Giving the reopening conditions an owner, and the first run changes two decisions (run)
also called strike watch · reopening-condition surveillance
When this project rules a drug target out, it writes down what would change its mind. Nobody was checking whether that had happened. A script now runs those checks against the medical literature, and on its first run it found new work that revives one ruled-out target and confirms a change made to another.
The same thing, for a scientist
Converts the `reopens_if` sentences in the phase-2 go/no-go register into executable PubMed queries and reports papers published since a watermark. First run over 9 watched decisions returned 17 candidates, of which two matter: SIK2/3 inhibitors with oral in vivo efficacy in an MV4-11 xenograft, confirming the MEF2C redefinition; and USP22 as a MEIS1 protein-stability regulator found by genome-wide CRISPR in a KMT2A-rearranged B-ALL line, which reopens the MEIS1 demotion.
The hole this closes
The cycle-22 target rewrite struck seven candidates. The cycle-23 audit then found that four of seven rested on reasoning that fails on reading, while an independent reason happened to hold in every case, and drew the sharp conclusion:
A list robust to its own reasoning being wrong is a list whose reasoning wasn't doing the work — a genuinely wrong decision would have looked identical. That's why each strike now names one load-bearing reason and the result that reopens it. The residual hole: those reopening conditions have no owner.
A reopens_if sentence is not checkable by a person who never reads it. scripts/watch-reopening-conditions.py pairs each one with a query written to catch the specific result named, not the gene's general literature — a query returning everything about MEIS1 is a query nobody will read — and reports what is new since a watermark.
It decides nothing. A hit is a candidate to read. The purpose is narrow: to stop a strike becoming permanent by inattention, which is the failure mode the audit named 1.
First run: two decisions move1 deeper
Nine watched decisions, 17 candidate papers since 2025-01-01. Fifteen are reviews or off-target. Two are not, and the coordinator fetched and read both.
The MEF2C redefinition is confirmed, and has chemistry behind it. Cycle 23 redefined MEF2C from a dosage target to a phospho-state target on mouse genetics alone: a phospho-dead S222 knock-in has normal haematopoiesis yet resists leukemogenesis, so the handle is the upstream MARK/SIK kinase. An independent medicinal-chemistry programme has since reported oral SIK2/3 inhibitors with potency and selectivity in MEF2C-high over MEF2C-low lines, and significant tumour growth inhibition in an MV4-11 xenograft without body-weight loss 2. MV4-11 is a KMT2A::AFF1 line. A redefinition reached from mouse genetics turns out to point at an active programme with in vivo efficacy in this project's own fusion.
The MEIS1 demotion is reopened. MEIS1 was demoted because its leukemic stem-cell function is the normal adult HSC function, so lowering it should cost normal haematopoiesis. A genome-wide CRISPR screen in a KMT2A-rearranged B-ALL line has since identified USP22, a SAGA-complex deubiquitinase, as a regulator of MEIS1 protein stability: USP22 and MEIS1 bind cooperatively at oncogenic targets, and genetic or chemical USP22 inhibition drives MEIS1 polyubiquitination and proteasomal degradation 3.
That does not rehabilitate MEIS1 as a direct target — it relocates the handle upstream, exactly as happened with MEF2C. The demotion of MEIS1 itself stands; what changes is that a tractable route to lowering MEIS1 now exists and USP22 is a candidate the graph did not contain.
The pattern both hits share, which is worth more than either
MEF2C and MEIS1 are both transcription factors, the protein class with the worst record of direct ligandability, and both were correctly judged poor direct targets. In both cases the literature's answer was the same: target the regulator of the factor, not the factor — a kinase controlling its phospho-state, a deubiquitinase controlling its abundance.
This project's target triage scores genes on co-dependency, constraint, pan-essentiality and now normal-tissue expression. None of those axes would surface a regulator. A gene can be undruggable and still be the right thing to lower, and the register has no column for how a candidate might be reached indirectly. That is a gap in the triage, not in these two entries.
What the watch cannot do
The queries are hand-written and will miss things. Each is deliberately narrow so the output stays readable, which trades recall for signal. A reopening result published in language the query does not anticipate will not appear, and silence is therefore weak evidence.
KDM6A has no query yet and is watched in name only. The script names it in its own output rather than failing silently.
PubMed only. Preprints, conference abstracts and registry changes would not appear, and two of the most consequential findings in this graph this month came from a trial registry field and an FDA approval letter — neither reachable by this script.
A hit is not a reopening. Fifteen of seventeen were noise on this run, and a future run that surfaced nothing should not be read as confirming the strikes.
| script | scripts/watch-reopening-conditions.py |
|---|---|
| status | run |
| run date | 2026-09-18 |
| report | docs/watch-report.json |
| n watched | 9 |
| n candidate papers | 17 |
| n material | 2 |
| watermark | 2025/01/01 |
| new candidate not in graph | USP22 |
| query precision first run | ~12% (2 material of 17) |
unwatched for lack of query
[ "KDM6A" ]
decisions moved
{
"MEF2C": "redefinition to the upstream kinase confirmed; oral SIK2/3 inhibitors show in vivo efficacy in MV4-11",
"MEIS1": "demotion of MEIS1 itself stands, but USP22 supplies an upstream route to lowering it"
}- A watch that is ignored is worse than no watch, because it creates the appearance of surveillance. At 12% precision this will be ignored if run frequently, so the queries need tightening before the cadence increases.
- Neither hit licenses a programme. SIK2/3 inhibition rests on a cell-line xenograft in a line that also carries FLT3-ITD, and USP22 is a core SAGA subunit whose depletion impairs growth for many possible reasons.
- The watch is PubMed-only, and the two most consequential findings this month came from a trial-registry field and an FDA approval letter. Confidence that nothing has changed should not rest on this script.
- Does USP22 contact the fusion, or is it purely a MEIS1-abundance regulator? That determines whether it belongs in the interactome or only among dependencies, and the abstract does not say.
- USP22 did not surface in this project's own 4,589-gene selectivity scan. Did the scan miss it, is the dependency non-selective in DepMap's panel, or is it below the scanned fraction? Checkable against the full-genome scan now running.
- The register scores candidates on co-dependency, constraint, pan-essentiality and tissue expression. None of those would surface a REGULATOR of an undruggable factor. Should the register gain an 'indirect route' column?
- Query precision on the first run was about 12%. What tightening keeps the two material hits while dropping the reviews, and can the watch be run on registry and regulatory sources too?
- KDM6A is watched in name only. What result would actually reopen its reframing?
- E1strong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.dataset
Nine struck, redefined or demoted candidates in the phase-2 go/no-go register carry a reopening condition; paired with targeted PubMed queries and run against papers indexed since 2025-01-01, they returned 17 candidate papers, of which 2 were judged material on reading. KDM6A carries no query and is reported as unwatched.
Reopening-condition watch over concept-phase2-go-no-go-register; script at scripts/watch-reopening-conditions.py, output at docs/watch-report.json · analysis run by this project · Derived analysis 2026What this evidence cannot show
Queries are hand-written and narrow, trading recall for readability, so silence is weak evidence. PubMed only: preprints, conference abstracts, trial-registry changes and regulatory documents are invisible to it, and two of this month's most consequential findings came from a registry field and an FDA approval letter.
Evidence that argues against this (1)
- Fifteen of seventeen hits were reviews or off-target, so the precision of these queries is around 12%. A watch with that precision will be ignored if it is run often, and a watch that is ignored is worse than none because it creates the appearance of surveillance. The queries need tightening before this is run on a short cadence. analysis run by this project 2026
- E2moderate confidence 3 of 5: One strong study, or several smaller consistent ones.paper
Oral SIK2/3 inhibitors have been developed for MEF2C-high AML showing potency and strong selectivity in MEF2C high-expression cell lines over MEF2C-low lines, with significant tumour growth inhibition on oral administration in an MV4-11 AML cell-line-derived xenograft model without body-weight loss.
Discovery of Novel SIK2/3 Inhibitors for the Potential Treatment of MEF2C+ Acute Myeloid Leukemia (AML) · Zhu W, Zhao P, Liu T, Gao F, Li Q, Cai X, Zhang M, Aliper A, Ren F, Zhavoronkov A, Ding X · Journal of Medicinal Chemistry 68:7518-7538 2025What this evidence cannot show
Read as abstract only. A medicinal-chemistry paper from a single commercial group; the compound identifiers are omitted from the abstract text. MV4-11 is a KMT2A::AFF1 line but carries FLT3-ITD, so xenograft activity there is not attributable to the fusion alone. Cell-line-derived xenograft activity is a long way from clinical benefit, and selectivity for MEF2C-high lines does not establish that the effect runs through MEF2C S222 phosphorylation.
Evidence that argues against this (1)
- SIK2 and SIK3 have physiological roles beyond MEF2C, including in metabolism and inflammation, so an inhibitor's therapeutic window is an open question this abstract does not address. The absence of body-weight loss in a short xenograft study is a weak safety signal, and this project's own normal-tissue analysis found MEF2C expressed 11.6-fold higher in cerebral cortex than in bone marrow, with MEF2C haploinsufficiency causing a neurodevelopmental syndrome. Human Protein Atlas; analysis run by this project 2026
- E3moderate confidence 3 of 5: One strong study, or several smaller consistent ones.paper
A genome-wide CRISPR/Cas9 screen in a KMT2A-rearranged B-cell acute lymphoblastic leukemia cell line identified the deubiquitinase USP22, a subunit of the SAGA complex, as a regulator of MEIS1 protein stability. Genetic depletion of USP22 impaired growth and proliferation in KMT2A-rearranged models; chromatin immunoprecipitation showed cooperative binding of USP22 and MEIS1 at oncogenic target genes; and genetic or chemical inhibition of USP22 led to polyubiquitination of MEIS1, its proteasomal degradation, and downregulation of target-gene expression.
USP22 is a novel vulnerability regulating MEIS1 protein abundance and gene transcription in KMT2Ar acute leukemia · Bröchtel S, Schneider C, Müller M, Villinger C, Plenge T, Gupta MK, et al. (Cremer A, senior author) · Blood 2026What this evidence cannot show
Read as abstract only. The mechanism is indirect: USP22 regulates MEIS1 abundance rather than contacting the fusion, so whether it belongs in the fusion's interactome or only among its dependencies is unresolved. 'Chemical inhibition' is not characterised in the abstract and the selectivity of available USP22 tool compounds is not stated.
Evidence that argues against this (1)
- USP22 is a core SAGA subunit with broad transcriptional functions, so impaired growth on depletion is not by itself evidence of a MEIS1-specific or fusion-specific mechanism. This project's own unbiased scan of 4,589 genes did not surface USP22 among selectively required genes in KMT2A-rearranged lines, which is a point of tension: either the scan missed it, or the dependency is not selective in DepMap's panel. analysis run by this project 2026
gives the reopening conditions an owner: each reopens_if is paired with a query and checked against new literature
the mitigation that entry called for, now executable rather than described
the redefinition to the upstream kinase is confirmed by oral SIK2/3 inhibitors with in vivo efficacy in MV4-11
reopens the demotion indirectly: USP22 supplies an upstream route to lowering MEIS1 without targeting it
closes the residual hole that audit identified, and its first run moves two of the decisions it made
tension to resolve: USP22 is a reported KMT2A-r vulnerability that the unbiased scan did not surface
the MEF2C cortical-expression flag bears directly on a SIK2/3 programme aimed at MEF2C-high disease