The downgrade by Stifel, coupled with the EPS miss for Q4 2023, signals a negative sentiment towards ALX Oncology's short-term financial health and its developmental prospects. The skepticism around the market size for its leading treatment, evorpacept, and the uncertainties in development paths for other indications, particularly head and neck squamous cell carcinomas, contribute to a bearish outlook. The immediate impact was a 3.51% drop in share price, indicating market reaction to these developments.