0000950170-22-009950 | 10-Q | XBRL Viewer

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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2022	May 11, 2022
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2022
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Entity Registrant Name	Galera Therapeutics, Inc.
Entity Central Index Key	0001563577
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	true
Title of 12(b) Security	Common Stock,$0.001 par value per share
Trading Symbol	GRTX
Security Exchange Name	NASDAQ
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		26,821,589
Entity File Number	001-39114
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	46-1454898
Entity Address, Address Line One	2 W. Liberty Blvd #100
Entity Address, City or Town	Malvern
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19355
City Area Code	610
Local Phone Number	725-1500
Document Quarterly Report	true
Document Transition Report	false

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 19,645	$ 19,859
Short-term investments	41,302	51,358
Prepaid expenses and other current assets	4,329	6,175
Total current assets	65,276	77,392
Property and equipment, net	509	527
Acquired intangible asset	2,258	2,258
Goodwill	881	881
Right-of-use lease assets	229	296
Other assets	1,946	1,957
Total assets	71,099	83,311
Current liabilities:
Accounts payable	4,131	5,044
Accrued expenses	6,566	7,633
Lease liabilities	234	258
Total current liabilities	10,931	12,935
Royalty purchase liability	130,366	128,063
Lease liabilities, net of current portion		44
Deferred tax liability	273	273
Total liabilities	141,570	141,315
Stockholders' deficit:
Preferred stock, $0.001 par value: 10,000,000 shares authorized; no shares issued and outstanding
Common stock, $0.001 par value: 200,000,000 shares authorized; 26,819,421 and 26,458,767 shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively	27	26
Additional paid-in capital	261,108	258,086
Accumulated other comprehensive loss	(61)	(14)
Accumulated deficit	(331,545)	(316,102)
Total stockholders' deficit	(70,471)	(58,004)
Total liabilities and stockholders' deficit	$ 71,099	$ 83,311

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized (shares)	10,000,000	10,000,000
Preferred stock, shares issued (shares)	0	0
Preferred stock, shares outstanding (shares)	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized (shares)	200,000,000	200,000,000
Common stock, shares issued (shares)	26,819,421	26,458,767
Common stock, shares outstanding (shares)	26,819,421	26,458,767

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Operating expenses:
Research and development	$ 8,107	$ 12,423
General and administrative	5,047	5,058
Loss from operations	(13,154)	(17,481)
Other income (expenses):
Interest income	14	19
Interest expense	(2,303)	(1,253)
Net loss	$ (15,443)	$ (18,715)
Net loss per share of common stock, basic and diluted	$ (0.58)	$ (0.75)
Weighted-average shares of common stock outstanding, basic and diluted	26,749,379	24,988,198

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement of Comprehensive Income [Abstract]
Net loss	$ (15,443)	$ (18,715)
Unrealized loss on short-term investments	(47)	(2)
Comprehensive loss	$ (15,490)	$ (18,717)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' DEFICIT - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive income (loss)	Accumulated Deficit
Balance at Dec. 31, 2020	$ 6,118	$ 25	$ 241,649	$ 12	$ (235,568)
Balance (in shares) at Dec. 31, 2020		24,976,142
Share-based compensation expense	1,791		1,791
Exercise of stock options	235		235
Exercise of stock options, shares		217,015
Unrealized loss on short-term investments	(2)			(2)
Net loss	(18,715)				(18,715)
Balance at Mar. 31, 2021	(10,573)	$ 25	243,675	10	(254,283)
Balance (in shares) at Mar. 31, 2021		25,193,157
Balance at Dec. 31, 2021	$ (58,004)	$ 26	258,086	(14)	(316,102)
Balance (in shares) at Dec. 31, 2021	26,458,767	26,458,767
Share-based compensation expense	$ 1,848		1,848
Exercise of stock options	$ 58		58
Exercise of stock options, shares	46,358	46,358
Sale of shares under Open Market Sale Agreement, net	$ (1,117)	$ (1)	(1,116)
Sale of shares under open market sale agreement, shares		(314,296)
Unrealized loss on short-term investments	(47)			(47)
Net loss	(15,443)				(15,443)
Balance at Mar. 31, 2022	$ (70,471)	$ 27	$ 261,108	$ (61)	$ (331,545)
Balance (in shares) at Mar. 31, 2022	26,819,421	26,819,421

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

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+ Details

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	3 Months Ended
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	Mar. 31, 2022	Mar. 31, 2021
Operating activities:
Net loss	$ (15,443,000)	$ (18,715,000)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	31,000	106,000
Noncash interest expense	2,303,000	1,253,000
Share-based compensation expense	1,848,000	1,791,000
Changes in operating assets and liabilities:
Prepaid expenses and other current assets	1,846,000	(1,568,000)
Other assets	78,000	4,000
Accounts payable	(913,000)	4,071,000
Accrued expense	(1,067,000)	(2,242,000)
Other liabilities	(68,000)	(3,000)
Cash used in operating activities	(11,385,000)	(15,303,000)
Investing activities:
Purchases of short-term investments	(15,651,000)	(6,931,000)
Proceeds from sales of short-term investments	25,660,000	20,000,000
Purchase of property and equipment	(13,000)	(186,000)
Cash provided by investing activities	9,996,000	12,883,000
Financing activities:
Proceeds from the sale of common stock, net of issuance costs	1,117,000	0
Proceeds from exercise of stock options	58,000	235,000
Cash provided by financing activities	1,175,000	235,000
Net decrease in cash and cash equivalents	(214,000)	(2,185,000)
Cash and cash equivalents at beginning of period	19,859,000	15,872,000
Cash and cash equivalents at end of period	19,645,000	13,687,000
Supplemental schedule of non-cash financing activities:
Unrealized loss on marketable securities	$ (47,000)	$ (2,000)

Organization and description of business

3 Months Ended

Mar. 31, 2022

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and description of business

Galera Therapeutics, Inc. was incorporated as a Delaware corporation on November 19, 2012 (inception) and together with its subsidiaries (the Company, or Galera) is a clinical stage biopharmaceutical company focused on developing and commercializing a pipeline of novel, proprietary therapeutics that have the potential to transform radiotherapy in cancer. Galera's technology consists of selective small molecule dismutase mimetics that are in late-stage development in patients with cancer. Avasopasem manganese (GC4419, also referred to as avasopasem) is in development for radiotherapy-induced toxicities, including severe oral mucositis (SOM) in patients with locally advanced head and neck cancer (HNC) and esophagitis in patients with lung cancer. In February 2018, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation to avasopasem for the reduction of SOM induced by radiotherapy with or without systemic therapy. Galera’s second dismutase mimetic product candidate, rucosopasem manganese (GC4711, also referred to as rucosopasem), is in clinical-stage development to augment the anti-cancer efficacy of stereotactic body radiation therapy (SBRT) in patients with non-small cell lung cancer (NSCLC) and locally advanced pancreatic cancer (LAPC).

In December 2021, the Company announced corrected topline efficacy results from a Phase 3 trial (referred to as the ROMAN trial) evaluating avasopasem for the reduction of radiotherapy-induced SOM in patients with locally advanced HNC. The Company had previously announced topline results from the ROMAN trial in October 2021. Upon further analysis following the October topline data announcement, an error by the contract research organization was identified in the statistical program. Correction of this error resulted in improved p-values for the primary and secondary endpoints. The corrected results demonstrated efficacy across multiple SOM endpoints with a statistically significant reduction on the primary endpoint of reduction in the incidence of SOM and a statistically significant reduction on the secondary endpoint of number of days of SOM. The ROMAN trial is the Company’s second randomized trial conducted in patients with HNC to achieve statistical significance and demonstrate improved clinical benefit in reducing SOM. Based on these data, the Company plans to submit to the FDA a New Drug Application, or NDA, of avasopasem for radiotherapy-induced SOM by the end of 2022.

In addition to developing avasopasem for the reduction of normal tissue toxicity from radiotherapy, the Company is developing its second dismutase mimetic product candidate, rucosopasem, to increase the anti-cancer efficacy of higher daily doses of radiotherapy, or SBRT. In September 2021, in support of rucosopasem, the Company announced final results from its Phase 1/2 pilot trial of avasopasem in combination with SBRT in patients with unresectable or borderline resectable LAPC. In this proof-of-concept trial, survival and tumor outcome benefits were observed. The Company used its observations from this pilot trial to inform the design of rucosopasem clinical trials in combination with SBRT. The Company has successfully completed Phase 1 trials of intravenous rucosopasem in healthy volunteers and is currently evaluating rucosopasem in combination with SBRT in a Phase 1/2 safety and anti-cancer efficacy trial in NSCLC, and a Phase 2b trial of rucosopasem in combination with SBRT in patients with LAPC.

Liquidity

The Company has incurred recurring losses and negative cash flows from operations since inception and has an accumulated deficit of $331.5 million as of March 31, 2022. The Company anticipates incurring additional losses until such time, if ever, that it can generate significant sales of its product candidates currently in development. The Company expects its existing cash, cash equivalents and short-term investments as of March 31, 2022 will enable the Company to fund its operating expenses and capital expenditure requirements into the second half of 2023. In the future, if the Company is not able to continue to raise sufficient capital to fund its operations, the Company may decide to delay or discontinue certain activities, including planned research and development activities, hiring plans, manufacturing activities and commercial preparation efforts. In December 2020, the Company filed a registration statement with the Securities and Exchange Commission (SEC) which covers the offering, issuance and sale of up to $200.0 million in Company securities, which includes an Open Market Sale Agreement with Jefferies LLC (the Sales Agreement) covering the offering, issuance and sale of up to a maximum aggregate offering price of $50.0 million of the Company’s common stock, which could be utilized to raise funding for future operating expenses and capital expenditure requirements. During the three months ended March 31, 2022, the Company sold approximately 0.3 million shares of common stock and received net proceeds of $1.1 million pursuant to the Sales Agreement. As of March 31, 2022, there remained approximately $40.6 million available under the Sales Agreement.

Basis of Presentation and Significant Accounting Policies

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Basis of Presentation and Significant Accounting Policies

Basis of presentation and significant accounting policies

The summary of significant accounting policies disclosed in the Company’s annual consolidated financial statements for the years ended December 31, 2021 and 2020 included in the Company’s annual report on Form 10-K filed with the SEC on March 10, 2022 have not materially changed, except as set forth below.

Basis of presentation and consolidation

The accompanying unaudited interim consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (U.S. GAAP) for interim financial information. Any reference in these notes to applicable guidance is meant to refer to U.S. GAAP as found in the Accounting Standards Codification (ASC) and Accounting Standards Updates (ASU) of the Financial Accounting Standards Board (FASB).

In the opinion of management, the accompanying interim consolidated financial statements include all normal and recurring adjustments (which consist primarily of accruals, estimates and assumptions that impact the financial statements) considered necessary to present fairly the Company’s financial position as of March 31, 2022 and its results of operations for the three months ended March 31, 2022 and 2021, and statements of changes in stockholder’s equity (deficit) and cash flows for the three months ended March 31, 2022 and 2021. Operating results for the three months ended March 31, 2022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2022, or for any future period. The interim consolidated financial statements, presented herein, do not contain the required disclosures under U.S. GAAP for annual financial statements. Therefore, these interim consolidated financial statements should be read in conjunction with the annual audited consolidated financial statements and related notes as of and for the year ended December 31, 2021, included in the Company’s annual report on Form 10-K and filed with the SEC on March 10, 2022.

Use of estimates

The preparation of unaudited interim consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the unaudited interim consolidated financial statements and the reported amounts of expenses during the reporting period. Actual results could differ from those estimates.

Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the unaudited interim consolidated financial statements in the period they are determined to be necessary. Significant areas that require management’s estimates include share-based compensation assumptions, royalty purchase liability assumptions and accrued research and development expenses.

Research and development expenses

Research and development costs are expensed as incurred and consist primarily of funds paid to third parties for the provision of services for product candidate development, clinical and preclinical development and related supply and manufacturing costs, and regulatory compliance costs. The Company accrues and expenses preclinical studies and clinical trial activities performed by third parties based upon estimates of the proportion of work completed over the term of the individual trial and patient enrollment rates in accordance with agreements with clinical research organizations and clinical trial sites. The Company determines the estimates by reviewing contracts, vendor agreements and purchase orders, and through discussions with internal clinical personnel and external service providers as to the progress or stage of completion of trials or services and the agreed-upon fee to be paid for such services. However, actual costs and timing of clinical trials are highly uncertain, subject to risks and may change depending upon a number of factors, including the Company’s clinical development plan.

Management makes estimates of the Company’s accrued expenses as of each balance sheet date in the Company’s consolidated financial statements based on facts and circumstances known to the Company at that time. If the actual timing of the performance of services or the level of effort varies from the estimate, the Company will adjust the accrual accordingly. Nonrefundable advance payments for goods and services, including fees for process development or manufacturing and distribution of clinical supplies that will be used in future research and development activities, are deferred and recognized as expense in the period that the related goods are consumed or services are performed.

In September 2020, the Company was awarded a Small Business Innovation Research grant from the National Cancer Institute of the National Institutes of Health, which will partially fund its Phase 1/2 safety and anti-cancer efficacy trial in NSCLC (the Grant). Costs entitled to reimbursement under the Grant are accounted for as a reduction to research and development expenses. During the three months ended March 31, 2021, the Company recorded a reduction to research and development expense of $0.3 million for expenses for which it has been reimbursed, or is entitled to reimbursement, under the Grant. The Company has fully

utilized the $1.1 million of available funding under the Grant and did not receive any reimbursement during the three months ended March 31, 2022.

Net loss per share

Basic loss per share of common stock is computed by dividing net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding during each period. Diluted loss per share of common stock includes the effect, if any, from the potential exercise or conversion of securities, such as stock options and common stock warrants, which would result in the issuance of incremental shares of common stock. For diluted net loss per share, the weighted-average number of shares of common stock is the same for basic net loss per share due to the fact that when a net loss exists, dilutive securities are not included in the calculation as the impact is anti-dilutive.

The following potentially dilutive securities have been excluded from the computation of diluted weighted-average shares of common stock outstanding, as they would be anti-dilutive:


	March 31,
	2022		2021
Stock options		5,976,403		5,173,716
Common stock warrants		550,661		550,661
		6,527,064		5,724,377

Fair Value Measurements

3 Months Ended

Mar. 31, 2022

Fair Value Disclosures [Abstract]

Fair Value Measurements

Fair value measurements

The Company utilizes valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible. The Company determines fair value based on assumptions that market participants would use in pricing an asset or liability in the principal or most advantageous market. When considering market participant assumptions in fair value measurements, the following fair value hierarchy distinguishes between observable and unobservable inputs, which are categorized in one of the following levels:

•

Level 1 Inputs: Unadjusted quoted prices in active markets for identical assets or liabilities accessible to the reporting entity at the measurement date.

•

Level 2 Inputs: Other than quoted prices included in Level 1 inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability.

•

Level 3 Inputs: Unobservable inputs for the asset or liability used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at measurement date.

The following table presents the Company’s assets and liabilities that are measured at fair value on a recurring basis (amounts in thousands):


	March 31, 2022
	(Level 1)		(Level 2)		(Level 3)
Assets
Money market funds and U.S. Treasury obligations (included in cash equivalents)	$	13,362	$	—	$	—

Short-term investments
U.S. Treasury obligations	$	41,302		—		—


	December 31, 2021
	(Level 1)		(Level 2)		(Level 3)
Assets
Money market funds and U.S. Treasury obligations (included in cash equivalents)	$	12,346	$	—	$	—

Short-term investments
U.S. government agency securities	$	—	$	5,413	$	—
U.S. Treasury obligations		45,945		—		—
Total short-term investments	$	45,945	$	5,413	$	—

There were no changes in valuation techniques during the three months ended March 31, 2022. The Company’s short-term investment instruments classified using Level 1 inputs within the fair value hierarchy are classified as such because they are valued using quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price transparency. The fair value of Level 2 securities is estimated based on observable inputs other than quoted prices in active markets for identical assets and liabilities, quoted prices for identical or similar assets or liabilities in inactive markets, or other inputs that are observable or can be corroborated by observable market data for substantially the full term on the assets or liabilities.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Property and Equipment

3 Months Ended

Mar. 31, 2022

Property, Plant and Equipment [Abstract]

Property and Equipment

Property and equipment

Property and equipment consist of (amounts in thousands):


	March 31,			December 31,
	2022			2021
Laboratory equipment	$	1,393		$	1,379
Computer hardware and software		292			292
Leasehold improvements		264			264
Furniture and fixtures		179			179
Property and equipment, gross		2,128			2,114
Less: Accumulated depreciation and amortization		(1,619	)		(1,587	)
Property and equipment, net	$	509		$	527

Depreciation and amortization expense was $31,000 and $0.1 million for the three months ended March 31, 2022 and 2021, respectively.

Accrued Expenses

3 Months Ended

Mar. 31, 2022

Payables and Accruals [Abstract]

Accrued Expenses

Accrued expenses

Accrued expenses consist of (amounts in thousands):


	March 31,		December 31,
	2022		2021
Compensation and related benefits	$	945	$	2,038
Research and development expenses		5,330		5,360
Professional fees and other expenses		291		235
	$	6,566	$	7,633

Royalty Purchase Liability

3 Months Ended

Mar. 31, 2022

Royalty Purchase Liability [Abstract]

Royalty Purchase Liability

Royalty purchase liability

Pursuant to our Amended and Restated Purchase and Sale Agreement (the Royalty Agreement), with Clarus IV Galera Royalty AIV, L.P., Clarus IV-A, L.P., Clarus IV-B, L.P., Clarus IV-C, L.P. and Clarus IV-D, L.P. (collectively, Blackstone or Blackstone Life Sciences), Blackstone agreed to pay up to $80.0 million (the Royalty Purchase Price) in four tranches of $20.0 million each upon the achievement of specific Phase 3 clinical trial patient enrollment milestones. The Company received the first tranche of the Royalty Purchase Price in November 2018, the second tranche of the Royalty Purchase Price in April 2019, and the third tranche of the Royalty Purchase Price in February 2020, in each case in connection with the achievement of the first three milestones, respectively.

In May 2020, the Company entered into Amendment No. 1 to the Royalty Agreement (the Amendment) with Clarus IV Galera Royalty AIV, L.P. (the Blackstone Purchaser). The Blackstone Purchaser is affiliated with Blackstone Life Sciences, the successor in interest to Clarus Ventures. The Amendment increased the Royalty Purchase Price by $37.5 million, to $117.5 million by increasing the fourth tranche from $20.0 million to $37.5 million and adding a new $20.0 million tranche upon the achievement of an additional clinical enrollment milestone. The Company accounted for the Amendment as a debt modification and is amortizing fees paid to the Blackstone Purchaser related to the Amendment over the estimated term of the royalty purchase liability utilizing the effective-interest method. In June 2021, the Company received the new tranche ($20.0 million) under the Amendment in connection with the enrollment of the first patient in a Phase 2b trial of rucosopasem in combination with SBRT in patients with locally advanced pancreatic cancer, which the Company refers to as the GRECO-2 trial. Also in June 2021, the Company completed enrollment in the ROMAN trial, thereby achieving the milestone associated with the fourth tranche ($37.5 million) under the Amendment, which was received in July 2021.

The Company accounts for the Royalty Agreement as a debt instrument. The $117.5 million in proceeds received as of March 31, 2022 have been recorded as a liability on the accompanying consolidated balance sheets. Interest expense is imputed based on the estimated royalty repayment period described below, which takes into consideration the probability and timing of obtaining FDA approval and the potential future revenue from commercializing its product candidates, and which results in a corresponding increase in the liability balance. As the Company continues to evaluate the next steps for its programs focused on the reduction of radiotherapy-induced toxicity, planned or possible next steps may have a material impact on the royalty purchase liability. The Company recognized $2.3 million and $1.3 million in noncash interest expense during the three months ended March 31, 2022 and 2021, respectively. As of March 31, 2022, the effective interest rate was 7.2%.

Pursuant to the Royalty Agreement and the Amendment, in connection with the payment of each tranche of the Royalty Purchase Price, the Company has agreed to sell, convey, transfer and assign to Blackstone all of its right, title and interest in a high single-digit percentage of (i) worldwide net sales of avasopasem and rucosopasem (collectively, the Products) and (ii) all amounts received by the Company or its affiliates, licensees and sublicensees with respect to Product-related damages (collectively, the Product Payments) during the Royalty Period. The Royalty Period means, on a Product-by-Product and country-by-country basis, the period of time commencing on the commercial launch of such Product in such country and ending on the latest to occur of (i) the 12th anniversary of such commercial launch, (ii) the expiration of all valid claims of the Company’s patents covering such Product in such country, and (iii) the expiration of regulatory data protection or market exclusivity or similar regulatory protection afforded by the health authorities in such country, to the extent such protection or exclusivity effectively prevents generic versions of such Product from entering the market in such country.

The Royalty Agreement and the Amendment will remain in effect until the date on which the aggregate amount of the Product Payments paid to Blackstone exceeds a fixed single-digit multiple of the actual amount of the Royalty Purchase Price received by the Company, unless earlier terminated pursuant to the mutual written agreement of the Company and Blackstone. If no Products are commercialized, the Company would not have an obligation to make Product Payments to Blackstone, which is the sole mechanism for repaying the liability.

Upon execution of the Amendment, the Company issued common stock warrants to the Blackstone Purchaser, each of which became exercisable upon the receipt by the Company of the applicable specified milestone payment. The issued warrants expire six years after the initial exercise dates, as follows:

Exercise Price

Initial Exercise Date

Expiration Date

New Milestone Warrant

293,686

13.62

6/7/2021

6/6/2027

Fourth Milestone Warrant

256,975

13.62

7/19/2021

7/18/2027

The warrants are equity-classified and were valued at $4.7 million using the Black-Scholes option pricing model. The warrants were recorded as a discount to the royalty purchase liability. The Company amortizes the debt discount to interest expense over the estimated term of the royalty purchase liability utilizing the effective-interest method.

Leases

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Leases

The Company has a non-cancelable operating lease for office space in Malvern, Pennsylvania which, as of March 31, 2022, has a remaining lease term of approximately 0.9 years. The discount rate used to account for the Company’s operating leases under FASB ASU No. 2018-11, Leases (Topic 842), is the Company’s estimated incremental borrowing rate of 5.3%.

Supplemental balance sheet information related to leases was as follows:


	March 31,		December 31,
	2022		2021
Operating Leases
Right-of-use lease assets	$	229	$	296

Lease liabilities, current		234		258
Lease liabilities, net of current portion		—		44
Total operating lease liabilities	$	234	$	302

The components of lease expense were as follows:


	Three months ended March 31,
	2022		2021
Operating lease costs
Operating lease rental expense	$	68	$	73
Interest on lease liabilities		3		7
Total operating lease expense	$	71	$	80

Supplemental cash flow information related to leases was as follows:


	Three months ended March 31,
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows for operating leases	$	71	$	81
Right-of-use assets obtained in exchange for lease obligation
Operating leases		—		70

Future minimum rental payments under the Company’s non-cancelable operating lease liabilities as of March 31, 2022 (amounts in thousands):


Remainder of 2022	$	195
2023		44
Total		239
Less: imputed interest		(5	)
	$	234

Equity

3 Months Ended

Mar. 31, 2022

Equity [Abstract]

Equity

Equity offerings

In December 2020, the Company entered into the Sales Agreement with Jefferies LLC (Jefferies) as sales agent, pursuant to which it may, from time to time, issue and sell common stock with an aggregate value of up to $50.0 million in “at-the-market” (ATM) offerings under the Company’s Registration Statement on Form S-3 (File No. 333-251061) filed with the SEC on December 1, 2020. Sales of common stock, if any, pursuant to the Sales Agreement, may 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 the Company’s common stock. The Company is required to pay Jefferies a commission equal to three percent of the gross sales proceeds and has provided Jefferies with customary indemnification rights. During the three months ended March 31, 2022, 314,296 shares were sold under the Sales Agreement at a weighted average price per share of $3.70. Net proceeds to the Company after deducting fees, commissions and other expenses related to the offering were approximately $1.1 million for the three months ended March 31, 2022. As of March 31, 2022, there was approximately $40.6 million of available capacity under the Sales Agreement.

Share-based compensation

In connection with the Company’s Initial Public Offering, or IPO, in November 2019, the Company’s board of directors adopted and the Company’s stockholders approved the Galera Therapeutics, Inc. 2019 Incentive Award Plan (the 2019 Plan), which became effective upon the effectiveness of the registration statement on Form S-1 for the IPO. Upon effectiveness of the 2019 Plan, the Company ceased granting new awards under the Prior Plan (as defined herein).

The 2019 Plan provides for the grant of incentive stock options, nonstatutory stock options, restricted stock awards, restricted stock units, stock appreciation rights and other stock-based awards. The number of shares of common stock initially available for issuance under the 2019 Plan was 1,948,970 shares of common stock plus the number of shares subject to awards outstanding under the Prior Plan that expire, terminate or are otherwise surrendered, cancelled, forfeited or repurchased by the Company on or after the effective date of the 2019 Plan. In addition, the number of shares of common stock available for issuance under the 2019 Plan is subject to an annual increase on the first day of each calendar year beginning on January 1, 2020 and ending on and including January 1, 2029 equal to the lesser of (i) 4% of the Company’s outstanding shares of common stock on the final day of the immediately preceding calendar year, and (ii) such smaller number of shares of common stock as determined by the Company’s board of directors. As of March 31, 2022, there were 1,258,494 shares available for future issuance under the 2019 Plan, including 1,058,350 shares added pursuant to this provision effective January 1, 2022. The maximum number of shares of common stock that may be issued under the 2019 Plan upon the exercise of incentive stock options is 14,130,029.

In November 2019, the Company’s board of directors adopted and the Company’s stockholders approved the Galera Therapeutics, Inc. 2019 Employee Stock Purchase Plan (the ESPP). The ESPP allows employees to buy Company stock through after-tax payroll deductions at a discount from market value. The number of shares of common stock initially available for issuance under the ESPP was 243,621 shares of common stock. In addition, the number of shares of common stock available for issuance under the ESPP is subject to an annual increase on the first day of each calendar year beginning on January 1, 2020 and ending on and including January 1, 2029 equal to the lesser of (i) 1% of the Company’s outstanding shares of common stock on the final day of the immediately preceding calendar year and (ii) such smaller number of shares of common stock as determined by the Company’s board of directors, provided that not more than 3,288,886 shares of common stock may be issued under the ESPP. As of March 31, 2022, there were 1,006,084 shares available for issuance under the ESPP, including 264,587 shares added pursuant to this provision effective January 1, 2022.

In November 2012, the Company adopted the Equity Incentive Plan (the Prior Plan). The total number of shares subject to outstanding awards under the Prior Plan as of March 31, 2022 was 2,093,811. No shares remain available for issuance under the Prior Plan and no further grants will be made under the Prior Plan; however, the Prior Plan continues to govern awards that are outstanding under it.

The Company’s stock option awards vest based on the terms in the governing agreements and generally vest over four years and have a term of 10 years.

Share-based compensation expense was as follows for the three months ended March 31, 2022 and 2021 (in thousands):


	Three months ended March 31,
	2022		2021
Research and development	$	661	$	784
General and administrative		1,187		1,007
	$	1,848	$	1,791

The following table summarizes the activity related to stock option grants for the three months ended March 31, 2022:


	Shares			Weighted average exercise price per share		Weighted- average remaining contractual life (years)
Outstanding at January 1, 2022		4,970,975			8.45
Granted		1,250,900			2.24
Exercised		(46,358	)		1.26
Forfeited		(199,114	)		11.31
Outstanding at March 31, 2022		5,976,403		$	7.11		7.4
Vested and exercisable at March 31, 2022		2,906,783		$	6.91		5.7
Vested and expected to vest at March 31, 2022		5,976,403		$	7.11		7.4

As of March 31, 2022, the unrecognized compensation cost was $15.8 million and will be recognized over an estimated weighted-average amortization period of 2.6 years. The aggregate intrinsic value of options outstanding and options exercisable as of March 31, 2022 was $0.4 million and $0.3 million, respectively. Options granted during the three months ended March 31, 2022 and 2021 had weighted-average grant-date fair values of $1.71 and $9.00 per share, respectively.

The fair value of options is estimated using the Black-Scholes option pricing model, which takes into account inputs such as the exercise price, the estimated fair value of the underlying common stock at the grant date, expected term, expected stock price volatility, risk-free interest rate and dividend yield. The fair value of stock options during the three months ended March 31, 2022 and 2021 was determined using the methods and assumptions discussed below.

•

The expected term of employee stock options with service-based vesting is determined using the “simplified” method, as prescribed in SEC’s Staff Accounting Bulletin (SAB) No. 107, whereby the expected life equals the arithmetic average of the vesting term and the original contractual term of the option due to the Company’s lack of sufficient historical data. The expected term of nonemployee options is equal to the contractual term.

•

The expected stock price volatility is based on historical volatilities of comparable public entities within the Company’s industry which were commensurate with the expected term assumption as described in SAB No. 107.

•

The risk-free interest rate is based on the interest rate payable on U.S. Treasury securities in effect at the time of grant for a period that is commensurate with the expected term.

•

The expected dividend yield is 0% because the Company has not historically paid, and does not expect for the foreseeable future to pay, a dividend on its common stock.

•

The Company’s board of directors has determined the per share value of the Company’s common stock based on the closing price as reported by the NASDAQ Global Market on the date of the grant.

The grant date fair value of each option grant was estimated throughout the three months ended March 31, 2022 and 2021 using the Black-Scholes option-pricing model using the following weighted-average assumptions:


	Three months ended March 31,
	2022			2021
Expected term (in years)		6.3			6.2
Expected stock price volatility		92.4	%		91.6	%
Risk-free interest rate		1.74	%		0.59	%
Expected dividend yield		0	%		0	%

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

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-SubTopic 10
-Section 50
-Paragraph 18
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496189-112644

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 16
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496180-112644

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (i)
-URI http://asc.fasb.org/extlink&oid=123467817&loc=SL123496158-112644

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Related Party Transactions	3 Months Ended
Related Party Transactions	Mar. 31, 2022
Related Party Transactions [Abstract]
Related Party Transactions	9. Related party transactions IntellectMap provides information technology advisory services to the Company. The chief executive officer of IntellectMap is the brother of the Company’s chief executive officer. Fees incurred by the Company with respect to IntellectMap during the three months ended March 31, 2022 and 2021 were $33,000 and $49,000, respectively.

Subsequent events

3 Months Ended

Mar. 31, 2022

Subsequent Events [Abstract]

Subsequent events

10.

Subsequent events

On May 16, 2022, the Company announced that it intends to file an NDA submission of avasopasem for radiotherapy-induced SOM by the end of 2022 after recent interactions with the FDA. The planned NDA submission for this program may have an impact on the Company's consolidated financial statements, including amounts recorded for the royalty purchase liability, and such impact may be material. Interest expense associated with the royalty purchase liability is imputed based on the estimated royalty repayment period, which takes into consideration the probability and timing of obtaining FDA approval and the potential future revenue from commercializing the Company’s product candidates. The imputed interest expense results in a corresponding increase in the royalty purchase liability.

Basis of Presentation and Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Liquidity

Basis of Presentation and Consolidation

Basis of presentation and consolidation

Use of Estimates

Use of estimates

Research and Development Expenses

Research and development expenses

utilized the $1.1 million of available funding under the Grant and did not receive any reimbursement during the three months ended March 31, 2022.

Net Loss Per Share

Net loss per share

The following potentially dilutive securities have been excluded from the computation of diluted weighted-average shares of common stock outstanding, as they would be anti-dilutive:


	March 31,
	2022		2021
Stock options		5,976,403		5,173,716
Common stock warrants		550,661		550,661
		6,527,064		5,724,377

Basis of Presentation and Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares of Common Stock Outstanding

The following potentially dilutive securities have been excluded from the computation of diluted weighted-average shares of common stock outstanding, as they would be anti-dilutive:


	March 31,
	2022		2021
Stock options		5,976,403		5,173,716
Common stock warrants		550,661		550,661
		6,527,064		5,724,377

Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2022

Fair Value Disclosures [Abstract]

Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis

The following table presents the Company’s assets and liabilities that are measured at fair value on a recurring basis (amounts in thousands):


	March 31, 2022
	(Level 1)		(Level 2)		(Level 3)
Assets
Money market funds and U.S. Treasury obligations (included in cash equivalents)	$	13,362	$	—	$	—

Short-term investments
U.S. Treasury obligations	$	41,302		—		—


	December 31, 2021
	(Level 1)		(Level 2)		(Level 3)
Assets
Money market funds and U.S. Treasury obligations (included in cash equivalents)	$	12,346	$	—	$	—

Short-term investments
U.S. government agency securities	$	—	$	5,413	$	—
U.S. Treasury obligations		45,945		—		—
Total short-term investments	$	45,945	$	5,413	$	—

Property and Equipment (Tables)

3 Months Ended

Mar. 31, 2022

Property, Plant and Equipment [Abstract]

Schedule of Property Plant and Equipment

Property and equipment consist of (amounts in thousands):


	March 31,			December 31,
	2022			2021
Laboratory equipment	$	1,393		$	1,379
Computer hardware and software		292			292
Leasehold improvements		264			264
Furniture and fixtures		179			179
Property and equipment, gross		2,128			2,114
Less: Accumulated depreciation and amortization		(1,619	)		(1,587	)
Property and equipment, net	$	509		$	527

Accrued Expenses (Tables)

3 Months Ended

Mar. 31, 2022

Payables and Accruals [Abstract]

Schedule of Accrued Expenses

Accrued expenses consist of (amounts in thousands):


	March 31,		December 31,
	2022		2021
Compensation and related benefits	$	945	$	2,038
Research and development expenses		5,330		5,360
Professional fees and other expenses		291		235
	$	6,566	$	7,633

Royalty purchase liability (Tables)

3 Months Ended

Mar. 31, 2022

Royalty Purchase Liability [Abstract]

Schedule of Common Stock Warrants

Exercise Price

Initial Exercise Date

Expiration Date

New Milestone Warrant

293,686

13.62

6/7/2021

6/6/2027

Fourth Milestone Warrant

256,975

13.62

7/19/2021

7/18/2027

Leases (Tables)

3 Months Ended

Mar. 31, 2022

Leases [Abstract]

Summary of Supplemental Balance Sheet Information Related to Leases

Supplemental balance sheet information related to leases was as follows:


	March 31,		December 31,
	2022		2021
Operating Leases
Right-of-use lease assets	$	229	$	296

Lease liabilities, current		234		258
Lease liabilities, net of current portion		—		44
Total operating lease liabilities	$	234	$	302

Summary of Components of Lease Expense

The components of lease expense were as follows:


	Three months ended March 31,
	2022		2021
Operating lease costs
Operating lease rental expense	$	68	$	73
Interest on lease liabilities		3		7
Total operating lease expense	$	71	$	80

Summary of Supplemental Cash Flow Information Related to Leases

Supplemental cash flow information related to leases was as follows:


	Three months ended March 31,
	2022		2021
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows for operating leases	$	71	$	81
Right-of-use assets obtained in exchange for lease obligation
Operating leases		—		70

Summary of Future Minimum Rental Payments Under Non Cancelable Operating Leases

Future minimum rental payments under the Company’s non-cancelable operating lease liabilities as of March 31, 2022 (amounts in thousands):


Remainder of 2022	$	195
2023		44
Total		239
Less: imputed interest		(5	)
	$	234

Equity (Tables)

3 Months Ended

Mar. 31, 2022

Equity [Abstract]

Summary of Share-based Compensation Expense

Share-based compensation expense was as follows for the three months ended March 31, 2022 and 2021 (in thousands):


	Three months ended March 31,
	2022		2021
Research and development	$	661	$	784
General and administrative		1,187		1,007
	$	1,848	$	1,791

Summary of Activity Related to Stock Option Grants

The following table summarizes the activity related to stock option grants for the three months ended March 31, 2022:


	Shares			Weighted average exercise price per share		Weighted- average remaining contractual life (years)
Outstanding at January 1, 2022		4,970,975			8.45
Granted		1,250,900			2.24
Exercised		(46,358	)		1.26
Forfeited		(199,114	)		11.31
Outstanding at March 31, 2022		5,976,403		$	7.11		7.4
Vested and exercisable at March 31, 2022		2,906,783		$	6.91		5.7
Vested and expected to vest at March 31, 2022		5,976,403		$	7.11		7.4

Summary of Fair Value of Each Option Grant Estimated Throughout Year Using Black-Scholes Option-pricing Model


	Three months ended March 31,
	2022			2021
Expected term (in years)		6.3			6.2
Expected stock price volatility		92.4	%		91.6	%
Risk-free interest rate		1.74	%		0.59	%
Expected dividend yield		0	%		0	%

Organization and description of business - Additional Information (Details) - USD ($) $ in Thousands, shares in Millions	1 Months Ended	3 Months Ended
	Dec. 31, 2020	Mar. 31, 2022	Dec. 31, 2021
Organization And Description Of Business [Line Items]
Date of incorporation		Nov. 19, 2012
Accumulated deficit		$ (331,545)	$ (316,102)
Open Market Sale Agreement
Organization And Description Of Business [Line Items]
Number of shares sold		0.3
Net proceeds from common stock		$ 1,100
Proceeds from issuance of remaining common stock		$ 40,600
Open Market Sale Agreement \| Jefferies LLC
Organization And Description Of Business [Line Items]
Maximum Offering Issuance And Sale Expense Covered In Company Securities	$ 200,000
Maximum Aggregate Offering Price	$ 50,000

Basis of Presentation and Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Accounting Policies [Abstract]
Reduction to research and development expense		$ 0.3
Funding available under the grant	$ 1.1

Basis of Presentation and Significant Accounting Policies - Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares of Common Stock Outstanding (Details) - shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities excluded from computation of earnings per share	6,527,064	5,724,377
Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities excluded from computation of earnings per share	5,976,403	5,173,716
Common Stock Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities excluded from computation of earnings per share	550,661	550,661

Fair Value Measurements - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Level 1 \| Money Market Funds and U.S. Treasury Obligations
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents, at fair value	$ 13,362	$ 12,346
Level 1 \| U.S. government agency securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value
Level 1 \| U.S. Treasury obligations
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	41,302	45,945
Level 1 \| Short- Term Investments
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total short-term investments		45,945
Level 2 \| Money Market Funds and U.S. Treasury Obligations
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents, at fair value
Level 2 \| U.S. government agency securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value		5,413
Level 2 \| U.S. Treasury obligations
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value
Level 2 \| Short- Term Investments
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total short-term investments		5,413
Level 3 \| Money Market Funds and U.S. Treasury Obligations
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash equivalents, at fair value
Level 3 \| U.S. government agency securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value
Level 3 \| U.S. Treasury obligations
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value
Level 3 \| Short- Term Investments
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total short-term investments

Fair Value Measurements - Additional Information (Details)	3 Months Ended
	Mar. 31, 2022 USD ($)
Fair Value Disclosures [Abstract]
Changes in valuation techniques	$ 0

Property and Equipment - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 2,128	$ 2,114
Less: Accumulated depreciation and amortization	(1,619)	(1,587)
Property and equipment, net	509	527
Laboratory Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,393	1,379
Computer Hardware and Software
Property Plant And Equipment [Line Items]
Property and equipment, gross	292	292
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property and equipment, gross	264	264
Furniture and Fixtures
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 179	$ 179

Property and Equipment - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Property, Plant and Equipment [Abstract]
Depreciation and amortization	$ 31,000	$ 106,000

Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Compensation and related benefits	$ 945	$ 2,038
Research and development expenses	5,330	5,360
Professional fees and other expenses	291	235
Accrued expenses	$ 6,566	$ 7,633

Royalty Purchase Liability - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended
	Nov. 30, 2018	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Jul. 31, 2021	Jun. 30, 2021	May 31, 2020
Royalty Purchase Liability [Line Items]
Total agreed amount of royalty purchase price		$ 130,366		$ 128,063
Noncash interest expense		$ 2,303	$ 1,253
Warrant expiration term		6 years
Fair value of equity classified warrants		$ 4,700
Royalty Agreements
Royalty Purchase Liability [Line Items]
Total agreed amount of royalty purchase price	$ 80,000
Royalty purchase price		117,500
Outstanding amount of royalty agreement							$ 20,000
Noncash interest expense		$ 2,300	$ 1,300
Effective interest rate		7.20%
Royalty Agreements \| First Tranche
Royalty Purchase Liability [Line Items]
Royalty purchase price	$ 20,000
Royalty Agreements \| Fifth Tranche
Royalty Purchase Liability [Line Items]
Outstanding amount of royalty agreement						$ 20,000
Royalty Agreements \| Fourth Tranche
Royalty Purchase Liability [Line Items]
Outstanding amount of royalty agreement					$ 37,500
Amended Royalty Agreements
Royalty Purchase Liability [Line Items]
Total agreed amount of royalty purchase price							117,500
Outstanding amount of royalty agreement							37,500
Amended Royalty Agreements \| Fifth Tranche
Royalty Purchase Liability [Line Items]
Outstanding amount of royalty agreement							$ 20,000

Royalty Purchase Liability - Schedule of Common Stock Warrants (Details)	3 Months Ended
	Mar. 31, 2022 $ / shares shares
New Milestone Warrant
Class of Warrant or Right [Line Items]
Class of warrant, shares issued \| shares	293,686
Exercise price \| $ / shares	$ 13.62
Initial Exercise Date	Jun. 07, 2021
Expiration Date	Jun. 06, 2027
Fourth Milestone Warrant
Class of Warrant or Right [Line Items]
Class of warrant, shares issued \| shares	256,975
Exercise price \| $ / shares	$ 13.62
Initial Exercise Date	Jul. 19, 2021
Expiration Date	Jul. 18, 2027

Leases - Additional Information (Details)	Mar. 31, 2022
Laboratory Space
Lessee Lease Description [Line Items]
Non-cancelable operating lease, term	10 months 24 days
ASC 842
Lessee Lease Description [Line Items]
Operating lease, discount rate	5.30%

Leases - Summary of Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Right-of-use lease assets	$ 229	$ 296
Lease liabilities, current	234	258
Lease liabilities, net of current portion		44
Total operating lease liabilities	$ 234	$ 302

Leases - Summary of Components of Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Leases [Abstract]
Operating lease rental expense	$ 68	$ 73
Interest on lease liabilities	3	7
Total operating lease expense	$ 71	$ 80

Leases - Summary of Supplemental Cash Flow Information Related to Lease (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Leases [Abstract]
Operating cash flows from operating leases	$ 71	$ 81
Right-of-use assets obtained in exchange for lease obligation
Operating leases		$ 70

Leases - Summary of Future Minimum Rental Payments Under Non Cancelable Operating Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Remainder of 2022	$ 195
2023	44
Total	239
Less: imputed interest	(5)
Operating lease liabilities	$ 234	$ 302

Equity - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended		3 Months Ended
	Dec. 31, 2020	Nov. 30, 2019	Mar. 31, 2022	Mar. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized compensation cost			$ 15.8
Estimated recognition weighted-average amortization period			2 years 7 months 6 days
Aggregate intrinsic value of options outstanding			$ 0.4
Aggregate intrinsic value of options exercisable			$ 0.3
Weighted-average grant-date fair values of options granted			$ 1.71	$ 9.00
Expected dividend yield			0.00%	0.00%
Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Sale of shares under ATM, Shares			1,258,494
2019 Incentive Award Plan \| Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Sale of shares under ATM, Shares			1,058,350
Number of shares of common stock initially available for issuance		1,948,970
Percentage of shares of common stock outstanding		4.00%
2019 Incentive Award Plan \| Common Stock \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares issued under the plan		14,130,029
2019 Employee Stock Purchase Plan \| Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Sale of shares under ATM, Shares		264,587	1,006,084
Percentage of shares of common stock outstanding		1.00%
Number of shares available for issuance		243,621
2019 Employee Stock Purchase Plan \| Common Stock \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares issued under the plan		3,288,886
2012 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares available for issuance			0
Number of shares authorized			2,093,811
Vesting period			4 years
Term of award			10 years
At-the-market Offering [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Aggregate value of common stock sale under ATM offering	$ 50.0		$ 40.6
Commission to agent as percentage of ATM offering proceeds			3.00%
Sale of shares under ATM, Shares			314,296
Weighted average price per share			$ 3.70
Net proceeds from common stock			$ 1.1

Equity - Summary of Share-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total share-based compensation expense	$ 1,848	$ 1,791
Research and Development
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total share-based compensation expense	661	784
General and Administrative
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total share-based compensation expense	$ 1,187	$ 1,007

Equity - Summary of Activity Related to Stock Option Grants (Details)	3 Months Ended
	Mar. 31, 2022 $ / shares shares
Share-based Payment Arrangement [Abstract]
Shares, Outstanding beginning balance \| shares	4,970,975
Shares, Granted \| shares	1,250,900
Shares, Exercised \| shares	(46,358)
Shares, Forfeited \| shares	(199,114)
Shares, Outstanding ending balance \| shares	5,976,403
Shares, Vested and exercisable \| shares	2,906,783
Shares, Vested and expected to vest \| shares	5,976,403
Weighted average exercise price per share, Outstanding beginning balance \| $ / shares	$ 8.45
Weighted average exercise price per share, Granted \| $ / shares	2.24
Weighted average exercise price per share, Exercised \| $ / shares	1.26
Weighted average exercise price per share, Forfeited \| $ / shares	11.31
Weighted average exercise price per share, Outstanding ending balance \| $ / shares	7.11
Weighted average exercise price per share, Vested and exercisable \| $ / shares	6.91
Weighted average exercise price per share, Vested and expected to vest \| $ / shares	$ 7.11
Weighted average remaining contractual life, Outstanding	7 years 4 months 24 days
Weighted average remaining contractual life, Vested and exercisable	5 years 8 months 12 days
Weighted average remaining contractual life, Vested and expected to vest	7 years 4 months 24 days

Equity - Summary of Fair Value of Each Option Grant Estimated Throughout Year Using Black-Scholes Option-pricing Model (Details)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected term (in years)	6 years 3 months 18 days	6 years 2 months 12 days
Expected stock price volatility	92.40%	91.60%
Risk-free interest rate	1.74%	0.59%
Expected dividend yield	0.00%	0.00%

Related Party Transactions (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
IntellectMap
Related Party Transaction [Line Items]
Advisory services fees	$ 33,000	$ 49,000