You should read the following discussion and analysis of our financial condition
and results of operations in conjunction with the consolidated financial
statements and the related notes to those statements included later in this
Annual Report. In addition to historical financial information, the following
discussion contains forward-looking statements that reflect our plans,
estimates, beliefs and expectations that involve risks and uncertainties. Our
actual results and the timing of events could differ materially from those
discussed in these forward-looking statements. Factors that could cause or
contribute to these differences include those discussed below and elsewhere in
this Annual Report, particularly in Part I, Item 1A. "Risk Factors," and
"Special Note Regarding Forward-Looking Statements."

Overview



We are a clinical-stage biopharmaceutical company developing novel,
immune-modulating cancer vaccines based on our T-win technology platform. Our
product candidates are designed to induce the immune system to simultaneously
target and disrupt multiple pathways that regulate tumor-induced
immunosuppression. We believe this represents a paradigm shift in the management
of cancer and that our product candidates have the potential to become
cornerstones of the treatment regimens of multiple solid tumors. Our lead
product candidate, IO102-IO103, is designed to target the immunosuppressive
mechanisms mediated by key immunosuppressive proteins such as Indoleamine
2,3-dioxygenase (IDO) and programmed death ligand (PD-L1). In a single-arm Phase
1/2 clinical trial of 30 patients with metastatic melanoma with the primary
objective of investigating safety and tolerability, the secondary objective of
investigating immunogenicity, and the tertiary objective of investigating
clinical efficacy, IO102-IO103, in combination with nivolumab, demonstrated an
ability to induce meaningful tumor regression and establish durable antitumor
response while achieving a manageable tolerability profile for patients. The
clinical efficacy endpoints in this trial included OR, PFS and OS. In this
trial, we observed a confirmed overall response rate ORR of 73% and a complete
response rate CRR of 50%. Based on the results from this trial, IO102-IO103, in
combination with pembrolizumab, was granted BTD by the FDA for treatment of
unresectable/metastatic melanoma.

We enrolled the first patient in a potentially registrational Phase 3 trial for
IO102-IO103 in combination with pembrolizumab as a potential first-line
treatment in advanced melanoma, the IOB-013/KN-D18 trial, in May of 2022. We
have made significant progress with the activation of clinical sites
participating in the Phase 3 IOB-013/KN-D18 trial, ending February 2023 with
nearly 100 active sites in the trial, compared to 55 at the end of October 2022.
The IOB-013/KN-D18 trial has a target enrollment of 300 patients and is designed
with an interim analysis of ORR one year after 75% of patients have been
randomized and a final analysis of the primary endpoint of PFS for the full
trial population. We expect to enroll 75% of patients in the trial by mid-2023
and to complete recruitment by the end of 2023. The trial design and discussions
with FDA are aimed at potentially pursuing accelerated approval, if the trial
data are favorable, based on the interim analysis of ORR, supported by other
data. If the data are supportive, we also plan to file a MAA with the EMA based
on the primary endpoint of PFS.

Our ability to generate revenue from product sales sufficient to achieve
profitability will depend heavily on the successful development and eventual
commercialization of one or more of our product candidates. Our operations to
date have been financed primarily by aggregate net proceeds of $288.7 million
from the issuance of convertible preference shares, convertible notes, ordinary
shares and, most recently, our IPO. On November 9, 2021, we completed an IPO of
our common stock and issued and sold 8,222,500 shares of common stock at a
public offering price of $14.00 per share, including 1,072,500 shares of common
stock sold pursuant to the underwriters' exercise of their option to purchase
additional shares of common stock, resulting in net proceeds of $103.3 million
after deducting underwriting discounts and commissions and estimated offering
expenses. Since inception, we have had significant operating losses. Our net
loss was $71.5 million and $67.9 million for the years ended December 31, 2022
and 2021, respectively. As of December 31, 2022, we had an accumulated deficit
of $177.7 million and $142.6 million in cash and cash equivalents.

Cash used to fund operating expenses is impacted by the timing of when we pay
these expenses, as reflected in the change in our accounts payable and accrued
expenses. We expect to continue to incur net losses for the foreseeable future,
and we expect our research and development expenses, general and administrative
expenses, and capital expenditures will continue to increase. In particular, we
expect our expenses to increase as we continue our development of, and seek
regulatory approvals for, our product candidates, as well as hire additional
personnel, pay fees to outside consultants, lawyers and accountants, and incur
other increased costs associated with being a public company. In addition, if
and when we seek and obtain regulatory approval to commercialize any product
candidate, we will also incur increased expenses in connection with
commercialization and marketing of any such product. Our net losses may
fluctuate significantly from quarter-to-quarter and year-to-year, depending on
the timing of our clinical trials and our expenditures on other research and
development activities.

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Based upon our current operating plan, we believe that our existing cash and
cash equivalents of $142.6 million as of December 31, 2022, will be sufficient
to continue funding our development activities through the third quarter of
2024. We have based this estimate on assumptions that may prove to be wrong, and
we could exhaust our available capital resources sooner than we expect. To
finance our operations beyond that point we will need to raise additional
capital, which cannot be assured.

To date, we have not had any products approved for sale and, therefore, have not
generated any product revenue. We do not expect to generate any revenues from
product sales unless and until we successfully complete development and obtain
regulatory approval for one or more of our product candidates. If we obtain
regulatory approval for any of our product candidates, we expect to incur
significant commercialization expenses related to product sales, marketing,
manufacturing and distribution. As a result, until such time, if ever, that we
can generate substantial product revenue, we expect to finance our cash needs
through equity offerings, debt financings or other capital sources, including
collaborations, licenses or similar arrangements. However, we may be unable to
raise additional funds or enter into such other arrangements when needed or on
favorable terms, if at all. Any failure to raise capital as and when needed
could have a negative impact on our financial condition and on our ability to
pursue our business plans and strategies, including our research and development
activities. If we are unable to raise capital, we will need to delay, reduce or
terminate planned activities to reduce costs.

Coronavirus Pandemic



In March 2020, the World Health Organization declared the COVID-19 outbreak a
pandemic. In order to mitigate the spread of COVID-19, governments have imposed
unprecedented restrictions on business operations, travel and gatherings,
resulting in a global economic downturn and other adverse economic and societal
impacts. The COVID-19 pandemic has also overwhelmed or otherwise led to changes
in the operations of many healthcare facilities, including clinical trial sites.
We cannot predict the scope and severity of any further disruptions as a result
of COVID-19 and continuing resource constraints or their impacts on CROs, us,
clinical trial sites and others. Continuing resource constraints or business
disruptions for us or any of the third parties with whom we engage, including
the collaborators, contract organizations, third-party manufacturers, suppliers,
clinical trial sites, regulators and other third parties with whom we conduct
business could materially and negatively impact our ability to conduct our
business in the manner and on the timelines presently planned. We are unable to
determine the extent of the impact of the pandemic on our clinical trials,
operations and financial condition going forward. These developments are highly
uncertain and unpredictable, and may materially adversely affect our financial
position and results of operations

Components of Operating Results

Operating Expenses

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

Research and Development



Our research and development expenses consist primarily of costs incurred for
the development of our product candidates and our drug discovery efforts, which
include:

personnel costs, which include salaries, benefits and equity-based compensation expense;

expenses incurred under agreements with outside consultants and advisors, including their fees and related travel expenses;


expenses incurred under agreements with third parties, including CROs that
conduct research, preclinical activities and clinical trials on our behalf as
well as CMOs that manufacture our product candidates for use in our preclinical
and clinical trials and perform chemistry, manufacturing and control activities
(CMC);

laboratory and vendor expenses related to the execution of preclinical studies and planned and ongoing clinical trials;

expenses related to research conducted by institutions, universities and hospitals as part of collaborations;


filing and maintenance of patents and intellectual property rights, including
payment to third parties for assignment of patent rights and licensing fees and
milestone payments incurred under product license agreements where no
alternative future use exists;

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laboratory supplies and equipment used for internal research and development activities; and

facility-related expenses, which include direct depreciation costs and allocated expenses for rent and maintenance of facilities and other operating costs.



We expense all research and development costs in the periods in which they are
incurred. Costs for certain research and development activities are recognized
based on an evaluation of the progress to completion of specific tasks using
information and data provided to us by our vendors and third-party service
providers.

From time to time, we obtain grants from public and private funds for our research and development projects. The grant income for a given period is recognized as a cost reimbursement and is typically based on the time and the costs that we have spent on the specific project during that period.



We have historically met the requirements to receive a tax credit in Denmark of
up to 5.5 million Danish Kroner per year for losses resulting from research and
development costs of up to 25 million Danish Kroner per year. The tax credit is
presented as a reduction to research and development expense in the statements
of operations.

We use our personnel and infrastructure resources across multiple research and
development programs directed toward identifying and developing product
candidates. We generally have not tracked our research and development expenses
on a program-by-program basis. Substantially all of our direct research and
development expenses in the years ended December 31, 2022 and 2021 were on
IO102-IO103 and consisted primarily of external costs, such as consultants,
third-party contract organizations that conduct research and development
activities on our behalf, costs related to production of preclinical and
clinical materials, including fees paid to contract manufacturers, and
laboratory and vendor expenses related to the execution of our ongoing and
planned preclinical studies and clinical trials.

We expect our research and development expenses to increase substantially for
the foreseeable future as we continue to invest in research and development
activities related to developing our product candidates, including investments
in conducting clinical trials, manufacturing and otherwise advancing our
programs. The process of conducting the necessary clinical research to obtain
regulatory approval is costly and time-consuming, and the successful development
of our product candidates is highly uncertain.

Because of the numerous risks and uncertainties associated with product
development and the current stage of development of our product candidates and
programs, we cannot reasonably estimate or know the nature, timing and estimated
costs necessary to complete the remainder of the development of our product
candidates or programs. We are also unable to predict if, when, or to what
extent we will obtain approval and generate revenues from the commercialization
and sale of our product candidates. The duration, costs and timing of
preclinical studies and clinical trials and development of our product
candidates will depend on a variety of factors, including:

successful completion of preclinical studies and of clinical trials for IO102-IO103, IO112, and our other current product candidates and any future product candidates;

successful enrollment and completion of our Phase 3 clinical trial for IO102-IO103, Phase 2 IO102-IO103 basket trials, and any clinical trials for future product candidates;

data from our clinical programs that support an acceptable risk-benefit profile of our product candidates in the intended patient populations;


acceptance by the FDA, regulatory authorities in Europe, or other regulatory
agencies of the IND applications, clinical trial applications and/or other
regulatory filings for IO102-IO103, our other current product candidates and any
future product candidates;

expansion and maintenance of a workforce of experienced scientists and others to continue to develop our product candidates;

successful application for and receipt of marketing approvals from applicable regulatory authorities;

obtainment and maintenance of intellectual property protection and regulatory exclusivity for our product candidates;

arrangements with third-party manufacturers for, or establishment of, commercial manufacturing capabilities;


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establishment of sales, marketing and distribution capabilities and successful
launch of commercial sales of our products, if and when approved, whether alone
or in collaboration with others;

acceptance of our products, if and when approved, by patients, the medical community and third-party payors;

effective competition with other therapies;

obtainment and maintenance of coverage, adequate pricing and adequate reimbursement from third-party payors, including government payors;

maintenance, enforcement, defense and protection of our rights in our intellectual property portfolio;

avoidance of infringement, misappropriation or other violations with respect to others' intellectual property or proprietary rights; and

maintenance of a continued acceptable safety profile of our products following receipt of any marketing approvals.



We may never succeed in achieving regulatory approval for any of our product
candidates. We may obtain unexpected results from our preclinical studies and
clinical trials. We may elect to discontinue, delay or modify clinical trials of
some product candidates or focus on others. A change in the outcome of any of
these factors could mean a significant change in the costs and timing associated
with the development of our current and future preclinical and clinical product
candidates. For example, if the FDA or another regulatory authority were to
require us to conduct clinical trials beyond those that we currently anticipate
will be required for the completion of clinical development, or if we experience
significant delays in execution of or enrollment in any of our preclinical
studies or clinical trials, we could be required to expend significant
additional financial resources and time on the completion of preclinical and
clinical development.

Research and development activities account for a significant portion of our
operating expenses. We expect our research and development expenses to increase
for the foreseeable future as we continue to implement our business strategy,
which includes advancing IO102-IO103 through clinical development and other
product candidates further into clinical development, expanding our research and
development efforts, including hiring additional personnel to support our
research and development efforts, and seeking regulatory approvals for our
product candidates that successfully complete clinical trials. In addition,
product candidates in later stages of clinical development generally incur
higher development costs than those in earlier stages of clinical development,
primarily due to the increased size and duration of later-stage clinical trials.
As a result, we expect our research and development expenses to increase as our
product candidates advance into later stages of clinical development. However,
we do not believe that it is possible at this time to accurately project total
program-specific expenses through commercialization. There are numerous factors
associated with the successful commercialization of any of our product
candidates, including future trial design and various regulatory requirements,
many of which cannot be determined with accuracy at this time based on our stage
of development.

General and Administrative Expenses



Our general and administrative expenses consist primarily of personnel costs,
depreciation expense and other expenses for outside professional services,
including legal fees relating to patent and corporate matters, human resources,
audit and accounting services and facility-related fees not otherwise included
in research and development expenses. Personnel costs consist of salaries,
benefits and equity-based compensation expense, for our personnel in executive,
finance and accounting, business operations and other administrative functions.
We expect our general and administrative expenses to increase over the next
several years to support our continued research and development activities,
manufacturing activities, increased costs of expanding our operations and
operating as a public company. These increases will likely include increases
related to the hiring of additional personnel, fees to outside consultants,
lawyers and accountants, and increased costs associated with being a public
company such as expenses related to services associated with maintaining
compliance with Nasdaq listing rules and SEC requirements, director and officer
insurance premiums and investor relations costs.

Other Income (Expense), Net

Our other income (expense), net is comprised of:


Foreign exchange: Our functional currency is the Euro. Transactions denominated
in currencies other than the Euro result in exchange gains and losses that are
recorded in our statements of operations.

Fair value adjustments on convertible notes: For the year ended December 31, 2021, we elected to account for our convertible notes at fair value, with corresponding adjustments to fair value accounted for as gains and losses


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in our statements of operations. The convertible notes were settled immediately prior to the consumption of our IPO in November 2021.

Interest expense: For the years ended December 31, 2022 and 2021, we incurred interest expense on account balances with banks and vendors.

Interest income: For the years ended December 31, 2022 and 2021, we recognized interest income on account balances invested in money market funds and on account balances with banks.

Results of Operations

Comparison of the Years Ended December 31, 2022 and 2021

The following sets forth our results of operations:



                                       Year Ended December 31,                Change
                                         2022             2021         Amount       Percent
                                                         (in thousands)
Operating expenses
Research and development             $     46,986       $  30,152     $  16,834         55.8 %
General and administrative                 24,438          11,082        13,356        120.5 %
Total operating expenses                   71,424          41,234        30,190         73.2 %
Loss from operations                      (71,424 )       (41,234 )     (30,190 )       73.2 %
Other income (expense), net                 1,239         (26,577 )     

27,816 (104.7 )% Net loss before income tax expense $ (70,185 ) $ (67,811 ) $ (2,374 ) 3.5 %

Research and Development Expenses

Research and development expenses were comprised of:



                                              Year Ended December 31,                 Change
                                               2022              2021         Amount        Percent
                                                                 (in thousands)
Preclinical studies and clinical
trial-related activities                   $     19,910       $   14,658     $   5,252           35.8 %
Chemistry, manufacturing and control              9,354            6,462         2,892           44.8 %
Personnel                                        15,101            7,403         7,698          104.0 %
Consultants and other costs                       2,621            1,629           992           60.9 %

Total research and development expenses $ 46,986 $ 30,152

  $  16,834           55.8 %



Research and development expenses were $47.0 million for the year ended December
31, 2022, compared to $30.2 million for the year ended December 31, 2021. The
increase of $16.8 million was primarily related to an increase in preclinical
studies and clinical trial-related activities for our IO102-IO103 product
candidate, including the continued execution of our Phase 3 clinical trial, of
$5.3 million, an increase in personnel costs of $7.7 million primarily related
to an increase in headcount and related recruiting costs and an increase in
costs for chemistry, manufacturing and control, activities of $2.9 million.

General and Administrative Expenses

General and administrative expenses were comprised of:



                                               Year Ended December 31,                 Change
                                                2022              2021         Amount        Percent
                                                                  (in thousands)
Personnel                                   $      7,260       $    2,956     $   4,304          145.6 %
Professional services                              5,167            3,981         1,186           29.8 %
Consultants and other costs                       12,011            4,145         7,866          189.8 %
Total general and administrative expenses   $     24,438       $   11,082

$ 13,356 120.5 %





General and administrative expenses were $24.4 million for the year ended
December 31, 2022, compared to $11.1 million for the year ended December 31,
2021. The increase of $13.4 million was primarily related to an increase in
personnel costs of $4.3 million primarily related to an increase in headcount
and related recruiting costs and an increase in consultants

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and other costs of $7.9 million primarily related to $2.9 million in insurance premiums, $2.3 million in consulting expense and $0.8 million in travel costs.

Other Income (Expense), Net

Other income (expense), net was comprised of:



                                             Year Ended December 31,                Change
                                              2022              2021         Amount        Percent
                                                                (in thousands)
Net foreign exchange (loss) gain           $       130       $      319     $    (189 )       (59.2 )%
Interest income                                  1,411                -         1,411         100.0 %
Interest expense                                  (302 )           (361 )          59         (16.3 )%
Fair value adjustments on preferred
stock tranche obligations                            -          (26,535 )      26,535        (100.0 )%
Other income (expense), net                $     1,239       $  (26,577 )   $  27,816        (104.7 )%


Other income (expense), net was $1.2 million for the year ended December 31,
2022 compared to ($26.6) million for the year ended December 31, 2021. The
increase of $27.8 million was primarily due to the decrease in the fair value
adjustments on the Company's preferred stock tranche obligations.

Liquidity and Capital Resources

Sources of Liquidity



Our operations to date have been financed primarily by aggregate net proceeds of
$288.7 million from the issuance of convertible preference shares, convertible
notes, Class A ordinary shares and, most recently, our IPO. On November 9, 2021,
we completed an IPO of our common stock and issued and sold 8,222,500 shares of
common stock at a public offering price of $14.00 per share, including 1,072,500
shares of common stock sold pursuant to the underwriters' exercise of their
option to purchase additional shares of common stock, resulting in net proceeds
of $103.3 million after deducting underwriting discounts and commissions and
estimated offering expenses. Since inception, we have had significant operating
losses. Our net loss was $71.5 million and $67.9 million for the years ended
December 31, 2022 and 2021, respectively. As of December 31, 2022, we had an
accumulated deficit of $177.7 million and $142.6 million in cash and cash
equivalents. Our primary use of cash is to fund operating expenses, which
consist primarily of research and development expenditures, and to a lesser
extent, general and administrative expenditures. Cash used to fund operating
expenses is impacted by the timing of when we pay these expenses, as reflected
in the change in our outstanding accounts payable and accrued expenses.

We currently expect that our cash and cash equivalents of $142.6 million as of
December 31, 2022 will be sufficient to fund our operating expenses and capital
requirements through the third quarter of 2024. However, additional funding will
be necessary to fund our future clinical and pre-clinical activities. If we are
unable to obtain funding, we could be forced to delay, reduce or eliminate our
research and development programs, product portfolio expansion or
commercialization efforts, which could adversely affect our business prospects
and our ability to continue operations.

Cash Flows

The following table summarizes our cash flows for the periods indicated:



                                                         Year Ended December 31,
                                                           2022             2021
                                                              (in thousands)
Net cash used in operating activities                  $    (59,729 )     $ (40,646 )
Net cash used in investing activities                          (690 )          (153 )
Net cash provided by financing activities                         -         

252,951

Net (decrease) increase in cash and cash equivalents $ (60,419 ) $ 212,152

Net Cash Used in Operating Activities



Cash used in operating activities of $59.7 million during the year ended
December 31, 2022 was primarily attributable to our net loss of $71.5 million
and a net increase of $4.2 million in our working capital accounts, partially
offset by non-cash items of $7.5 million primarily due to equity-based
compensation.

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Cash used in operating activities of $40.6 million during the year ended
December 31, 2021 was primarily attributable to our net loss of $67.9 million
and a net increase of $0.8 million in our working capital accounts, partially
offset by non-cash items of $28.0 million primarily due to fair value
adjustments on our preferred stock tranche obligations.

Net Cash Used in Investing Activities



Cash used in investing activities of $0.7 million and $0.2 million for the years
ended December 31, 2022 and 2021, respectively, was related to the purchase of
property and equipment.

Net Cash Provided by Financing Activities

We had no cash provided by financing activities for the year ended December 31, 2022.



Cash provided by financing activities for the year ended December 31, 2021 was
$253.0 million comprised of $103.3 million of aggregate net proceeds from the
issuance of common stock in our IPO in November 2021 and $149.6 million of net
proceeds from the sale and issuance of our Class C convertible preference shares
in January, March and October 2021.

Funding Requirements



Any product candidates we may develop may never achieve commercialization and we
anticipate that we will continue to incur losses for the foreseeable future. We
expect that our research and development expenses, general and administrative
expenses, and capital expenditures will continue to increase. As a result, until
such time, if ever, as we can generate substantial product revenue, we expect to
finance our cash needs through a combination of equity offerings, debt
financings or other capital sources, including potentially collaborations,
licenses and other similar arrangements. Our primary uses of capital are, and we
expect will continue to be, compensation and related expenses; costs related to
third-party clinical research, manufacturing and development services; costs
relating to the build-out of our headquarters and our other offices,
laboratories and manufacturing facility; license payments or milestone
obligations that may arise; laboratory expenses and costs for related supplies;
clinical costs; manufacturing costs; legal and other regulatory expenses; and
general overhead costs.

Based upon our current operating plan, we believe that our existing cash and
cash equivalents of $142.6 million as of December 31, 2022 will be sufficient to
continue funding our development activities through the third quarter of 2024.
To finance our operations beyond that point we will need to raise additional
capital, which cannot be assured. We have based this estimate on assumptions
that may prove to be wrong, and we could utilize our available capital resources
sooner than we currently expect. We will continue to require additional
financing to advance our current product candidates through clinical
development, to develop, acquire or in-license other potential product
candidates and to fund operations for the foreseeable future. We will continue
to seek funds through equity offerings, debt financings or other capital
sources, potentially including collaborations, licenses and other similar
arrangements. However, we may be unable to raise additional funds or enter into
such other arrangements when needed on favorable terms or at all. If we do raise
additional capital through public or private equity offerings, the ownership
interest of our existing stockholders will be diluted, and the terms of these
securities may include liquidation or other preferences that adversely affect
our stockholders' rights. If we raise additional capital through debt financing,
we may be subject to covenants limiting or restricting our ability to take
specific actions, such as incurring additional debt, making capital expenditures
or declaring dividends. Any failure to raise capital as and when needed could
have a negative impact on our financial condition and on our ability to pursue
our business plans and strategies. If we are unable to raise capital, we may
need to delay, reduce or terminate planned activities to reduce costs.

Because of the numerous risks and uncertainties associated with research, development and commercialization of pharmaceutical products, we are unable to estimate the exact amount of our operating capital requirements. Our future funding requirements will depend on many factors, including, but not limited to:

the progress, costs and results of our ongoing and planned clinical trials of IO102-IO103, as well as our planned trials for our other product candidates;

the scope, progress, results and costs of discovery research, preclinical development, laboratory testing and clinical trials for our product candidates, including our ongoing clinical trials of IO102-IO103;

the impacts of the COVID-19 pandemic;

the number of, and development requirements for, other product candidates that we pursue;

the costs, timing and outcome of regulatory review of our product candidates;


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our ability to enter into contract manufacturing arrangements for supply of active pharmaceutical ingredient, or API, and manufacture of our product candidates and the terms of such arrangements;

our ability to establish and maintain strategic collaborations, licensing or other arrangements and the financial terms of such arrangements;

the payment or receipt of milestones and receipt of other collaboration-based revenues, if any;

the costs and timing of any future commercialization activities, including product manufacturing, sales, marketing and distribution, for any of our product candidates for which we may receive marketing approval;

the amount and timing of revenue, if any, received from commercial sales of our product candidates for which we receive marketing approval;


the costs and timing of preparing, filing and prosecuting patent applications,
maintaining and enforcing our intellectual property and proprietary rights and
defending any intellectual property-related claims;

the extent to which we acquire or in-license other products, product candidates, technologies or data referencing rights;

enrollment for our upcoming Phase 3 registration trial, the IOB-013/KN-D18 trial;

the ability to receive additional non-dilutive funding, including grants from organizations, public institutions and foundations;

addition of operational, financial and management information systems and personnel, including personnel to support our drug development, any future commercialization efforts and our transition to a public company; and

the costs of operating as a public company.



Further, our operating plans may change, and we may need additional funds to
meet operational needs and capital requirements for clinical trials and other
research and development activities. Because of the numerous risks and
uncertainties associated with the development and commercialization of our
product candidates, we are unable to estimate the amounts of increased capital
outlays and operating expenditures associated with our current and anticipated
product development programs.

Contractual Obligations and Commitments



In March 2021, we entered into a new lease for our office space in Copenhagen,
Denmark that was amended in September 2022 and set to expire in December 2027.
The lease for our office space in Copenhagen, Denmark is terminable upon six
months' notice. In August 2021, we entered into a new lease for laboratory
facilities and office space in Rockville, Maryland that expires in April 2027.
In October 2021, we entered into a new lease for office space in New York, NY
that expires in January 2027.

We enter into contracts in the ordinary course of business with third-party
service providers for clinical trials, preclinical research studies and testing,
manufacturing and other services and products for operating purposes. These
contracts generally provide for termination upon notice of 30 to 90 days, and
therefore, we believe that our non-cancelable obligations under these agreements
are not material and we cannot reasonably estimate whether they will occur.
However, in the event of a termination of any contracts with CROs or other
institutions and with respect to active patients enrolled in our clinical
trials, we may be financially obligated for a period beyond the contractual
termination notice periods.

We may also enter into additional research, manufacturing, supplier, lease and
other agreements in the future, which may require up-front payments and even
long-term commitments of cash.

Critical Accounting Policies and Significant Judgments and Estimates



Our management's discussion and analysis of our financial condition and results
of operations is based on our financial statements, which have been prepared in
accordance with U.S. GAAP. The preparation of these financial statements
requires us to make estimates and assumptions that affect the reported amounts
of assets and liabilities, the disclosure of contingent assets and liabilities
at the date of the financial statements, and the reported expenses incurred
during the reporting periods. Our estimates are based on our historical
experience and on various other factors that we believe are reasonable under the
circumstances, the results of which form the basis for making judgments about
the carrying value of assets and liabilities that

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are not readily apparent from other sources. Actual results may differ from
these estimates under different assumptions or conditions. We believe that the
accounting policies discussed below are critical to understanding our historical
and future performance, as these policies relate to the more significant areas
involving management's judgments and estimates.

Going Concern



Our evaluation of our ability to continue as a going concern requires us to
evaluate our future sources and uses of cash sufficient to fund our currently
expected operations in conducting research and development activities. We
evaluate the probability associated with each source and use of cash resources
in making our going concern determination. The research and development of
pharmaceutical products is inherently subject to uncertainty. We currently
expect that our cash and cash equivalents of $142.6 million as of December 31,
2022 will be sufficient to fund our operating expenses and capital requirements
for at least 12 months from the date the financial statements are issued.

Research and Development Costs



We incur substantial expenses associated with clinical trials. Accounting for
clinical trials relating to activities performed by CMO's, CRO's and other
external vendors requires management to exercise significant estimates in regard
to the timing and accounting for these expenses. We estimate costs of research
and development activities conducted by service providers, which include costs
associated with the conduct of sponsored research, preclinical studies, contract
manufacturing activities and pass-through costs. The diverse nature of services
being provided under CRO and other arrangements, the different compensation
arrangements that exist for each type of service and the lack of timely
information related to certain clinical activities complicates the estimation of
accruals for services rendered by CROs and other vendors in connection with
clinical trials. We record the estimated costs of research and development
activities based upon the estimated amount of services provided but not yet
invoiced and include these costs in the accrued and other current liabilities or
prepaid expenses on the balance sheets and within research and development
expense on the statements of operations. In estimating the duration of a
clinical study, we evaluate the start-up treatment and wrap-up periods,
compensation arrangements and services rendered attributable to each clinical
trial. Fluctuations are regularly tested against payment plans and trial
completion assumptions.


We estimate these costs based on factors such as estimates of the work completed
and budget provided and in accordance with agreements established with our
collaboration partners and third-party service providers. We make significant
judgments and estimates in determining the accrued liabilities and prepaid
expense balances in each reporting period. As actual costs become known, we
adjust our accrued liabilities or prepaid expenses. We have not experienced any
material differences between accrued costs and actual costs incurred since our
inception.


Our expenses related to clinical trials are based on estimates of patient
enrollment and related expenses at clinical investigator sites as well as
estimates for the services received and efforts expended pursuant to contracts
with multiple research institutions, CMOs and CROs that may be used to conduct
and manage clinical trials, chemistry and testing and manufacturing services on
our behalf. We generally accrue expenses related to clinical trials based on
contracted amounts applied to the level of patient enrollment and activity. If
timelines or contracts are modified based upon changes in the clinical trial
protocol or scope of work to be performed, we modify our estimates of accrued
expenses accordingly on a prospective basis.

Equity-based Compensation



We issued stock-based compensation awards through the granting of warrants and
stock options, which generally vest over a four-year period. We issued 1,211,155
options with a weighted average exercise price of $5.34 to certain employees,
board members and advisors during the year ended December 31, 2022. We issued
2,306,478 warrants with a weighted average exercise price of $14.74 to certain
employees, board members and advisors during the year ended December 31, 2021.
These warrants, and all previously issued warrants, were transferred to the 2021
Equity Plan in November 2021. We also issued 675,200 options with an exercise
price of $14.00 under our 2021 Equity Plan during the year ended December 31,
2021.

We account for equity-based compensation in accordance with ASC 718, Compensation-Stock Compensation (ASC 718). In accordance with ASC 718, compensation cost is measured at estimated fair value and is included as compensation expense over the vesting period during which service is provided in exchange for the award. The Company reverses any previously recognized compensation cost associated with forfeited awards in the period of the forfeiture occurs.



We use a Black-Scholes option pricing model to determine fair value of our
warrants and options. The Black-Scholes option pricing model includes various
assumptions, including the fair value of common shares, expected life of
warrants and options, the expected volatility and the expected risk-free
interest rate. These assumptions reflect our best estimates, but they involve
inherent uncertainties based on market conditions generally outside our control.
As a result, if other assumptions had been used, equity-based compensation cost
could have been materially impacted. Furthermore, if we use different
assumptions

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for future grants, share-based compensation cost could be materially impacted in future periods.

We will continue to use judgment in evaluating the assumptions utilized for our equity-based compensation expense calculations on a prospective basis. In addition to the assumptions used in the Black-Scholes model, the amount of equity-based compensation expense we recognize in our financial statements includes warrant forfeitures as they occurred.

Income Taxes



Deferred tax assets and liabilities are recognized for the future tax
consequences attributable to differences between the financial statement
carrying amounts of existing assets and liabilities and their respective tax
bases, and operating losses and tax credit carry forwards. Deferred tax assets
and liabilities are measured using enacted statutory tax rates expected to apply
to taxable income in the jurisdictions and years in which those temporary
differences are expected to be recovered or settled. The effect on deferred tax
assets and liabilities of a change in tax rates is recognized in income in the
period that includes the enactment date.


Based on the level of historical operating results and projections for the
taxable income for the future, we have determined that it is more likely than
not that our net deferred tax assets will not be realized. Accordingly, we have
recorded a full valuation allowance to reduce our net deferred tax assets in IO
Biotech ApS, IO Bio US, Inc and IO Biotech, Inc.


We recognize tax benefits from uncertain tax positions only if, based on the
technical merits of the position, it is more likely than not that the tax
positions will be sustained on examination by the tax authority. The tax
benefits recognized in the financial statements from such positions are measured
based on the largest amount that is more than 50% likely to be realized upon
ultimate settlement. We recognize interest and penalties related to unrecognized
tax benefits within the provision for taxes in our statements of operations and
comprehensive loss.


We operate in Denmark and may be subject to audits from various tax authorities.
Management's judgment is required in determining our provision for income taxes,
our deferred tax assets and liabilities, liabilities for uncertain tax
positions, and any valuation allowance recorded against our net deferred tax
assets. We will monitor the extent to which our deferred tax assets may be
realized and adjust the valuation allowance accordingly.

Recently Adopted Accounting Pronouncements

Refer to Note 2, "Summary of Significant Accounting Policies," in the accompanying notes to our financial statements for the years ended December 31, 2022 and 2021 appearing elsewhere in this Annual Report on Form 10-K for a discussion of recently issued accounting standards.

Off-Balance Sheet Arrangements

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

Emerging Growth Company Status



As an EGC under the JOBS Act, we may delay the adoption of certain accounting
standards until such time as those standards apply to private companies. We have
elected to use this extended transition period for complying with new or revised
accounting standards that have different effective dates for public and private
companies until the earlier of the date we (1) are no longer an emerging growth
company or (2) affirmatively and irrevocably opt out of the extended transition
period provided in the JOBS Act. As a result, our financial statements may not
be comparable to companies that comply with new or revised accounting
pronouncements as of public company effective dates.


Other exemptions and reduced reporting requirements under the JOBS Act for EGCs
include presentation of only two years of audited financial statements in a
registration statement for an IPO, an exemption from the requirement to provide
an auditor's report on internal controls over financial reporting pursuant to
Section 404(b) of the Sarbanes-Oxley Act, an exemption from any requirement that
may be adopted by the Public Company Accounting Oversight Board (PCAOB)
regarding mandatory audit firm rotation, and less extensive disclosure about our
executive compensation arrangements.


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We may remain classified as an EGC until December 31, 2026, although if the
market value of our common stock that is held by non-affiliates exceeds $700
million as of June 30 of any year before that time, or if we have annual gross
revenues of $1.235 billion or more in any fiscal year, we would cease to be an
EGC as of December 31 of the applicable year. We also would cease to be an EGC
if we issue more than $1.0 billion of non-convertible debt over a three-year
period.

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