{"ok":true,"data":{"subject":{"kind":"trial","nctId":"NCT04066491","title":"Gemcitabine Plus Cisplatin With or Without Bintrafusp Alfa (M7824) in Participants With 1L BTC","sponsor":"EMD Serono Research & Development Institute, Inc.","phases":["PHASE2","PHASE3"],"status":"TERMINATED","indication":null,"disease":"biliary tract cancer"},"rows":[{"n":1,"question":"Is the biology right?","flags":[{"id":"somatic_driver","label":"Somatic driver evidence","value":"no","detail":"None of CD274, TGFB1, TGFB2 has somatic-mutation evidence in biliary tract cancer","rule":"Open Targets has somatic-mutation evidence for the target in this cancer","source":{"label":"Open Targets: CD274 in biliary tract cancer","url":"https://platform.opentargets.org/evidence/ENSG00000120217/MONDO_0003060","date":"2026-11-12T05:31:58.358Z"},"context":[]},{"id":"human_genetic","label":"Human genetic evidence","value":"no","detail":"No germline or somatic evidence for CD274, TGFB1, TGFB2 in biliary tract cancer","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: CD274 in biliary tract cancer","url":"https://platform.opentargets.org/evidence/ENSG00000120217/MONDO_0003060","date":"2026-11-12T05:31:58.358Z"},"context":[]},{"id":"pediatric_target","label":"Pediatric target","value":"yes","detail":"CD274 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":"no","detail":"Solid tumour","rule":"From the indication, or the registry conditions when no indication matches","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491","date":"2026-11-12T05:31:58.358Z"},"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":"CD274 (via M7824)","text":"Evidence types in biliary tract cancer: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc.","source":{"label":"Open Targets: CD274 in biliary tract cancer","url":"https://platform.opentargets.org/evidence/ENSG00000120217/MONDO_0003060","date":"2026-11-12T05:31:58.358Z"}},{"label":"TGFB1 (via M7824)","text":"Evidence types in biliary tract cancer: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc.","source":{"label":"Open Targets: TGFB1 in biliary tract cancer","url":"https://platform.opentargets.org/evidence/ENSG00000105329/MONDO_0003060","date":"2026-11-12T05:31:58.358Z"}},{"label":"TGFB2 (via M7824)","text":"Evidence types in biliary tract cancer: clinical. Datasources: clinical_precedence.","source":{"label":"Open Targets: TGFB2 in biliary tract cancer","url":"https://platform.opentargets.org/evidence/ENSG00000092969/MONDO_0003060","date":"2026-11-12T05:31:58.358Z"}}],"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":"yes","detail":"Randomised allocation","rule":"Registry allocation field","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491","date":"2026-11-12T05:31:58.358Z"},"context":[]},{"id":"small_denominator","label":"Small denominator","value":"no","detail":"309 enrolled; each patient moves a rate by 100 ÷ 309 = 0.3 points","rule":"Enrolment under 30; the arithmetic is shown, not a benchmark","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491","date":"2026-11-12T05:31:58.358Z"},"context":[]},{"id":"primary_os","label":"Primary endpoint is overall survival","value":"yes","detail":"Safety Run-in Part: Number of Participants Who Experienced Dose Limiting Toxicities (DLTs); Double-blind Part: Overall Survival","rule":"A registered primary outcome measure names overall survival","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491","date":"2026-11-12T05:31:58.358Z"},"context":[]},{"id":"results_overdue","label":"Results overdue","value":"no","detail":"Results posted 2022-06-13","rule":"Primary completion (actual) more than 12 months ago and no results posted to the registry","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491?tab=results","date":"2026-11-12T05:31:58.358Z"},"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":"415 terminated, withdrawn or suspended trials of drugs against CD274; 1 of the 200 most recent give no reason. Reasons are quoted as the registry gives them on the target page.","source":{"label":"CD274: what already stopped","url":"/target/ENSG00000120217#stopped","date":"2026-11-12T05:31:58.394Z"}}],"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":"no","detail":"99 sites in 15 countries; 12 in the United States (12%)","rule":"All listed sites are in one country; the share of US sites is shown","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491?tab=locations","date":"2026-11-12T05:31:58.358Z"},"context":[]},{"id":"eu_pip","label":"EU paediatric investigation plan","value":"no","detail":"No EMA paediatric investigation plan decision names M7824","rule":"An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name","source":{"label":"EMA data download (dated snapshot)","url":"https://www.ema.europa.eu/en/documents/report/medicines-output-paediatric_investigation_plans-output-json-report_en.json","date":"2026-11-11T09:12:26Z"},"context":[]},{"id":"eu_orphan","label":"EU orphan designation","value":"no","detail":"No EU orphan designation names M7824","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":"no","detail":"EMA lists no centrally authorised medicine of M7824","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 data download (dated snapshot)","url":"https://www.ema.europa.eu/en/documents/report/medicines-output-medicines_json-report_en.json","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 M7824","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":"2026-11-12T05:31:58.451Z"},"context":[]},{"id":"studies_under_18","label":"Registered studies open to children","value":"no","detail":"No interventional study of M7824 includes patients under 18","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=%22M7824%22&aggFilters=ages%3Achild%2CstudyType%3Aint","date":"2026-11-12T05:31:58.461Z"},"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":"EMD Serono Research & Development Institute, Inc. (industry)","source":{"label":"ClinicalTrials.gov NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491","date":"2026-11-12T05:31:58.358Z"}},{"label":"study director","text":"Medical Responsible, Merck Healthcare KGaA, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany","source":{"label":"Person page","url":"/person/Medical%20Responsible","date":"2026-11-12T05:31:58.358Z"}}],"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 NCT04066491","url":"https://clinicaltrials.gov/study/NCT04066491","date":"2026-11-12T05:31:58.358Z"},{"label":"Open Targets Platform","url":"https://platform.opentargets.org","date":"2026-11-12T05:31:58.358Z"},{"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":"2026-11-12T05:31:58.350Z"}