{"ok":true,"data":{"subject":{"kind":"trial","nctId":"NCT03214562","title":"Venetoclax With Combination Chemotherapy in Treating Patients With Newly Diagnosed or Relapsed or Refractory Acute Myeloid Leukemia","sponsor":"M.D. Anderson Cancer Center","phases":["PHASE1","PHASE2"],"status":"RECRUITING","indication":{"slug":"aml","name":"Acute myeloid leukemia"},"disease":"acute myeloid leukemia"},"rows":[{"n":1,"question":"Is the biology right?","flags":[{"id":"somatic_driver","label":"Somatic driver evidence","value":"yes","detail":"BCL2 in acute myeloid leukemia","rule":"Open Targets has somatic-mutation evidence for the target in this cancer","source":{"label":"Open Targets: BCL2 in acute myeloid leukemia","url":"https://platform.opentargets.org/evidence/ENSG00000171791/MONDO_0018874","date":"2026-11-11T20:52:55.512Z"},"context":[{"figure":"2.3× relative success for targets with somatic (IntOGen) support in oncology","dataset":"Minikel et al., Nature 2024","years":"drug programs to 2023","caveat":"A ratio between groups, not a probability for this program; mostly phase 2 to 3."}]},{"id":"human_genetic","label":"Human genetic evidence","value":"yes","detail":"BCL2: somatic","rule":"Any germline or somatic human genetic evidence for the target in this cancer, counted apart from animal-model and literature evidence","source":{"label":"Open Targets: BCL2 in acute myeloid leukemia","url":"https://platform.opentargets.org/evidence/ENSG00000171791/MONDO_0018874","date":"2026-11-11T20:52:55.512Z"},"context":[{"figure":"2.6× relative probability of success, phase 1 to launch, with human genetic support","dataset":"Minikel et al., Nature 2024","years":"drug programs to 2023","caveat":"All therapy areas, mostly germline evidence; not a probability for this program."}]},{"id":"pediatric_target","label":"Pediatric target","value":"no","detail":"Not on the FDA list","rule":"Target is on FDA's Pediatric Molecular Target List (relevant targets); membership alone neither requires nor waives a study","source":{"label":"FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01))","url":"https://www.fda.gov/media/191157/download?attachment","date":"2026-11-11T07:05:03Z"},"context":[]},{"id":"haematologic","label":"Haematologic cancer","value":"yes","detail":"Haematologic","rule":"From the indication, or the registry conditions when no indication matches","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"},"context":[{"figure":"Likelihood of approval from phase 1: 7.5% haematologic vs 4.6% solid","dataset":"BIO / Informa / QLS 2021","years":"2011–2020","caveat":"Population-level, not a prediction."}]}],"facts":[{"label":"Background therapy","text":"Cytarabine, Filgrastim, Fludarabine, Idarubicin, Pegfilgrastim: standard agents, not counted in these flags."},{"label":"BCL2 (via Venetoclax)","text":"Evidence types in acute myeloid leukemia: clinical, affected_pathway, literature, somatic_mutation; literature listed separately from human genetics. Datasources: clinical_precedence, cancer_gene_census, crispr, europepmc.","source":{"label":"Open Targets: BCL2 in acute myeloid leukemia","url":"https://platform.opentargets.org/evidence/ENSG00000171791/MONDO_0018874","date":"2026-11-11T20:52:55.512Z"}}],"pending":[{"what":"Normal-tissue expression in vital organs","source":"Human Protein Atlas (ticket 36)"},{"what":"Pan-essential in cell lines","source":"DepMap (ticket 36)"},{"what":"Approved drug on this target","source":"Drugs@FDA (ticket 30)"}]},{"n":2,"question":"Can the result be trusted?","flags":[{"id":"randomised","label":"Randomised","value":"no","detail":"Single group","rule":"Registry allocation field","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"},"context":[]},{"id":"small_denominator","label":"Small denominator","value":"no","detail":"116 planned; each patient moves a rate by 100 ÷ 116 = 0.9 points","rule":"Enrolment under 30; the arithmetic is shown, not a benchmark","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"},"context":[]},{"id":"primary_os","label":"Primary endpoint is overall survival","value":"yes","detail":"Overall response rate (ORR); CR/CRi rate; Hematologic response (and 7 more)","rule":"A registered primary outcome measure names overall survival","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"},"context":[]},{"id":"results_overdue","label":"Results overdue","value":"no","detail":"Primary completion expected 2027-09-30; not yet due","rule":"Primary completion (actual) more than 12 months ago and no results posted to the registry","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"},"context":[]}],"facts":[],"pending":[{"what":"Treated and evaluable counts, assessor, confirmed response, follow-up and data cutoff","source":"Readout extraction (ticket 32)"},{"what":"Primary endpoint changed between registry versions","source":"Registry versions in the store (ticket 32)"}]},{"n":3,"question":"What must it beat?","flags":[],"facts":[],"pending":[{"what":"Control-arm result and approved therapies for the same segment, with label links","source":"Drugs@FDA, FDA labels and readouts (tickets 30, 32)"}]},{"n":4,"question":"Too crowded, or too late?","flags":[],"facts":[{"label":"Stopped on this target","text":"147 terminated, withdrawn or suspended trials of drugs against BCL2; 9 give no reason. Reasons are quoted as the registry gives them on the target page.","source":{"label":"BCL2: what already stopped","url":"/target/ENSG00000171791#stopped","date":"2026-11-11T20:52:55.516Z"}}],"pending":[{"what":"Programs on the target by phase and months behind the leader","source":"Programs and Drugs@FDA (ticket 33)"}]},{"n":5,"question":"Can it be approved, and stay approved?","flags":[{"id":"single_country","label":"Single-country","value":"yes","detail":"The only site is in United States","rule":"All listed sites are in one country; the share of US sites is shown","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562?tab=locations","date":"2026-11-11T20:52:55.512Z"},"context":[]},{"id":"eu_pip","label":"EU paediatric investigation plan","value":"yes","detail":"EMA/PE/0000182075 (venetoclax, Treatment of malignant neoplasms of the haematopoietic and lymphoid tissue;Treatment of solid malignant tumours): PM: decision on the application for modification of an agreed PIP, 3 Jan 2025","rule":"An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name","source":{"label":"EMA EMA/PE/0000182075","url":"https://www.ema.europa.eu/en/medicines/human/paediatric-investigation-plans/ema-pe-0000182075","date":"2026-11-11T09:12:26Z"},"context":[]},{"id":"eu_orphan","label":"EU orphan designation","value":"yes","detail":"EU/3/17/1954 withdrawn 12 Dec 2017: Treatment of mantle cell lymphoma; EU/3/16/1766 withdrawn 14 Oct 2016: Treatment of diffuse large B-cell lymphoma; EU/3/16/1617 withdrawn 17 Feb 2016: Treatment of acute myeloid leukaemia; EU/3/12/1080 withdrawn 6 Dec 2012: Treatment of chronic lymphocytic leukaemia; +1 more","rule":"An EU orphan designation lists the drug as its active substance (exact name) or belongs to a medicine that does; withdrawn and expired designations are listed with their status","source":{"label":"EMA data download (dated snapshot)","url":"https://www.ema.europa.eu/en/documents/report/medicines-output-orphan_designations-json-report_en.json","date":"2026-11-11T09:12:26Z"},"context":[]},{"id":"eu_authorised","label":"Authorised in the EU","value":"yes","detail":"Venclyxto: authorised since 4 Dec 2016","rule":"An EMA medicine record lists the drug as its active substance or INN, exact name; national-only authorisations are not in this file","source":{"label":"EMA EPAR Venclyxto","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/venclyxto","date":"2026-11-11T09:12:26Z"},"context":[]},{"id":"fda_orphan","label":"FDA orphan designation","value":"not published","detail":"FDA's orphan designation database turns away automated requests, so this app does not read it; search it by hand at the link","rule":"Would be: an FDA orphan designation names the drug","source":{"label":"FDA orphan designations search","url":"https://www.accessdata.fda.gov/scripts/opdlisting/oopd/","date":""},"context":[]},{"id":"fda_ped_approval","label":"FDA pediatric oncology approval","value":"no","detail":"FDA's table lists no pediatric approval of Venetoclax","rule":"FDA's Pediatric Oncology Drug Approvals table names the drug","source":{"label":"FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03)","url":"https://www.fda.gov/about-fda/oncology-center-excellence/pediatric-oncology-drug-approvals","date":"2026-11-11T20:52:55.529Z"},"context":[]},{"id":"studies_under_18","label":"Registered studies open to children","value":"yes","detail":"111 interventional studies of Venetoclax include patients under 18; 85 are recruiting, not yet recruiting or active","rule":"The registry's age group includes Child (birth to 17 years), which also counts studies that set no minimum age","source":{"label":"ClinicalTrials.gov search","url":"https://clinicaltrials.gov/search?intr=%22Venetoclax%22&aggFilters=ages%3Achild%2CstudyType%3Aint","date":"2026-11-11T20:52:55.529Z"},"context":[]}],"facts":[{"label":"Caveat","text":"Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where the sites are is a fact about the record, not a judgement of its quality."},{"label":"Rare pediatric disease voucher","text":"FDA, content current as of 29 Apr 2026: “As of February 3, 2026, enactment of the Consolidated Appropriations Act, 2026, the rare pediatric disease PRV program will sunset after September 30, 2029. FDA may not award any PRVs under this program after September 30, 2029.” Voucher sale prices are not shown here; they appear only as company-reported news.","source":{"label":"FDA: Rare Pediatric Disease Designation and Priority Review Voucher Programs","url":"https://www.fda.gov/industry/medical-products-rare-diseases-and-conditions/rare-pediatric-disease-designation-and-priority-review-voucher-programs","date":"2026-11-11"}}],"pending":[{"what":"Precedent approvals for target, modality and endpoint; accelerated-approval status","source":"Drugs@FDA and FDA accelerated-approval tables (ticket 30)"}]},{"n":6,"question":"Can the sponsor finish?","flags":[],"facts":[{"label":"Sponsor","text":"M.D. Anderson Cancer Center (academic or other)","source":{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"}},{"label":"principal investigator","text":"Courtney DiNardo, M.D. Anderson Cancer Center","source":{"label":"Person page","url":"/person/Courtney%20DiNardo?ind=aml","date":"2026-11-11T20:52:55.512Z"}}],"pending":[{"what":"Filed cash, quarterly spend and the runway arithmetic","source":"SEC XBRL company facts (ticket 37)"},{"what":"Sponsor's completed vs stopped oncology trials and results-reporting record","source":"Registry, by company (ticket 37)"}]}],"limits":"Public records cannot show: sales forecasts; a probability of success for this asset; full deal terms and net prices; FDA designations and action dates before approval (shown only as company-reported); clinical holds unless the company disclosed them; manufacturing; patents on unapproved drugs; whether preclinical findings have been replicated.","sources":[{"label":"ClinicalTrials.gov NCT03214562","url":"https://clinicaltrials.gov/study/NCT03214562","date":"2026-11-11T20:52:55.512Z"},{"label":"Open Targets Platform","url":"https://platform.opentargets.org","date":"2026-11-11T20:52:55.512Z"},{"label":"FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01))","url":"https://www.fda.gov/media/191157/download?attachment","date":"2026-11-11T07:05:03Z"}]},"source":"ClinicalTrials.gov + Open Targets","fetchedAt":"2026-11-11T20:52:55.509Z"}