{"ok":true,"data":{"subject":{"kind":"trial","nctId":"NCT06450041","title":"NANT 2021-01 Phase II STING (Sequential Temozolomide, Irinotecan, NK Cells and GD2 mAb) Trial","sponsor":"New Approaches to Neuroblastoma Therapy Consortium","phases":["PHASE2"],"status":"RECRUITING","indication":{"slug":"neuroblastoma","name":"Neuroblastoma"},"disease":"neuroblastoma"},"rows":[{"n":1,"question":"Is the biology right?","flags":[{"id":"somatic_driver","label":"Somatic driver evidence","value":"no","detail":"None of CSF2RA, CSF2RB has somatic-mutation evidence in neuroblastoma","rule":"Open Targets has somatic-mutation evidence for the target in this cancer","source":{"label":"Open Targets: CSF2RA in neuroblastoma","url":"https://platform.opentargets.org/evidence/ENSG00000198223/MONDO_0005072","date":"2026-11-11T19:23:59.184Z"},"context":[]},{"id":"human_genetic","label":"Human genetic evidence","value":"no","detail":"No germline or somatic evidence for CSF2RA, CSF2RB in neuroblastoma","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: CSF2RA in neuroblastoma","url":"https://platform.opentargets.org/evidence/ENSG00000198223/MONDO_0005072","date":"2026-11-11T19:23:59.184Z"},"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 NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"},"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":"Temozolomide, Irinotecan: standard agents, not counted in these flags."},{"label":"CSF2RA (via GM-CSF)","text":"Evidence types in neuroblastoma: clinical. Datasources: clinical_precedence.","source":{"label":"Open Targets: CSF2RA in neuroblastoma","url":"https://platform.opentargets.org/evidence/ENSG00000198223/MONDO_0005072","date":"2026-11-11T19:23:59.184Z"}},{"label":"CSF2RB (via GM-CSF)","text":"Evidence types in neuroblastoma: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc.","source":{"label":"Open Targets: CSF2RB in neuroblastoma","url":"https://platform.opentargets.org/evidence/ENSG00000100368/MONDO_0005072","date":"2026-11-11T19:23:59.184Z"}}],"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 NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"},"context":[]},{"id":"small_denominator","label":"Small denominator","value":"no","detail":"62 planned; each patient moves a rate by 100 ÷ 62 = 1.6 points","rule":"Enrolment under 30; the arithmetic is shown, not a benchmark","source":{"label":"ClinicalTrials.gov NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"},"context":[]},{"id":"primary_os","label":"Primary endpoint is overall survival","value":"no","detail":"Best Overall Response Rate of Evaluable Patients","rule":"A registered primary outcome measure names overall survival","source":{"label":"ClinicalTrials.gov NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"},"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":"Primary completion expected 2028-12; not yet due","rule":"Primary completion (actual) more than 12 months ago and no results posted to the registry","source":{"label":"ClinicalTrials.gov NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"},"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":"111 terminated, withdrawn or suspended trials of drugs against CSF2RA; 23 give no reason. Reasons are quoted as the registry gives them on the target page.","source":{"label":"CSF2RA: what already stopped","url":"/target/ENSG00000198223#stopped","date":"2026-11-11T19:23:59.192Z"}}],"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 13 sites in United States","rule":"All listed sites are in one country; the share of US sites is shown","source":{"label":"ClinicalTrials.gov NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041?tab=locations","date":"2026-11-11T19:23:59.184Z"},"context":[]},{"id":"eu_pip","label":"EU paediatric investigation plan","value":"yes","detail":"EMEA-001285-PIP01-12-M02 (dinutuximab, Treatment of neuroblastoma): PM: decision on the application for modification of an agreed PIP, 12 Aug 2016; compliance positive 16 Dec 2016","rule":"An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name","source":{"label":"EMA EMEA-001285-PIP01-12-M02","url":"https://www.ema.europa.eu/en/medicines/human/paediatric-investigation-plans/emea-001285-pip01-12-m02","date":"2026-11-11T09:12:26Z"},"context":[]},{"id":"eu_orphan","label":"EU orphan designation","value":"yes","detail":"EU/3/11/879 withdrawn 21 Jun 2011: Treatment of neuroblastoma; EU/3/06/405 positive 23 Oct 2006: Treatment of renal-cell carcinoma","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":"Unituxin: withdrawn since 14 Aug 2015","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 Unituxin","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/unituxin","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":"Dinutuximab [Unituxin], 10 Mar 2015: In combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy","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":"2026-11-11T19:23:59.203Z"},"context":[]},{"id":"studies_under_18","label":"Registered studies open to children","value":"yes","detail":"785 interventional studies of Universal Donor (UD) TGFβi NK Cells, Dinutuximab, GM-CSF include patients under 18; 113 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=%22Universal+Donor+UD+TGF%CE%B2i+NK+Cells%22+OR+%22Dinutuximab%22+OR+%22GM-CSF%22&aggFilters=ages%3Achild%2CstudyType%3Aint","date":"2026-11-11T19:23:59.215Z"},"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":"New Approaches to Neuroblastoma Therapy Consortium (academic or other)","source":{"label":"ClinicalTrials.gov NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"}},{"label":"study chair","text":"Keri Streby, MD, Nationwide Children's Hospital","source":{"label":"Person page","url":"/person/Keri%20Streby%2C%20MD?ind=neuroblastoma","date":"2026-11-11T19:23:59.184Z"}},{"label":"study chair","text":"Mark Ranalli, MD, Nationwide Children's Hospital","source":{"label":"Person page","url":"/person/Mark%20Ranalli%2C%20MD?ind=neuroblastoma","date":"2026-11-11T19:23:59.184Z"}}],"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 NCT06450041","url":"https://clinicaltrials.gov/study/NCT06450041","date":"2026-11-11T19:23:59.184Z"},{"label":"Open Targets Platform","url":"https://platform.opentargets.org","date":"2026-11-11T19:23:59.184Z"},{"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":"2026-11-11T19:23:59.183Z"}