{"ok":true,"data":{"subject":{"kind":"trial","nctId":"NCT04285086","title":"Ropeginterferon Alfa-2b (P1101) vs. Anagrelide in Essential Thrombocythemia Patients With Hydroxyurea Resistance or Intolerance","sponsor":"PharmaEssentia","phases":["PHASE3"],"status":"ACTIVE_NOT_RECRUITING","indication":null,"disease":"essential thrombocythemia"},"rows":[{"n":1,"question":"Is the biology right?","flags":[{"id":"somatic_driver","label":"Somatic driver evidence","value":"no","detail":"None of IFNAR1, IFNAR2, PDE3A, PDE3B has somatic-mutation evidence in essential thrombocythemia","rule":"Open Targets has somatic-mutation evidence for the target in this cancer","source":{"label":"Open Targets: IFNAR1 in essential thrombocythemia","url":"https://platform.opentargets.org/evidence/ENSG00000142166/MONDO_0005029","date":"2026-11-12T00:32:46.691Z"},"context":[]},{"id":"human_genetic","label":"Human genetic evidence","value":"no","detail":"No germline or somatic evidence for IFNAR1, IFNAR2, PDE3A, PDE3B in essential thrombocythemia","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: IFNAR1 in essential thrombocythemia","url":"https://platform.opentargets.org/evidence/ENSG00000142166/MONDO_0005029","date":"2026-11-12T00:32:46.691Z"},"context":[]},{"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":"no","detail":"Solid tumour","rule":"From the indication, or the registry conditions when no indication matches","source":{"label":"ClinicalTrials.gov NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"},"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":"IFNAR1 (via Ropeginterferon alfa-2b)","text":"Evidence types in essential thrombocythemia: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc.","source":{"label":"Open Targets: IFNAR1 in essential thrombocythemia","url":"https://platform.opentargets.org/evidence/ENSG00000142166/MONDO_0005029","date":"2026-11-12T00:32:46.691Z"}},{"label":"IFNAR2 (via Ropeginterferon alfa-2b)","text":"Evidence types in essential thrombocythemia: clinical. Datasources: clinical_precedence.","source":{"label":"Open Targets: IFNAR2 in essential thrombocythemia","url":"https://platform.opentargets.org/evidence/ENSG00000159110/MONDO_0005029","date":"2026-11-12T00:32:46.691Z"}},{"label":"PDE3A (via Anagrelide)","text":"Evidence types in essential thrombocythemia: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc.","source":{"label":"Open Targets: PDE3A in essential thrombocythemia","url":"https://platform.opentargets.org/evidence/ENSG00000172572/MONDO_0005029","date":"2026-11-12T00:32:46.691Z"}},{"label":"PDE3B (via Anagrelide)","text":"Evidence types in essential thrombocythemia: clinical. Datasources: clinical_precedence.","source":{"label":"Open Targets: PDE3B in essential thrombocythemia","url":"https://platform.opentargets.org/evidence/ENSG00000152270/MONDO_0005029","date":"2026-11-12T00:32:46.691Z"}}],"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 NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"},"context":[]},{"id":"small_denominator","label":"Small denominator","value":"no","detail":"174 enrolled; each patient moves a rate by 100 ÷ 174 = 0.6 points","rule":"Enrolment under 30; the arithmetic is shown, not a benchmark","source":{"label":"ClinicalTrials.gov NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"},"context":[]},{"id":"primary_os","label":"Primary endpoint is overall survival","value":"no","detail":"Peripheral blood count remission; Improvement or non-progression in disease-related signs; Large symptoms improvement or maintain non-progression (and 1 more)","rule":"A registered primary outcome measure names overall survival","source":{"label":"ClinicalTrials.gov NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"},"context":[{"figure":"Non-OS primary endpoint: odds ratio 2.79 for a positive phase 3","dataset":"Otsuka 2021, 400 phase 3 oncology trials","years":"to 2020","caveat":"Shown with the next figure: a surrogate is easier to hit, and often a weak guide to survival."},{"figure":"52% of surrogate-to-OS correlations are low","dataset":"Prasad 2015","years":"published to 2014","caveat":"Shown with the figure above."}]},{"id":"results_overdue","label":"Results overdue","value":"yes","detail":"Primary completion 2024-11-12, 23 months ago; no results posted","rule":"Primary completion (actual) more than 12 months ago and no results posted to the registry","source":{"label":"ClinicalTrials.gov NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"},"context":[{"figure":"40.9% of applicable trials report results within a year","dataset":"Results-reporting studies summarised in spec §11","years":"all therapy areas","caveat":"All areas, not oncology only."}]}],"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":"99 terminated, withdrawn or suspended trials of drugs against IFNAR1; 24 give no reason. Reasons are quoted as the registry gives them on the target page.","source":{"label":"IFNAR1: what already stopped","url":"/target/ENSG00000142166#stopped","date":"2026-11-12T00:32:46.718Z"}}],"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":"67 sites in 8 countries; 4 in the United States (6%)","rule":"All listed sites are in one country; the share of US sites is shown","source":{"label":"ClinicalTrials.gov NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086?tab=locations","date":"2026-11-12T00:32:46.691Z"},"context":[]},{"id":"eu_pip","label":"EU paediatric investigation plan","value":"yes","detail":"EMEA-000720-PIP01-09-M02 (anagrelide, Treatment of essential thrombocythaemia): PM: decision on the application for modification of an agreed PIP, 19 Dec 2013; compliance positive 14 Feb 2014","rule":"An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name","source":{"label":"EMA EMEA-000720-PIP01-09-M02","url":"https://www.ema.europa.eu/en/medicines/human/paediatric-investigation-plans/emea-000720-pip01-09-m02","date":"2026-11-11T09:12:26Z"},"context":[]},{"id":"eu_orphan","label":"EU orphan designation","value":"yes","detail":"EU/3/22/2709 positive 11 Oct 2022: Treatment of essential thrombocythaemia; EU/3/22/2627 positive 21 Jun 2022: Treatment of chronic myeloid leukaemia; EU/3/11/932 withdrawn 9 Dec 2011: Treatment of polycythaemia vera; EU/3/00/010 expired 30 Dec 2000: Treatment of essential thrombocythaemia","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":"Besremi: authorised since 15 Feb 2019; Anagrelide Viatris (previously Anagrelide Mylan): authorised since 15 Feb 2018; Xagrid: authorised since 15 Nov 2004","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 Ropeginterferon alfa-2b, Anagrelide","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":"2026-11-12T00:32:46.730Z"},"context":[]},{"id":"studies_under_18","label":"Registered studies open to children","value":"yes","detail":"1 interventional studies of Ropeginterferon alfa-2b, Anagrelide include patients under 18; 1 is 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=%22Ropeginterferon+alfa-2b%22+OR+%22Anagrelide%22&aggFilters=ages%3Achild%2CstudyType%3Aint","date":"2026-11-12T00:32:46.735Z"},"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":"PharmaEssentia (industry)","source":{"label":"ClinicalTrials.gov NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"}},{"label":"study director","text":"Toshiaki Sato, MD/PhD, PharmaEssentia Japan K.K.","source":{"label":"Person page","url":"/person/Toshiaki%20Sato%2C%20MD%2FPhD","date":"2026-11-12T00:32:46.691Z"}},{"label":"study director","text":"Craig Zimmerman, PhD, PharmaEssentia USA Corp.","source":{"label":"Person page","url":"/person/Craig%20Zimmerman%2C%20PhD","date":"2026-11-12T00:32:46.691Z"}}],"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 NCT04285086","url":"https://clinicaltrials.gov/study/NCT04285086","date":"2026-11-12T00:32:46.691Z"},{"label":"Open Targets Platform","url":"https://platform.opentargets.org","date":"2026-11-12T00:32:46.691Z"},{"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":"2026-11-12T00:32:46.689Z"}