{"ok":true,"data":{"subject":{"kind":"trial","nctId":"NCT05463133","title":"Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Granulomatous Disease (CGD) With an Alemtuzumab, Busulfan and TBI-based Conditioning Regimen Combined With Cytokine (IL-6, +/- IFN-gamma) Antagonists","sponsor":"National Institute of Allergy and Infectious Diseases (NIAID)","phases":["PHASE1","PHASE2"],"status":"RECRUITING","indication":null,"disease":"chronic granulomatous disease"},"rows":[{"n":1,"question":"Is the biology right?","flags":[{"id":"somatic_driver","label":"Somatic driver evidence","value":"no","detail":"None of FKBP1A, CD52 has somatic-mutation evidence in chronic granulomatous disease","rule":"Open Targets has somatic-mutation evidence for the target in this cancer","source":{"label":"Open Targets: FKBP1A in chronic granulomatous disease","url":"https://platform.opentargets.org/evidence/ENSG00000088832/MONDO_0018305","date":"2026-11-11T19:02:35.741Z"},"context":[]},{"id":"human_genetic","label":"Human genetic evidence","value":"no","detail":"No germline or somatic evidence for FKBP1A, CD52 in chronic granulomatous disease","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: FKBP1A in chronic granulomatous disease","url":"https://platform.opentargets.org/evidence/ENSG00000088832/MONDO_0018305","date":"2026-11-11T19:02:35.741Z"},"context":[]},{"id":"pediatric_target","label":"Pediatric target","value":"yes","detail":"CD52 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 NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"},"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":"Cyclophosphamide: standard agents, not counted in these flags."},{"label":"FKBP1A (via Sirolimus)","text":"Evidence types in chronic granulomatous disease: clinical. Datasources: clinical_precedence.","source":{"label":"Open Targets: FKBP1A in chronic granulomatous disease","url":"https://platform.opentargets.org/evidence/ENSG00000088832/MONDO_0018305","date":"2026-11-11T19:02:35.741Z"}},{"label":"CD52 (via Alemtuzumab)","text":"Evidence types in chronic granulomatous disease: clinical. Datasources: clinical_precedence.","source":{"label":"Open Targets: CD52 in chronic granulomatous disease","url":"https://platform.opentargets.org/evidence/ENSG00000169442/MONDO_0018305","date":"2026-11-11T19:02:35.741Z"}}],"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 NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"},"context":[]},{"id":"small_denominator","label":"Small denominator","value":"no","detail":"50 planned; each patient moves a rate by 100 ÷ 50 = 2.0 points","rule":"Enrolment under 30; the arithmetic is shown, not a benchmark","source":{"label":"ClinicalTrials.gov NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"},"context":[]},{"id":"primary_os","label":"Primary endpoint is overall survival","value":"yes","detail":"Overall Survival","rule":"A registered primary outcome measure names overall survival","source":{"label":"ClinicalTrials.gov NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"},"context":[]},{"id":"results_overdue","label":"Results overdue","value":"no","detail":"Primary completion expected 2032-12-31; not yet due","rule":"Primary completion (actual) more than 12 months ago and no results posted to the registry","source":{"label":"ClinicalTrials.gov NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"},"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":"578 terminated, withdrawn or suspended trials of drugs against FKBP1A; 8 of the 200 most recent give no reason. Reasons are quoted as the registry gives them on the target page.","source":{"label":"FKBP1A: what already stopped","url":"/target/ENSG00000088832#stopped","date":"2026-11-11T19:02:35.780Z"}}],"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 NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133?tab=locations","date":"2026-11-11T19:02:35.741Z"},"context":[]},{"id":"eu_pip","label":"EU paediatric investigation plan","value":"yes","detail":"EMEA-003168-PIP01-21 (sirolimus, Treatment of tuberous sclerosis complex): P: decision agreeing on a investigation plan, with or without partial waiver(s) and or deferral(s), 2 Dec 2022; EMEA-003168-PIP01-21 (sirolimus, Treatment of tuberous sclerosis complex): P: decision agreeing on a investigation plan, with or without partial waiver(s) and or deferral(s), 2 Dec 2022; EMEA-002982-PIP01-21 (sirolimus, Treatment of ornithine transcarbamylase deficiency): P: decision agreeing on a investigation plan, with or without partial waiver(s) and or deferral(s), 10 Jun 2022; EMEA-001416-PIP01-12-M03 (sirolimus, Treatment of chronic non-infectious uveitis): PM: decision on the application for modification of an agreed PIP, 11 Aug 2021; +2 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":"yes","detail":"EU/3/25/3189 positive 9 Jan 2026: Treatment of osteosarcoma; EU/3/25/3051 positive 16 Apr 2025: Treatment of familial adenomatous polyposis (FAP); EU/3/13/1204 positive 13 Nov 2013: Prevention of arteriovenous access dysfunction in haemodialysis patients; EU/3/17/1910 positive 23 Aug 2017: Treatment of tuberous sclerosis; +11 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":"Lemtrada: authorised since 12 Sept 2013; Hyftor: authorised since 15 May 2023, orphan medicine; Rapamune: authorised since 13 Mar 2001; Busulfan Fresenius Kabi: authorised since 22 Sept 2014; +3 more","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":"yes","detail":"Busulfan [Busulfex], 13 Jan 2003: For use in combination with cyclophosphamide as a conditioning regimen prior to allogeneic hematopoietic progenitor cell transplantation for chronic myelogenous leukemia","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":"2026-11-11T19:02:35.818Z"},"context":[]},{"id":"studies_under_18","label":"Registered studies open to children","value":"yes","detail":"924 interventional studies of Sirolimus, Alemtuzumab, Busulfan, Pheripheral blood stem cells include patients under 18; 194 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=%22Sirolimus%22+OR+%22Alemtuzumab%22+OR+%22Busulfan%22+OR+%22Pheripheral+blood+stem+cells%22&aggFilters=ages%3Achild%2CstudyType%3Aint","date":"2026-11-11T19:02:35.830Z"},"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":"National Institute of Allergy and Infectious Diseases (NIAID) (academic or other)","source":{"label":"ClinicalTrials.gov NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"}},{"label":"principal investigator","text":"Elizabeth M Kang, M.D., National Institute of Allergy and Infectious Diseases (NIAID)","source":{"label":"Person page","url":"/person/Elizabeth%20M%20Kang%2C%20M.D.","date":"2026-11-11T19:02:35.741Z"}}],"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 NCT05463133","url":"https://clinicaltrials.gov/study/NCT05463133","date":"2026-11-11T19:02:35.741Z"},{"label":"Open Targets Platform","url":"https://platform.opentargets.org","date":"2026-11-11T19:02:35.741Z"},{"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":"2026-11-11T19:02:35.738Z"}