OncoSignal
Live from Open Targets Platform, fetched 2026-11-11 15:28 UTC. Every row links to its source record.

MDM2 MDM2 proto-oncogene

ENSG00000135679 · protein coding · Open Targets profile

E3 ubiquitin-protein ligase that mediates ubiquitination of p53/TP53, leading to its degradation by the proteasome (PubMed:29681526, PubMed:21317885). Inhibits p53/TP53- and p73/TP73- mediated cell cycle arrest and apoptosis by binding its transcriptional activation domain. Also acts as a ubiquitin ligase E3 toward itself and ARRB1. Permits the nuclear export of p53/TP53. Promotes proteasome- dependent ubiquitin-independent degradation of retinoblastoma RB1 protein. Inhibits DAXX-mediated apoptosis by inducing its ubiquitination and degradation. Component of the TRIM28/KAP1-MDM2- p53/TP53 complex involved in stabilizing p53/TP53. Also a component of the TRIM28/KAP1-ERBB4-MDM2 complex which links growth factor and DNA damage response pathways. Mediates ubiquitination and subsequent proteasome degradation of DYRK2 in nucleus. Ubiquitinates IGF1R and SNAI1 and promotes them to proteasomal degradation (PubMed:12821780, PubMed:15053880, PubMed:15195100, PubMed:15632057, PubMed:16337594, PubMed:17290220, PubMed:19098711, PubMed:19219073, PubMed:19837670, PubMed:19965871, PubMed:20173098, PubMed:20385133, PubMed:20858735, PubMed:22128911). Ubiquitinates DCX, leading to DCX degradation and reduction of the dendritic spine density of olfactory bulb granule cells (By similarity). Ubiquitinates DLG4, leading to proteasomal degradation of DLG4 which is required for AMPA receptor endocytosis (By similarity). Negatively regulates NDUFS1, leading to decreased mitochondrial respiration, marked oxidative stress, and commitment to the mitochondrial pathway of apoptosis (PubMed:30879903). Binds NDUFS1 leading to its cytosolic retention rather than mitochondrial localization resulting in decreased supercomplex assembly (interactions between complex I and complex III), decreased complex I activity, ROS production, and apoptosis (PubMed:30879903). {ECO:0000250|UniProtKB:P23804, ECO:0000269|PubMed:12821780, ECO:0000269|PubMed:15053880, ECO:0000269|PubMed:15195100, ECO:0000269|PubMed:15632057, ECO:0000269|PubMed:16337594, ECO:0000269|PubMed:17290220, ECO:0000269|PubMed:19098711, ECO:0000269|PubMed:19219073, ECO:0000269|PubMed:19837670, ECO:0000269|PubMed:19965871, ECO:0000269|PubMed:20173098, ECO:0000269|PubMed:20385133, ECO:0000269|PubMed:20858735, ECO:0000269|PubMed:21317885, ECO:0000269|PubMed:22128911, ECO:0000269|PubMed:29681526, ECO:0000269|PubMed:30879903}.

None of the 4 drugs recorded against MDM2 is approved yet; 2 reached Phase 3

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.

2 small molecule drugs at Phase 3: IDASANUTLIN, NAVTEMADLIN2 small molecule drugs at Phase 2: SIREMADLIN, ALRIZOMADLINSmall molecule 4Phase 3 2Phase 2 2

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 14 of 15 cancers, the evidence for MDM2 comes mainly from mutations found in tumours

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)
00.250.50.751prostate carcinomaprostate carcinomaprostate carcinoma: somatic 0.61Li-Fraumeni syndromeLi-Fraumeni syndromeLi-Fraumeni syndrome: germline 0.61skin basal cell carcinomaskin basal cell carcinomaskin basal cell carcinoma: somatic 0.61lymphoid neoplasmlymphoid neoplasmlymphoid neoplasm: somatic 0.61hemangioblastomahemangioblastomahemangioblastoma: somatic 0.61skin squamous cell carcinomaskin squamous cell carcinomaskin squamous cell carcinoma: somatic 0.61breast ductal adenocarcinomabreast ductal adenocarcinomabreast ductal adenocarcinoma: somatic 0.61nodular malignant melanomanodular malignant melanomanodular malignant melanoma: somatic 0.61hepatobiliary neoplasmhepatobiliary neoplasmhepatobiliary neoplasm: somatic 0.61ovarian endometrioid adenocarcinoma wit…ovarian endometrioid adenocarcinoma with squamous differentiationovarian endometrioid adenocarcinoma with squamous differentiation: somatic 0.61superficial spreading melanomasuperficial spreading melanomasuperficial spreading melanoma: somatic 0.61Transitional MeningiomaTransitional MeningiomaTransitional Meningioma: somatic 0.61carcinoma of liver and intrahepatic bil…carcinoma of liver and intrahepatic biliary tractcarcinoma of liver and intrahepatic biliary tract: somatic 0.61melanomamelanomamelanoma: somatic 0.46acute myeloid leukemiaacute myeloid leukemiaacute myeloid leukemia: somatic 0.46

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
Advanced Clinical, Structure with Ligand, High-Quality Ligand, High-Quality Pocket, Druggable Family
Antibody
GO CC high conf
PROTAC
Literature, UniProt Ubiquitination, Database Ubiquitination, Small Molecule Binder

gnomAD loss of function constraint: o/e 0.1709499955177307 (upper bound 0.2829599976539612). 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 21 registry trials, updated in the last three years, of the most advanced drugs against MDM2 (idasanutlin, navtemadlin, siremadlin, alrizomadlin), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.

9 of 19 trials of drugs against MDM2 have sites only in United States

Registry trials of idasanutlin, navtemadlin, siremadlin, alrizomadlin 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; 11 of 19 have all sites in one country.

Sites only in this groupSites here and elsewhere
United StatesUnited States: 9 trials with sites only hereUnited States: 6 trials with sites here and elsewhere15EuropeEurope: 3 trials with sites only hereEurope: 7 trials with sites here and elsewhere10OtherOther: 0 trials with sites only hereOther: 7 trials with sites here and elsewhere7

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. 2 trials list no sites and are left out. Source: ClinicalTrials.gov, fetched live.

21 trials of drugs against MDM2 were stopped early

Terminated, withdrawn and suspended interventional trials of idasanutlin, navtemadlin, siremadlin, alrizomadlin, 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 21 most recent of 21.

  • withdrawn · 2026-03-17 · National Cancer Institute (NCI) · alrizomadlin
    “The study is being withdrawn due to the CRADA with the company not being finalized”
  • terminated · 2026-02-10 · National Cancer Institute (NCI) · Navtemadlin
    “Inadequate accrual rate”
  • terminated · 2025-11-13 · National Cancer Institute (NCI) · Navtemadlin
    “Drug supply issues”
  • terminated · 2025-10-10 · Novartis Pharmaceuticals · matched by the registry's drug synonyms
    “Business decision”
  • terminated · 2025-08-07 · Novartis Pharmaceuticals · Siremadlin
    “Sponsor Decision”
  • terminated · 2025-05-16 · Novartis Pharmaceuticals · Siremadlin
    “Study has been stopped following the strategic decision from the Sponsor. Not based on any safety findings or safety concerns with siremadlin.”
  • terminated · 2024-12-20 · Hoffmann-La Roche · Idasanutlin
    “Study was terminated by the sponsor based on insufficient tolerability and efficacy to proceed beyond Part 1b.”
  • withdrawn · 2024-03-27 · St. Jude Children's Research Hospital · Idasanutlin
    “Drug withdrawn by company.”
  • terminated · 2024-03-22 · Kartos Therapeutics, Inc. · matched by the registry's drug synonyms
    “In September 2023, the study was terminated because of a Sponsor decision, unrelated to safety concerns.”
  • withdrawn · 2024-03-22 · Kartos Therapeutics, Inc. · Navtemadlin, Navtemadlin Placebo
    “Sponsor Decision”
  • terminated · 2023-11-07 · Hoffmann-La Roche · Idasanutlin
    “The Sponsor made the decision to terminate the study due to start up and recruitment issues caused by limited resource availability at the treating centers.”
  • terminated · 2023-08-16 · Kartos Therapeutics, Inc. · matched by the registry's drug synonyms
    “Unanticipated and extremely high screen failure rate. There was no evidence of safety concerns in the study.”
  • terminated · 2022-10-06 · Insel Gruppe AG, University Hospital Bern · matched by the registry's drug synonyms
    “Insufficient recruitment”
  • terminated · 2022-09-29 · Novartis Pharmaceuticals · matched by the registry's drug synonyms
    “The combination part of the study was terminated early due to business reasons”
  • terminated · 2022-06-21 · Hoffmann-La Roche · Idasanutlin
    “Sponsor's decision to terminate the study after Phase 1; will not proceed with Phase 2.”
  • terminated · 2022-01-11 · Hoffmann-La Roche · Idasanutlin
    “The study was stopped for futility based on efficacy results at the interim analysis; no unexpected safety findings were observed.”
  • terminated · 2021-12-08 · Hoffmann-La Roche · Idasanutlin
    “The Sponsor decided to discontinue the development of idasanutlin in the polycythemia vera indication.”
  • terminated · 2021-12-07 · Hoffmann-La Roche · Idasanutlin
    “Sponsor's decision to terminate the study after Phase 1; will not proceed with Phase 2.”
  • terminated · 2021-08-11 · Vanderbilt-Ingram Cancer Center · Idasanutlin
    “Low accrual/Loss of funding”
  • terminated · 2020-05-18 · Hoffmann-La Roche · Idasanutlin
    “Sponsor's decision to terminate the study after Phase 1; will not proceed with Phase 2.”
  • withdrawn · 2020-01-09 · Novartis Pharmaceuticals · matched by the registry's drug synonyms
    “It was determined that the study design may not be optimal given the changing AML treatment landscape.”
Paediatric incentives and obligations for MDM2's drugs

For idasanutlin, navtemadlin, siremadlin, alrizomadlin: 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: yes · MDM2 is on the list. Membership alone neither requires nor waives a pediatric study.
  • EU paediatric investigation plan: yes · EMEA-001489-PIP02-19 (Idasanutlin, Treatment of all conditions included in the category of malignant neoplasms (except nervous system, haematopoietic and lymphoid tissue)): PM: decision on the application for modification of an agreed PIP, 15 May 2020; EMEA-001489-PIP01-13-M02 (Idasanutlin, Treatment of acute lymphoblastic leukaemia;Treatment of acute myeloid leukaemia): PM: decision on the application for modification of an agreed PIP, 18 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/3/25/3178 positive 9 Jan 2026: Treatment of myelofibrosis; EU/3/21/2556 positive 14 Jan 2022: Treatment of Merkel cell 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: no · EMA lists no centrally authorised medicine of idasanutlin, navtemadlin, siremadlin, alrizomadlin
    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 idasanutlin, navtemadlin, siremadlin, alrizomadlin
    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 · 2 interventional studies of idasanutlin, navtemadlin, siremadlin, alrizomadlin include patients under 18; 0 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

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 4 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
IDASANUTLINSmall moleculephase 3acute myeloid leukemia by FAB classification, acute myeloid leukemia, acquired polycythemia vera, follicular lymphoma, diffuse large B-cell lymphoma, plasma cell myeloma, glioblastoma, colorectal cancer, +7 moreOpen Targets · ChEMBL
NAVTEMADLINSmall moleculephase 3myelofibrosis, essential thrombocythemia, acquired polycythemia vera, endometrial cancer, Merkel cell skin cancer, small cell lung carcinoma, B-cell chronic lymphocytic leukemia, acute myeloid leukemia, +11 moreOpen Targets · ChEMBL
SIREMADLINSmall moleculephase 2metastatic malignant neoplasm, acute myeloid leukemia, myelofibrosis, soft tissue sarcoma, liposarcoma, hematopoietic and lymphoid cell neoplasm, uveal melanoma, colorectal cancer, +2 moreOpen Targets · ChEMBL
ALRIZOMADLINSmall moleculephase 2non-Hodgkin lymphoma, T-cell prolymphocytic leukemia, mesothelioma, liposarcoma, non-small cell lung carcinoma, urothelial carcinoma, malignant peripheral nerve sheath tumor, melanoma, +7 moreOpen Targets · ChEMBL