OncoSignal
Live from Open Targets Platform, fetched 2026-11-12 04:30 UTC. Every row links to its source record.

CYP11B1 cytochrome P450 family 11 subfamily B member 1

ENSG00000160882 · protein coding · Open Targets profile

A cytochrome P450 monooxygenase mainly involved in the biosynthesis of adrenal corticoids (PubMed:12530636, PubMed:1518866, PubMed:1775135, PubMed:18215163, PubMed:23322723, PubMed:23685396, PubMed:29277707). Catalyzes a variety of reactions that are essential for many species, including detoxification, defense, and the formation of endogenous chemicals like steroid hormones. Steroid 11beta, 18- and 19-hydroxylase with preferred regioselectivity at 11beta, then 18, and lastly 19 (By similarity). Catalyzes the hydroxylation of 11- deoxycortisol and 11-deoxycorticosterone (21-hydroxyprogesterone) at 11beta position, yielding cortisol or corticosterone, respectively, but cannot produce aldosterone (PubMed:12530636, PubMed:1518866, PubMed:1775135, PubMed:18215163, PubMed:23322723, PubMed:23685396, PubMed:29277707). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate for hydroxylation 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:18215163, PubMed:23685396). Due to its lack of 18-oxidation activity, it is incapable of generating aldosterone (PubMed:23322723). Besides its role in the biosynthesis of mineralocorticoids and glucocorticoids, it can also participate in the androgen metabolic pathway, converting androst-4-ene-3,17-dione to 11beta-hydroxyandrost-4-ene-3,17-dione, and testosterone (17beta- hydroxy-4-androsten-3-one) to 11beta,17beta-dihydroxyandrost-4-ene-3- one (PubMed:23685396, PubMed:29277707). {ECO:0000250|UniProtKB:P15393, ECO:0000269|PubMed:12530636, ECO:0000269|PubMed:1518866, ECO:0000269|PubMed:1775135, ECO:0000269|PubMed:18215163, ECO:0000269|PubMed:23322723, ECO:0000269|PubMed:23685396, ECO:0000269|PubMed:29277707, ECO:0000305|PubMed:23322723}.

5 of the 5 drugs recorded against CYP11B1 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.

5 small molecule drugs at Approved: MITOTANE, OSILODROSTAT PHOSPHATE, LEVOKETOCONAZOLE, OSILODROSTAT, METYRAPONESmall molecule 5Approved 5

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.

CYP11B1: inherited and tumour-mutation evidence across 15 cancers

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)
00.250.50.751adrenal cortex carcinomaadrenal cortex carcinomaadrenal cortex neoplasmadrenal cortex neoplasmACTH Syndrome, EctopicACTH Syndrome, EctopicCongenital adrenal insufficiency with 4…Congenital adrenal insufficiency with 46, XY sex reversal OR 46,XY disorder of sex development-adrenal insufficiency due to CYP11A1 deficiencyaldosterone-producing adrenal cortex ad…aldosterone-producing adrenal cortex adenomamultiple endocrine neoplasia type 4multiple endocrine neoplasia type 4familial hyperaldosteronism type IIfamilial hyperaldosteronism type IIhereditary pheochromocytoma-paraganglio…hereditary pheochromocytoma-paragangliomamultiple endocrine neoplasia type 1multiple endocrine neoplasia type 1Zollinger-Ellison syndromeZollinger-Ellison syndromepituitary adenoma 3, multiple typespituitary adenoma 3, multiple typesthymic neuroendocrine tumorthymic neuroendocrine tumormultiple endocrine neoplasia type 2Amultiple endocrine neoplasia type 2Aprostate cancerprostate cancerpituitary adenocarcinomapituitary adenocarcinoma

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 Ligand, Druggable Family
Antibody
UniProt loc med conf
PROTAC
Small Molecule Binder

gnomAD loss of function constraint: o/e 0.7036799788475037 (upper bound 0.9368399977684021). 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 30 registry trials, updated in the last three years, of the most advanced drugs against CYP11B1 (mitotane, osilodrostat, levoketoconazole, metyrapone), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.

11 of 30 trials of drugs against CYP11B1 have sites only in United States

Registry trials of mitotane, osilodrostat, levoketoconazole, metyrapone 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; 25 of 30 have all sites in one country.

Sites only in this groupSites here and elsewhere
United StatesUnited States: 11 trials with sites only hereUnited States: 5 trials with sites here and elsewhere16ChinaChina: 1 trials with sites only hereChina: 1 trials with sites here and elsewhere2EuropeEurope: 10 trials with sites only hereEurope: 4 trials with sites here and elsewhere14JapanJapan: 0 trials with sites only hereJapan: 1 trials with sites here and elsewhere1OtherOther: 3 trials with sites only hereOther: 3 trials with sites here and elsewhere6

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 CYP11B1 were stopped early

Terminated, withdrawn and suspended interventional trials of mitotane, osilodrostat, levoketoconazole, metyrapone, 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 CYP11B1's drugs

For mitotane, osilodrostat, levoketoconazole, metyrapone: 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.

  • EU paediatric investigation plan: yes · EMEA-000315-PIP02-15-M04 (osilodrostat, Treatment of adrenal cortical hyperfunction): PM: decision on the application for modification of an agreed PIP, 13 Sept 2024
    Rule: An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name. Source: EMA EMEA-000315-PIP02-15-M04, 2026-11-11
  • EU orphan designation: yes · EU/3/14/1345 positive 15 Oct 2014: Treatment of Cushing's syndrome; 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 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: EMA data download (dated snapshot), 2026-11-11
  • Authorised in the EU: yes · Lysodren: authorised since 28 Apr 2004; Isturisa: authorised since 9 Jan 2020, orphan medicine
    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: no · FDA's table lists no pediatric approval of mitotane, osilodrostat, levoketoconazole, metyrapone
    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 · 4 interventional studies of mitotane, osilodrostat, levoketoconazole, metyrapone include patients under 18; 1 is 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

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 5 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
MITOTANESmall moleculeapprovaladrenal cortex carcinoma, adrenal cortex neoplasm, neoplasm, prostate cancerOpen Targets · ChEMBL
OSILODROSTAT PHOSPHATESmall moleculeapprovalCushing syndrome, ACTH-dependent Cushing syndromeOpen Targets · ChEMBL
LEVOKETOCONAZOLESmall moleculeapprovalCushing syndrome, adrenal gland hyperfunction, adrenal gland disorder, type 2 diabetes mellitusOpen Targets · ChEMBL
OSILODROSTATSmall moleculephase 4Cushing syndrome, adrenal gland disorder, ACTH-dependent Cushing syndrome, primary aldosteronism, essential hypertension, hypertensive disorder, Hypertension resistant to conventional therapyOpen Targets · ChEMBL
METYRAPONESmall moleculephase 4depressive disorder, ACTH Syndrome, Ectopic, Cushing syndrome, smoking cessation, major depressive disorder, cocaine use disorder, cocaine dependence, nicotine dependence, +3 moreOpen Targets · ChEMBL