SECURITIES AND EXCHANGE COMMISSION
280 East Grand Avenue
South San Francisco, California 94080
To Be Held on June 30, 2026
Chief Legal Officer and Corporate Secretary
May 18, 2026
| | | Important Notice Regarding the Availability of Proxy Materials for the 2026 Annual Meeting of Stockholders to be Held on Tuesday, June 30, 2026 at 9:00 a.m. Pacific Time via live audio webcast. | | |
| | | We intend to mail the Notice of Internet Availability of Proxy Materials (the “Notice”) on or about May 18, 2026 to all stockholders of record entitled to vote at the Annual Meeting. The Notice, the accompanying Proxy Statement and our 2025 Annual Report on Form 10-K are available at www.virtualshareholdermeeting.com/ALMS2026. | | |
| | | Your vote is important. Whether or not you expect to attend the Annual Meeting, please vote as promptly as possible to ensure your representation at the Annual Meeting. You may vote online or over the telephone prior to the Annual Meeting, or, if you request a paper proxy card by mail, by completing and returning such proxy card as instructed in these materials. Even if you have voted by proxy, you may still vote at the Annual Meeting. | | |
280 East Grand Avenue
South San Francisco, California 94080
FOR THE 2026 ANNUAL MEETING OF STOCKHOLDERS
June 30, 2026
| Proposals | | | Page | | | Board Recommendation | |
| Election of Directors | | | | | “For” each director nominee | | |
| Ratification of the appointment of PricewaterhouseCoopers LLP as the Company’s independent auditor for fiscal 2026 | | | | | “For” | |
| | | | | | 1 | | | |
| | | | | | 8 | | | |
| | | | | | 9 | | | |
| | | | | | 10 | | | |
| | | | | | 13 | | | |
| | | | | | 13 | | | |
| | | | | | 13 | | | |
| | | | | | 14 | | | |
| | | | | | 14 | | | |
| | | | | | 14 | | | |
| | | | | | 15 | | | |
| | | | | | 17 | | | |
| | | | | | 17 | | | |
| | | | | | 18 | | | |
| | | | | | 18 | | | |
| | | | | | 19 | | | |
| | | | | | 19 | | | |
| | | | | | 19 | | | |
| | | | | | 21 | | | |
| | | | | | 22 | | | |
| | | | | | 24 | | | |
| | | | | | 28 | | | |
| | | | | | 28 | | | |
| | | | | | 28 | | | |
| | | | | | 33 | | | |
| | | | | | 33 | | | |
| | | | | | 35 | | | |
| | | | | | 35 | | | |
| | | | | | 35 | | | |
| | | | | | 35 | | | |
| | | | | | 35 | | | |
| | | | | | 35 | | | |
| | | | | | 36 | | | |
| | | | | | 38 | | | |
| | | | | | 38 | | | |
| | | | | | 40 | | | |
| | | | | | 40 | | | |
| | | | | | 42 | | | |
| | | | | | 42 | | | |
| | | | | | 42 | | |
FOR THE 2026 ANNUAL MEETING OF STOCKHOLDERS
| | | Internet proxy voting will be provided to allow you to vote your shares online, with procedures designed to ensure the authenticity and correctness of your proxy vote instructions. However, please be aware that you must bear any costs associated with your internet access, such as usage charges from internet access providers and telephone companies. | | |
| Name of Director Nominee | | | Class | | | Age | | | Position | | | Director Since | | ||||||
| James B. Tananbaum, M.D.(1)(3) | | | | | II | | | | | | 63 | | | | Director | | | January 2021 | |
| Lynn Tetrault, J.D.(1) | | | | | II | | | | | | 64 | | | | Director | | | May 2025 | |
| Zhengbin (Bing) Yao, Ph.D.(2)(3) | | | | | II | | | | | | 60 | | | | Director | | | June 2021 | |
| Name of Director Nominee | | | Class | | | Age | | | Position | | | Director Since | | |||
| Martin Babler | | | III | | | | | 61 | | | | President, Chief Executive Officer, and Chairman of the Board | | | September 2021 | |
| Alan B. Colowick, M.D., M.P.H.(1)(2)(4) | | | III | | | | | 64 | | | | Director | | | December 2021 | |
| Patrick Machado, J.D.(1)(3) | | | III | | | | | 62 | | | | Director | | | June 2024 | |
| Srinivas Akkaraju, M.D., Ph.D.(1)(4) | | | I | | | | | 58 | | | | Director | | | March 2024 | |
| Sapna Srivastava, Ph.D.(3) | | | I | | | | | 55 | | | | Director | | | May 2022 | |
| Name | | | Audit | | | Compensation | | | Nominating and Corporate Governance | | | Science and Technology(1) | | ||||||||||||
| Martin Babler | | | | | | | | | | | | | | | | | | | | | | | | | |
| Srinivas Akkaraju, M.D., Ph.D.(1) | | | | | X | | | | | | | | | | | | | | | | | | X | | |
| Alan B. Colowick, M.D., M.P.H. | | | | | X | | | | | | X* | | | | | | | | | | | | X | | |
| Patrick Machado, J.D. | | | | | X* | | | | | | | | | | | | X | | | | | | | | |
| Sapna Srivastava, Ph.D. | | | | | | | | | | | | | | | | | X* | | | | | | | | |
| James B. Tananbaum, M.D. | | | | | | | | | | | X | | | | | | | | | | | | X | | |
| Lynn Tetrault, J.D.(2) | | | | | | | | | | | X | | | | | | | | | | | | | | |
| Zhengbin (Bing) Yao, Ph.D.(3) | | | | | | | | | | | | | | | | | X | | | | | | X* | | |
| Total meetings in fiscal year 2025 | | | | | 4 | | | | | | 6 | | | | | | 3 | | | | | | 2 | | |
| | | | Fiscal Year Ended December 31, | | |||||||||
| | | | 2025 | | | 2024 | | ||||||
| Audit Fees(1) | | | | $ | 2,110 | | | | | $ | 1,691 | | |
| Audit-Related Fees(2) | | | | | 121 | | | | | | — | | |
| Tax Fees | | | | | — | | | | | | — | | |
| All Other Fees(3) | | | | | 2 | | | | | | 2 | | |
| Total Fees | | | | $ | 2,233 | | | | | $ | 1,693 | | |
Srinivas Akkaraju, M.D., Ph.D.
Alan B. Colowick, M.D., M.P.H.
| Name | | | Age | | | Position(s) | |
| Martin Babler | | | 61 | | | President, Chief Executive Officer, and Chairman of the Board | |
| Mark Bradley | | | 61 | | | Chief Development Officer | |
| Jörn Drappa, M.D., Ph.D. | | | 61 | | | Chief Medical Officer | |
| David M. Goldstein, Ph.D. | | | 60 | | | Chief Scientific Officer | |
| Roy Hardiman, J.D. | | | 66 | | | Chief Business and Strategy Officer | |
| John Schroer | | | 60 | | | Chief Financial Officer | |
| Sanam Pangali, J.D. | | | 42 | | | Chief Legal Officer and Corporate Secretary | |
| | | | Voting Common Stock | | |||||||||
| Name of Beneficial Owner | | | Number of Shares Beneficially Owned | | | % of Total Voting Power | | ||||||
| Greater than 5% Stockholders: | | | | | | | | | | | | | |
| Entities affiliated with Foresite Capital Management(1) | | | | | 15,693,820 | | | | | | 12.7% | | |
| AyurMaya Capital Management Fund, LP(2) | | | | | 15,139,707 | | | | | | 12.3% | | |
| Entities affiliated with Deep Track Capital, LP(3) | | | | | 7,362,035 | | | | | | 6.0% | | |
| Samsara BioCapital, L.P.(4) | | | | | 6,345,219 | | | | | | 5.1% | | |
| Directors and Named Executive Officers: | | | | | | | | | | | | | |
| Martin Babler(5) | | | | | 2,653,697 | | | | | | 2.1% | | |
| David Goldstein, Ph.D.(6) | | | | | 797,691 | | | | | | * | | |
| Jörn Drappa, M.D., Ph.D.(7) | | | | | 544,398 | | | | | | * | | |
| Srinivas Akkaraju, M.D., Ph.D.(4) | | | | | 6,345,219 | | | | | | 5.1% | | |
| Alan Colowick, M.D., M.P.H.(8) | | | | | 15,158,111 | | | | | | 12.3% | | |
| Patrick Machado, J.D.(9) | | | | | 162,781 | | | | | | * | | |
| Sapna Srivastava, Ph.D.(10) | | | | | 49,197 | | | | | | * | | |
| James B. Tananbaum, M.D.(1) | | | | | 15,693,820 | | | | | | 12.7% | | |
| | | | Voting Common Stock | | |||||||||
| Name of Beneficial Owner | | | Number of Shares Beneficially Owned | | | % of Total Voting Power | | ||||||
| Lynn Tetrault, J.D.(11) | | | | | 64,331 | | | | | | * | | |
| Zhengbin (Bing) Yao, Ph.D.(12) | | | | | 48,484 | | | | | | * | | |
| All directors and executive officers as a group (14 persons)(13) | | | | | 43,477,487 | | | | | | 33.7% | | |
| Name and Principal Position | | | Year | | | Salary ($) | | | Option Awards ($)(1) | | | Non-Equity Incentive Plan Compensation ($)(2) | | | Total ($) | | |||||||||||||||
| Martin Babler President, Chief Executive Officer, and Chairman of the Board | | | | | 2025 | | | | | | 680,830 | | | | | | 4,743,220 | | | | | | 524,239 | | | | | | 5,948,289 | | |
| | | | 2024 | | | | | | 605,900 | | | | | | 9,748,581 | | | | | | 306,738 | | | | | | 10,661,219 | | | ||
| David M. Goldstein, Ph.D. Chief Scientific Officer | | | | | 2025 | | | | | | 526,401 | | | | | | 1,187,353 | | | | | | 294,785 | | | | | | 2,008,539 | | |
| | | | 2024 | | | | | | 466,500 | | | | | | 2,593,094 | | | | | | 184,868 | | | | | | 3,244,462 | | | ||
| Jörn Drappa, M.D., Ph.D. Chief Medical Officer | | | | | 2025 | | | | | | 523,755 | | | | | | 1,161,607 | | | | | | 293,303 | | | | | | 1,978,665 | | |
| Name | | | 2025 Base Salary ($) | | |||
| Martin Babler | | | | | 680,830 | | |
| David M. Goldstein, Ph.D. | | | | | 526,401 | | |
| Jörn Drappa, M.D., Ph.D. | | | | | 523,755 | | |
| | | | | | | | | | Option Awards(1) | | | Stock Awards | | ||||||||||||||||||||||||||||||||||||
| Name | | | Grant Date | | | Number of Securities Underlying Unexercised Options Exercisable (#) | | | Number of Securities Underlying Unexercised Options Unexercisable (#) | | | Equity Incentive Plan Awards: Number of Securities Underlying Unexercised Unearned Options (#) | | | Option Exercise Price Per Share ($)(2) | | | Option Expiration Date | | | Number of Shares or Units of Stock that Have Not Vested (#) | | | Market Value of Shares or Units of Stock that Have Not Vested ($) | | ||||||||||||||||||||||||
| Martin Babler | | | | | 9/15/2021 | | | | | | 380,852(3) | | | | | | — | | | | | | — | | | | | | 3.83 | | | | | | 9/14/2031 | | | | | | — | | | | | | — | | |
| | | | 1/27/2022 | | | | | | 106,951(4)(5) | | | | | | 2,229 | | | | | | — | | | | | | 8.84 | | | | | | 1/26/2032 | | | | | | — | | | | | | — | | | ||
| | | | 1/27/2022 | | | | | | 534,759(6)(7) | | | | | | 186,609 | | | | | | — | | | | | | 8.84 | | | | | | 1/26/2032 | | | | | | — | | | | | | — | | | ||
| | | | 6/22/2023 | | | | | | 263,101(8)(9) | | | | | | 93,182 | | | | | | — | | | | | | 8.84 | | | | | | 6/22/2033 | | | | | | — | | | | | | — | | | ||
| | | | 10/9/2023 | | | | | | 107,028(10)(11) | | | | | | 49,055 | | | | | | — | | | | | | 8.84 | | | | | | 10/8/2033 | | | | | | — | | | | | | — | | | ||
| | | | 3/29/2024 | | | | | | 241,210(12)(13) | | | | | | 135,681 | | | | | | — | | | | | | 8.84 | | | | | | 3/28/2034 | | | | | | — | | | | | | — | | | ||
| | | | 5/6/2024 | | | | | | — | | | | | | — | | | | | | 478,288(14) | | | | | | 10.19 | | | | | | 5/5/2034 | | | | | | — | | | | | | — | | | ||
| | | | 6/6/2024 | | | | | | 245,989(15)(16) | | | | | | 153,742 | | | | | | — | | | | | | 13.32 | | | | | | 6/5/2034 | | | | | | — | | | | | | — | | | ||
| | | | 6/27/2024 | | | | | | 8,021(17) | | | | | | 13,369(17) | | | | | | — | | | | | | 16.00 | | | | | | 6/26/2034 | | | | | | — | | | | | | — | | | ||
| | | | 2/18/2025 | | | | | | — | | | | | | 523,000(18) | | | | | | — | | | | | | 5.06 | | | | | | 2/17/2035 | | | | | | — | | | | | | — | | | ||
| | | | 7/29/2025 | | | | | | — | | | | | | 662,000(19) | | | | | | — | | | | | | 3.95 | | | | | | 7/28/2035 | | | | | | — | | | | | | — | | | ||
| | | | 7/29/2025 | | | | | | — | | | | | | 150,000(19) | | | | | | — | | | | | | 3.95 | | | | | | 7/28/2035 | | | | | | — | | | | | | — | | | ||
| David M. Goldstein, Ph.D. | | | | | 1/27/2022 | | | | | | 171,122(6)(20) | | | | | | 59,715 | | | | | | — | | | | | | 8.84 | | | | | | 1/26/2032 | | | | | | — | | | | | | — | | |
| | | | 1/27/2022 | | | | | | 42,780(4)(21) | | | | | | 892 | | | | | | — | | | | | | 8.84 | | | | | | 1/26/2032 | | | | | | — | | | | | | — | | | ||
| | | | 6/22/2023 | | | | | | 11,978(8)(22) | | | | | | 5,303 | | | | | | — | | | | | | 8.84 | | | | | | 6/22/2033 | | | | | | — | | | | | | — | | | ||
| | | | 10/9/2023 | | | | | | 30,642(10)(23) | | | | | | 14,045 | | | | | | — | | | | | | 8.84 | | | | | | 10/8/2033 | | | | | | — | | | | | | — | | | ||
| | | | 6/6/2024 | | | | | | 53,475(15)(24) | | | | | | 33,422 | | | | | | — | | | | | | 13.32 | | | | | | 6/5/2034 | | | | | | — | | | | | | — | | | ||
| | | | 5/6/2024 | | | | | | — | | | | | | — | | | | | | 206,074(14) | | | | | | 10.19 | | | | | | 5/5/2034 | | | | | | — | | | | | | — | | | ||
| | | | 2/18/2025 | | | | | | — | | | | | | 180,000(18) | | | | | | — | | | | | | 5.06 | | | | | | 2/17/2035 | | | | | | — | | | | | | — | | | ||
| | | | 7/29/2025 | | | | | | — | | | | | | 107,950(19) | | | | | | — | | | | | | 3.95 | | | | | | 7/28/2035 | | | | | | — | | | | | | — | | | ||
| | | | 7/29/2025 | | | | | | — | | | | | | — | | | | | | — | | | | | | — | | | | | | — | | | | | | 27,000(25) | | | | | | 263,520(26) | | | ||
| Jörn Drappa, M.D., Ph.D. | | | | | 8/29/2022 | | | | | | 171,122(27)(28) | | | | | | 28,521 | | | | | | — | | | | | | 8.84 | | | | | | 8/29/2032 | | | | | | — | | | | | | — | | |
| | | | 8/29/2022 | | | | | | 85,561(29)(30) | | | | | | 38,218 | | | | | | — | | | | | | 8.84 | | | | | | 8/29/2032 | | | | | | — | | | | | | — | | | ||
| | | | 6/22/2023 | | | | | | 12,834(8)(31) | | | | | | 4,546 | | | | | | — | | | | | | 8.84 | | | | | | 6/22/2033 | | | | | | — | | | | | | — | | | ||
| | | | 10/9/2023 | | | | | | 18,652(10)(32) | | | | | | 8,549 | | | | | | — | | | | | | 8.84 | | | | | | 10/8/2033 | | | | | | — | | | | | | — | | | ||
| | | | 3/29/2024 | | | | | | 54,545(12)(33) | | | | | | 30,682 | | | | | | — | | | | | | 8.84 | | | | | | 3/28/2034 | | | | | | — | | | | | | — | | | ||
| | | | 5/6/2024 | | | | | | — | | | | | | — | | | | | | 70,802(14) | | | | | | 10.19 | | | | | | 5/5/2034 | | | | | | — | | | | | | — | | | ||
| | | | 6/6/2024 | | | | | | 64,171(15)(34) | | | | | | 40,107 | | | | | | — | | | | | | 13.32 | | | | | | 6/5/2034 | | | | | | — | | | | | | — | | | ||
| | | | 6/27/2024 | | | | | | 2,005(17) | | | | | | 3,342(17) | | | | | | — | | | | | | 16.00 | | | | | | 6/26/2034 | | | | | | — | | | | | | — | | | ||
| | | | 2/18/2025 | | | | | | — | | | | | | 180,000(18) | | | | | | — | | | | | | 5.06 | | | | | | 2/17/2035 | | | | | | — | | | | | | — | | | ||
| | | | 7/29/2025 | | | | | | — | | | | | | 101,850(19) | | | | | | — | | | | | | 3.95 | | | | | | 7/28/2035 | | | | | | — | | | | | | — | | | ||
| | | | 7/29/2025 | | | | | | — | | | | | | — | | | | | | — | | | | | | — | | | | | | — | | | | | | 25,450(25) | | | | | | 248,392(26) | | | ||
| Name | | | Fees Earned or Paid in Cash ($) | | | Option Awards(1) | | | Total | | |||||||||
| Srinivas Akkaraju, Ph.D. | | | | | 52,651 | | | | | | 161,307 | | | | | | 213,958 | | |
| Alan B. Colowick, M.D., M.P.H. | | | | | — | | | | | | — | | | | | | — | | |
| Patrick Machado, J.D. | | | | | 65,000 | | | | | | 161,307 | | | | | | 226,307 | | |
| Sapna Srivastava, Ph.D. | | | | | 64,423 | | | | | | 161,307 | | | | | | 225,730 | | |
| James B. Tananbaum, M.D. | | | | | — | | | | | | — | | | | | | — | | |
| Lynn Tetrault, J.D.(2) | | | | | 28,832 | | | | | | 161,307 | | | | | | 190,139 | | |
| Zhengbin (Bing) Yao, Ph.D. | | | | | 51,360 | | | | | | 161,307 | | | | | | 212,667 | | |
| Name | | | Number of Shares Underlying Outstanding Options as of December 31, 2025 | | |||
| Srinivas Akkaraju, Ph.D. | | | | | 49,800 | | |
| Alan B. Colowick, M.D., M.P.H. | | | | | — | | |
| Patrick Machado, J.D. | | | | | 218,184 | | |
| Sapna Srivastava, Ph.D. | | | | | 108,623 | | |
| Name | | | Number of Shares Underlying Outstanding Options as of December 31, 2025 | | |||
| James B. Tananbaum, M.D. | | | | | — | | |
| Lynn Tetrault, J.D.(1) | | | | | 114,131 | | |
| Zhengbin (Bing) Yao, Ph.D. | | | | | 85,094 | | |
| Participants(1) | | | Shares of Series C Redeemable Convertible Preferred Stock (#) | | | Shares of Series C-1 Redeemable Convertible Preferred Stock (#) | | | Aggregate Proceeds ($) | | |||||||||
| AyurMaya Capital Management Fund, LP(2) | | | | | 12,745,916 | | | | | | — | | | | | | 39,999,998.36 | | |
| Entities affiliated with Baker Brothers Life Sciences, L.P.(3) | | | | | 8,252,980 | | | | | | — | | | | | | 25,899,997.04 | | |
| Entities affiliated with Foresite Capital Management(4) | | | | | 19,118,870 | | | | | | — | | | | | | 59,999,985.00 | | |
| Samsara BioCapital, LP(5) | | | | | 7,966,196 | | | | | | — | | | | | | 24,999,994.26 | | |
| venBio Global Strategic Fund IV, L.P.(6) | | | | | 9,559,436 | | | | | | — | | | | | | 29,999,995.64 | | |
/s/ Sanam Pangali
Chief Legal Officer and Corporate Secretary
May 18, 2026