Exploring ALX Oncology Holdings Inc. (ALXO) Investor Profile: Who’s Buying and Why?

You're looking at ALX Oncology Holdings Inc. (ALXO) right now and asking the right question: with the stock trading near $1.28 per share as of November 2025, who is actually accumulating shares, and what are they seeing that the market is missing? The answer is a focused group of institutional heavyweights, including venBio Partners LLC and Vanguard Group Inc., who collectively own about 51.56% of the company's total shares outstanding. This isn't a retail-driven gamble; it's a calculated bet on a clinical-stage biotech.

The core of this investment thesis is the lead drug, evorpacept, and its new biomarker-driven strategy targeting the CD47 pathway (a protein that helps cancer cells hide from the immune system). Just look at the Q3 2025 financial results: the company reported a GAAP net loss of $22.1 million, but more importantly, their cash, cash equivalents, and investments of $66.5 million are expected to fund operations into Q1 2027. That runway gives them time to execute.

Honstly, the real catalyst is the latest clinical data showing that in HER2-positive gastric cancer patients with high CD47 expression, evorpacept achieved a remarkable 65.0% objective response rate (ORR). That's a massive signal, and it's why smart money is now piling into the stock ahead of the Phase 2 ASPEN-09-Breast Cancer trial, which is set to enroll in Q4 2025. Are you positioned to benefit from this highly targeted, biomarker-guided clinical strategy?

Who Invests in ALX Oncology Holdings Inc. (ALXO) and Why?

The investor base for ALX Oncology Holdings Inc. (ALXO) is a classic biotech profile: heavily weighted toward specialized institutional money, driven by the binary risk/reward of their lead oncology candidate, evorpacept. As of late 2025, institutional investors hold the vast majority of the company's shares, signaling a high-conviction, long-term growth play.

You need to know that your fellow institutional investors, including hedge funds and specialized mutual funds, own approximately 68.45% of the outstanding shares, based on October 2025 filings. That's a huge concentration, meaning a few key decisions by large funds can swing the stock. Retail investors, by comparison, hold a smaller, though still significant, slice at around 3.06%.

The Dominance of Institutional and Specialist Funds

When you look at the shareholder list, you see names that specialize in high-growth, clinical-stage biotechnology. These are not passive index funds; they are active managers making a bet on the science. For example, major holders include venBio Partners LLC, Redmile Group, LLC, and Tang Capital Management Llc. These funds are looking for a multi-bagger return, not a steady dividend yield.

Here's the quick math on institutional weight: they hold a total of over 28,976,927 shares, with the total value of major institutional holdings reported at approximately $39 million as of November 2025. This means the stock's direction is defintely dictated by their conviction in the clinical pipeline. Plus, the insider ownership is relatively low at about 2.5%, worth around US$1.1 million, but recent insider buying, like the CFO's August 2025 purchase of US$58k worth of stock, is a positive signal.

Investment Motivations: Betting on Evorpacept's Breakthrough

The core motivation for buying ALX Oncology Holdings Inc. is the potential of its lead asset, evorpacept, a CD47 blocking therapeutic. This is a classic growth-stock thesis: near-term losses for massive future market capture. They don't pay a dividend, so it's all about clinical data. The Q3 2025 earnings call provided the concrete evidence investors wanted.

The ASPEN-06 trial data was a critical catalyst. In HER2-positive gastric cancer patients with high CD47 expression, evorpacept showed an Objective Response Rate (ORR) of 65%, which is a significant jump from the 26% seen in the control arm. That's a huge difference. Furthermore, the median Progression-Free Survival (PFS) was over 18 months in the evorpacept arm, compared to seven months in the control. This data validates the company's biomarker-driven strategy, which is the whole game changer for a clinical-stage company. The cash runway into Q1 2027, backed by a $67 million cash balance, also gives investors comfort that the company has enough time to hit its next milestones.

• Buy the science: Evorpacept's ORR of 65% in CD47-High gastric cancer patients.
• Target the market: A potential $2-4 billion opportunity in the estimated 20,000 addressable CD47 high, HER2-positive breast cancer patients.
• Fund the runway: $67 million cash provides a clear path into Q1 2027.

Strategies: Long-Term Growth and Binary Outcomes

The typical strategy here is a long-term holding, or what we call a venture-capital-style investment in a publicly traded company. Institutional holders are not short-term traders; they are waiting for the next major clinical milestone or a potential partnership. The analyst community agrees, with a consensus of 'Moderate Buy' and an average 12-month price target of $3.50, representing a forecasted upside of 124.36% from current levels.

For a detailed look at the company's financial stability, you should read Breaking Down ALX Oncology Holdings Inc. (ALXO) Financial Health: Key Insights for Investors. The short-selling activity is relatively muted, with a short percent of 3.39% as of October 2025, which suggests the market is not aggressively betting against the company's long-term prospects. This is a pure growth-at-any-cost play, where the strategy is simple: buy on positive clinical data and hold until commercialization or acquisition. What this estimate hides, of course, is the risk of a failed trial, which would wipe out most of that value.

Institutional Ownership and Major Shareholders of ALX Oncology Holdings Inc. (ALXO)

You need to know who is really steering the ship at ALX Oncology Holdings Inc. (ALXO), and the answer is clear: institutional investors. They hold the vast majority of the company, but their recent activity shows a notable shift in sentiment. As of the latest filings near the end of the 2025 fiscal year, institutions collectively own approximately 29,500,148 shares, representing about 55.09% of the outstanding shares (excluding 13D/G filers).

This high concentration of ownership-with institutional ownership at roughly 68.45% of the float-means the stock's movement is heavily dictated by a relatively small group of large funds. For a clinical-stage biotech with a market capitalization around US$74.82 million and a recent net loss of -US$108.0 million in the third quarter of 2025, this is defintely the norm. Your investment thesis must align with the conviction of these major players, or you're betting against the smart money.

Top Institutional Investors: Who's Holding the Line?

The largest institutional investors in ALX Oncology Holdings Inc. are primarily specialist biotech funds and major index providers. These firms are not just passive holders; their initial investment was a calculated bet on the success of the lead candidate, evorpacept, a CD47 blocking therapeutic. The top holders are a mix of venture capital (VC) money still backing their initial investment and large asset managers providing liquidity and stability.

Here's a quick look at some of the largest institutional shareholders, based on recent 13F filings:

• venBio Partners LLC: A key biotech-focused investor.
• Redmile Group, LLC: Another prominent healthcare-focused investment firm.
• Tang Capital Management Llc: Often an activist or deep-value biotech investor.
• Vanguard Group Inc: Provides a stable base through its index funds.
• BlackRock, Inc.: A massive asset manager, often through passive funds.

To understand the full context of these holdings, especially the company's foundational strategy, you should review the ALX Oncology Holdings Inc. (ALXO): History, Ownership, Mission, How It Works & Makes Money analysis.

Recent Shifts: The Institutional Exodus in Q3 2025

The most important near-term trend is the recent institutional selling. This is a clear signal of risk re-evaluation. In the most recent reporting period, institutional shares (Long) saw a significant reduction of 6.63 million shares, which translates to a drop of 18.36% quarter-over-quarter. That's a massive reduction in exposure.

Here's the quick math on the selling pressure:

• Total Institutional Owners: Decreased by 35.06% in the last quarter.
• Shares Sold (Net): 6.63 million shares.
• Institutional Value (Long): Decreased to approximately $14.83 million (in thousands of USD).

This selling pressure coincided with the stock price hovering around $1.27 per share as of November 10, 2025. When a large number of funds-113 total owners down to 112 in one source-decide to cut their positions, it signals either a loss of confidence in the near-term clinical milestones or a portfolio-wide de-risking in the small-cap biotech space.

The Impact of Institutional Ownership on Stock and Strategy

For a company like ALX Oncology Holdings Inc., institutional investors play two distinct roles: they are the primary source of liquidity and they are the ultimate arbiters of the clinical development strategy. The high ownership percentage means that any major buying or selling decision by a top-tier fund can cause dramatic stock price volatility. One clean one-liner: Institutional conviction is the only thing that matters in clinical-stage biotech.

The recent Q3 2025 financial results and corporate update, which highlighted positive data from the ASPEN-06 trial showing evorpacept's benefit in HER2-positive gastric cancer patients with high CD47 expression, is what these investors are focused on. The institutional selling before or immediately after this data suggests a mixed reaction: some are taking profits or reducing risk after a major data release, while others may be waiting for the next catalysts, like the Phase 2 ASPEN-09-Breast Cancer trial data expected in Q3 2026.

The institutional influence on strategy is direct. Their investment hinges on the successful progression of evorpacept and the newer ALX2004 EGFR-targeted antibody-drug conjugate (ADC) program, which is currently enrolling patients in a Phase 1 trial. The company's stated cash runway-expected into Q1 2027-is a critical metric for these funds, as it dictates the timeline to the next financing event. Their collective pressure ensures management remains tightly focused on data-driven pipeline development, especially the use of CD47 expression as a predictive biomarker to guide future trials.

Next Step: Portfolio Managers should review the Q3 2025 earnings call transcript to gauge management's commentary on the cash runway and the specific enrollment progress of the ALX2004 trial.

Key Investors and Their Impact on ALX Oncology Holdings Inc. (ALXO)

You need to know who is driving the bus at ALX Oncology Holdings Inc. (ALXO) because their conviction, or lack thereof, directly impacts the stock's volatility and the company's strategic path. The direct takeaway is that institutional investors hold the majority of the shares, meaning their collective sentiment-especially around clinical trial data-is the primary price mover, not retail trading.

As of the 2025 fiscal year, institutional ownership sits at a substantial 51.56% of the total shares outstanding, representing over 28.9 million shares held by major funds. This isn't a retail-driven stock; it's a battleground for specialist funds. When institutions hold this much of a clinical-stage biotech, every data release becomes a high-stakes event. The power is concentrated.

The Institutional Heavyweights: Who's Buying the Biotech Story?

The investor base for ALX Oncology Holdings Inc. is dominated by sophisticated funds specializing in biotechnology and healthcare, a common pattern for companies advancing experimental therapies like their lead candidate, evorpacept (a CD47 blocking therapeutic). These aren't passive index funds; they're capital looking for a multi-bagger return on clinical success. The top institutional holders, who collectively own a massive block of shares, include:

• venBio Partners LLC: A major healthcare-focused venture capital firm.
• Redmile Group, LLC: Known for significant investments in the biotech sector.
• Tang Capital Management Llc: Often takes large, concentrated positions.
• Vanguard Group Inc.: A major index and mutual fund manager, providing a foundational, long-term stake.

These large stakes mean a single decision by one of these firms-say, a portfolio rebalancing or a shift in their outlook on the CD47 pathway-can create significant selling pressure. For a company focused on its Mission Statement, Vision, & Core Values of ALX Oncology Holdings Inc. (ALXO)., having such specialized investors is a double-edged sword: they understand the science, but they also demand results.

Investor Influence: The Power of Clinical Data

In the biotech space, investor influence isn't usually about activist letters demanding board seats; it's about validating the science. The sheer size of the institutional stake-over half the company-means their reaction to clinical data is the primary driver of stock movements. You saw this clearly when the company reported its Q3 2025 financial results on November 7, 2025.

The stock's movement is less about quarterly earnings per share (EPS), which was an estimated loss of $-0.37 for Q3 2025, and more about pipeline updates. For example, the promising data from the ASPEN-06 trial, which showed a 65.0% objective response rate (ORR) in CD47-high expressing gastric cancer patients treated with evorpacept, is what truly moves the needle. That data is the real currency here. The market is betting on the future value of that clinical success, not today's revenue. The company's total cash balance of $67 million as of Q3 2025, which provides a runway into Q1 2027, also gives these investors confidence that the trials won't be stopped due to lack of capital.

Recent Moves: Insiders Show Confidence in Q3 2025

While institutional movements are often delayed in public filings, we can see direct confidence from the executive team in the near-term. Insider buying is a strong signal, and ALX Oncology Holdings Inc. saw a notable cluster of purchases in Q3 2025, right before the clinical data updates. This is defintely a bullish sign from those who know the most.

Here's the quick math on recent insider buys:

The CEO's September 17, 2025, purchase of 92,233 shares at $1.08 is a concrete vote of confidence. When the people running the company put their own money on the line, especially following a period where the stock has been trading near its 52-week low of $0.405, it tells you they believe the stock is undervalued based on their internal view of the pipeline progress. Conversely, there were also insider sales, such as SVP, Finance and CAO Shelly Pinto selling shares in August 2025, which is often tied to compensation and liquidity needs, but the net insider activity has been positive in the recent three-month period.

Market Impact and Investor Sentiment

You're looking at ALX Oncology Holdings Inc. (ALXO) and trying to figure out if the smart money is still in the game, and honestly, the picture is complex but leans toward cautious optimism from the big players. Institutional investors, the mutual funds and hedge funds, hold a substantial stake, but their recent moves show a classic biotech risk-reward calculation.

As of November 2025, institutional ownership sits around 68.45% of the company, with 112 firms reporting holdings. This is a high level of institutional backing for a clinical-stage company. The largest shareholders include specialist life science funds like venBio Partners LLC, Redmile Group, LLC, and Tang Capital Management Llc. Their continued presence signals belief in the core science-specifically, the potential of the lead candidate, evorpacept, a CD47 blocker.

Still, the most compelling sentiment signal is from the insiders themselves. In a clear vote of confidence, CEO Jason Lettmann purchased 71,163 shares at an average price of $1.08 in September 2025, and CFO Harish Shantharam bought $58,000 worth of stock in August 2025. When the people running the company put their own capital on the line, defintely pay attention. Insiders now own about 21% of the company, aligning their interests directly with yours.

Recent Market Reactions to Ownership and News

The market's response to ALX Oncology Holdings Inc. (ALXO) has been volatile, which is typical for a clinical-stage biotech where news is the primary driver. The stock price, which traded at $1.38 per share on November 14, 2025, has been under pressure, declining 4.48% from a year prior. This near-term drop is largely a reaction to the financial realities and clinical trial hurdles.

For example, the company reported its Q3 2025 financial results on November 7, 2025, posting an Earnings Per Share (EPS) of ($0.41), which missed the analyst consensus estimate of ($0.37). A miss like that always hits the stock, but the market is also digesting positive clinical updates.

The positive news is that the company validated CD47 high expression as a predictive biomarker for evorpacept response in HER2-positive gastric cancer patients. This is a huge de-risking event because it helps focus the trials on the patients most likely to respond, a key step in clinical development. This kind of data can stabilize the institutional base, even if the overall stock price is down 10.39% in a recent 10-day period. The market is trying to price in the future potential of the pipeline against the current cash burn.

• Q3 2025 EPS Miss: ($0.41) vs. ($0.37) consensus.
• Insider Buying: CEO bought 71,163 shares at $1.08.
• Cash Runway: Total cash of $67 million funds operations into Q1 2027.

Analyst Perspectives and Key Investor Impact

The sell-side analysts who cover ALX Oncology Holdings Inc. (ALXO) have a generally favorable outlook, which is a strong counterpoint to the recent stock volatility. The consensus rating is a Moderate Buy from the seven firms tracking the stock. This rating is supported by five Buy ratings, one Hold, and one Sell.

The average 12-month price target is set at $3.50, which represents a significant potential upside from the current trading price. The recent initiation of coverage by Jefferies Financial Group on November 14, 2025, with a Buy rating and a $4.00 price target, further reinforces this bullish view on the long-term value. They are betting on the successful execution of the clinical programs, especially the lead candidate evorpacept.

The impact of key investors is twofold: their initial large positions provide the capital runway-the company's $67 million cash balance is expected to fund operations into Q1 2027-and their continued holding validates the strategy. Analysts see the value in the clinical pipeline, particularly the focus on the CD47 high expression biomarker, which is viewed as a strategic pivot to increase the probability of success in later-stage trials. The company's strategic vision is detailed in their Mission Statement, Vision, & Core Values of ALX Oncology Holdings Inc. (ALXO).