SCH 66336 With or Without Gemcitabine Followed by Surgery Compared With Surgery Alone in Treating Patients With Primary Liver Cancer

1. Is the biology right?

• Somatic driver evidence: no · None of RRM1, RRM2B, RRM2, FNTA, FNTB has somatic-mutation evidence in liver cancer

  Rule: Open Targets has somatic-mutation evidence for the target in this cancer. Source: Open Targets: RRM1 in liver cancer, 2026-11-12
• Human genetic evidence: no · No germline or somatic evidence for RRM1, RRM2B, RRM2, FNTA, FNTB in liver cancer

  Rule: Any germline or somatic human genetic evidence for the target in this cancer, counted apart from animal-model and literature evidence. Source: Open Targets: RRM1 in liver cancer, 2026-11-12
• Pediatric target: no · 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: 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)), 2026-11-11
• Haematologic cancer: no · Solid tumour

  Rule: From the indication, or the registry conditions when no indication matches. Source: ClinicalTrials.gov NCT00020774, 2026-11-12

  Published context: Likelihood of approval from phase 1: 7.5% haematologic vs 4.6% solid (BIO / Informa / QLS 2021, 2011–2020). Population-level, not a prediction.

• RRM1 (via gemcitabine hydrochloride): Evidence types in liver cancer: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: RRM1 in liver cancer
• RRM2B (via gemcitabine hydrochloride): Evidence types in liver cancer: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: RRM2B in liver cancer
• RRM2 (via gemcitabine hydrochloride): Evidence types in liver cancer: literature, clinical; literature listed separately from human genetics. Datasources: europepmc, clinical_precedence. · Open Targets: RRM2 in liver cancer
• FNTA (via lonafarnib): Evidence types in liver cancer: clinical. Datasources: clinical_precedence. · Open Targets: FNTA in liver cancer
• FNTB (via lonafarnib): Evidence types in liver cancer: clinical. Datasources: clinical_precedence. · Open Targets: FNTB in liver cancer

• Not loaded on this app yet: Normal-tissue expression in vital organs. Source: Human Protein Atlas (ticket 36).
• Not loaded on this app yet: Pan-essential in cell lines. Source: DepMap (ticket 36).
• Not loaded on this app yet: Approved drug on this target. Source: Drugs@FDA (ticket 30).

2. Can the result be trusted?

• Randomised: not published · The record gives no allocation.

  Rule: Registry allocation field. Source: ClinicalTrials.gov NCT00020774, 2026-11-12
• Small denominator: yes · 0 enrolled; each patient moves a rate by 100 ÷ 0 = – points

  Rule: Enrolment under 30; the arithmetic is shown, not a benchmark. Source: ClinicalTrials.gov NCT00020774, 2026-11-12
• Primary endpoint is overall survival: not published · The record lists no primary outcome.

  Rule: A registered primary outcome measure names overall survival. Source: ClinicalTrials.gov NCT00020774, 2026-11-12
• Results overdue: yes · Primary completion 2003-01, 286 months ago; no results posted

  Rule: Primary completion (actual) more than 12 months ago and no results posted to the registry. Source: ClinicalTrials.gov NCT00020774, 2026-11-12

  Published context: 40.9% of applicable trials report results within a year (Results-reporting studies summarised in spec §11, all therapy areas). All areas, not oncology only.

• Not loaded on this app yet: Treated and evaluable counts, assessor, confirmed response, follow-up and data cutoff. Source: Readout extraction (ticket 32).
• Not loaded on this app yet: Primary endpoint changed between registry versions. Source: Registry versions in the store (ticket 32).

3. What must it beat?

• Not loaded on this app yet: Control-arm result and approved therapies for the same segment, with label links. Source: Drugs@FDA, FDA labels and readouts (tickets 30, 32).

4. Too crowded, or too late?

• Stopped on this target: 1131 terminated, withdrawn or suspended trials of drugs against RRM1; 6 of the 200 most recent give no reason. Reasons are quoted as the registry gives them on the target page. · RRM1: what already stopped

• Not loaded on this app yet: Programs on the target by phase and months behind the leader. Source: Programs and Drugs@FDA (ticket 33).

5. Can it be approved, and stay approved?

• Single-country: not published · The record lists no sites.

  Rule: All listed sites are in one country; the share of US sites is shown. Source: ClinicalTrials.gov NCT00020774, 2026-11-12
• EU paediatric investigation plan: yes · EMA/PE/0000230592 (gemcitabine hydrochloride, condition not given): W: decision granting a waiver in all age groups for all conditions or indications, 14 Apr 2025; EMEA-002516-PIP02-21 (Lonafarnib, Hepatitis D virus infection): P: decision agreeing on a investigation plan, with or without partial waiver(s) and or deferral(s), 8 Jul 2022; EMEA-003007-PIP01-21 (gemcitabine hydrochloride, Treatment of urothelial carcinoma): W: decision granting a waiver in all age groups for all conditions or indications, 13 Aug 2021; EMEA-002516-PIP01-18 (Lonafarnib, Treatment of Hutchinson-Gilford Progeria Syndrome;Treatment of progeroid laminopathies): P: decision agreeing on a investigation plan, with or without partial waiver(s) and or deferral(s), 16 Jul 2019; compliance positive 27 Mar 2020

  Rule: An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name. Source: EMA data download (dated snapshot), 2026-11-11
• EU orphan designation: yes · EU/3/13/1225 positive 16 Jan 2014: Treatment of hepatitis delta virus infection; EU/3/18/2118 positive 14 Dec 2018: Treatment of Hutchinson-Gilford progeria

  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: EMA data download (dated snapshot), 2026-11-11
• Authorised in the EU: yes · Zokinvy: authorised since 18 Jul 2022, orphan medicine, exceptional circumstances

  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: EMA EPAR Zokinvy, 2026-11-11
• FDA orphan designation: not published · 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: FDA orphan designations search
• FDA pediatric oncology approval: no · FDA's table lists no pediatric approval of gemcitabine hydrochloride, lonafarnib

  Rule: FDA's Pediatric Oncology Drug Approvals table names the drug. Source: FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03), 2026-11-12
• Registered studies open to children: yes · 189 interventional studies of gemcitabine hydrochloride, lonafarnib include patients under 18; 38 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: ClinicalTrials.gov search, 2026-11-12

• Caveat: 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.
• Rare pediatric disease voucher: 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. · FDA: Rare Pediatric Disease Designation and Priority Review Voucher Programs

• Not loaded on this app yet: Precedent approvals for target, modality and endpoint; accelerated-approval status. Source: Drugs@FDA and FDA accelerated-approval tables (ticket 30).

6. Can the sponsor finish?

• Sponsor: Jonsson Comprehensive Cancer Center (academic or other) · ClinicalTrials.gov NCT00020774
• study chair: Rafael G. Amado, MD, Jonsson Comprehensive Cancer Center · Person page

• Not loaded on this app yet: Filed cash, quarterly spend and the runway arithmetic. Source: SEC XBRL company facts (ticket 37).
• Not loaded on this app yet: Sponsor's completed vs stopped oncology trials and results-reporting record. Source: Registry, by company (ticket 37).

What public data cannot tell you

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.