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Stock Analysis & ValuationALX Oncology Holdings Inc. (ALXO)

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$1.74
Sector Valuation Confidence Level
High
Valuation methodValue, $Upside, %
Artificial intelligence (AI)n/an/a
Intrinsic value (DCF)n/a
Graham-Dodd Methodn/a
Graham Formulan/a

Strategic Investment Analysis

Company Overview

ALX Oncology Holdings Inc. (NASDAQ: ALXO) is a clinical-stage immuno-oncology company pioneering novel therapies to enhance cancer treatment. Focused on leveraging the immune system to combat malignancies, ALX Oncology's lead candidate, ALX148, is a CD47 blocker in Phase 1b/2 trials targeting hematologic cancers (e.g., AML, MDS) and solid tumors (e.g., HER2+ gastric, breast, and head/neck cancers). The company’s pipeline also includes ALTA-002, a SIRPa TRAAC designed to activate innate and adaptive immunity. Strategic collaborations with Merck, Zymeworks, and Tallac Therapeutics bolster its clinical development, while partnerships with Selexis SA and Crystal Bioscience enhance manufacturing capabilities. Headquartered in South San Francisco, ALX Oncology operates in the high-growth biotechnology sector, addressing unmet needs in oncology with a focus on combination therapies. With no approved products yet, its valuation hinges on clinical milestones and partnerships, positioning it as a high-risk, high-reward player in immuno-oncology.

Investment Summary

ALX Oncology presents a speculative investment opportunity with significant upside tied to clinical success but carries substantial risk due to its pre-revenue status and cash burn. The company’s lead asset, ALX148, targets CD47—a promising but competitive pathway in immuno-oncology—with early data showing potential in combination therapies. Partnerships with Merck and Zymeworks validate its approach but also expose it to competition from larger peers (e.g., Gilead, Bristol-Myers). Negative EPS (-$2.58) and operating cash flow (-$121.9M in FY2023) highlight reliance on capital markets for funding. Investors should monitor Phase 2 readouts and partnership milestones, as positive data could drive upside, while setbacks may exacerbate liquidity concerns. The stock’s high beta (1.21) reflects volatility typical of clinical-stage biotechs.

Competitive Analysis

ALX Oncology’s competitive edge lies in its focus on CD47 inhibition, a mechanism gaining traction for its role in immune evasion by tumors. ALX148 differentiates via engineered Fc inactivation, aiming to reduce toxicity (e.g., anemia) seen with rival CD47 blockers. However, the space is crowded: Gilead’s magrolimab (acquired via Forty Seven) leads in late-stage trials, while Trillium Therapeutics (acquired by Pfizer) and Surface Oncology also advance CD47 candidates. ALX’s collaborations with Merck (Keytruda combinations) and Zymeworks (HER2 bispecifics) provide validation but hinge on competing effectively against established checkpoint inhibitors. The company’s capital constraints ($17.6M cash vs. $134.8M net loss in FY2023) limit R&D flexibility compared to deep-pocketed rivals. Its preclinical SIRPa TRAAC (ALTA-002) could offer differentiation but remains unproven. Success depends on demonstrating superior safety/efficacy in niche indications (e.g., HER2+ cancers) where larger players may not prioritize.

Major Competitors

  • Gilead Sciences (GILD): Gilead dominates the CD47 space with magrolimab (Phase 3 trials in MDS/AML), backed by robust resources from its Forty Seven acquisition. Strengths include commercial infrastructure and combo therapy expertise. Weaknesses include safety concerns (clinical holds) and broader pipeline distractions.
  • Pfizer (PFE): Pfizer’s acquisition of Trillium gives it TTI-622/621 (CD47 blockers in Phase 1/2). Strengths include global scale and financial muscle. Weaknesses include slower CD47 development pace and less focus on ALX’s niche solid tumor targets.
  • Bristol-Myers Squibb (BMY): BMS leads in immuno-oncology with Opdivo/Yervoy but lacks a CD47 candidate. Strengths: commercial dominance in checkpoint inhibitors. Weaknesses: late to CD47, creating an opening for ALX in combo trials with anti-PD-1 agents.
  • Zymeworks (ZYME): Partnered with ALX on HER2-targeted combos, Zymeworks brings bispecific antibody expertise (zanidatamab). Strengths: synergistic collaboration. Weaknesses: limited financial resources compared to mega-cap peers.
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