Core Insights - Several small-cap stocks experienced significant gains in after-hours trading, driven by strategic updates, leadership changes, and pipeline developments, indicating renewed investor interest [1] Adaptimmune Therapeutics plc (ADAP) - ADAP's stock surged 30% in after-hours trading, reaching $0.2020 after a 98% gain during the regular session, closing at $0.16 [2] - The company reported a net loss of $30.3 million for Q2 2025, with total revenue of $13.7 million, primarily from product sales of TECELRA, which saw over 150% growth compared to Q1 [3] - In August, Adaptimmune sold several cell therapies to US WorldMeds for $55 million upfront, with potential future milestone payments of up to $30 million, allowing the company to repay its debt and restructure [4] Butterfly Network Inc. (BFLY) - BFLY's stock rose 10.58% in after-hours trading to $2.09, following a 15.95% increase during the regular session [4] - The company was recognized in TIME's list of the World's Top HealthTech Companies for 2025, and appointed a new Chief Technology Officer, enhancing its focus on innovation [5] - A recent study confirmed that Butterfly-enabled POCUS programs significantly reduce hospital stays and costs, validating its clinical impact [5] Aquestive Therapeutics Inc. (AQST) - AQST's stock increased 7.69% in after-hours trading to $5.32, continuing a year-to-date rise of nearly 39% [6] - The FDA confirmed it will not require an advisory committee meeting for AQST's NDA for Anaphylm, streamlining the regulatory process with a PDUFA date set for January 2026 [7] - The company secured a $75 million strategic funding agreement to support the potential launch of Anaphylm, reinforcing its commercial readiness [7] ALX Oncology Holdings Inc. (ALXO) - ALXO's stock rose 9.17% in after-hours trading to $1.19, following a 3.81% increase during the regular session [8] - Insider buying activity, particularly by CEO Jason Lettmann, who purchased 92,233 shares, has boosted investor confidence [9] - The company's lead candidate, Evorpacept, is in multiple Phase 1 and Phase 2 trials across various cancers, collaborating with major partners [9] Ekso Bionics Holdings Inc. (EKSO) - EKSO's stock increased 5.37% in after-hours trading to $4.51, following a 9.74% gain during the regular session [10] - The company's inclusion in the NVIDIA Connect Program has spotlighted its efforts to integrate AI into its technologies [11] - EKSO launched Virtual eksoUniversity to support continuing education for physical therapists, potentially broadening adoption of its rehabilitation devices [11] CEL-SCI Corp. (CVM) - CVM's stock rose 5.27% in after-hours trading to $9.39, after a 1.02% increase during the regular session [12] - The company completed a $10 million public offering to support ongoing clinical and regulatory efforts [13] - CEL-SCI filed for Breakthrough Medicine Designation in Saudi Arabia for its lead candidate, Multikine, which could expedite patient access and reimbursement [13]

Core Viewpoint - ALX Oncology has appointed Dr. Barbara Klencke as Interim Chief Medical Officer, succeeding Dr. Alan Sandler, who will return to the Board of Directors [1][2][5] Company Overview - ALX Oncology is a clinical-stage biotechnology company focused on developing novel therapies for cancer treatment, with a pipeline that includes evorpacept and ALX2004 [3] - Evorpacept is positioned as a cornerstone therapy in immuno-oncology and is currently undergoing multiple clinical trials across various cancer indications [3] - ALX2004 is a novel EGFR-targeted antibody-drug conjugate that entered Phase 1 clinical trials in August 2025 [3] Leadership Changes - Dr. Klencke brings over 30 years of experience in oncology and has previously served as CMO at Sierra Oncology, contributing to its acquisition by GlaxoSmithKline [2][5] - The transition aims to enhance the execution of the company's development strategy for its clinical programs [2]

Core Insights - ALX Oncology is participating in two significant healthcare conferences in New York, showcasing its commitment to advancing cancer therapies [1][2]. Group 1: Conference Participation - ALX Oncology leadership will engage in the Cantor Global Healthcare Conference on September 3, 2025, featuring a fireside chat and one-on-one meetings [2]. - The H.C. Wainwright 27th Annual Global Investment Conference will take place on September 9, 2025, with a focus on one-on-one meetings [2]. - Webcasts for both conferences will be available on ALX Oncology's website, with replays archived for up to 90 days [2]. Group 2: Company Overview - ALX Oncology is a clinical-stage biotechnology company focused on developing novel therapies aimed at treating cancer and improving patient survival [3]. - The lead therapeutic candidate, evorpacept, is being evaluated in multiple clinical trials across various cancer indications, indicating its potential as a cornerstone therapy in immuno-oncology [3]. - ALX2004, the second pipeline candidate, is an EGFR-targeted antibody-drug conjugate that entered Phase 1 trials in August 2025, highlighting the company's innovative approach to cancer treatment [3].

Core Insights - ALX2004 is a potential best- and first-in-class antibody-drug conjugate (ADC) designed for treating EGFR-expressing solid tumors, with components optimized to maximize the therapeutic window [1][4] - The first patient has been dosed in the Phase 1 clinical trial for ALX2004, marking a significant milestone for ALX Oncology [2][3] - Initial safety data from the trial is expected in the first half of 2026 [1][3] Company Overview - ALX Oncology is a clinical-stage biotechnology company focused on developing novel therapies for cancer treatment [6] - The company’s lead candidate, evorpacept, is being evaluated in multiple clinical trials across various cancer indications [6] Clinical Trial Details - The Phase 1 clinical trial (NCT07085091) is an open-label multicenter study targeting advanced or metastatic EGFR-expressing solid tumors, including non-small cell lung cancer, head and neck squamous cell carcinoma, esophageal squamous cell carcinoma, and colorectal cancer [3][5] - The trial consists of a Phase 1a dose escalation followed by a Phase 1b dose expansion [3] Preclinical Data - Preclinical studies indicate that ALX2004 has a differentiated linker-payload construct, demonstrating superior stability and dose-dependent anti-tumor activity [5] - The preclinical model findings suggest a favorable safety profile, with no EGFR-related skin toxicity or payload-related interstitial lung disease observed at clinically relevant doses [5]

Financial Data and Key Metrics Changes - The company has extended its cash runway guidance into 2027, positioning itself to achieve multiple value-enhancing data milestones in the upcoming years [6][38] - The financials reflect a significant decline in clinical trial spending as multiple legacy trials are closing out, which will positively impact cash flow [38] Business Line Data and Key Metrics Changes - The analysis of the ASPEN six trial indicates that CD47 expression is a key predictive biomarker for clinical response, with a notable increase in overall response rates (ORR) for patients with high CD47 expression [3][8] - The company is modifying its Phase II clinical trial in breast cancer to pursue a CD47 and HER2 biomarker-driven strategy, enhancing the potential for targeted oncology approaches [4][12] Market Data and Key Metrics Changes - Approximately 20,000 patients are identified as addressable in the HER2 positive and CD47 high segment, representing a market opportunity estimated between $2 billion to $4 billion [30] - The company anticipates that CD47 overexpression is found in roughly 50% to 70% of HER2 positive breast cancer patients, indicating a significant commercial opportunity [13][30] Company Strategy and Development Direction - The company is focused on advancing its HER2 positive breast cancer program with a CD47 biomarker-driven approach, which has been derisked by positive data from two different HER2 positive cancers [22][36] - The development strategy includes pursuing a targeted IO breakthrough with EVO, aiming to replicate successful results across various tumor types [9][12] Management's Comments on Operating Environment and Future Outlook - Management expressed excitement about the potential of CD47 as a predictive biomarker, which could facilitate smaller and faster future studies, enhancing the ability to select patients effectively [40] - The management team is optimistic about the upcoming data presentations and the implications for future clinical trials, particularly in breast cancer [41] Other Important Information - The company is set to present full data from the ASPEN six trial at an upcoming medical conference in Q4 of this year, which is expected to provide further insights into the efficacy of EVO [8][20] - The clinical pipeline remains focused on the combination of evorpercept with anti-cancer antibodies, with a priority on the HER2 positive breast cancer program [36][37] Q&A Session Summary Question: Do you need to meet with FDA to finalize trial design changes for Aspen breast? - The company has submitted the amendment for the Aspen breast study to the FDA and is ready to proceed without any holdup [44] Question: Can you frame investigator feedback on the CD47 biomarker approach? - Feedback from investigators has been positive, with enthusiasm for the CD47 biomarker and its potential to address unmet needs in patients progressing on HER2 therapies [46] Question: What kind of data would give confidence to continue pursuing the biomarker approach? - The company is looking for response rates in the high 30s to 40% range to consider the data compelling enough for further development [48] Question: Will the current Phase II study support registration? - The current study is designed to inform decision-making for future registrational studies, with the potential for accelerated approval depending on the data [55][56] Question: How does the baseline characteristic compare between CD47 high and low patient groups? - The baseline characteristics are generally well balanced, and further details will be shared at a medical meeting [76] Question: Is there any data on CD47 expression post HER2 treatment? - There is evidence suggesting that CD47 levels may increase with subsequent lines of therapy, indicating a potential resistance mechanism [81]

Clinical Trial Updates - Data from the ASPEN-06 trial highlights CD47 expression as a key predictive biomarker, demonstrating a compelling clinical response of evorpacept activity in HER2+ gastric cancer[12] - The Phase 2 ASPEN-Breast evorpacept trial design was updated to enable a CD47 and HER2 biomarker-driven strategy in a single-arm study[12] - Dose escalation was completed in the Sanofi-sponsored trial of evorpacept with SARCLISA® and dexamethasone in previously treated multiple myeloma, with Sanofi moving into dose optimization[12] - The first patient is anticipated to be enrolled in August in the phase 1 clinical trial of the novel EGFR-targeted antibody-drug conjugate (ADC), ALX2004[12] Financial Strategy - Focus on evorpacept in ASPEN-Breast and ALX2004, while pausing ASPEN-CRC, results in cash runway extended into Q1 2027[12] - The company had cash, cash equivalents, and investments of $84 million as of June 30, 2025[100] Upcoming Milestones - ASPEN-06 CD47 expression data update is expected in Q4 2025[12] - Initial safety data for ALX2004 is anticipated in 1H 2026[12] - ASPEN-breast interim data readout is expected in Q3 2026[12] ASPEN-06 Trial Results - In the ITT population, Evorpacept + TRP showed a 41% ORR compared to 27% in the TRP control arm[42] - In patients with HER2-positivity confirmed by fresh biopsy or ctDNA, evorpacept demonstrated a 49% ORR compared to 245% in control[45] - In patients with HER2+ and CD47-high gastric cancer (n=43), evorpacept + TRP had a 65% ORR versus 26% ORR for TRP[53] ASPEN-Breast Trial - In breast cancer patients with confirmed HER2-positivity, evorpacept + zanidatamab had a 56% confirmed ORR[63]

PART I FINANCIAL INFORMATION [Item 1. Financial Statements (Unaudited)](index=5&type=section&id=Item%201%20Financial%20Statements%20%28Unaudited%29) The unaudited condensed consolidated financial statements for ALX Oncology Holdings Inc. as of June 30, 2025, show a decrease in total assets to $95.3 million from $147.8 million at year-end 2024, primarily due to a reduction in cash and investments [Condensed Consolidated Balance Sheets](index=5&type=section&id=Condensed%20Consolidated%20Balance%20Sheets) As of June 30, 2025, the company had total assets of $95.3 million, a decrease from $147.8 million at December 31, 2024, driven by a reduction in cash, cash equivalents, and short-term investments Condensed Consolidated Balance Sheet Highlights (in thousands) | Balance Sheet Item | June 30, 2025 | December 31, 2024 | | :--- | :--- | :--- | | **Assets** | | | | Cash and cash equivalents | $19,302 | $17,567 | | Short-term investments | $60,012 | $110,190 | | Total current assets | $85,257 | $134,352 | | **Total assets** | **$95,320** | **$147,775** | | **Liabilities & Equity** | | | | Total current liabilities | $18,848 | $18,500 | | **Total liabilities** | **$30,905** | **$34,157** | | **Total stockholders' equity** | **$64,415** | **$113,618** | [Condensed Consolidated Statements of Operations](index=6&type=section&id=Condensed%20Consolidated%20Statements%20of%20Operations) For the three months ended June 30, 2025, the company reported a net loss of $25.9 million, an improvement from the $39.4 million loss in the same period of 2024, primarily due to lower research and development expenses Statement of Operations Summary (in thousands, except per share data) | Metric | Q2 2025 | Q2 2024 | Six Months 2025 | Six Months 2024 | | :--- | :--- | :--- | :--- | :--- | | Research and development | $18,022 | $34,653 | $41,910 | $66,370 | | General and administrative | $5,451 | $6,872 | $13,383 | $12,917 | | Impairment charge | $3,175 | $— | $3,175 | $— | | Total operating expenses | $26,648 | $41,525 | $58,468 | $79,287 | | Loss from operations | $(26,648) | $(41,525) | $(58,468) | $(79,287) | | **Net loss** | **$(25,949)** | **$(39,399)** | **$(56,703)** | **$(74,980)** | | Net loss per share | $(0.49) | $(0.76) | $(1.05) | $(1.47) | [Condensed Consolidated Statements of Cash Flows](index=9&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows) For the six months ended June 30, 2025, net cash used in operating activities was $48.1 million, offset by $50.0 million provided by investing activities, resulting in a net increase in cash of $1.7 million Cash Flow Summary for Six Months Ended June 30 (in thousands) | Activity | 2025 | 2024 | | :--- | :--- | :--- | | Net cash used in operating activities | $(48,069) | $(64,490) | | Net cash provided by investing activities | $49,961 | $27,380 | | Net cash (used in) provided by financing activities | $(157) | $30,238 | | **Net increase (decrease) in cash** | **$1,735** | **$(6,872)** | | Cash at end of period | $19,368 | $15,600 | [Notes to Condensed Consolidated Financial Statements](index=10&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements) The notes detail the company's accounting policies, financial instruments, and operational structure, including its clinical-stage status, reliance on future financing, and an impairment charge related to a leased property - The company is a clinical-stage biotechnology firm with no product revenues and expects to incur additional losses, though management believes existing capital is sufficient to fund operations for at least the next twelve months[27](index=27&type=chunk)[29](index=29&type=chunk)[30](index=30&type=chunk) - In May 2025, the company decided to sublease its Palo Alto property, resulting in a pre-tax long-lived asset impairment charge of **$3.2 million** on the right-of-use asset and leasehold improvements[55](index=55&type=chunk)[140](index=140&type=chunk) - The company has a term loan agreement for up to **$100.0 million**, with **$10.0 million** drawn, and a **$25.0 million** tranche remained available at the lenders' sole discretion as of June 30, 2025, after the company opted not to draw down other available tranches[63](index=63&type=chunk)[156](index=156&type=chunk) - As of June 30, 2025, the company had non-cancellable commitments of approximately **$1.5 million** for manufacturing and services, primarily with KBI Biopharma and three other contract manufacturers[89](index=89&type=chunk) [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=21&type=section&id=Item%202%20Management%27s%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) Management discusses the company's clinical-stage pipeline, led by evorpacept and ALX2004, highlighting recent clinical trial results, strategic shifts to preserve capital, and financial performance showing a reduced net loss for Q2 2025 [Overview](index=21&type=section&id=Overview) ALX Oncology is a clinical-stage biotechnology company focused on cancer therapies, with lead product evorpacept showing promising results in gastric cancer but not qualifying for accelerated FDA approval, leading to a strategic focus on the ASPEN-Breast trial - Lead product evorpacept is a next-generation CD47 blocker designed to avoid hematologic toxicities of other CD47 approaches[94](index=94&type=chunk)[95](index=95&type=chunk) - In the ASPEN-06 trial for gastric cancer, evorpacept plus TRP showed a **65% ORR** in CD47-high patients, compared to **26%** with TRP alone, with full data to be presented in Q4 2025[103](index=103&type=chunk)[105](index=105&type=chunk) - The FDA advised that ASPEN-06 data is not eligible for accelerated approval, leading the company to not pursue a Phase 3 trial in gastric cancer and instead focus resources on the ASPEN-Breast trial[105](index=105&type=chunk) - The company's second candidate, ALX2004, an EGFR-targeted ADC, received IND clearance from the FDA in April 2025[115](index=115&type=chunk) - The company received a Nasdaq minimum bid price non-compliance notice on April 23, 2025, and has until October 20, 2025, to regain compliance[114](index=114&type=chunk)[117](index=117&type=chunk) [Results of Operations](index=28&type=section&id=Results%20of%20Operations) The company's net loss decreased to $25.9 million in Q2 2025 from $39.4 million in Q2 2024, primarily driven by a 48% decrease in R&D expenses and a 21% decrease in G&A expenses Comparison of Results of Operations (in thousands) | Item | Q2 2025 | Q2 2024 | Change ($) | Change (%) | | :--- | :--- | :--- | :--- | :--- | | Research and development | $18,022 | $34,653 | $(16,631) | -48% | | General and administrative | $5,451 | $6,872 | $(1,421) | -21% | | Impairment charge | $3,175 | $— | $3,175 | 100% | | **Loss from operations** | **$(26,648)** | **$(41,525)** | **$14,877** | **-36%** | | **Net loss** | **$(25,949)** | **$(39,399)** | **$13,450** | **-34%** | - R&D expenses for Q2 2025 decreased by **$16.6 million** year-over-year, mainly due to a decrease of **$8.5 million** in clinical and development costs (less manufacturing of clinical trial materials) and a **$4.1 million** decrease in stock-based compensation[135](index=135&type=chunk) - G&A expenses for Q2 2025 decreased by **$1.4 million** year-over-year, primarily due to a **$1.0 million** decrease in stock-based compensation and lower legal consulting costs[138](index=138&type=chunk) - A **$3.2 million** impairment charge was recorded in Q2 2025 after the company decided to sublease its Palo Alto property[140](index=140&type=chunk) [Liquidity and Capital Resources; Plan of Operations](index=29&type=section&id=Liquidity%20and%20Capital%20Resources%3B%20Plan%20of%20Operations) As of June 30, 2025, the company had $83.5 million in cash, cash equivalents, and investments, which management believes is sufficient to fund operations into the first quarter of 2027 - The company had cash, cash equivalents, and investments of **$83.5 million** as of June 30, 2025[144](index=144&type=chunk)[189](index=189&type=chunk) - Management estimates that existing cash will fund operating expenses and capital requirements into the **first quarter of 2027**[157](index=157&type=chunk)[189](index=189&type=chunk) Cash Flow Summary for Six Months Ended June 30 (in thousands) | Activity | 2025 | 2024 | | :--- | :--- | :--- | | Net cash used in operating activities | $(48,069) | $(64,490) | | Net cash provided by investing activities | $49,961 | $27,380 | | Net cash (used in) provided by financing activities | $(157) | $30,238 | - The company decided not to draw down on a **$40.0 million** tranche of its loan agreement by the June 30, 2024 deadline, resulting in only a **$25.0 million** tranche remaining available at the lenders' sole discretion as of June 30, 2025[156](index=156&type=chunk) [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=33&type=section&id=Item%203%20Quantitative%20and%20Qualitative%20Disclosures%20about%20Market%20Risk) The company's primary market risks are related to interest rate sensitivity on its $83.5 million in cash and investments and $10.0 million in floating-rate debt, and credit risk managed through highly-rated securities - The company is exposed to interest rate risk on its **$83.5 million** in cash, cash equivalents, and investments, and on its **$10.0 million** in floating-rate debt[171](index=171&type=chunk)[172](index=172&type=chunk) - Borrowings under the Loan Agreement bear interest at a floating rate equal to the greater of 1-month term SOFR or **2.33%**, plus **6.25%**[172](index=172&type=chunk) - Credit risk is concentrated in cash and investments, mitigated by investing in highly-rated securities, though deposits may exceed federally insured limits[173](index=173&type=chunk) [Item 4. Controls and Procedures](index=34&type=section&id=Item%204%20Controls%20and%20Procedures) Management, including the CEO and CFO, concluded that the company's disclosure controls and procedures were effective as of June 30, 2025, with no material changes in internal control over financial reporting during the quarter - The CEO and CFO concluded that the company's disclosure controls and procedures were effective as of June 30, 2025[178](index=178&type=chunk) - There were no changes in internal control over financial reporting during the quarter ended June 30, 2025, that materially affected, or are reasonably likely to materially affect, internal controls[180](index=180&type=chunk) PART II OTHER INFORMATION [Item 1. Legal Proceedings](index=35&type=section&id=Item%201%20Legal%20Proceedings) The company reports that it is not currently a party to any material legal proceedings, while acknowledging potential involvement in legal matters in the ordinary course of business - As of the filing date, the company is not a party to any material legal proceedings[182](index=182&type=chunk) [Item 1A. Risk Factors](index=35&type=section&id=Item%201A%20Risk%20Factors) This section details significant risks including a history of net losses, the need for substantial additional capital, dependence on evorpacept's success, clinical trial uncertainties, reliance on third-party manufacturers, competition, intellectual property challenges, potential Nasdaq delisting, and regulatory hurdles [Risks Related to Financial Position and Need for Additional Capital](index=36&type=section&id=Risks%20Related%20to%20Our%20Financial%20Position%20and%20Need%20for%20Additional%20Capital) The company has a history of significant net losses and expects them to continue, requiring substantial additional capital to fund operations, with existing cash projected to last into Q1 2027, subject to restrictive loan covenants - The company has incurred significant net losses since inception, with an accumulated deficit of **$677.8 million** as of June 30, 2025, and expects to continue incurring losses[186](index=186&type=chunk) - The company will require substantial additional capital, with existing cash of **$83.5 million** projected to fund operations into **Q1 2027**, though this estimate is subject to change[188](index=188&type=chunk)[189](index=189&type=chunk) - The company's Loan Agreement contains covenants that restrict its ability to, among other things, incur additional debt, make acquisitions, or pay dividends, and a default could lead to acceleration of obligations[197](index=197&type=chunk)[200](index=200&type=chunk)[201](index=201&type=chunk) [Risks Related to Product Discovery, Development, and Commercialization](index=39&type=section&id=Risks%20Related%20to%20the%20Discovery%2C%20Development%20and%20Commercialization%20of%20Our%20Product%20Candidates) The company's success is heavily dependent on its lead candidate, evorpacept, facing inherent risks in clinical development, potential adverse side effects, substantial competition, and reliance on third-party manufacturers for supply and quality - The business is substantially dependent on the success of its lead product candidate, evorpacept, which has not completed a pivotal trial[202](index=202&type=chunk) - Early clinical trial outcomes are not predictive of later success, as evidenced by the company's April 2025 announcement that Phase 2 trials for evorpacept in HNSCC (ASPEN-03 and ASPEN-04) did not meet their primary endpoints[203](index=203&type=chunk)[205](index=205&type=chunk) - The company relies on third-party contract manufacturers for its product candidates and has no manufacturing facilities of its own, creating risks related to supply, quality, and regulatory compliance[233](index=233&type=chunk) - The company faces substantial competition from major pharmaceutical and biotech companies, many of whom are also developing drugs targeting the CD47 pathway, including Pfizer and Gilead Sciences[220](index=220&type=chunk)[221](index=221&type=chunk) [Risks Related to Government Regulation](index=50&type=section&id=Risks%20Related%20to%20Government%20Regulation) The company is subject to extensive, costly, and unpredictable government regulation, including lengthy approval processes, post-marketing requirements, potential impacts from healthcare reform, and compliance with fraud, abuse, data privacy, and anti-corruption laws - The regulatory approval process is lengthy and unpredictable, and there is no guarantee of approval for any product candidate[271](index=271&type=chunk) - While the company has received Fast Track and Orphan Drug designations for evorpacept, these may not lead to a faster review or approval and do not increase the likelihood of receiving marketing approval[276](index=276&type=chunk)[278](index=278&type=chunk) - Current and future legislation, including the Inflation Reduction Act of 2022, may increase the difficulty and cost of commercialization and negatively affect drug pricing[280](index=280&type=chunk)[285](index=285&type=chunk) - The company is subject to complex data privacy laws like GDPR in Europe and CCPA/CPRA in California, which impose significant compliance costs and potential liabilities for non-compliance[303](index=303&type=chunk)[310](index=310&type=chunk)[311](index=311&type=chunk) [Risks Related to Intellectual Property](index=61&type=section&id=Risks%20Related%20to%20Intellectual%20Property) The company's success depends on its ability to obtain, maintain, and enforce patent protection, facing an uncertain and litigious patent landscape, global protection challenges, infringement claims from third parties, and difficulties in protecting trade secrets - The company's ability to protect its product candidates through patents is uncertain and may not prevent competitors from developing similar products[313](index=313&type=chunk)[315](index=315&type=chunk) - The company may not be able to protect its intellectual property rights globally, as laws in some foreign countries are less protective than in the U.S[318](index=318&type=chunk) - The company is aware of third-party patents, such as those owned by University Health Network (UHN) and licensed to Pfizer, that could potentially be construed to cover evorpacept and limit its ability to commercialize in certain indications and geographies[343](index=343&type=chunk) - The company relies on trade secrets and confidentiality agreements, but these may be breached, and enforcing claims of misappropriation is difficult and costly[334](index=334&type=chunk)[335](index=335&type=chunk) [Risks Related to Operations](index=69&type=section&id=Risks%20Related%20to%20Our%20Operations) The company faces operational risks including managing growth, hiring and retaining key personnel, potential adverse effects from a recent reduction in force, reliance on third parties for critical services, challenges with novel technology, and potential product liability claims - The company is highly dependent on key personnel and faces significant competition for talent, with a recently announced reduction in force (RIF) potentially harming morale and leading to loss of expertise[361](index=361&type=chunk) - The company relies on third parties for crucial services, including clinical trial management and manufacturing, and any failure by these parties could delay or terminate development programs[358](index=358&type=chunk) - The company's product candidates are based on novel technology, making it difficult to predict the time and cost of development[360](index=360&type=chunk) - The company may be exposed to costly product liability claims from clinical trials or commercial use, and its insurance may not be sufficient to cover all damages[371](index=371&type=chunk)[373](index=373&type=chunk) [Risks Related to Ownership of Our Common Stock](index=74&type=section&id=Risks%20Related%20to%20Ownership%20of%20Our%20Common%20Stock) Ownership of the company's common stock involves significant risk due to high price volatility, non-compliance with Nasdaq's minimum bid price requirement, potential dilution from future equity financings, significant insider control, and a history of material weaknesses in internal controls - The trading price of the company's common stock is highly volatile[389](index=389&type=chunk) - The company is not in compliance with the Nasdaq Global Select Market's minimum bid price requirement and faces a risk of delisting if it cannot regain compliance by October 20, 2025[394](index=394&type=chunk) - Future sales of common stock, including under the ATM facility or upon exercise of warrants, will cause dilution to stockholders[388](index=388&type=chunk)[414](index=414&type=chunk) - As of June 30, 2025, executive officers, directors, and affiliated 5% holders beneficially owned approximately **21.3%** of the stock, allowing them to exert significant control[410](index=410&type=chunk) - The company has identified and remediated material weaknesses in internal control over financial reporting in the past and may identify others in the future, which could harm investor confidence[422](index=422&type=chunk) [Item 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=83&type=section&id=Item%202%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) The company reports no material change in the planned use of proceeds from its initial public offering and no unregistered sales of equity securities during the period - There has been no material change in the planned use of proceeds from the company's initial public offering[438](index=438&type=chunk) - There were no unregistered sales of equity securities in the reported quarter[439](index=439&type=chunk) [Item 3. Defaults Upon Senior Securities](index=83&type=section&id=Item%203%20Defaults%20Upon%20Senior%20Securities) This item is not applicable as the company has not defaulted upon any senior securities - Not applicable[441](index=441&type=chunk) [Item 4. Mine Safety Disclosures](index=83&type=section&id=Item%204%20Mine%20Safety%20Disclosures) This item is not applicable to the company - Not applicable[442](index=442&type=chunk) [Item 5. Other Information](index=83&type=section&id=Item%205%20Other%20Information) The company reports that none of its officers or directors adopted or terminated a Rule 10b5-1 trading arrangement or a non-Rule 10b5-1 trading arrangement during the last fiscal quarter - No officers or directors adopted or terminated a Rule 10b5-1 trading arrangement during the last fiscal quarter[443](index=443&type=chunk) [Item 6. Exhibits](index=84&type=section&id=Item%206%20Exhibits) This section lists the exhibits filed with the Form 10-Q, including certifications by the Principal Executive Officer and Principal Financial Officer as required by the Sarbanes-Oxley Act, and XBRL data files - Exhibits filed include CEO and CFO certifications pursuant to Sarbanes-Oxley Sections 302 and 906, and Inline XBRL documents[445](index=445&type=chunk)

Core Insights - ALX Oncology is advancing its clinical programs, particularly focusing on evorpacept and ALX2004, with significant data expected in the coming years [1][3][4] Clinical Developments - The ASPEN-06 trial indicates that CD47 expression is a predictive biomarker for response to evorpacept in HER2+ gastric cancer, with a 65% objective response rate (ORR) in CD47-high patients compared to 26% with standard treatment [4] - The ASPEN-Breast trial design has been updated to a single-arm study to evaluate CD47 and HER2 biomarker-driven strategies, with interim data expected in Q3 2026 [1][4] - The Phase 1 clinical trial for ALX2004 is on track to enroll its first patient in August 2025, targeting EGFR-expressing solid tumors [1][4][6] Financial Overview - As of June 30, 2025, ALX Oncology reported cash, cash equivalents, and investments totaling $83.5 million, sufficient to fund operations into Q1 2027 [11][16] - Research and Development (R&D) expenses for Q2 2025 were $18.0 million, a decrease from $34.7 million in the prior year, attributed to reduced clinical trial material manufacturing and other cost-saving measures [11][14] - The net loss for Q2 2025 was $25.9 million, down from $39.4 million in Q2 2024, reflecting lower R&D expenses [11][14] Corporate Updates - Daniel Curran, M.D., has been appointed to the Board of Directors, bringing extensive experience in drug discovery and corporate strategy [2][3][5] - The company has extended its cash runway into Q1 2027, allowing for the achievement of multiple data milestones across its pipeline [1][4][11]

[Executive Summary](index=1&type=section&id=Executive%20Summary) ALX Oncology reported Q2 2025 financial results and corporate updates, highlighting significant progress in evorpacept and ALX2004 clinical programs, cash runway extension, and new board appointment - ASPEN-06 trial data indicates **CD47 expression** as a key predictive biomarker for better evorpacept response in HER2+ gastric cancer patients; updated data to be presented in Q4 2025[1](index=1&type=chunk) - The Phase 2 ASPEN-Breast evorpacept trial design is updated to a single-arm study with a CD47 and HER2 biomarker-driven strategy; interim data expected in Q3 2026[1](index=1&type=chunk) - The ALX2004 Phase 1 clinical trial is on track to enroll its first patient in August[1](index=1&type=chunk) - The company focuses on advancing ASPEN-Breast and ALX2004 data milestones within its cash runway, now extended to **Q1 2027**[1](index=1&type=chunk)[2](index=2&type=chunk) - Dr Daniel Curran appointed to the Board of Directors[1](index=1&type=chunk)[2](index=2&type=chunk) [Q2 2025 Highlights and Recent Developments](index=2&type=section&id=Q2%202025%20Highlights%20and%20Recent%20Developments) The company achieved significant clinical and strategic progress in Q2 2025, including positive evorpacept biomarker data, revised breast cancer trial design, ALX2004 IND approval, and strategic prioritization to extend financial runway [Evorpacept Clinical Program Updates](index=2&type=section&id=Evorpacept%20Clinical%20Program%20Updates) [ASPEN-06 Trial (HER2+ Gastric Cancer)](index=2&type=section&id=ASPEN-06%20Trial%20(HER2%2B%20Gastric%20Cancer)) - In a pre-planned exploratory analysis of the ASPEN-06 clinical trial, **CD47 overexpression** was identified as a key predictive biomarker for response and durable clinical benefit[3](index=3&type=chunk) ASPEN-06 Trial Results | Patient Group (n) | Combination Therapy | ORR | vs. TRP alone ORR | | :-------------------- | :------------------ | :-- | :---------------- | | HER2+, CD47-high (43) | Evorpacept + TRP | 65% | 26% | | HER2+, CD47-low (47) | Evorpacept + TRP | 39% | 25% | - In CD47-high expressing patients, evorpacept demonstrated significant benefits in **Duration of Response (DOR)**, **Progression-Free Survival (PFS)**, and **Overall Survival (OS)**[3](index=3&type=chunk) - The full dataset will be presented at an upcoming medical conference in **Q4 2025**[3](index=3&type=chunk) [ASPEN-Breast Trial (HER2+ Breast Cancer)](index=2&type=section&id=ASPEN-Breast%20Trial%20(HER2%2B%20Breast%20Cancer)) - Based on significant benefits in CD47-high expressing patients with HER2+ gastric cancer, the ASPEN-Breast study has been revised to a single-arm design evaluating evorpacept in all previously treated HER2-positive patients, assessed by CD47 expression[3](index=3&type=chunk) - The revised study design is expected to optimize enrollment and allow for an interim data readout in **Q3 2026**[3](index=3&type=chunk)[6](index=6&type=chunk) - The goal is for these study results to support a biomarker-driven registrational study in HER2-positive breast cancer[3](index=3&type=chunk) [UMBRELLA Study (Multiple Myeloma)](index=2&type=section&id=UMBRELLA%20Study%20(Multiple%20Myeloma)) - Sanofi and ALX Oncology announced the completion of the dose-escalation portion of the UMBRELLA randomized Phase 1/2 study, combining evorpacept with SARCLISA® (isatuximab-irfc) and dexamethasone in previously treated multiple myeloma patients[3](index=3&type=chunk) - Sanofi will initiate the dose-optimization portion of the study[3](index=3&type=chunk) [ALX2004 Clinical Program Update (EGFR-expressing Solid Tumors)](index=2&type=section&id=ALX2004%20Clinical%20Program%20Update%20(EGFR-expressing%20Solid%20Tumors)) - The company received FDA IND approval in April to advance ALX2004 for clinical evaluation in epidermal growth factor receptor (EGFR)-positive solid tumors, with the first patient in the Phase 1 clinical trial expected to be dosed in August[3](index=3&type=chunk) - The Phase 1 dose-escalation trial will include patients with relapsed/refractory EGFR-expressing solid tumors, including non-small cell lung cancer, colorectal cancer, head and neck squamous cell carcinoma, and esophageal squamous cell carcinoma[3](index=3&type=chunk) - Preliminary safety data from the Phase 1 trial are anticipated in **H1 2026**[3](index=3&type=chunk)[6](index=6&type=chunk) - ALX2004 utilizes a proprietary topoisomerase I inhibitor payload and linker-payload platform, designed to provide enhanced bystander effect and improved linker stability for targeted payload delivery[3](index=3&type=chunk) - Preclinical model results showed no EGFR-related skin toxicity or payload-related interstitial lung disease at clinically relevant doses, suggesting a potentially differentiated safety profile[3](index=3&type=chunk) [Strategic Prioritizations and Cash Runway Extension](index=2&type=section&id=Strategic%20Prioritizations%20and%20Cash%20Runway%20Extension) - The company prioritized evorpacept development, focusing on breast cancer and pausing the ASPEN-CRC study in colorectal cancer to extend its cash runway[3](index=3&type=chunk) - Through these strategic prioritizations, the company extended its cash runway into **Q1 2027**[2](index=2&type=chunk)[6](index=6&type=chunk) [Corporate and Leadership Changes](index=1&type=section&id=Corporate%20and%20Leadership%20Changes) - Dr Daniel Curran, a physician executive with extensive experience in business development, corporate strategy, drug discovery, and development, was appointed to the Board of Directors[1](index=1&type=chunk)[2](index=2&type=chunk)[6](index=6&type=chunk) - Dr Allison Dillon, previously Chief Business Officer, was appointed Chief Operating Officer, effective immediately[6](index=6&type=chunk) [Upcoming Clinical Milestones](index=3&type=section&id=Upcoming%20Clinical%20Milestones) Key upcoming clinical milestones include ASPEN-Breast patient dosing in Q4 2025 with interim data in Q3 2026, and ALX2004 patient dosing in August with preliminary safety data in H1 2026 - ASPEN-Breast cancer: Patient dosing expected to commence in **Q4 2025**; interim data from this trial are anticipated in **Q3 2026**[6](index=6&type=chunk) - ALX2004: Patient dosing expected to commence in **August**; preliminary safety data from the Phase 1 trial in EGFR-expressing solid tumors are anticipated in **H1 2026**[6](index=6&type=chunk) [Second Quarter 2025 Financial Results](index=3&type=section&id=Second%20Quarter%202025%20Financial%20Results) ALX Oncology reported a reduced net loss in Q2 2025, driven by lower R&D and G&A expenses, partially offset by an impairment charge, with cash sufficient to fund operations until Q1 2027 [Financial Summary and Cash Position](index=3&type=section&id=Financial%20Summary%20and%20Cash%20Position) Cash, Cash Equivalents and Investments | Metric | Amount (June 30, 2025) | | :----------------------------------- | :--------------------- | | Cash, cash equivalents and investments | **$83.5 million** | - The company believes its cash, cash equivalents, and investments are sufficient to support planned operations into **Q1 2027**[7](index=7&type=chunk) [Operating Expenses Analysis](index=3&type=section&id=Operating%20Expenses%20Analysis) [Research and Development (R&D) Expenses](index=3&type=section&id=Research%20and%20Development%20(R%26D)%20Expenses)) R&D Expenses Overview | Metric | Q2 2025 (Millions) | Q2 2024 (Millions) | Change (Millions) | | :----------- | :----------------- | :----------------- | :---------------- | | R&D Expenses | **$18.0** | **$34.7** | **$(16.6)** | - The decrease in R&D expenses was primarily due to a **$8.5 million reduction** in clinical and development costs (mainly from decreased clinical trial material manufacturing for evorpacept), a **$4.1 million decrease** in stock-based compensation, a **$2.1 million reduction** in personnel and related costs, and a **$1.7 million decrease** in preclinical costs due to pipeline prioritization[7](index=7&type=chunk)[8](index=8&type=chunk) [General and Administrative (G&A) Expenses](index=4&type=section&id=General%20and%20Administrative%20(G%26A)%20Expenses)) G&A Expenses Overview | Metric | Q2 2025 (Millions) | Q2 2024 (Millions) | Change (Millions) | | :----------- | :----------------- | :----------------- | :---------------- | | G&A Expenses | **$5.5** | **$6.9** | **$(1.4)** | - The decrease in G&A expenses was primarily attributable to a reduction in stock-based compensation expense[11](index=11&type=chunk) [Net Loss and Per Share Data](index=4&type=section&id=Net%20Loss%20and%20Per%20Share%20Data) Net Loss and Per Share Summary | Metric | Q2 2025 (Millions) | Q2 2024 (Millions) | Change (Millions) | | :---------------------- | :----------------- | :----------------- | :---------------- | | GAAP Net Loss | **$(25.9)** | **$(39.4)** | **$13.5** | | GAAP Net Loss per Share | **$(0.49)** | **$(0.76)** | **$0.27** | | Non-GAAP Net Loss | **$(23.7)** | **$(32.1)** | **$8.4** | - The decrease in net loss was primarily due to lower R&D expenses, partially offset by a **$3.2 million impairment charge** on long-lived assets recorded in Q2 2025, related to leased laboratory space following preclinical research staff reductions announced in March 2025[11](index=11&type=chunk) [Condensed Consolidated Financial Statements](index=5&type=section&id=Condensed%20Consolidated%20Financial%20Statements) This section presents unaudited condensed consolidated statements of operations, balance sheet data, and GAAP to non-GAAP reconciliation for the three and six months ended June 30, 2025 and 2024 [Condensed Consolidated Statements of Operations](index=5&type=section&id=Condensed%20Consolidated%20Statements%20of%20Operations) Condensed Consolidated Statements of Operations (in thousands) | Metric (in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :------------------------------------------------------------------------------- | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | Research and development | $18,022 | $34,653 | $41,910 | $66,370 | | General and administrative | $5,451 | $6,872 | $13,383 | $12,917 | | Impairment charge | $3,175 | — | $3,175 | — | | Total operating expenses | $26,648 | $41,525 | $58,468 | $79,287 | | Loss from operations | $(26,648) | $(41,525) | $(58,468) | $(79,287) | | Interest income | $1,106 | $2,563 | $2,589 | $5,185 | | Interest expense | $(405) | $(429) | $(811) | $(856) | | Other (expense) income, net | $(2) | $(8) | $(13) | $(22) | | Net loss | $(25,949) | $(39,399) | $(56,703) | $(74,980) | | Net loss per share, basic and diluted | $(0.49) | $(0.76) | $(1.05) | $(1.47) | | Weighted-average shares of common stock used to compute net loss per shares, basic and diluted | 53,445,631 | 51,831,157 | 54,031,176 | 50,969,089 | [Condensed Consolidated Balance Sheet Data](index=5&type=section&id=Condensed%20Consolidated%20Balance%20Sheet%20Data) Condensed Consolidated Balance Sheet Data (in thousands) | Metric (in thousands) | June 30, 2025 | December 31, 2024 | | :----------------------------- | :------------ | :---------------- | | Cash, cash equivalents and investments | $83,546 | $131,281 | | Total assets | $95,320 | $147,775 | | Total liabilities | $30,905 | $34,157 | | Accumulated deficit | $(677,825) | $(621,122) | | Total stockholders' equity | $64,415 | $113,618 | [GAAP to Non-GAAP Reconciliation](index=5&type=section&id=GAAP%20to%20Non-GAAP%20Reconciliation) GAAP to Non-GAAP Reconciliation (in thousands) | Metric (in thousands) | Three Months Ended June 30, 2025 | Three Months Ended June 30, 2024 | Six Months Ended June 30, 2025 | Six Months Ended June 30, 2024 | | :------------------------------------------------ | :------------------------------- | :------------------------------- | :----------------------------- | :----------------------------- | | GAAP net loss, as reported | $(25,949) | $(39,399) | $(56,703) | $(74,980) | | Stock-based compensation expense | $2,136 | $7,252 | $7,352 | $14,283 | | Accretion of term loan discount and issuance costs | $69 | $66 | $136 | $130 | | Total adjustments | $2,205 | $7,318 | $7,488 | $14,413 | | Non-GAAP net loss | $(23,744) | $(32,081) | $(49,215) | $(60,567) | [Use of Non-GAAP Financial Measures](index=6&type=section&id=Use%20of%20Non-GAAP%20Financial%20Measures) This section explains that non-GAAP financial measures provide additional information for management's business assessment but are not GAAP compliant and should not be considered in isolation or as substitutes for GAAP results - Non-GAAP financial measures provide additional information reflecting the amounts and financial basis on which management assesses and operates the business[18](index=18&type=chunk) - These non-GAAP financial measures are not in accordance with GAAP and should not be viewed in isolation or as a substitute for reported GAAP net loss[18](index=18&type=chunk) - "Non-GAAP net loss" is GAAP net loss adjusted to exclude stock-based compensation expense and accretion of term loan discount and issuance costs[19](index=19&type=chunk) [About ALX Oncology](index=4&type=section&id=About%20ALX%20Oncology) ALX Oncology is a clinical-stage biotechnology company advancing a pipeline of novel therapies to treat cancer and extend patient lives, with evorpacept as its lead candidate and ALX2004 as its second pipeline candidate - ALX Oncology is a clinical-stage biotechnology company dedicated to advancing a pipeline of novel therapies designed to treat cancer and extend patient lives[9](index=9&type=chunk) - ALX Oncology's lead therapeutic candidate, evorpacept, has shown potential as a cornerstone immuno-oncology therapy and is being evaluated in multiple ongoing clinical trials across a broad range of cancer indications[9](index=9&type=chunk) - ALX Oncology's second pipeline candidate, ALX2004, is a novel EGFR-targeted antibody-drug conjugate with a differentiated mechanism of action, expected to enter Phase 1 trials in mid-2025[9](index=9&type=chunk) [Cautionary Note Regarding Forward-Looking Statements](index=4&type=section&id=Cautionary%20Note%20Regarding%20Forward-Looking%20Statements) This section warns that the press release contains forward-looking statements involving significant risks and uncertainties, where actual results may differ materially from those expressed or implied - This press release contains forward-looking statements involving significant risks and uncertainties[10](index=10&type=chunk) - Forward-looking statements are based on ALX Oncology's beliefs and assumptions and may involve known and unknown risks, uncertainties, and other factors that could cause ALX Oncology's actual results, performance, or achievements to differ materially from those expressed or implied[10](index=10&type=chunk) - Except as required by law, ALX Oncology undertakes no obligation to update such statements to reflect events or circumstances occurring after their publication date[10](index=10&type=chunk) [Investor and Media Contacts](index=6&type=section&id=Investor%20and%20Media%20Contacts) This section provides contact information for investor relations and media inquiries - Investor Relations Contact: Elhan Webb, CFA, IR Consultant, ewebb@alxoncology.com[20](index=20&type=chunk) - Media Contact: Audra Friis, Sam Brown LLC, audrafriis@sambrown.com, (917) 519-9577[20](index=20&type=chunk)

Core Viewpoint - ALX Oncology Holdings Inc. is set to report its second quarter 2025 financial results and provide a business update on August 12, 2025, after market close [1] Group 1: Financial Results Announcement - The company will host a teleconference in conjunction with its financial results press release [1] - The webcast for the financial results will take place on August 12, 2025, at 1:30 PM PT / 4:30 PM ET [2] - Access to the conference call can be made via phone or through a dedicated link for instant telephone access [3] Group 2: Company Overview - ALX Oncology is a clinical-stage biotechnology company focused on developing novel therapies for cancer treatment [4] - The lead therapeutic candidate, evorpacept, is being evaluated in multiple ongoing clinical trials across various cancer indications [4] - The second pipeline candidate, ALX2004, is an EGFR-targeted antibody-drug conjugate expected to enter Phase 1 trials in mid-2025 [4]