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). .
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.
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 Withdrawn means the drug was pulled from the market or from development.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.
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.
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.
- Alfredo BerrutiASST Spedali Civili di Brescia and University of Brescia · 3 of 3 trials Phase 2+
- Carlos Rodriguez-GalindoChildren's Oncology Group · 1 of 1 trials Phase 2+
- Fredric CohenCortendo AB · 1 of 1 trials Phase 2+
- Jeena VargheseM.D. Anderson Cancer Center · 1 of 1 trials Phase 2+
- Mouhammed HabraM.D. Anderson Cancer Center · 1 of 1 trials Phase 2+
- Tak YunNational Cancer Center, Republic of Korea · 1 of 1 trials Phase 2+
- Thierry ANDREHôpital Sainte Antoine - Paris - France · 1 of 1 trials Phase 2+
- Naris NilubolNational Cancer Institute (NCI) · 0 of 1 trials Phase 2+
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.
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.
- terminated · 2025-06-19 · M.D. Anderson Cancer Center · Mitotane“Slow accrual”
- terminated · 2014-04-29 · National Cancer Institute (NCI) · mitotane“The trial was permanently halted due to futility concerns.”
- terminated · 2012-09-27 · H. Lee Moffitt Cancer Center and Research Institute · aminoglutethimide“low accrual”
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.
- FDA pediatric target list: no · CYP11A1 is not on the listRule: Target is on FDA's Pediatric Molecular Target List (relevant targets). 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
- EU paediatric investigation plan: no · No EMA paediatric investigation plan decision names levoketoconazole, aminoglutethimide, mitotaneRule: 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/3/02/102 expired 12 Jun 2002: Treatment of adrenal cortical carcinoma; EU/3/02/113 withdrawn 11 Sept 2002: Treatment of adrenal cortical carcinomaRule: 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 · Lysodren: authorised since 28 Apr 2004Rule: 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 Lysodren, 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 linkRule: 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 levoketoconazole, aminoglutethimide, mitotaneRule: 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 · 3 interventional studies of levoketoconazole, aminoglutethimide, mitotane include patients under 18; 0 are recruiting, not yet recruiting or activeRule: 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
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.
| Drug | Type | Highest stage | Indications | Source records |
|---|---|---|---|---|
| LEVOKETOCONAZOLE | Small molecule | approval | Cushing syndrome, adrenal gland hyperfunction, adrenal gland disorder, type 2 diabetes mellitus | Open Targets · ChEMBL |
| AMINOGLUTETHIMIDE | Small molecule | approval | neoplasm, breast cancer, prostate cancer | Open Targets · ChEMBL |
| MITOTANE | Small molecule | approval | adrenal cortex carcinoma, adrenal cortex neoplasm, neoplasm, prostate cancer | Open Targets · ChEMBL |