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

TERT telomerase reverse transcriptase

ENSG00000164362 · protein coding · Open Targets profile

Telomerase is a ribonucleoprotein enzyme essential for the replication of chromosome termini in most eukaryotes. Active in progenitor and cancer cells. Inactive, or very low activity, in normal somatic cells. Catalytic component of the teleromerase holoenzyme complex whose main activity is the elongation of telomeres by acting as a reverse transcriptase that adds simple sequence repeats to chromosome ends by copying a template sequence within the RNA component of the enzyme. Catalyzes the RNA-dependent extension of 3'-chromosomal termini with the 6-nucleotide telomeric repeat unit, 5'-TTAGGG-3'. The catalytic cycle involves primer binding, primer extension and release of product once the template boundary has been reached or nascent product translocation followed by further extension. More active on substrates containing 2 or 3 telomeric repeats. Telomerase activity is regulated by a number of factors including telomerase complex- associated proteins, chaperones and polypeptide modifiers. Modulates Wnt signaling. Plays important roles in aging and antiapoptosis. {ECO:0000269|PubMed:14963003, ECO:0000269|PubMed:15082768, ECO:0000269|PubMed:15857955, ECO:0000269|PubMed:17026956, ECO:0000269|PubMed:17264120, ECO:0000269|PubMed:17296728, ECO:0000269|PubMed:17548608, ECO:0000269|PubMed:19188162, ECO:0000269|PubMed:19567472, ECO:0000269|PubMed:19571879, ECO:0000269|PubMed:19777057, ECO:0000269|PubMed:9389643}.

2 of the 2 drugs recorded against TERT 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.

2 unknown drugs at Approved: IMETELSTAT, IMETELSTAT SODIUMUnknown 2Approved 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 Withdrawn means the drug was pulled from the market or from development.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 15 of 15 cancers, the evidence for TERT 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)
00.250.50.751dyskeratosis congenita, autosomal domin…dyskeratosis congenita, autosomal dominant 2dyskeratosis congenita, autosomal dominant 2: germline 0.93dyskeratosis congenitadyskeratosis congenitadyskeratosis congenita: germline 0.85acute myeloid leukemiaacute myeloid leukemiaacute myeloid leukemia: somatic 0.46acute myeloid leukemia: germline 0.79autosomal recessive dyskeratosis congen…autosomal recessive dyskeratosis congenita 4autosomal recessive dyskeratosis congenita 4: germline 0.82melanoma, cutaneous malignant, suscepti…melanoma, cutaneous malignant, susceptibility to, 9melanoma, cutaneous malignant, susceptibility to, 9: germline 0.63urinary bladder cancerurinary bladder cancerurinary bladder cancer: somatic 0.68urinary bladder cancer: germline 0.70prostate carcinomaprostate carcinomaprostate carcinoma: somatic 0.46prostate carcinoma: germline 0.93lung carcinomalung carcinomalung carcinoma: somatic 0.61lung carcinoma: germline 0.87myelodysplastic syndromemyelodysplastic syndromemyelodysplastic syndrome: somatic 0.46myelodysplastic syndrome: germline 0.49breast carcinomabreast carcinomabreast carcinoma: somatic 0.46breast carcinoma: germline 0.70hepatocellular carcinomahepatocellular carcinomahepatocellular carcinoma: somatic 0.46hepatocellular carcinoma: germline 0.75lung adenocarcinomalung adenocarcinomalung adenocarcinoma: somatic 0.46lung adenocarcinoma: germline 0.85uterine corpus leiomyomauterine corpus leiomyomauterine corpus leiomyoma: germline 0.77gliomagliomaglioma: somatic 0.46glioma: germline 0.79prostate cancerprostate cancerprostate cancer: germline 0.90

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
High-Quality Ligand, Druggable Family
Antibody
GO CC med conf
PROTAC
UniProt Ubiquitination, Small Molecule Binder
Other modalities
Advanced Clinical

gnomAD loss of function constraint: o/e 0.40369001030921936 (upper bound 0.5221400260925293). 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 10 registry trials, updated in the last three years, of the most advanced drugs against TERT (imetelstat), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.

7 of 10 trials of drugs against TERT have sites only in United States

Registry trials of imetelstat 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; 7 of 10 have all sites in one country.

Sites only in this groupSites here and elsewhere
United StatesUnited States: 7 trials with sites only hereUnited States: 2 trials with sites here and elsewhere9EuropeEurope: 0 trials with sites only hereEurope: 3 trials with sites here and elsewhere3OtherOther: 0 trials with sites only hereOther: 3 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.

12 trials of drugs against TERT were stopped early; 3 give no reason

Terminated, withdrawn and suspended interventional trials of imetelstat, 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 12 most recent of 12.

  • withdrawn · 2025-05-02 · Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University · matched by the registry's drug synonyms
    No reason given
  • withdrawn · 2020-09-21 · NCIC Clinical Trials Group · Imetelstat
    “drug company withdrew support following re-examination of benefit-risk assessment for the investigational use of imetelstat in this population”
  • withdrawn · 2018-08-07 · Children's Oncology Group · Imetelstat Sodium
    “IND no longer available.”
  • terminated · 2018-07-20 · Pediatric Brain Tumor Consortium · imetelstat sodium
    “Due to several intracranial hemorrhages and recommendation by the PBTC DSMB.”
  • terminated · 2018-01-11 · Gynecologic Oncology Group · matched by the registry's drug synonyms
    “Study was stopped for severe toxicity causing concern for patients”
  • terminated · 2018-01-04 · Amgen · matched by the registry's drug synonyms
    No reason given
  • terminated · 2015-12-14 · Takeda · matched by the registry's drug synonyms
    “Sponsor decision to terminate the study because the study did not meet the primary endpoint.”
  • terminated · 2015-10-15 · Amgen · matched by the registry's drug synonyms
    “Sponsor decision to close study”
  • terminated · 2015-10-15 · Amgen · matched by the registry's drug synonyms
    “Amgen decision”
  • terminated · 2015-09-07 · Amgen · matched by the registry's drug synonyms
    “Amgen discontinued the development of AMG706 because 20050201 did not meet its primary objective.”
  • terminated · 2014-03-20 · Amgen · matched by the registry's drug synonyms
    “Study terminated per recommendation of Data Review Team”
  • withdrawn · 2012-11-21 · National Cancer Institute (NCI) · Imetelstat
    No reason given
Paediatric incentives and obligations for TERT's drugs

For imetelstat: 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 · TERT is on the list. Membership alone neither requires nor waives a pediatric study.
  • EU paediatric investigation plan: yes · EMEA-001910-PIP03-20-M01 (imetelstat, Treatment of acute myeloid leukemia;Treatment of myelodysplastic syndromes, including juvenile myelomonocytic leukemia): PM: decision on the application for modification of an agreed PIP, 30 Dec 2022; EMEA-001910-PIP01-15 (imetelstat, Treatment of myelofibrosis): W: decision granting a waiver in all age groups for all conditions or indications, 15 Jun 2016
    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/3/20/2305 positive 27 Jul 2020: Treatment of myelodysplastic syndromes; EU/3/15/1593 positive 14 Dec 2015: Treatment of myelofibrosis
    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 · Rytelo: authorised since 7 Mar 2025, 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 EPAR Rytelo, 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 imetelstat
    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 · 6 interventional studies of imetelstat 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, 2026-11-11

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 2 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
IMETELSTATUnknownapprovalmyelodysplastic syndrome, anemia, neoplasm, myelofibrosis, breast cancer, essential thrombocythemia, plasma cell myeloma, non-small cell lung carcinoma, +7 moreOpen Targets · ChEMBL
IMETELSTAT SODIUMUnknownapprovalanemia, myelodysplastic syndrome, breast cancer, myelofibrosis, myeloid neoplasm, diffuse intrinsic pontine glioma, ependymoma, malignant glioma, +4 moreOpen Targets · ChEMBL