ALX Oncology Holdings Inc.

What they do

ALX Oncology develops cancer therapies and has two clinical-stage candidates. Evorpacept is a fusion protein combining a high-affinity CD47 binding domain with an inactivated Fc domain, designed to block the CD47 'don't eat me' signal while avoiding the blood-cell toxicity seen with active-Fc CD47 approaches. It is being tested in the Phase 2 ASPEN-09-Breast trial with trastuzumab and chemotherapy in metastatic HER2-positive breast cancer and in other trials with targeted antibodies. ALX2004 is an EGFR-targeted antibody-drug conjugate that entered Phase 1 in August 2025.

Revenue drivers

• Product revenue — None. The company has no products approved for commercial sale and, per the 10-K risk factors, has not generated any revenue from product sales, licenses or collaborations.
• Evorpacept (ALX 148) — Lead clinical candidate; no revenue recorded. Development-stage only, currently in Phase 2 ASPEN-09-Breast and other combination trials.
• ALX2004 — Second clinical candidate, an EGFR-targeted ADC in Phase 1 dose escalation; no revenue recorded.
• Historical collaboration revenue — Reported revenue was $2.1M in 2018, $4.8M in 2019 and $1.2M in 2020, and $0 in 2021 and 2022, consistent with no ongoing product or collaboration revenue.

Recent performance

No revenue was reported in recent periods, and the company reported net losses of $160.8M in 2023, $134.8M in 2024 and $101.7M in 2025, with diluted EPS of -$3.74, -$2.58 and -$1.90 respectively. Operating cash use was $130.4M in 2023, $121.9M in 2024 and $84.1M in 2025. At June 30, 2026, total assets were $160.8M, total liabilities $24.6M, shareholders' equity $136.2M, cash and equivalents $22.7M, and long-term debt $9.7M. In the second quarter of 2026 the company refinanced $10 million of existing debt with HSBC Ventures USA Inc. and secured the ability to draw up to an additional $20 million through June 2028 under a facility with an aggregate principal amount of up to $50 million.

Strategy

Management is prioritizing evorpacept with a biomarker-driven strategy, focusing on patients whose tumors overexpress CD47 and retain HER2 expression. Enrollment continues in the Phase 2 ASPEN-09-Breast trial, with topline data from 80 patients expected in mid-2027, and in the Phase 1 dose-escalation trial of ALX2004, with initial safety data expected in the second half of 2026. In May 2026 the company presented exploratory Phase 1b/2 data at ESMO Breast Cancer 2026 for evorpacept combined with Jazz Pharmaceuticals' zanidatamab (ZIIHERA) in heavily pre-treated metastatic breast cancer. The June 2026 debt refinancing was described as strengthening the balance sheet, alongside the appointments of Scott Garland as Chairman and Michael Listgarten as General Counsel.

Risks

• No revenue and continuing losses — The company has no approved products or product revenue and reported net losses of $101.7M in 2025, and expects to continue incurring significant net losses for the foreseeable future.
• Dependence on evorpacept — The 10-K states the company is substantially dependent on the success of lead candidate evorpacept, which is in clinical development and has not completed a pivotal trial.
• Need for additional capital — The 10-K risk factors state the company will require substantial additional capital, which may not be available when needed or may be available only on unfavorable terms.
• Clinical and regulatory uncertainty — The 10-K notes that preclinical and early clinical results may not predict later trial success, and trial results may not satisfy FDA or comparable foreign regulatory requirements.

Outlook

Management says enrollment in ASPEN-09-Breast remains on track for a topline data readout from 80 patients in mid-2027. The Phase 1 trial of ALX2004 is on track to report initial safety data in the second half of 2026. The company describes itself as having multiple upcoming catalysts and, following the HSBC refinancing, the ability to draw up to an additional $20 million at its discretion through the end of June 2028.