We generally plan to seek regulatory approval
to commercialize our product candidates in the United States, the European Union and in additional foreign countries where we have
commercial rights. To obtain regulatory approval in other countries, we must comply with numerous and varying regulatory requirements
of such other countries regarding safety, efficacy, chemistry, manufacturing and controls, clinical studies, commercial sales,
pricing, marketing and distribution of our product candidates. Even if we are successful in obtaining approval in one jurisdiction,
we cannot ensure that we will obtain approval in any other jurisdictions. Failure to obtain marketing authorization for our product
candidates will result in our being unable to market and sell such products, which would materially adversely affect our business,
financial conditional and results of operation. If we fail to obtain approval in any jurisdiction, the geographic market for our
product candidates could be limited. Similarly, regulatory agencies may not approve the labeling claims that are necessary or desirable
for the successful commercialization of our product candidates.
Clinical drug development involves a lengthy
and expensive process with uncertain timelines and uncertain outcomes. If clinical studies of our product candidates are prolonged
or delayed, we may be unable to obtain required regulatory approvals, and therefore be unable to commercialize our product candidates
on a timely basis or at all.
To obtain the requisite regulatory approvals
to market and sell any of our product candidates, we must demonstrate through extensive preclinical and clinical studies that our
products are safe and effective in humans. Clinical testing is expensive and can take many years to complete, and its outcome is
inherently uncertain. Failure can occur at any time during the clinical study process. The results of preclinical and early clinical
studies of our product candidates may not be predictive of the results of later-stage clinical studies. For example, the positive
results generated to date in clinical studies for our product candidates do not ensure that later clinical studies will demonstrate
similar results. Product candidates in later stages of clinical studies may fail to show the desired safety and efficacy traits
despite having progressed through preclinical studies and initial clinical studies. A number of companies in the biopharmaceutical
industry have suffered significant setbacks in advanced clinical studies due to lack of efficacy or adverse safety profiles, notwithstanding
promising results in earlier studies. Our future clinical study results may not be successful.
Clinical studies must be conducted in accordance
with FDA, EMA and comparable foreign regulatory authorities’ legal requirements, regulations or guidelines, and are subject
to oversight by these governmental agencies and Institutional Review Boards, or IRBs, at the medical institutions where the clinical
studies are conducted. In addition, clinical studies must be conducted with supplies of our product candidates produced under cGMP
and other requirements. We depend on medical institutions and CROs, to conduct our clinical studies in compliance with cGCP standards.
To the extent the CROs fail to enroll participants for our clinical studies, fail to conduct the study to cGCP standards or are
delayed for a significant time in the execution of studies, including achieving full enrollment, we may be affected by increased
costs, program delays or both, which may harm our business.
To date, neither we nor our collaboration
partners have completed all clinical studies required for the approval of any of our product candidates. In January 2019, Roche,
the parent of our collaboration partner discontinued the CREAD 1 and CREAD 2 Phase III studies of crenezumab in patients with prodromal
to mild sporadic Alzheimer’s disease (AD). The Phase 2 development of crenezumab continues in a preventive trial of cognitively
healthy individuals in Colombia with a risk of developing familial AD. ACI-24 for AD is in a Phase 2 clinical study, ACI-24 for
Down syndrome completed recruitment for a high dose cohort of the Phase 1b clinical study, ACI-35 completed a Phase 1b clinical
study, anti-Tau antibody is in a Phase 2 clinical study and Tau-PET imaging tracer completed a Phase 1 clinical study. The development
of our other product candidates is less advanced and studies have not yet started.
The completion of clinical studies for
our clinical product candidates may be delayed, suspended or terminated as a result of many factors, including but not limited
|·||the delay or refusal of regulators or IRBs to authorize us to commence a clinical study at a prospective study site or changes
in regulatory requirements, policies and guidelines;|
|·||delays or failure to reach agreement on acceptable terms with prospective CROs and clinical study sites, the terms of which
can be subject to extensive negotiation and may vary significantly among different CROs and study sites;|
|·||delays in patient enrollment and variability in the number and types of patients available for clinical studies;|