~This standard had a significant ~~minimum~~impact ~~lease~~on ~~payments~~the ~~under~~Company’s ~~non-cancellable~~consolidated ~~leases~~balance assheet but did not have a significant impact on the Company’s consolidated statements of ~~October~~operations. ~~31,~~The ~~2022~~most ~~were~~significant aseffects ~~follows:~~relate to the recognition on the consolidated balance sheet of ROU assets and lease liabilities for offices and for car operating leases.

~~SCHEDULE~~Upon adoption, OFthe ~~FUTURE~~Company ~~MINIMUM~~recognized ~~LEASE~~lease ~~PAYMENTS~~liabilities ~~UNDER~~and ~~NON-CANCELLABLE~~corresponding ~~LEASES~~ ROU assets, adjusted for the accrued rent and remaining lease incentives received on the adoption date, as follows:

Fiscal Year ending October 31,
2023	$	13
Less: Imputed interest		(1	)
Total	$	12

7. COMMON STOCK PURCHASE WARRANTS AND WARRANT LIABILITY

	ROU assets		Lease liabilities
	January 1, 2022
	ROU assets		Lease liabilities
Offices	$	1,448	$	2,020
Cars		302		267
Total operating leases	$	1,750	$	2,287

~~Warrants~~In January 2019, the Company signed a new lease agreement. The term of the lease is for 63 months and includes an option to extend the lease for an additional 60 months. As part of the agreement, the lessor also provided the Company an amount of approximately $0.5 million paid in arrears for of leasehold improvements. The amount was recorded as an incentive and is taken into account when computing the ROU asset.

AsA subsidiary of ~~October~~the ~~31,~~Company ~~2022~~obtained ~~and~~a ~~2021,~~bank ~~there~~guarantee ~~were~~in ~~outstanding~~the ~~and~~amount ~~exercisable warrants to purchase 377,818 shares~~ of ~~our~~approximately ~~common stock with exercise prices ranging from~~ $200.002 tomillion ~~$224.00 per share. Information on~~ for the ~~outstanding~~office ~~warrants~~lease ~~is as follows:~~agreement.

~~SCHEDULE~~On OFMarch ~~COMMON~~25, ~~STOCK~~2021, ~~PURCHASE~~the ~~WARRANTS~~Company ~~AND~~entered ~~WARRANT~~into ~~LIABILITY~~ a one-year lease agreement for its corporate office/lab with base rent of approximately $29 thousand per year, plus other expenses. In September 2021, the Company exercised its option to renew the lease, extending the lease term until March 31, 2023. On March 25, 2023 the Company signed an extension up to March 31, 2025, with base rent of approximately $36 thousand per year. The Company recorded an ROU asset and liability of approximately $65 thousand.

Exercise Price		Number of Shares Underlying Warrants		Expiration Date	Type of Financing
$	20.00		879	September 2024	September 2018 Public Offering
$	224.00		4,092	July 2024	July 2019 Public Offering
$	28.00		57,230	November 2025	November 2020 Public Offering
$	56.00		140,552	April 2026	April 2021 Registered Direct Offering (Accompanying Warrants)
$	56.00		175,065	5 years after the date such warrants become exercisable, if ever	April 2021 Private Placement (Private Placement Warrants)
	Grand Total		377,818

The Company did not extend the lease for an additional five years, and as such the Company recognized a gain of $238 thousand in the consolidated income statement due to early termination of the lease liabilities.

F-17

AsThe ~~of October 31, 2022 and 2021, the~~ Company ~~had~~has ~~201,874 of its total 377,818 outstanding warrants classified as equity (equity warrants). At issuance, equity warrants are recorded in Additional Paid-In Capital in~~ the ~~shareholders~~following ~~equity~~operating ~~section~~ROU ofassets ~~the~~and ~~consolidated balance~~lease ~~sheets.~~liabilities:

A Schedule ~~summary~~ of ~~warrant~~Operating ~~activity~~Right ~~was~~of asUse ~~follows~~Assets ~~(In thousands, except share~~ and ~~per~~Lease ~~share data):~~Liabilities

	Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life In Years		Aggregate Intrinsic Value
	December 31, 2023
Outstanding and exercisable warrants at October 31, 2020		4,971		$	6.40		3.76	$	110,640
	ROU assets			Lease liabilities
Issued		603,190			38.40
Offices	$	42		$	134
Exercised		(230,343	)		16.00
Cars		60			41
Outstanding and exercisable warrants at October 31, 2021		377,818		$	53.49		4.63	$	631,089
Total operating leases	$	102		$	175
Outstanding and exercisable warrants at October 31, 2022		377,818		$	53.49		4.09	$	-

Shares Issued for Warrants Exercises

		December 31, 2022
		ROU assets			&nbs

Filing Compare · Ayala Pharmaceuticals, Inc.