{"ok":true,"data":{"subject":{"kind":"trial","nctId":"NCT04494958","title":"Palbociclib and Binimetinib in Advanced Triple Negative Breast Cancer","sponsor":"Fundacion Oncosur","phases":["PHASE1","PHASE2"],"status":"COMPLETED","indication":{"slug":"breast","name":"Breast cancer"},"disease":"breast carcinoma"},"rows":[{"n":1,"question":"Is the biology right?","flags":[{"id":"somatic_driver","label":"Somatic driver evidence","value":"yes","detail":"CCND1, CDK6, CDK4, MAP2K1, MAP2K2 in breast carcinoma","rule":"Open Targets has somatic-mutation evidence for the target in this cancer","source":{"label":"Open Targets: CCND1 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000110092/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"},"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":"CCND1: germline, somatic; CDK6: somatic; CDK4: somatic; MAP2K1: somatic; MAP2K2: 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: CCND1 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000110092/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"},"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":"yes","detail":"CCND1, CDK6, CDK4, MAP2K1, MAP2K2 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 NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958","date":"2026-11-11T19:52:27.685Z"},"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":"ADRB1 (via Combination)","text":"Evidence types in breast carcinoma: literature; literature listed separately from human genetics. Datasources: europepmc.","source":{"label":"Open Targets: ADRB1 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000043591/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}},{"label":"ADRB2 (via Combination)","text":"Evidence types in breast carcinoma: literature, rna_expression; literature listed separately from human genetics. Datasources: europepmc, expression_atlas.","source":{"label":"Open Targets: ADRB2 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000169252/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}},{"label":"CCND1 (via Palbociclib)","text":"Evidence types in breast carcinoma: rna_expression, clinical, affected_pathway, literature, genetic_association, somatic_mutation; literature listed separately from human genetics. Datasources: clinical_precedence, cancer_gene_census, crispr, gwas_credible_sets, europepmc, expression_atlas.","source":{"label":"Open Targets: CCND1 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000110092/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}},{"label":"CDK6 (via Palbociclib)","text":"Evidence types in breast carcinoma: literature, rna_expression, somatic_mutation, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, cancer_gene_census, europepmc, expression_atlas.","source":{"label":"Open Targets: CDK6 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000105810/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}},{"label":"CDK4 (via Palbociclib)","text":"Evidence types in breast carcinoma: literature, affected_pathway, somatic_mutation, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, cancer_gene_census, crispr, europepmc.","source":{"label":"Open Targets: CDK4 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000135446/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}},{"label":"MAP2K1 (via Binimetinib)","text":"Evidence types in breast carcinoma: literature, somatic_mutation; literature listed separately from human genetics. Datasources: cancer_gene_census, europepmc.","source":{"label":"Open Targets: MAP2K1 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000169032/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}},{"label":"MAP2K2 (via Binimetinib)","text":"Evidence types in breast carcinoma: literature, somatic_mutation; literature listed separately from human genetics. Datasources: cancer_gene_census, europepmc.","source":{"label":"Open Targets: MAP2K2 in breast carcinoma","url":"https://platform.opentargets.org/evidence/ENSG00000126934/MONDO_0004989","date":"2026-11-11T19:52:27.685Z"}}],"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 NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958","date":"2026-11-11T19:52:27.685Z"},"context":[]},{"id":"small_denominator","label":"Small denominator","value":"yes","detail":"24 enrolled; each patient moves a rate by 100 ÷ 24 = 4.2 points","rule":"Enrolment under 30; the arithmetic is shown, not a benchmark","source":{"label":"ClinicalTrials.gov NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958","date":"2026-11-11T19:52:27.685Z"},"context":[]},{"id":"primary_os","label":"Primary endpoint is overall survival","value":"no","detail":"3 Months Progression Free Survival. Probability That the Cancer Has Not Progressed at 3 Months Calculated With Kaplan…","rule":"A registered primary outcome measure names overall survival","source":{"label":"ClinicalTrials.gov NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958","date":"2026-11-11T19:52:27.685Z"},"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":"no","detail":"Results posted 2025-03-24","rule":"Primary completion (actual) more than 12 months ago and no results posted to the registry","source":{"label":"ClinicalTrials.gov NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958?tab=results","date":"2026-11-11T19:52:27.685Z"},"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":"57 terminated, withdrawn or suspended trials of drugs against ADRB1; 11 give no reason. Reasons are quoted as the registry gives them on the target page.","source":{"label":"ADRB1: what already stopped","url":"/target/ENSG00000043591#stopped","date":"2026-11-11T19:52:27.704Z"}}],"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":"All 8 sites in Spain","rule":"All listed sites are in one country; the share of US sites is shown","source":{"label":"ClinicalTrials.gov NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958?tab=locations","date":"2026-11-11T19:52:27.685Z"},"context":[]},{"id":"eu_pip","label":"EU paediatric investigation plan","value":"yes","detail":"EMEA-001454-PIP06-23 (binimetinib, Treatment of lung cancer): W: decision granting a waiver in all age groups for all conditions or indications, 8 Sept 2023; EMEA-001454-PIP03-15-M03 (binimetinib, Treatment of melanoma): PM: decision on the application for modification of an agreed PIP, 21 Apr 2023; compliance positive 26 Apr 2024; EMEA-002146-PIP01-17-M04 (Palbociclib, Treatment of Ewing sarcoma): PM: decision on the application for modification of an agreed PIP, 13 Apr 2022; EMEA-002146-PIP02-18 (Palbociclib, Treatment of breast malignant neoplasms): W: decision granting a waiver in all age groups for all conditions or indications, 3 Jan 2019; +1 more","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 Combination, Palbociclib, Binimetinib","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":"Palbociclib Viatris: authorised since 19 Jun 2026; Ibrance: authorised since 9 Nov 2016; Mektovi: authorised since 20 Sept 2018; Balimek: application withdrawn","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 Combination, Palbociclib, Binimetinib","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":"2026-11-11T19:52:27.714Z"},"context":[]},{"id":"studies_under_18","label":"Registered studies open to children","value":"yes","detail":"6903 interventional studies of Combination, Palbociclib, Binimetinib include patients under 18; 1396 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=%22Combination%22+OR+%22Palbociclib%22+OR+%22Binimetinib%22&aggFilters=ages%3Achild%2CstudyType%3Aint","date":"2026-11-11T19:52:27.721Z"},"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":"Cited case","text":"In February 2022 FDA asked its Oncologic Drugs Advisory Committee whether sintilimab's application, resting on ORIENT-11, a phase 3 run only in China, needed further trials showing it applies to US patients and US practice. One case, not a rule.","source":{"label":"FDA, ODAC 10 Feb 2022, draft questions","url":"https://www.fda.gov/media/156017/download","date":"2022-02-10"}},{"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":"Fundacion Oncosur (academic or other)","source":{"label":"ClinicalTrials.gov NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958","date":"2026-11-11T19:52:27.685Z"}},{"label":"principal investigator","text":"Miguel Ángel Quintela-Fandino, MD, Centro Nacional de Investigaciones Oncológicas","source":{"label":"Person page","url":"/person/Miguel%20%C3%81ngel%20Quintela-Fandino%2C%20MD?ind=breast","date":"2026-11-11T19:52:27.685Z"}}],"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 NCT04494958","url":"https://clinicaltrials.gov/study/NCT04494958","date":"2026-11-11T19:52:27.685Z"},{"label":"Open Targets Platform","url":"https://platform.opentargets.org","date":"2026-11-11T19:52:27.685Z"},{"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":"2026-11-11T19:52:27.684Z"}