OncoSignal
Live from Open Targets Platform, fetched 2026-11-12 04:45 UTC. Every row links to its source record.

CYP11A1 cytochrome P450 family 11 subfamily A member 1

ENSG00000140459 · protein coding · Open Targets profile

A cytochrome P450 monooxygenase that catalyzes the side-chain hydroxylation and cleavage of cholesterol to pregnenolone, the precursor of most steroid hormones (PubMed:21636783). Catalyzes three sequential oxidation reactions of cholesterol, namely the hydroxylation at C22 followed with the hydroxylation at C20 to yield 20R,22R- hydroxycholesterol that is further cleaved between C20 and C22 to yield the C21-steroid pregnenolone and 4-methylpentanal (PubMed:21636783). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate and reducing the second into a water molecule. Two electrons are provided by NADPH via a two-protein mitochondrial transfer system comprising flavoprotein FDXR (adrenodoxin/ferredoxin reductase) and nonheme iron-sulfur protein FDX1 or FDX2 (adrenodoxin/ferredoxin) (PubMed:21636783). .

3 of the 3 drugs recorded against CYP11A1 are approved

Each band is a group of drugs. It runs from the kind of drug on the left to the furthest stage that drug has reached in any disease on the right. Thicker bands mean more drugs.

3 small molecule drugs at Approved: LEVOKETOCONAZOLE, AMINOGLUTETHIMIDE, MITOTANESmall molecule 3Approved 3

Approved bands are highlighted. Withdrawn means the drug was pulled from the market or from development. A combined phase counts as the later one (Phase 1/2 is shown as Phase 2). Hover a band for the drug names. Source: Open Targets Platform, fetched live.

In 1 of 15 cancers, the evidence for CYP11A1 comes mainly from inherited variants

Each row is a cancer, strongest overall evidence first. The two dots show how strong the inherited (germline) and tumour-mutation (somatic) evidence is; the line between them is the gap.

Inherited (germline) variantsMutations in tumours (somatic)
00.250.50.751Congenital adrenal insufficiency with 4…Congenital adrenal insufficiency with 46, XY sex reversal OR 46,XY disorder of sex development-adrenal insufficiency due to CYP11A1 deficiencyCongenital adrenal insufficiency with 46, XY sex reversal OR 46,XY disorder of sex development-adrenal insufficiency due to CYP11A1 deficiency: germline 0.90adrenal cortex carcinomaadrenal cortex carcinomaadrenal cortex neoplasmadrenal cortex neoplasmbreast cancerbreast cancerprostate cancerprostate cancerhereditary pheochromocytoma-paraganglio…hereditary pheochromocytoma-paragangliomapituitary adenoma 3, multiple typespituitary adenoma 3, multiple typesFamilial prostate cancerFamilial prostate cancerprostate carcinomaprostate carcinomaLi-Fraumeni syndromeLi-Fraumeni syndromemultiple endocrine neoplasia type 1multiple endocrine neoplasia type 1multiple endocrine neoplasia type 4multiple endocrine neoplasia type 417,20-lyase deficiency, isolated17,20-lyase deficiency, isolatedfamilial hyperaldosteronism type IIfamilial hyperaldosteronism type IIpheochromocytoma/paraganglioma syndrome…pheochromocytoma/paraganglioma syndrome 3

Scores run from 0 (no evidence) to 1 (strongest). A missing dot at 0 means Open Targets holds no evidence of that kind. Source: Open Targets Platform, fetched live.

Tractability

Small molecule
Approved Drug, Structure with Ligand, High-Quality Pocket, Druggable Family
Antibody
UniProt loc high conf

gnomAD loss of function constraint: o/e 0.481469988822937 (upper bound 0.6724399924278259). Low values mean loss of function is poorly tolerated, a safety flag for inhibition.

Who runs trials of these drugs

Principal investigators and study chairs on 11 registry trials, updated in the last three years, of the most advanced drugs against CYP11A1 (levoketoconazole, aminoglutethimide, mitotane), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.

4 of 11 trials of drugs against CYP11A1 have sites only in Europe

Registry trials of levoketoconazole, aminoglutethimide, mitotane updated in the last three years, counted by the country group of their listed sites. A trial with sites in several groups counts in each; 8 of 11 have all sites in one country.

Sites only in this groupSites here and elsewhere
United StatesUnited States: 2 trials with sites only hereUnited States: 3 trials with sites here and elsewhere5ChinaChina: 1 trials with sites only hereChina: 0 trials with sites here and elsewhere1EuropeEurope: 4 trials with sites only hereEurope: 2 trials with sites here and elsewhere6OtherOther: 1 trials with sites only hereOther: 2 trials with sites here and elsewhere3

Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where sites are is a fact about the record, not a judgement of its quality. Europe is the EU and EEA, the UK and Switzerland. Source: ClinicalTrials.gov, fetched live.

3 trials of drugs against CYP11A1 were stopped early

Terminated, withdrawn and suspended interventional trials of levoketoconazole, aminoglutethimide, mitotane, newest update first, live from ClinicalTrials.gov. Each reason is quoted exactly as the registry gives it; we do not sort reasons into safety, efficacy or business. Dates are the last registry update. Showing the 3 most recent of 3.

Paediatric incentives and obligations for CYP11A1's drugs

For levoketoconazole, aminoglutethimide, mitotane: what EMA and FDA publish about paediatric plans, orphan status and pediatric approvals, and how many registered studies take children. Each line is a yes, no or not published fact from the record linked under it; none of it is a forecast.

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

All 3 drugs and clinical candidates as a table

Each drug, stage and indication links to its Open Targets record, where the trials and approvals behind it are listed. Salt forms (for example a mesylate) are listed as Open Targets records them, as separate entries.

DrugTypeHighest stageIndicationsSource records
LEVOKETOCONAZOLESmall moleculeapprovalCushing syndrome, adrenal gland hyperfunction, adrenal gland disorder, type 2 diabetes mellitusOpen Targets · ChEMBL
AMINOGLUTETHIMIDESmall moleculeapprovalneoplasm, breast cancer, prostate cancerOpen Targets · ChEMBL
MITOTANESmall moleculeapprovaladrenal cortex carcinoma, adrenal cortex neoplasm, neoplasm, prostate cancerOpen Targets · ChEMBL