Brentuximab Vedotin and Imatinib in Patients With Relapsed or Refractory ALK+ ALCL

1. Is the biology right?

• Somatic driver evidence: no · None of TUBB4B, TUBB1, TUBA3C, ABL1, PDGFRB, KIT has somatic-mutation evidence in anaplastic large cell lymphoma

  Rule: Open Targets has somatic-mutation evidence for the target in this cancer. Source: Open Targets: TUBB4B in anaplastic large cell lymphoma, 2026-11-11
• Human genetic evidence: no · No germline or somatic evidence for TUBB4B, TUBB1, TUBA3C, ABL1, PDGFRB, KIT in anaplastic large cell lymphoma

  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: TUBB4B in anaplastic large cell lymphoma, 2026-11-11
• Pediatric target: yes · ABL1, PDGFRB, KIT 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: yes · Haematologic

  Rule: From the indication, or the registry conditions when no indication matches. Source: ClinicalTrials.gov NCT02462538, 2026-11-11

  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.

• TUBB4B (via Brentuximab vedotin): Evidence types in anaplastic large cell lymphoma: clinical. Datasources: clinical_precedence. · Open Targets: TUBB4B in anaplastic large cell lymphoma
• TUBB1 (via Brentuximab vedotin): Evidence types in anaplastic large cell lymphoma: clinical. Datasources: clinical_precedence. · Open Targets: TUBB1 in anaplastic large cell lymphoma
• TUBA3C (via Brentuximab vedotin): Evidence types in anaplastic large cell lymphoma: clinical. Datasources: clinical_precedence. · Open Targets: TUBA3C in anaplastic large cell lymphoma
• ABL1 (via Imatinib): Evidence types in anaplastic large cell lymphoma: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: ABL1 in anaplastic large cell lymphoma
• PDGFRB (via Imatinib): Evidence types in anaplastic large cell lymphoma: literature, clinical; literature listed separately from human genetics. Datasources: europepmc, clinical_precedence. · Open Targets: PDGFRB in anaplastic large cell lymphoma
• KIT (via Imatinib): Evidence types in anaplastic large cell lymphoma: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: KIT in anaplastic large cell lymphoma

• 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: no · Single group

  Rule: Registry allocation field. Source: ClinicalTrials.gov NCT02462538, 2026-11-11
• Small denominator: yes · 3 enrolled; each patient moves a rate by 100 ÷ 3 = 33.3 points

  Rule: Enrolment under 30; the arithmetic is shown, not a benchmark. Source: ClinicalTrials.gov NCT02462538, 2026-11-11
• Primary endpoint is overall survival: no · Safety of brentuximab vedotin and imatinib regime as measured by type, frequency and severity of adverse events (AEs)…

  Rule: A registered primary outcome measure names overall survival. Source: ClinicalTrials.gov NCT02462538, 2026-11-11

  Published context: Non-OS primary endpoint: odds ratio 2.79 for a positive phase 3 (Otsuka 2021, 400 phase 3 oncology trials, to 2020). Shown with the next figure: a surrogate is easier to hit, and often a weak guide to survival.

  Published context: 52% of surrogate-to-OS correlations are low (Prasad 2015, published to 2014). Shown with the figure above.
• Results overdue: yes · Primary completion 2021-11-03, 60 months ago; no results posted

  Rule: Primary completion (actual) more than 12 months ago and no results posted to the registry. Source: ClinicalTrials.gov NCT02462538, 2026-11-11

  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: 362 terminated, withdrawn or suspended trials of drugs against TUBB4B; 18 of the 200 most recent give no reason. Reasons are quoted as the registry gives them on the target page. · TUBB4B: 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: yes · The only site is in Austria

  Rule: All listed sites are in one country; the share of US sites is shown. Source: ClinicalTrials.gov NCT02462538, 2026-11-11
• EU paediatric investigation plan: yes · EMEA-000980-PIP01-10-M07 (Brentuximab vedotin, Treatment of anaplastic large cell lymphoma;Treatment of Hodgkin lymphoma): PM: decision on the application for modification of an agreed PIP, 28 Jan 2021; compliance positive 25 Jun 2021; EMEA-002643-PIP01-19-M01 (imatinib, Treatment of acute lymphoblastic leukaemia;Treatment of chronic myeloid leukaemia): PM: decision on the application for modification of an agreed PIP, 29 Oct 2021; EMEA-000980-PIP04-18 (Brentuximab vedotin, Treatment of Mature T and NK neoplasms (excluding anaplastic large-cell lymphoma and cutaneous Tcell lymphoma)): W: decision granting a waiver in all age groups for all conditions or indications, 8 Oct 2018; EMEA-000980-PIP02-15 (Brentuximab vedotin, Treatment of Cutaneous T-Cell Lymphoma): W: decision granting a waiver in all age groups for all conditions or indications, 7 Aug 2015; +2 more

  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/3/11/939 withdrawn 11 Jan 2012: Treatment of cutaneous T-cell lymphoma; EU/3/08/596 withdrawn 15 Jan 2009: Treatment of Hodgkin's lymphoma; EU/3/21/2449 positive 21 Jun 2021: Treatment of pulmonary arterial hypertension; EU/3/14/1357 positive 19 Nov 2014: Treatment of acute respiratory distress syndrome (ARDS); +7 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: EMA data download (dated snapshot), 2026-11-11
• Authorised in the EU: yes · Glivec: authorised since 7 Nov 2001; Imatinib Accord: authorised since 30 Jun 2013; Adcetris: authorised since 25 Oct 2012; Imatinib Teva: authorised since 7 Jan 2013; +5 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: EMA data download (dated snapshot), 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: yes · Brentuximab vedotin [Adcetris], 10 Nov 2022: Treatment of pediatric patients 2 years and older with previously untreated high risk classical Hodgkin lymphoma (cHL), in combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide; Imatinib Mesylate [Gleevec] &, 25 Jan 2013: Pediatric patients with newly diagnosed Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) in combination with chemotherapy; Imatinib Mesylate [Gleevec] &, 27 Sept 2006: Newly diagnosed adult and pediatric patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase

  Rule: FDA's Pediatric Oncology Drug Approvals table names the drug. Source: FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03), 2026-11-11
• Registered studies open to children: yes · 177 interventional studies of Brentuximab vedotin, Imatinib include patients under 18; 32 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, 2026-11-11

• 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.
• Cited case: 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. · FDA, ODAC 10 Feb 2022, draft questions
• 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: Arbeitsgemeinschaft medikamentoese Tumortherapie (academic or other) · ClinicalTrials.gov NCT02462538
• principal investigator: Ulrich Jäger, MD, Universitätsklinik für Innere Medizin I: Klinische Abteilung für Hämatologie und Hämostaseologie · 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.