Cogent’s lead drug candidate, bezuclastinib, is designed to target exon 17 mutations found within the KIT receptor tyrosine kinase, including KIT D816V. When KIT D816V remains in a perpetual ‘on’ state causing mast cells, a type of white blood cell, to accumulate in various internal organs including the bone marrow. The result is an orphan disease called Systemic Mastocytosis.
Exon 17 mutations have also been found in advanced Gastrointestinal Stromal Tumors (GIST), which have a strong dependence on oncogenic KIT signaling. Bezuclastinib is a highly selective and potent KIT inhibitor with the potential to provide a powerful new treatment option for patients with both of these diseases.
Systemic Mastocytosis occurs when mast cells inappropriately accumulate in various internal organs in the body. About 90% of people with Systemic Mastocytosis have Nonadvanced Systemic Mastocytosis (NonAdvSM), a life-long illness with chronic symptoms including headaches, urticaria pigmentosa, skin lesions, skin redness and warmth (flushing), abdominal pain, bloating, vomiting, diarrhea, and gastroesophageal reflux (GERD), that significantly impact the patient’s quality of life.
Many patients are also at high risk for severe, life-threatening anaphylactic reactions to various triggers such as insect bites. Advanced Systemic Mastocytosis (AdvSM) is a rare, very aggressive form of Systemic Mastocytosis. Patients with AdvSM may suffer from a multitude of debilitating symptoms such as anemia, thrombocytopenia, ascites, bone fractures, gastrointestinal abnormalities, and enlargement of the liver, spleen, and lymph nodes, which ultimately lead to organ failure and early death. The median life expectancy for AdvSM is less than 3.5 years.
Cogent is currently enrolling Apex, a Phase 2 clinical trial of bezuclastinib in patients with AdvSM. Apex is an open-label, global, multicenter trial that will evaluate the safety, efficacy, pharmacokinetic, and pharmacodynamic profiles of bezuclastinib.
In December 2024, Cogent announced the Company completed enrollment in SUMMIT, a registration-directed, randomized, double-blind, placebo-controlled, global, multicenter, clinical trial of bezuclastinib in patients with NonAdvSM. Top-line results are expected in July 2025. Learn more about Cogent’s clinical trials at www.cogentclinicaltrials.com.
Gastrointestinal Stromal Tumors (GIST) are categorized by uncontrolled cell growth in the tissues of the gastrointestinal (GI) tract. At diagnosis, about 80% of GIST patients’ tumors are the result of primary KIT mutations. Approved therapies currently inhibit a subset of these mutations, but most patients develop resistance due to additional secondary KIT mutations, including mutations in Exon 17. Bezuclastinib is designed to be a potent and selective inhibitor of KIT Exon 17 mutations, and by combining bezuclastinib with drugs that inhibit additional KIT mutations, Cogent is addressing a clear unmet medical need for patients with GIST.
The safety profile of bezuclastinib has been clinically evaluated in two completed trials both as a single agent and as part of a combination therapy.
In a Phase 1/2 trial testing the combination of bezuclastinib with sunitinib in 18 patients with advanced GIST, median progression-free survival (PFS) reached 11 months. Most of these patients were heavily treated previously, having received sunitinib or other kinase inhibitors prior to treatment with bezuclastinib.
In September 2024, Cogent announced the Company completed enrollment in PEAK, a randomized Phase 3 clinical trial of bezuclastinib in combination with sunitinib compared to sunitinib alone in patients with locally advanced, unresectable or metastatic GIST who have received prior treatment with imatinib. Top-line results are expected by the end of 2025.
Cogent Biosciences, Inc. (“Cogent”) is a company of people who are passionate and dedicated to turning the promises of our therapies into reality to transform the lives of patients. To accomplish this, we work with researchers, clinicians, patient advocacy groups, patients, and caregivers throughout the clinical development process. We believe that the most appropriate way to deliver on our commitment to patients is through completion of our clinical trials and subsequent successful registration of our medicine(s) as this will provide us with the greatest opportunity to potentially provide long-term access to as many patients as possible. Expanded access refers to the use of an investigational therapy outside a clinical trial when the primary purpose is to diagnose, monitor, or treat a serious condition in a patient. This is different from a clinical trial, where more comprehensive information on the safety and effectiveness of an investigational therapy is collected.
Cogent has initiated a Bezuclastinib Expanded Access Program (“EAP”) for patients affected with advanced, metastatic, and/or unresectable Gastrointestinal Stromal Tumors (“GIST”), intolerant to imatinib or received prior imatinib therapy for treatment that resulted in disease progression, who meet other inclusion and exclusion criteria, per the Bezuclastinib EAP protocol, and reside in the United States. This program aims to provide investigational bezuclastinib to be combined with physician-prescribed, commercially sourced sunitinib to eligible patients. Expanded access will be considered when the following criteria are met:
- The patient has a serious or immediately life-threatening disease or condition.
- There is no comparable or satisfactory alternative therapy to treat the disease or condition.
- Patient enrollment in a clinical trial is not possible.
- Potential patient benefit justifies the potential risks of treatment.
- Providing investigational therapy will not interfere with development or marketing approval for the treatment indication.
- The requesting physician must be willing to manage the patient’s treatment with investigational therapy.
- A mechanism is in place for reporting of safety data during treatment.
- Adequate supply of investigational therapy is available.
If you are a patient, family member, or caregiver and want to know more about the Bezuclastinib EAP for GIST, please discuss this EAP, and all treatment options, with your treating physician. Requests for expanded access must be submitted voluntarily by the patient’s treating physician. Requests cannot be made directly by an individual patient or a patient’s parent/legal guardian or caregiver. Requests are considered on a case-by-case basis. Submitting a request does not guarantee access will be granted.
To initiate the process for participation in the Bezuclastinib EAP, licensed physicians should send an email to medinfo@cogentbio.com. A response regarding the process for accessing the Bezuclastinib EAP will be provided within 2 to 3 business days of the initial request.
Physicians who obtain access to bezuclastinib through this EAP will be required to comply with all applicable laws, regulations, and contractual conditions, including, but not limited to, obtaining patient consent, patient monitoring and safety reporting, and obtaining appropriate institutional review board approvals.
Consistent with the 21st Century Cures Act, Cogent may revise this policy at any time.
