Alx Oncology Holdings Inc. · NASDAQ:ALXO

Alx Oncology — Q1 2026 Earnings Presentation

38 slides from Alx Oncology's earnings presentation, May 8, 2026

  1. Slide 1: Q1 2026 Earnings Presentation

    NASDAQ – ALXO Q1 2026 Earnings Presentation May 2026 © ALX Oncology Inc. All rights reserved.

  2. Slide 2: Forward-Looking Statements

    Forward-Looking Statements Certain information set forth in this presentation contains “forward-looking information”, under applicable laws collectively referred to herein as forward-looking statements. Except for statements of historical fact, information contained herein constitutes forward-lookin

  3. Slide 3: Q1 2026 Results & Business Update

    ALX Oncology Jason Lettmann Chief Executive Officer, ALX Oncology Q1 2026 Results & Business Update Sara Hurvitz, MD 1 Q1’26 Highlights Medical Oncologist, Fred Hutch Cancer Center 2 Breast Cancer Overview & ESMO CD47 Update Barb Klencke, MD 3 Evorpacept and ALX2004 Program Update Chief Medical Offi

  4. Slide 4: ALX is Rapidly Advancing Novel, Targeted Cancer Treatments

    ALX is Rapidly Advancing Novel, Targeted Cancer Treatments Evorpacept ALX2004 • Leading CD47 program in development • Highly differentiated EGFR ADC in Ph1 with potential to be next targeted immuno- dose escalation in the US oncology breakthrough • Meticulously designed and developed • Unique design

  5. Slide 5: Q1 2026 - Strong Execution, Deepening Conviction

    Q1 2026 - Strong Execution, Deepening Conviction Targeted CD47 Biomarker: Convergent evidence, one validated story Data presented at ESMO Breast showed ALL patients who were confirmed HER2+/high CD47 expressers responded (ORR = 5/5) post T-DXd, with strong durability (mDOR = 20.2 m, mPFS = 22.1 m) A

  6. Slide 6: ALX is Focused on Driving Toward Multiple Inflection Points in 2026-2027

    ALX is Focused on Driving Toward Multiple Inflection Points in 2026-2027 PROGRAM INDICATION ANTICIPATED MILESTONES EVORPACEPT ASPEN-Breast Evorpacept, trastuzumab + chemotherapy ENHERTU®-Experienced HER2-Positive Topline data for 80 patients – Breast Cancer mid-2027 ALX2004 ALX2004 Dose-escalation a

  7. Slide 7: ALX Oncology is Pursuing a Focused Development Plan with Upcoming Catalysts in 2026

    ALX Oncology is Pursuing a Focused Development Plan with Upcoming Catalysts in 2026 MODALITY IND /TARGET PROGRAM INDICATION ENABLING PHASE 1 PHASE 2 PHASE 3 STATUS EVORPACEPT PROGRAMS ASPEN-09-Breast ENHERTU®-Experienced HER2-Positive Breast Enrolling, topline data Evorpacept, Trastuzumab for 80 pat

  8. Slide 8: Evorpacept Program Overview

    EVORPACEPT Barb Klencke, MD Program Overview Chief Medical Officer, ALX Oncology

  9. Slide 9: Evorpacept Blocks the CD47-SIRPα Interaction

    Evorpacept Blocks the CD47-SIRPα Interaction, Enhancing the Targeted ADCP of Cancer Cells when Given in Combination with Anti-Cancer Antibodies SIRP⍺ Don’t SIRP⍺ Don’t SIRP⍺ Evorpacept Eat Me Eat Me MACROPHAGE MACROPHAGE MACROPHAGE CD47 CD47 CD47 CANCER CELL CANCER CELL CANCER CELL Eat Me Eat Me Fcγ

  10. Slide 10: Evorpacept is the Only CD47 Blocker with an Inactive Fc

    Evorpacept is the Only CD47 Blocker with an Inactive Fc Designed to Avoid Toxicities Seen with Conventional Anti-CD47 Conventional anti-CD47 with Active Fc Evorpacept with Inactive Fc SIRP⍺ MACROPHAGE Red Blood Eat me Cell CD47 Fcγ Conventional Anti-CD47 Due to CD47’s expression on red blood cells,

  11. Slide 11: Sara A. Hurvitz, MD, FACP

    Sara A. Hurvitz, MD, FACP • Senior Vice President and Director of Clinical Research Division, Fred Hutch • Professor Clinical Research Division, Fred Hutch • Professor and Head, Division of Hematology and Oncology Department of Medicine, University of Washington • Smith Family Endowed Chair in Women

  12. Slide 12: Breast Cancer

    EVORPACEPT Sara Hurvitz, MD Breast Cancer Medical Oncologist, Fred Hutch Cancer Center

  13. Slide 13: As ENHERTU Moves to 1L in mBC, Treatment Paradigm in 2L+ Remains Unclear

    As ENHERTU Moves to 1L in mBC, Treatment Paradigm in 2L+ Remains Unclear HER2+ Metastatic Cancer Treatment Paradigm • ENHERTU + PERJETA is T-DXd (ENHERTU) + Pertuzumab (PERJETA) or new 1st line standard of 1L THP (Trastuzumab + Pertuzumab + Taxane) care in HER2+ mBC • Significant unmet need exists a

  14. Slide 14: Why Do We Need More Novel Anti-HER2 Treatment Options?

    Why Do We Need More Novel Anti-HER2 Treatment Options? Outcomes from First Post-ENHERTU Treatment1 • Lack of effective options post ENHERTU treatment is Median PFS now one of the most important unmet needs in 4.1 months treating HER2+ breast (95% CI: 3.9, 4.5) cancer • Median real-world ORR for pati

  15. Slide 15: There Are No IO Agents Currently Approved for HER2-Positive mBC

    There Are No IO Agents Currently Approved for HER2-Positive mBC HER2-Directed Therapies IO Therapies (Approved / In late-stage development) (In late-stage development) HER2-Targeted Antibodies/Bispecifics CD47-Targeted • Trastuzumab • Margetuximab • Evorpacept • Pertuzumab • Zanidatamab HER2-Targete

  16. Slide 16: CD47 is Overexpressed Across a Range of Solid and Heme Malignancies

    CD47 is Overexpressed Across a Range of Solid and Heme Malignancies CD47 Expression Levels from RNA Sequencing1 • As a ”marker of self”, CD47 is expressed on all cell types2 Median TPM • Cancer cells take advantage of this by overexpressing CD47 • Due to this, the vast majority of both solid and liq

  17. Slide 17: Research in CD47 Over the Last 10+ Years

    Research in CD47 Over the Last 10+ Years Provides a Strong Foundation for Utilizing CD47 as a Negative Prognostic Biomarker Increased CD47 expression is correlated with poor patient outcomes in many tumor types including1: • Oral squamous cell carcinoma2 • Nasopharyngeal carcinoma3 In a meta-analysi

  18. Slide 18: CD47 Expression in Breast Cancer is Higher in HER2+ Disease

    CD47 Expression in Breast Cancer is Higher in HER2+ Disease, More Common in Resistant Cancer CD47 Expression is Higher on … CD47-High Cells are More HER2+ BC Cells vs HER2- and… Common in Recurrent HER2+ BC CD47 CD47 20 20 15 15 No. of Patients No. of Patients 10 10 5 5 0 0 HER2+ HER2- Recurrent Pri

  19. Slide 19: CD47 is Upregulated in Response to T-DXd Treatment

    CD47 is Upregulated in Response to T-DXd (ENHERTU) Treatment in HER2-Positive Breast Cancer Cell Lines T-DXd (Enhertu) Exposure Increases CD47 Expression CD47 Expression • Per Tsao, Nature Communications, 2025 : CD47 MFI Gated on Live Cells "Interestingly, we found that DXd treatment raised surface

  20. Slide 20: ESMO Breast Cancer 2026 – Abstract #72P

    ESMO Breast Cancer 2026 – Abstract #72P Exploratory Biomarker Analysis from a Phase 1b/2 Trial of Zanidatamab (zani) + Evorpacept (evo) in Patients (pts) with HER2+ Metastatic Breast Cancer (mBC) Funda Meric-Bernstam1, Kari B Wisinski2, Bruno Fang3, Kelly E McCann4, Sara Hurvitz5, Kay T Yeung6, Rite

  21. Slide 21: Phase 1b/2 Trial Evaluating Safety and Efficacy of Evorpacept Plus Zanidatamab

    Phase 1b/2 Trial Evaluating Safety and Efficacy of Evorpacept Plus Zanidatamab in Patients whose Breast Cancer Progressed After Prior HER2-Directed Therapy Ph1b/2 Evo + Zani Study Design Highlights Part 2: Expansion Cohorts • Safety and Expansion Cohorts Cohort 1: n=21 1. Safety: Dose escalation (N=

  22. Slide 22: Patients With Centrally Confirmed HER2+ Disease Had Better Responses And PFS

    Patients With Centrally Confirmed HER2+ Disease Had Better Responses And Progression Free Survival ccHER2- Not ccHER2- All Positive Positive (N = 24) (n = 10) (n = 14) cORR, n (%) 8 (33.3) 6 (60.0) 2 (14.3) • 24 patients were included in the cBOR, n (%) current analyses, including 10 with centrally

  23. Slide 23: Responses Were Largely Restricted To Patients With Higher CD47 Expression

    Responses Were Largely Restricted To Patients With Both Higher CD47 Expression And Centrally Confirmed HER2+ Breast Cancer Confirmed objective responses (CR/PR) were observed in 5 of 5 Patients with ccHER2-positive mBC and CD47 Expression ≥20% ccHER2-Positive and Not ccHER2-Positive and Evaluable fo

  24. Slide 24: Median PFS Longer In Those With CD47 High Expression

    Median PFS Longer In Those With CD47 High Expression (Total Membrane Staining ≥20%) Vs. CD47 Low (Total Membrane Staining <20%) PFS by CD47 Expression in Patients with ccHER2+ Breast Cancer Median PFS (95% CI) CD47 >20% = 22.1 mos (7.4,NE) CD47 <20% = 3.4 mos (1.5,NE) Data cutoff: August 1, 2024; cc

  25. Slide 25: Conclusions – Exploratory Ph1b/2 Biomarker Analysis

    Conclusions – Exploratory Ph1b/2 (Evo + Zani) Biomarker Analysis • Evorpacept + zanidatamab showed promising antitumor activity in patients with heavily pretreated HER2-positive mBC, all of whom had received prior T-DXd • Greater antitumor activity was observed in patients with ccHER2-positive disea

  26. Slide 26: Breast Cancer Program Overview

    EVORPACEPT Barb Klencke, MD Breast Cancer Chief Medical Officer, Program Overview ALX Oncology

  27. Slide 27: All Patients with Confirmed HER2+ and CD47 High Expression had Confirmed Responses

    All Patients with Confirmed HER2+ and CD47 High Expression had Confirmed Responses to Evorpacept Plus Zanidatamab Confirmed ORR in HER2+ Patient Cohort Best Confirmed Response by CD47 Expression Level in Centrally Assessed HER2+ (N=10) 100% 100% CD47 Total Best Cohort - Membrane Prior Confirmed 90%

  28. Slide 28: CD47 Overexpression Demonstrated Enrichment in Response Across 2 Independent Trials

    CD47 Overexpression Demonstrated Enrichment in Response Across 2 Independent HER2 Directed Trials with Evorpacept ITT HER2+ CD47 High and HER2+ HER2+ (Centrally Confirmed/ CD47-High Retained HER2+) 100.0 100 100 100 HER2+ Breast Confirmed ORR, % 80 80 80 Confirmed ORR, % Confirmed ORR, % 60.0 Cancer

  29. Slide 29: Long Median DOR in Patients with CD47-High Expression

    Long Median DOR in Patients with CD47-High Expression was Observed Across 2 Independent HER2-Directed Trials with Evorpacept Median Duration of Response (Months) HER2+ Breast Cancer – Ph1b/2 Evo + Zani CD47-High1 (TMS ≥ 20%) N=5 20.2 Evorpacept + Zanidatamab HER2+ Gastric Cancer – Ph2 ASPEN-06 CD47-

  30. Slide 30: Longer PFS in Patients with CD47-High Expression

    Longer PFS in Patients with CD47-High Expression was Observed in Two Independent HER2 Directed Trials with Evorpacept PFS - CD47 High vs. Low PFS - CD47 High Ph1b/2 Breast Cancer (Evo + Zani) Ph2 Aspen-6 Gastric Cancer (Centrally confirmed HER2+ Patients) (Retained HER2+ patients) 100 Evo + TRP TRP

  31. Slide 31: ASPEN-09 Phase 2: Evorpacept with Trastuzumab and Chemotherapy

    ASPEN-09 Phase 2: Evorpacept with Trastuzumab and Chemotherapy in HER2+ Breast Cancer - Currently Enrolling Key Eligibility Criteria Key Objectives • HER2+ mBC (IHC3+ or Primary IHC2+/ISH+) Evorpacept • ORR in CD47+ subpopulation • Measurable disease per RECIST 1.1 N=80-120 Secondary • Prior ENHERTU

  32. Slide 32: HER2+ and CD47-High 2L+ BC Represents a Significant Initial Commercial Opportunity

    HER2+ and CD47-High 2L+ BC Represents a Significant Initial Commercial Opportunity with Potential to Move into Earlier Lines of Therapy 2L+ HER2+ 48K1 Confirmed HER2+ 60-80%2 CD47 High • ~20K addressable patients are CD47-high 50-70%3 • Represents $2-4B market opportunity in CD47-high, HER2+ 2L+ BC4

  33. Slide 33: ALX2004 EGFR ADC

    ALX2004 EGFR ADC

  34. Slide 34: ALX2004 was Designed to Maximize the Therapeutic Window

    ALX2004 was Designed to Maximize the Therapeutic Window and Has the Potential to Establish Proof-of-Concept Early in Development Cycle EGFR Antibody Matuzumab-derived EGFR antibody selected to minimize off-tumor skin toxicity and to maximize therapeutic window Epitope distinct from that of FDA-appro

  35. Slide 35: Phase 1 Clinical Development Plan in EGFR-Expressing Tumors

    Phase 1 Clinical Development Plan in EGFR-Expressing Tumors Initial Safety Data Anticipated 2H 2026 Potential to Expand into Phase 2 Single-Arm Study to Support Dose Finding (Phase 1a) ALX2004 IV Q3W in Accelerated Approval NSCLC, HNSCC, CRC, and ESCC Dose Escalation Dose Expansion (Phase 1b) n = up

  36. Slide 36: Closing

    Jason Lettmann Closing Chief Executive Officer, ALX Oncology

  37. Slide 37: ALX is Rapidly Advancing Two Novel Cancer Treatments with Multiple Near-Term Catalysts

    ALX is Rapidly Advancing Two Novel Cancer Treatments with Multiple Near-Term Catalysts ALX is focused on driving toward multiple inflection points in 2026 and 2027 1 across both programs – evorpacept and ALX2004 Evorpacept biomarker strategy validated by data from both the Ph2 ASPEN-06 gastric cance

  38. Slide 38: NASDAQ – ALXO

    NASDAQ – ALXO © ALX Oncology Inc. All rights reserved.

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