Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
CGT9486 · 2 trials · 3 indications
Maximum plasma concentration (Cmax)
Area under the plasma concentration-time curve (AUC)
Maximum plasma concentration (Cmax)
Area under the plasma concentration-time curve (AUC)
Time to maximum observed plasma concentration (Tmax)
Time from first dose to documented disease progression or death due to any cause, whichever occurs first
Area under the plasma concentration-time curve (AUC)
Maximum plasma concentration (Cmax)
RP2D was determined by incidence of dose limiting toxicity (DLT) using Common Terminology Criteria for Adverse Events (CTCAE) V4.03. DLTs: AEs that occurred during Cycle 1, possibly/probably related to study drug, and met 1 of the following criteria: Hematologic Toxicities: Grade 4 neutropenia for \>7 days, Grade ≥3 neutropenia with fever, Grade 4 thrombocytopenia, Grade ≥3 thrombocytopenia for \>7 days, Grade 4 anemia; Other Toxicities: Any Grade ≥3 (AE or laboratory) toxicity despite adequate supportive care except for following: Grade ≥3 nausea, vomiting, or diarrhea that resolved to Grade ≤2 within 72 hours; Grade 3 fatigue that resolved to Grade ≤2 within 14 days; Grade ≥3 asymptomatic changes in alkaline phosphatase, hypomagnesemia, hyperglycemia, or hypophosphatemia; Grade 3 increases in transaminases for ≤5 days; Any other Grade ≥3 toxicity for which further dose escalation deemed inappropriate.
An adverse event (AE) was any untoward medical occurrence in a participant administered study drug, which did not necessarily have a causal relationship with the treatment. An AE could be any unfavorable and unintended sign (for example, including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not it was considered to be study drug related. This included any newly occurring event or previous condition that had increased in severity or frequency since the administration of study drug. A treatment-emergent AE (TEAE) was an AE that started or worsened in severity on or after the date of the initial dose of study drug. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
AUC0-24 was determined by the linear trapezoidal rule for the ascending portion and by the log trapezoidal rule for the descending portion of the plasma profile. For BID dosing, Cycle 1 Day 15 AUC0-24 was calculated as 2 x area under the concentration time curve from time zero to 12 hours after dosing (AUC0-12). Missing concentration data were excluded from Pharmacokinetic (PK) analysis.
Cmax was taken directly from bioanalytical data.
Tmax was taken directly from merged clinical and bioanalytical data, with time presented as nominal time relative to dose.
Participants in a selected Part 1 cohort (350 mg QD) participated in a PK substudy to obtain more complete information on the PK profile of PLX9486. Participants received a single dose of 350 mg of PLX9486 10 days prior to the start of repeated QD dosing and plasma concentrations were followed 0.5, 1, 2, 4, 6, and 9 hours postdose, and then once daily for 9 additional days prior to Cycle 1 Day 1.
RP2D was determined by incidence of DLT using CTCAE version 4.03 for severity grade. DLTs were defined as AEs that occurred during Cycle 1, classified as possibly/probably related to study drug, and met 1 of the following criteria: Hematologic Toxicities: Grade 4 neutropenia for \>7 days, Grade ≥3 neutropenia with fever, Grade 4 thrombocytopenia, Grade ≥3 thrombocytopenia for \>7 days or with bleeding, Grade 4 anemia; Other Toxicities: Any Grade ≥3 (AE or laboratory) toxicity despite adequate supportive care except for the following: Grade ≥3 nausea, vomiting, or diarrhea that resolved to Grade ≤2 within 72 hours; Grade 3 fatigue that resolved to Grade ≤2 within 14 days; Grade ≥3 asymptomatic changes in alkaline phosphatase, hypomagnesemia, hyperglycemia, or hypophosphatemia; Grade 3 increases in transaminases for ≤5 days; Any other Grade ≥3 toxicity for which further dose escalation deemed inappropriate.
RP2D was determined by incidence of DLT using CTCAE version 4.03 for severity grade. DLTs were defined as AEs that occurred during Cycle 1, classified as possibly/probably related to study drug, and met 1 of the following criteria: Hematologic Toxicities: Grade 4 neutropenia for \>7 days, Grade ≥3 neutropenia with fever, Grade 4 thrombocytopenia, Grade ≥3 thrombocytopenia for \>7 days or with bleeding, Grade 4 anemia; Other Toxicities: Any Grade ≥3 (AE or laboratory) toxicity despite adequate supportive care except for the following: Grade ≥3 nausea, vomiting, or diarrhea that resolved to Grade ≤2 within 72 hours; Grade 3 fatigue that resolved to Grade ≤2 within 14 days; Grade ≥3 asymptomatic changes in alkaline phosphatase, hypomagnesemia, hyperglycemia, or hypophosphatemia; Grade 3 increases in transaminases for ≤5 days; Any other Grade ≥3 toxicity for which further dose escalation deemed inappropriate.
An AE was any untoward medical occurrence in a participant administered study drug, which did not necessarily have a causal relationship with the treatment. An AE could be any unfavorable and unintended sign (for example, including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not it was considered to be study drug related. This included any newly occurring event or previous condition that had increased in severity or frequency since the administration of study drug. A TEAE was an AE that started or worsened in severity on or after the date of the initial dose of study drug. Treatment-related TEAEs included all events reported as "possibly related" or "probably related" to any of study treatment. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
An AE was any untoward medical occurrence in a participant administered study drug, which did not necessarily have a causal relationship with the treatment. An AE could be any unfavorable and unintended sign (for example, including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not it was considered to be study drug related. This included any newly occurring event or previous condition that had increased in severity or frequency since the administration of study drug. A TEAE was an AE that started or worsened in severity on or after the date of the initial dose of study drug. Treatment-related TEAEs included all events reported as "possibly related" or "probably related" to any of study treatment. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
| Arm | Type | Description |
|---|---|---|
| Part 1a | EXPERIMENTAL | CGT9486 plus sunitinib 37.5 mg QD |
| Part 2 - Experimental Group | EXPERIMENTAL | CGT9486 plus sunitinib 37.5 mg QD |
| Part 2 - Control Group | ACTIVE_COMPARATOR | sunitinib 37.5 mg QD |
| Part 1b - DDI Cohort 1 | EXPERIMENTAL | CGT9486 plus sunitinib 37.5 mg QD |
| Part 1b - DDI Cohort 2 | EXPERIMENTAL | sunitinib 37.5 mg QD plus CGT9486 |
| DDI Substudy (Midazolam) | EXPERIMENTAL | Midazolam, CGT9486, sunitinib |
| GIST 1L Substudy | EXPERIMENTAL | CGT9486, sunitinib |
| Part 1: CGT9486 250 mg QD | EXPERIMENTAL | Participants will receive CGT9486 250 milligrams (mg) orally once daily (QD) in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 1: CGT9486 350 mg QD | EXPERIMENTAL | Participants will receive CGT9486 350 mg orally QD in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 1: CGT9486 500 mg QD | EXPERIMENTAL | Participants will receive CGT9486 500 mg orally QD in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 1: CGT9486 1000 mg QD | EXPERIMENTAL | Participants will receive CGT9486 1000 mg orally QD in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 1: CGT9486 500 mg BID | EXPERIMENTAL | Participants will receive CGT9486 500 mg orally twice daily (BID) in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 2b: CGT9486 500 mg QD + Pexidartinib 600 mg (Fasting) | EXPERIMENTAL | Participants in fasting condition will receive CGT9486 500 mg orally QD in combination with pexidartinib 600 mg (administered as 1 capsule of 200 mg in the morning and 2 capsules of 200 mg in the evening) orally in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 2b: CGT9486 500 mg QD + Pexidartinib 600 mg (Non-Fasting) | EXPERIMENTAL | Participants in non-fasting condition will receive CGT9486 500 mg orally QD in combination with pexidartinib 600 mg (administered as 1 capsule of 200 mg in the morning and 2 capsules of 200 mg in the evening) orally in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 2e: CGT9486 500 mg QD + Sunitinib 25 mg | EXPERIMENTAL | Participants will receive CGT9486 500 mg orally QD in combination with sunitinib 25 mg orally in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 2e: CGT9486 1000 mg QD + Sunitinib 25 mg | EXPERIMENTAL | Participants will receive CGT9486 1000 mg orally QD in combination with sunitinib 25 mg orally in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Part 2e: CGT9486 1000 mg QD + Sunitinib 37.5 mg | EXPERIMENTAL | Participants will receive CGT9486 1000 mg orally QD in combination with sunitinib 37.5 mg orally in 28-day dosing cycles. Treatment will continue until participant discontinuation, withdrawal, or study termination. |
| Name | Type | Description |
|---|---|---|
| CGT9486 | DRUG | Participants will receive CGT9486 orally until study stopping rules are met. |
| Sunitinib | DRUG | Participants will receive sunitinib until steady state then both sunitinib and CGT9486 orally until study stopping rules are met. |
| Midazolam | DRUG | Participants will receive a single-dose of midazolam on Day 1 and Day 16 |
| Pexidartinib | DRUG | Pexidartinib capsules will be administered per dose and schedule specified in the arm. |
Key Inclusion Criteria: 1. Histologically confirmed locally advanced, metastatic, and/or unresectable GIST. Molecular pathology report must be available for Part 2; if molecular pathology report is unavailable or inadequate, an archival or fresh tumor tissue sample will be required to evaluate muta...
CGT9486 is an investigational small molecule being developed for gastrointestinal stromal tumors (GIST), including advanced GIST and metastatic cancer. It is currently in Phase 3 clinical development for these indications. The drug is designed to target the KIT D816V mutation, a tyrosine kinase receptor involved in tumor growth.
CGT9486 targets the KIT D816V mutation, a specific alteration in the KIT tyrosine kinase receptor. By inhibiting this target, the drug aims to block signaling pathways that drive tumor cell proliferation in gastrointestinal stromal tumors. This makes it a targeted therapy for patients with KIT-driven GIST.
CGT9486 is being developed by Cogent Biosciences, Inc., a biopharmaceutical company traded on the stock exchange under the ticker COGT. The company is conducting clinical trials to evaluate the drug's safety and efficacy in treating gastrointestinal stromal tumors.
CGT9486 is currently in Phase 3 clinical development. It is being studied in a randomized, active-controlled trial for advanced gastrointestinal stromal tumors. The drug is investigational and has not been approved by regulatory authorities. Its safety and efficacy are still being evaluated in clinical trials.
CGT9486 is being evaluated in two clinical trials. NCT05208047 is a Phase 3 randomized trial comparing CGT9486 plus sunitinib versus sunitinib alone in subjects with advanced GIST, with 482 participants. NCT02401815 is a completed Phase 1 trial studying CGT9486 as a single agent and in combination with other drugs in advanced solid tumors.
Yes, CGT9486 was formerly known as PLX9486. The earlier Phase 1 trial NCT02401815 was conducted under the name PLX9486. The drug is now referred to as CGT9486 in ongoing clinical development by Cogent Biosciences.