OncoSignal
Live from Open Targets Platform, fetched 2026-11-11 16:13 UTC. Every row links to its source record.

SMO smoothened, frizzled class receptor

ENSG00000128602 · protein coding · Open Targets profile

G protein-coupled receptor, which transduces the smoothened signaling pathway (PubMed:19592253, PubMed:27437577, PubMed:28344083, PubMed:31168089, PubMed:32929279, PubMed:36202993). Activated by cholesterol in response to hedgehog (DHH, IHH or SHH) morphogens (PubMed:27437577, PubMed:28344083, PubMed:32929279). In absence of hedgehog, SMO is inactivated by patched protein (PTCH1 or PTCH2), which prevents SMO access to cholesterol (PubMed:28344083). In response to hedgehog-binding to pathched, inhibition is relieved, promoting SMO translocation to primary cilium and activation by cholesterol: cholesterol causes a conformation change that triggers signaling via G protein G(i), mediating inhibition of adenylate cyclase activity and decreassed production of cAMP (PubMed:28344083, PubMed:31168089). Decreased cAMP levels then inhibit protein kinase A (PKA) and promote release of GLI (GLI1, GLI2 and GLI3) transcription factors, which activate expression of target genes (PubMed:31168089). Active SMO also directly inhibits PKA by sequestering its catalytic subunit, PRKACA, at the cell membrane, preventing PRKACA-mediated phosphorylation and subsequent processing of GLI transcription factors (PubMed:36202993, PubMed:39138140). Active SMO also promotes the removal of GPR161, a key inhibitor of the smoothened signaling pathway, from primary cilia (By similarity). {ECO:0000250|UniProtKB:P56726, ECO:0000269|PubMed:19592253, ECO:0000269|PubMed:27437577, ECO:0000269|PubMed:28344083, ECO:0000269|PubMed:31168089, ECO:0000269|PubMed:32929279, ECO:0000269|PubMed:36202993, ECO:0000269|PubMed:39138140}.

5 of the 10 drugs recorded against SMO are approved, and 1 more 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.

5 small molecule drugs at Approved: SONIDEGIB PHOSPHATE, GLASDEGIB, GLASDEGIB MALEATE, SONIDEGIB, VISMODEGIB1 small molecule drug at Phase 3: PATIDEGIB2 small molecule drugs at Phase 2: TALADEGIB, BMS-8339232 small molecule drugs at Phase 1: TAK-441, LEQ506Small molecule 10Approved 5Phase 3 1Phase 2 2Phase 1 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 Withdrawn means the drug was pulled from the market or from development.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 SMO 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)
00.250.50.751basal cell carcinomabasal cell carcinomabasal cell carcinoma: somatic 0.64acute myeloid leukemiaacute myeloid leukemiaacute myeloid leukemia: somatic 0.46medulloblastomamedulloblastomamedulloblastoma: somatic 0.69meningiomameningiomameningioma: somatic 0.61skin basal cell carcinomaskin basal cell carcinomaskin basal cell carcinoma: somatic 0.61ameloblastomaameloblastomaameloblastoma: somatic 0.61juvenile myelomonocytic leukemiajuvenile myelomonocytic leukemiaMeningothelial MeningiomaMeningothelial MeningiomaMeningothelial Meningioma: somatic 0.61colon adenocarcinomacolon adenocarcinomacolon adenocarcinoma: somatic 0.61Transitional MeningiomaTransitional MeningiomaTransitional Meningioma: somatic 0.61colorectal adenocarcinomacolorectal adenocarcinomacolorectal adenocarcinoma: somatic 0.61Atypical MeningiomaAtypical MeningiomaAtypical Meningioma: somatic 0.61nodular malignant melanomanodular malignant melanomanodular malignant melanoma: somatic 0.61pilocytic astrocytomapilocytic astrocytomapilocytic astrocytoma: somatic 0.61soft tissue sarcomasoft tissue sarcomasoft tissue sarcoma: 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
Approved Drug, Structure with Ligand, High-Quality Ligand, Druggable Family
Antibody
GO CC high conf, UniProt loc med conf, UniProt SigP or TMHMM
PROTAC
Small Molecule Binder

gnomAD loss of function constraint: o/e 0.4904100000858307 (upper bound 0.6383900046348572). 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 60 registry trials, updated in the last three years, of the most advanced drugs against SMO (sonidegib, glasdegib, vismodegib, patidegib, taladegib, BMS-833923), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.

24 of 59 trials of drugs against SMO have sites only in United States

Registry trials of sonidegib, glasdegib, vismodegib, patidegib, taladegib, BMS-833923 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; 44 of 59 have all sites in one country.

Sites only in this groupSites here and elsewhere
United StatesUnited States: 24 trials with sites only hereUnited States: 9 trials with sites here and elsewhere33ChinaChina: 1 trials with sites only hereChina: 0 trials with sites here and elsewhere1EuropeEurope: 13 trials with sites only hereEurope: 12 trials with sites here and elsewhere25JapanJapan: 1 trials with sites only hereJapan: 2 trials with sites here and elsewhere3OtherOther: 6 trials with sites only hereOther: 10 trials with sites here and elsewhere16

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

40 trials of drugs against SMO were stopped early; 10 give no reason

Terminated, withdrawn and suspended interventional trials of sonidegib, glasdegib, vismodegib, patidegib, taladegib, BMS-833923, TAK-441, LEQ506, 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 25 most recent of 40.

  • suspended · 2026-09-18 · Dwight Owen · Vismodegib
    “Pending ICF update”
  • terminated · 2026-07-21 · Sol-Gel Technologies, Ltd. · Patidegib Topical Gel, 2%, Patidegib Topical Gel, Vehicle
    “Terminated early due to low blinded event rate”
  • terminated · 2025-10-23 · European Organisation for Research and Treatment of Cancer - EORTC · Sonidegib
    “Poor accrual”
  • terminated · 2025-08-21 · Eli Lilly and Company · Taladegib
    “The study was terminated due to business considerations”
  • terminated · 2024-10-29 · Fred Hutchinson Cancer Center · Glasdegib
    “Study closed to accrual early due to side effects of study drug.”
  • terminated · 2024-09-24 · Sol-Gel Technologies, Ltd. · Patidegib Topical Gel, 2%
    “Study was terminated early due to low blinded event rate and this study termination is not related to safety of the drug Patidegib Topical Gel, 2%.”
  • terminated · 2024-08-06 · Giselle Sholler · Vismodegib
    “Lack of enrollment and commercial availability of drug”
  • terminated · 2024-03-04 · OHSU Knight Cancer Institute · Vismodegib
    “Low accrual”
  • withdrawn · 2024-01-23 · OHSU Knight Cancer Institute · Vismodegib
    “Withdrawn due to a change in therapeutic interventions.”
  • terminated · 2023-07-10 · M.D. Anderson Cancer Center · Taladegib
    “The sponsor sold the drug TALADEGIB to another company during the trial and thereafter no drug was available. The sponsor made a decision to stop development of this drug Taladegib.”
  • terminated · 2022-07-01 · University Hospital Heidelberg · Glasdegib
    “Study turned out no longer feasible. End of Recruitment: 25.5.2022”
  • withdrawn · 2022-06-09 · City of Hope Medical Center · Glasdegib Maleate
    “Drug availability”
  • terminated · 2021-10-15 · Yale University · Glasdegib
    “Unable to accrue patients following COVID-19 study pause.”
  • terminated · 2021-07-19 · National Cancer Institute (NCI) · Vismodegib
    No reason given
  • terminated · 2020-01-29 · Istituto Clinico Humanitas · Vismodegib
    “low recruitment rate”
  • terminated · 2020-01-22 · Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins · matched by the registry's drug synonyms
    “Study was terminated due to cease in manufacturing of study drug.”
  • withdrawn · 2019-12-18 · Columbia University · Vismodegib
    “Loss of funding”
  • terminated · 2019-08-14 · University of Arizona · Vismodegib
    “Low enrollment”
  • withdrawn · 2019-06-19 · Martin Gutierrez · matched by the registry's drug synonyms
    No reason given
  • terminated · 2019-05-21 · Centre Leon Berard · vismodegib
    “The number of successes is not reached at the end of first stage of the phase II. The study is stopped.”
  • terminated · 2019-02-28 · National Cancer Institute (NCI) · Vismodegib
    No reason given
  • terminated · 2019-01-29 · Anne Chang · Sonidegib
    “Business Decision”
  • terminated · 2019-01-17 · Pfizer · Glasdegib (PF-04449913)
    No reason given
  • terminated · 2018-12-28 · Eli Lilly and Company · matched by the registry's drug synonyms
    “Change in clinical strategy.”
  • terminated · 2018-03-19 · Massachusetts General Hospital · matched by the registry's drug synonyms
    No reason given
Paediatric incentives and obligations for SMO's drugs

For sonidegib, glasdegib, vismodegib, patidegib, taladegib, BMS-833923, TAK-441, LEQ506: 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 · SMO is on the list. Membership alone neither requires nor waives a pediatric study.
  • EU paediatric investigation plan: yes · EMA/PE/0000238063 (taladegib, Treatment of idiopathic pulmonary fibrosis): PM: decision on the application for modification of an agreed PIP, 14 Apr 2025; EMEA-000880-PIP02-11-M04 (sonidegib, Treatment of medulloblastoma): PM: decision on the application for modification of an agreed PIP, 20 Mar 2020; EMEA-002199-PIP01-17 (Glasdegib, Treatment of acute myeloid leukaemia): W: decision granting a waiver in all age groups for all conditions or indications, 15 Aug 2018; EMEA-002322-PIP01-17 (patidegib, Treatment of naevoid basal-cell carcinoma syndrome (Gorlin syndrome)): W: decision granting a waiver in all age groups for all conditions or indications, 17 Jul 2018
    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/3/25/3054 positive 22 May 2025: Treatment of idiopathic pulmonary fibrosis; EU/3/18/1998 positive 21 Mar 2018: Treatment of naevoid basal-cell carcinoma syndrome (Gorlin syndrome); EU/3/17/1923 positive 16 Oct 2017: Treatment of acute myeloid leukaemia
    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 · Erivedge: authorised since 12 Jul 2013; Odomzo: authorised since 14 Aug 2015; Daurismo: authorised since 26 Jun 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 sonidegib, glasdegib, vismodegib, patidegib, taladegib, bms-833923, tak-441, leq506
    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 · 10 interventional studies of sonidegib, glasdegib, vismodegib, patidegib, taladegib, bms-833923, tak-441, leq506 include patients under 18; 2 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 10 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
SONIDEGIB PHOSPHATESmall moleculeapprovalbasal cell carcinomaOpen Targets · ChEMBL
GLASDEGIBSmall moleculeapprovaljuvenile myelomonocytic leukemia, acute myeloid leukemia, neoplasm, soft tissue sarcoma, chronic myelomonocytic leukemia, myelodysplastic syndrome, myelofibrosis, myeloid sarcoma, +4 moreOpen Targets · ChEMBL
GLASDEGIB MALEATESmall moleculeapprovalacute myeloid leukemiaOpen Targets · ChEMBL
SONIDEGIBSmall moleculephase 4basal cell carcinoma, neoplasm, medulloblastoma, skin cancer, nevoid basal cell carcinoma syndrome, breast cancer, acute leukemia, hematopoietic and lymphoid cell neoplasm, +26 moreOpen Targets · ChEMBL
VISMODEGIBSmall moleculephase 4basal cell carcinoma, neoplasm, colorectal cancer, small cell lung carcinoma, medulloblastoma, nevoid basal cell carcinoma syndrome, glioblastoma, gastroesophageal junction adenocarcinoma, +35 moreOpen Targets · ChEMBL
PATIDEGIBSmall moleculephase 3nevoid basal cell carcinoma syndrome, basal cell carcinoma, chondrosarcoma, myelofibrosis, pancreatic neoplasm, malignant pancreatic neoplasm, head and neck cancer, pancreatic adenocarcinoma, +2 moreOpen Targets · ChEMBL
TALADEGIBSmall moleculephase 2idiopathic pulmonary fibrosis, small cell lung carcinoma, esophageal adenocarcinoma, gastroesophageal junction adenocarcinoma, ovarian cancer, cancer, rhabdomyosarcoma, medulloblastomaOpen Targets · ChEMBL
BMS-833923Small moleculephase 2chronic myeloid leukemia, plasma cell myeloma, gastric adenocarcinoma, esophageal adenocarcinoma, small cell lung carcinoma, nevoid basal cell carcinoma syndromeOpen Targets · ChEMBL
TAK-441Small moleculephase 1–Open Targets · ChEMBL
LEQ506Small moleculephase 1–Open Targets · ChEMBL