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Alto Neuroscience (NYSE: ANRO) shifts focus to ALTO-207 after ALTO-101 miss

Filing Impact
(High)
Filing Sentiment
(Neutral)
Form Type
8-K

Rhea-AI Filing Summary

Alto Neuroscience reported topline results from a Phase 2 proof-of-concept trial of ALTO-101 in cognitive impairment associated with schizophrenia. The drug did not achieve statistical significance on primary EEG or cognitive endpoints versus placebo, though directional EEG improvements were seen.

In a more cognitively impaired subgroup, ALTO-101 showed nominally significant benefits on the theta-ITC EEG measure, and several EEG signals improved between day 5 and day 10. ALTO-101 was well tolerated, with nausea and vomiting rates similar to placebo, suggesting its pharmacokinetic profile may address a key limitation of the PDE4 inhibitor class.

Alto has created a modified-release, once-daily oral formulation of ALTO-101 with improved pharmacokinetics and tolerability and plans to seek partners for this program rather than independently advancing ALTO-101 in CIAS. The company is prioritizing its lead program, ALTO-207 for treatment-resistant depression, with a Phase 2b trial in about 178 adults expected to start in the first half of 2026, supported by prior positive Phase 2a data. Management highlighted a cash position of $275 million and multiple advancing clinical programs.

Positive

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Negative

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Insights

ALTO-101 misses its primary goal, while ALTO-207 becomes the clear development focus.

ALTO-101’s Phase 2 proof-of-concept trial in cognitive impairment associated with schizophrenia did not meet primary EEG or cognitive endpoints versus placebo. This reduces the likelihood of Alto independently pursuing CIAS for this asset, although EEG subgroup and time-course signals suggest some underlying pharmacologic activity.

Safety is a relative positive: nausea and vomiting matched placebo despite ALTO-101 being a PDE4 inhibitor, indicating a favorable pharmacokinetic profile. Alto has also developed a modified-release, once-daily formulation with improved pharmacokinetics and tolerability and intends to pursue partnering, which could preserve some option value for the program.

The company is reallocating resources toward ALTO-207 in treatment-resistant depression, backed by prior Phase 2a success and external validation from the PAX-D study (Cohen’s d=0.87% for pramipexole vs. placebo at 12 weeks). A Phase 2b trial in approximately 178 adults is planned for the first half of 2026. Alto also cites a $275 million cash position to support its pipeline, which may mitigate concerns from the ALTO-101 setback.

Item 8.01 Other Events Other
Voluntary disclosure of events the company deems important to shareholders but not covered by other items.
Item 9.01 Financial Statements and Exhibits Exhibits
Financial statements, pro forma financial information, and exhibit attachments filed with this report.
Theta-ITC near-significant effect n=83, d=0.34, p=0.052 Overall ALTO-101 Phase 2 proof-of-concept trial EEG outcome
Theta-ITC subgroup effect n=59, d=0.44, p=0.03 More cognitively impaired subgroup in ALTO-101 trial
Cash position $275 million Management description of Alto’s cash resources
Planned ALTO-207 Phase 2b size ≈178 adults Treatment-resistant depression Phase 2b trial design
PAX-D effect size Cohen’s d=0.87 Pramipexole vs. placebo at 12 weeks in PAX-D study
ALTO-207 Phase 2b timing 1H 2026 Target initiation window for randomized Phase 2b trial
Phase 2 proof-of-concept clinical
"topline data from its Phase 2 proof-of-concept (POC) clinical trial evaluating ALTO-101"
A phase 2 proof-of-concept is a mid-stage clinical study that tests whether a drug or therapy has the intended effect in patients and continues to assess safety. Think of it as a small-scale real-world trial that shows whether a prototype idea actually works for its target problem. For investors, positive results reduce scientific uncertainty and can materially raise a program’s value, while negative outcomes increase risk and can sharply lower expectations.
theta-ITC clinical
"a near-significant effect on theta-ITC (n=83, d=0.34, p=0.052)"
PDE4 inhibitor clinical
"hallmark side effects associated with the PDE4 inhibitor class — in line with placebo rates"
A PDE4 inhibitor is a drug that blocks an enzyme (PDE4) involved in turning off certain cell signals linked to inflammation and brain activity; blocking it lets those signals persist and can reduce inflammation or alter nerve-cell behavior. Investors care because this drug class underlies treatments for conditions like chronic inflammatory and neurological disorders, so clinical trial results, regulatory decisions, or patent news can strongly affect a company’s drug pipeline value and stock outlook.
treatment-resistant depression clinical
"ALTO-207, our most advanced program in development for treatment -resistant depression"
A form of major depression that does not improve after a person has tried standard treatments such as common antidepressant medications and therapy; think of it as a stubborn problem that doesn’t respond to the usual fixes. It matters to investors because it represents a large unmet medical need and a higher-risk, higher-reward area for drug developers, with potential for premium pricing, regulatory scrutiny, and durable demand if an effective new therapy is approved.
fixed-dose combination clinical
"ALTO-207 is a fixed-dose combination of pramipexole and ondansetron"
A fixed-dose combination is a single medication that contains two or more active drugs combined in set proportions, like a combo meal that packages complementary items into one order. For investors it matters because such products can improve patient convenience and adherence, streamline manufacturing and marketing, and create distinct regulatory and patent opportunities or risks that affect a drug’s market size, pricing power, and long-term revenue potential.
Precision Psychiatry Platform clinical
"Alto’s Precision Psychiatry Platform™ measures brain biomarkers by analyzing EEG activity"
A precision psychiatry platform is a technology system that gathers medical, biological, and behavioral data to help match individuals with the most likely effective mental-health treatments, much like a GPS recommends the best route based on current traffic. It matters to investors because platforms that reduce trial-and-error care can improve patient outcomes, lower costs, speed product adoption, and create scalable services or software that can generate recurring revenue and competitive advantage.
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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

 

FORM 8-K

 

 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

 

Date of Report (Date of earliest event reported): April 1, 2026

 

 

 

ALTO NEUROSCIENCE, INC.

(Exact Name of Registrant as Specified in its Charter)

 

 

 

Delaware    001-41944   83-4210124
(State or Other Jurisdiction
of Incorporation)
  (Commission
File Number)
  (IRS Employer
Identification No.)

 

650 Castro Street, Suite 450, Mountain View, CA 94041
(Address of principal executive offices) (Zip Code)

 

Registrant’s telephone number, including area code: (650) 200-0412

 

N/A

(Former name or former address, if changed since last report)

 

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
   
¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
   
¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
   
¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class   Trading
Symbol(s)
  Name of each exchange
on which registered
Common Stock, $0.0001 par value per share   ANRO   New York Stock Exchange

 

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

 

Emerging growth company x

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨

 

 

 

 

 

Item 8.01 Other Events.

 

On April 1, 2026, Alto Neuroscience, Inc. issued a press release entitled “Alto Neuroscience Reports Topline Data from Phase 2 Proof-of-Concept Study of ALTO-101 and Highlights Pipeline Advancements.” The full text of the press release is attached as Exhibit 99.1 to this Current Report on Form 8-K and is incorporated herein by reference.

 

Item 9.01 Financial Statements and Exhibits.

 

(d) Exhibits.

 

Exhibit
No.
  Description
   
99.1   Press Release of Alto Neuroscience, Inc.
   
104   Cover Page Interactive Data File (embedded within the Inline XBRL document).

 

 

 

 

SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

  ALTO NEUROSCIENCE, INC.
     
Dated: April 1, 2026 By: /s/ Amit Etkin
    Amit Etkin, M.D., Ph.D.
    President and Chief Executive Officer

 

 

 

 

Exhibit 99.1

 

Alto Neuroscience Reports Topline Data from Phase 2 Proof-of-Concept Study of ALTO-101 and Highlights Pipeline Advancements

 

— In the proof-of-concept study, ALTO-101 did not achieve statistical significance on primary endpoint; signals observed across EEG measures including near-significant improvement in theta-ITC (p=0.052) —

 

— Alto has developed a modified-release, once-daily oral formulation of ALTO-101; the Company plans to explore partnering opportunities for this formulation —

 

— Development of ALTO-207 remains the top priority for the Company; Phase 2b on track to initiate in 1H 2026 —

 

MOUNTAIN VIEW, Calif., April 1, 2026 — Alto Neuroscience, Inc. (NYSE: ANRO), a clinical-stage biopharmaceutical company focused on precision medicines for neuropsychiatric disorders, today announced topline data from its Phase 2 proof-of-concept (POC) clinical trial evaluating ALTO-101 for the treatment of cognitive impairment associated with schizophrenia (CIAS), and provided an update on the Company's pipeline and prioritization.

 

ALTO-101 did not achieve statistical significance on primary electroencephalography (EEG) or cognitive endpoints versus placebo; however, the study demonstrated directional improvements across certain EEG measures, including a near-significant effect on theta-ITC (n=83, d=0.34, p=0.052) – a measure correlated with cognitive performance across datasets. In a pre-specified analysis in a more cognitively impaired subgroup (n=59), ALTO-101 exhibited nominally significant effects on theta-ITC compared to placebo (d=0.44, p=0.03). Further, certain EEG measures, including theta-ITC, showed improvements from day 5 to day 10 in the trial, suggesting a longer treatment period may elucidate greater effects. ALTO-101 demonstrated a favorable tolerability profile, with rates of nausea and vomiting — hallmark side effects associated with the PDE4 inhibitor class — in line with placebo rates. This finding suggests the pharmacokinetic profile of ALTO-101 may overcome a key tolerability barrier that has historically limited PDE4 inhibitor adoption. High rates of application site skin reactions were observed across both active and placebo arms.

 

Separately, the Company has developed a modified-release oral formulation of ALTO-101 that has demonstrated an improved pharmacokinetic and tolerability profile relative to the immediate-release formulation. Alto believes this formulation may offer potential benefits across multiple therapeutic areas and intends to explore partnering opportunities. The formulation is covered by a pending patent application.

 

Based on these results, the Company does not plan to independently advance ALTO-101 in CIAS and will instead prioritize resources toward its lead program, ALTO-207, while exploring strategic partnering opportunities for ALTO-101. The Company expects to present more data from this study at a future medical conference.

 

"While we are disappointed that the ALTO-101 data did not deliver the signal we were seeking, it is an exploratory program, and we remain heavily focused on ALTO-207, our most advanced program in development for treatment -resistant depression – which is supported by strong prior clinical data and external validation," said Amit Etkin, M.D., Ph.D., founder and chief executive officer of Alto Neuroscience. "We appreciate the commitment of the patients and clinical teams who participated in the ALTO-101 trial. We are excited about our oral, modified-release formulation of ALTO-101 to potentially provide benefit to patients, and we intend to seek partnering opportunities to drive future value for this program.”

 

 

 

 

“Alto enters this moment from a position of real strength: we have multiple clinical programs advancing, a $275 million cash position, and ALTO-207 — which we believe is one of the most compelling and independently validated mechanisms in psychiatry — on track to imminently enter a Phase 2b trial. Our focus remains squarely on executing for patients and shareholders across our pipeline."

 

ALTO-207 in Treatment-Resistant Depression

 

Alto's most advanced and differentiated program, ALTO-207, remains on track to initiate a Phase 2b clinical trial in the first half of 2026. ALTO-207 is a fixed-dose combination of pramipexole (a dopamine D3/D2 agonist) and ondansetron (a 5-HT3 antagonist), designed to enable rapid titration to higher pramipexole doses by mitigating dose-limiting nausea and vomiting. The planned Phase 2b trial is a randomized, double-blind, placebo-controlled study evaluating ALTO-207 as an adjunctive treatment in approximately 178 adults with treatment-resistant depression who have experienced two to five prior treatment failures.

 

The core mechanism of ALTO-207 is supported by the PAX-D study, published in The Lancet Psychiatry and conducted by the University of Oxford, which demonstrated a Cohen's d=0.87 effect size for pramipexole versus placebo at 12 weeks — substantially larger than the effect sizes observed for current approved treatment resistant depression (TRD) treatments. The Phase 2a trial of ALTO-207 met primary and secondary endpoints. Following a successful FDA meeting in 2025, Alto is positioned to advance ALTO-207 through Phase 3 and a potential NDA submission.

 

About Alto Neuroscience

 

Alto Neuroscience is a clinical-stage biopharmaceutical company with a mission to redefine psychiatry by leveraging neurobiology to develop personalized and highly effective treatment options. Alto’s Precision Psychiatry Platform™ measures brain biomarkers by analyzing EEG activity, neurocognitive assessments, wearable data, and other factors to better identify which patients are more likely to respond to Alto product candidates. Alto’s clinical-stage pipeline includes novel drug candidates in bipolar depression, major depressive disorder, treatment resistant depression, schizophrenia, and other mental health conditions. For more information, visit www.altoneuroscience.com or follow Alto on X.

 

Forward-Looking Statements

 

This press release may contain forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These statements may be identified by words such as “aims,” “anticipates,” “believes,” “could,” “estimates,” “expects,” “forecasts,” “goal,” “intends,” “look forward,” “may,” “plans,” “possible,” “potential,” “seeks,” “will,” and variations of these words or similar expressions that are intended to identify forward-looking statements, although not all forward-looking statements contain these words. Forward-looking statements in this press release include, but are not limited to, statements regarding Alto’s expectations about the potential benefits, activity, effectiveness, tolerability and safety of its product candidates and Precision Psychiatry Platform (“Platform”); Alto’s expectations with regard to the general design and results of its research and development programs and clinical trials; Alto’s clinical development plans for its product candidates, including the timing or likelihood of approvals for its product candidates; Alto’s business strategy, financial position and the sufficiency of its financial resources to fund its operations through expected milestones. Actual results or events could differ materially from the plans, intentions and expectations disclosed in these forward-looking statements as a result of various factors, including uncertainties inherent in the initiation, progress and completion of clinical trials and development of Alto’s product candidates, and other important factors, any of which could cause Alto’s actual results to differ from those contained in the forward-looking statements, which are described in greater detail in the section titled “Risk Factors” in Alto’s Annual Report on Form 10-K for the fiscal year ended December 31, 2025 filed with the Securities and Exchange Commission (“SEC”) as well as in other filings Alto may make with the SEC in the future. Any forward-looking statements contained in this press release speak only as of the date hereof, and Alto expressly disclaims any obligation to update any forward-looking statements contained herein, whether because of any new information, future events, changed circumstances or otherwise, except as required by law.

 

 

 

 

Availability of Information on Alto’s Website

 

Alto routinely uses its investor relations website to post presentations to investors and other important information, including information that may be material. Accordingly, Alto encourages investors and others interested in Alto to review the information it makes public on its investor relations website.

 

Investor and Media Contact:
Nick Smith
investors@altoneuroscience.com

 

media@altoneuroscience.com

 

 

 

FAQ

What did Alto Neuroscience (ANRO) report about the ALTO-101 Phase 2 study?

Alto Neuroscience reported topline data from a Phase 2 proof-of-concept trial of ALTO-101 in cognitive impairment associated with schizophrenia. The study did not meet primary EEG or cognitive endpoints versus placebo, though some directional EEG improvements and subgroup signals were observed.

Did ALTO-101 show any statistically significant effects in Alto Neuroscience’s trial?

ALTO-101 did not reach statistical significance on the primary endpoints, but in a pre-specified more impaired subgroup it showed nominally significant improvement in theta-ITC (d=0.44, p=0.03). Several EEG measures, including theta-ITC, also improved between day 5 and day 10 of treatment.

How was ALTO-101 tolerated in the Phase 2 proof-of-concept study reported by Alto Neuroscience?

ALTO-101 demonstrated a favorable tolerability profile in the trial, with nausea and vomiting rates similar to placebo despite being a PDE4 inhibitor. This suggests its pharmacokinetic profile may overcome a major tolerability barrier that has historically limited broader use of PDE4 inhibitors in practice.

What are Alto Neuroscience’s plans for the ALTO-101 program after this study?

Based on the Phase 2 results, Alto does not plan to independently advance ALTO-101 in cognitive impairment associated with schizophrenia. Instead, it developed a modified-release, once-daily oral formulation with improved pharmacokinetics and tolerability and intends to explore strategic partnering opportunities for this formulation.

Why is ALTO-207 now Alto Neuroscience’s top priority program?

ALTO-207, a fixed-dose combination for treatment-resistant depression, is Alto’s lead program, supported by prior positive Phase 2a results and strong external validation from the PAX-D study. A randomized Phase 2b trial in about 178 adults is planned to start in the first half of 2026.

What financial and pipeline position did Alto Neuroscience highlight in this update?

Alto emphasized entering this period with multiple advancing clinical programs and a cash position of about $275 million. The company plans to prioritize ALTO-207’s Phase 2b development while seeking partners for ALTO-101, aiming to maintain both financial flexibility and pipeline breadth.

Filing Exhibits & Attachments

4 documents