Alto Neuroscience, Inc. (ANRO)

Price$35.55Cached quoteAs of 2026-09-05 22:04 UTC

AI: Overvalued

Price checkThe shares look expensive because investors already assign substantial value to unproven medicines.

Using 38.9 million common shares after July’s sale plus 7.7 million pre-funded warrants, which cost almost nothing more to become shares, gives an equity value near $1.49 billion. Against roughly $338 million of pro forma cash and $21 million of debt, investors are assigning about $1.17 billion to the drug pipeline before stock options. That is about 4.7 times net cash, despite no product revenue or approved medicine. The valuation requires meaningful trial success and future sales, leaving little evidence-based margin for disappointment.

Big pictureAlto has years of cash, but faster trial spending steadily reduces that cushion.

The first-half net loss increased to $53.9 million from $32.9 million, while operating cash use rose to $46.9 million from $30.3 million. Free cash flow—cash remaining after operations and equipment spending—was negative by about $47.4 million. Pro forma cash after July’s financing was roughly $338 million versus $21 million of debt. Simply annualizing the latest burn suggests about 3.6 years of gross cash, broadly supporting management’s 2030 runway estimate, although costly Phase 3 trials should increase spending. With no sales, results follow trial and funding cycles rather than ordinary economic cycles.

Business strengthIndependent evidence supports the lead drug, but Alto has not proven it in large trials.

ALTO-207 combines pramipexole with ondansetron, intended to reduce treatment-limiting nausea. Oxford’s independent PAX-D study reported a large 0.87-standard-deviation advantage over placebo, while another 82-patient study found a 0.62-standard-deviation benefit for loss of pleasure. These are encouraging signals. However, neither tested Alto’s exact fixed-dose product within its planned approval package, and Alto’s acquired Phase 2a study enrolled only 32 people. Its 178-person Phase 2b result is not expected until late 2027. ALTO-101’s April primary-endpoint miss also shows that platform breadth has not produced consistent clinical success.

What could change the storySuccessful 2027 depression trials could justify the premium; another miss would expose sharp downside.

Results for ALTO-300 in early 2027, ALTO-100 around midyear, and ALTO-207 later in 2027 are the clearest tests. Starting an ALTO-207 Phase 3 trial before seeing Phase 2b results may accelerate approval, but it also commits cash before decisive evidence. Capital allocation has already been aggressive: March’s financing issued 6.0 million shares or near-share warrants, and July added 3.8 million shares. The economic share count rose from about 36.5 million at year-end to 46.6 million after July, roughly 28%, before another 7.2 million outstanding options.

AI: News

Lead program expandsAlto broadened its lead depression program and extended funding, increasing both potential reward and spending.

On August 12, Alto confirmed that its 178-person ALTO-207 Phase 2b trial remained on track for late-2027 results and added a Phase 3 monotherapy study to the planned adjunctive Phase 3 trial. Management estimated that pro forma cash of about $338 million could fund operations through 2030. The broader program could support more patients if successful, but raises spending before decisive results. Shares closed 10.7% higher the next session; that timing is consistent with a favorable response but does not prove the update alone caused it.

Fresh capital raisedA new share sale funded faster development but spread future gains across more shares.

On July 13, Alto announced the sale of 3,776,436 new shares, producing $100 million of gross proceeds and approximately $94.6 million after costs. The money supports an additional ALTO-207 Phase 3 trial and general operations. This materially strengthens the balance sheet and reduces near-term financing risk, while diluting existing owners. Shares closed 5.9% higher on the announcement day, suggesting dilution was not immediately dominant in trading; timing alone cannot establish why investors bought the stock.

Independent drug evidenceAn independent study strengthened the scientific case behind Alto’s lead depression medicine.

Nature Medicine published an 82-patient analysis on June 12 showing that pramipexole, ALTO-207’s main active ingredient, significantly improved loss of pleasure versus placebo. The standardized treatment advantage was 0.62, with a probability value of 0.006. However, the single-center study tested pramipexole rather than Alto’s pramipexole-and-ondansetron combination, and several depression measures were not significantly different at week nine. The result strengthens the drug’s biological rationale but does not replace Alto’s required registration trials.

Schizophrenia study missedA failed study showed that Alto’s broader pipeline still carries serious clinical risk.

On April 1, ALTO-101 failed to achieve statistical significance on its primary measure in cognitive impairment associated with schizophrenia; its closest brain-wave signal had a probability value of 0.052, just outside the conventional cutoff. Alto said it would seek a partner rather than independently advance the program. Shares closed 7.4% lower the next session. The timing and direct relevance make the result a plausible driver, although a one-day move cannot isolate causation.

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Revenue

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Total cash / debt

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Financial statements

	2025	2024	2023	2022
Revenue	$0	$0	$0	$0
Research & development	$45.6M	$47.0M	$30.3M	$23.7M
Operating expenses	$66.4M	$68.6M	$37.8M	$27.5M
Operating income	−$66.4M	−$68.6M	−$37.8M	−$27.5M
EBITDA	−$65.7M	−$68.1M	−$37.4M	−$27.4M
Net income	−$63.2M	−$61.4M	−$36.3M	−$27.7M
Basic EPSper basic share	-$2.19	-$2.50	-$9.73	-$2.13
Diluted EPSper diluted share	-$2.19	-$2.50	-$9.73	-$2.13

Review official source filings ↗

Owners

Reported shareholders

Reference date Jun 30, 2026

10.57%of listed shares

Alpha Wave Global, LP3.71M shares · Jun 30, 2026

View holders

Top 20 reported holders of ANRO
Holder	% owned
Alpha Wave Global, LP	10.57%3.71M shares
Commodore Capital LP	7.76%2.72M shares
BlackRock, Inc.	6.04%2.12M shares
PERCEPTIVE ADVISORS LLC	4.59%1.61M shares
ADAGE CAPITAL PARTNERS GP, L.L.C.	4.56%1.6M shares
VANGUARD CAPITAL MANAGEMENT LLC	3.96%1.39M shares
Spruce Street Capital LP	3.86%1.35M shares
Vivo Capital, LLC	3.44%1.21M shares
FRANKLIN RESOURCES INC	2.89%1.01M shares
ARMISTICE CAPITAL, LLC	2.46%864K shares
Affinity Asset Advisors, LLC	2.42%850K shares
Etkin Amit	≈2.38%833.95K shares
Vestal Point Capital, LP	2.24%785K shares
STATE STREET CORP	1.95%685.95K shares
GEODE CAPITAL MANAGEMENT, LLC	1.93%678.2K shares
72 Investment Holdings, LLC	1.90%667.78K shares
NORTHERN TRUST CORP	1.80%632.7K shares
MILLENNIUM MANAGEMENT LLC	1.59%558.32K shares
Point72 Asset Management, L.P.	1.43%502.95K shares
Venrock Adviser, LLC	1.42%500K shares

Percentages use 35.09M shares of this listed class outstanding on Jun 30, 2026. ≈ compares the latest reported holding with a share total from a different date; it is not a confirmed current stake.

Gray completes the 100% scale. Reported positions may overlap; holders have different reporting dates.

Source: SEC Form 13F ↗Updated Sep 29, 2026 · Quarterly data

Insider buys & sells

Jul 1, 2024–Jun 30, 2026

Buys3$190.8K disclosed value

Sells (SEC code S)0$0.00 disclosed value

Transaction	Insider	Type	Shares	Price	Value	Owned after
Jul 10, 2024Form 4	Savitz AdamCHIEF MEDICAL OFFICER	BuyCommon Stock · indirect	2.9K	$13.22	$38.7K	39.9K
Jul 9, 2024Form 4	Savitz AdamCHIEF MEDICAL OFFICER	BuyCommon Stock · indirect	1.4K	$13.15	$18.3K	36.9K
Jul 9, 2024Form 4	Savitz AdamCHIEF MEDICAL OFFICER	BuyCommon Stock · indirect	10.7K	$12.53	$133.8K	35.5K

Review ownership filings at SEC.gov ↗

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Alto Neuroscience, Inc. (ANRO)

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