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CGT9486

Phase 3

Advanced Gastrointestinal Stromal Tumors | Small molecule | Oncology |Cogent Biosciences, Inc.|Last Updated: Jun 16, 2026

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLEDDMC
Total Trials1
Total Enrollment482

FDA Designations

No designations recorded

Clinical trial landscape

CGT9486 · 2 trials · 3 indications

Phase 3 1Phase 1 1
NCT05208047(Peak) A Phase 3 Randomized Trial of CGT9486+Sunitinib vs. Sunitinib in Subjects With Gastrointestinal Stromal TumorsAdvanced Gastrointestinal Stromal Tumors
RECRUITING482 Analytics
PHASE3RECRUITING
(Peak) A Phase 3 Randomized Trial of CGT9486+Sunitinib vs. Sunitinib in Subjects With Gastrointestinal Stromal Tumors
Advanced Gastrointestinal Stromal TumorsUnlock trial analytics

Study Endpoints

Primary Endpoints

Part 1a - pharmacokinetics - Cmax
16 days

Maximum plasma concentration (Cmax)

Part 1a - pharmacokinetics - AUC
16 days

Area under the plasma concentration-time curve (AUC)

Part 1b - pharmacokinetics - Cmax
14 days

Maximum plasma concentration (Cmax)

Part 1b - pharmacokinetics - AUC
14 days

Area under the plasma concentration-time curve (AUC)

Part 1b - pharmacokinetics - Tmax
14 days

Time to maximum observed plasma concentration (Tmax)

Part 2 - Progression Free Survival (PFS)
Approximately 48 months

Time from first dose to documented disease progression or death due to any cause, whichever occurs first

DDI Substudy - pharmacokinetics - AUC
16 days

Area under the plasma concentration-time curve (AUC)

DDI Substudy - pharmacokinetics - Cmax
14 days

Maximum plasma concentration (Cmax)

Part 1: Recommended Phase 2 Dose (RP2D) of CGT9486
Cycle 1 of Part 1 (Cycle length = 28 days)

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.

Part 1: Number of Participants With Treatment Emergent Adverse Events (TEAEs)
From the date of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 670 days)

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.

Part 1: Area Under The Concentration Time Curve From Time Zero to 24 Hours After Dosing (AUC0-24) of CGT9486
Predose, 1, 3, 5, 7, 9, and 24 hours postdose at Cycle 1 Day 1 and Cycle 1 Day 15

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.

Part 1: Maximum Observed Plasma Concentration (Cmax) of CGT9486
Predose, 1, 3, 5, 7, 9, and 24 hours postdose at Cycle 1 Day 1 and Cycle 1 Day 15

Cmax was taken directly from bioanalytical data.

Part 1: Time to Reach Cmax (Tmax) of CGT9486
Predose, 1, 3, 5, 7, 9, and 24 hours postdose at Cycle 1 Day 1 (Day -10 for 350 mg QD cohort) and Cycle 1 Day 15

Tmax was taken directly from merged clinical and bioanalytical data, with time presented as nominal time relative to dose.

Part 1: Half Life (T1/2) of PLX9486
Predose, 0.5, 1, 2, 4, 9, 24, 49, 72, 96, 120, 144, 168, 192, 216 hours postdose on Day -10

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.

Part 2e: RP2D of CGT9486 in Combination With Sunitinib
Cycle 1 of Part 2e (Cycle length = 28 days)

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.

Part 2b: RP2D of PLX9486 in Combination With Pexidartinib
Cycle 1 of Part 2 b (Cycle length = 28 days)

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.

Part 2b: Number of Participants With Any TEAEs and Treatment-Related TEAEs
From the date of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 868 days)

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.

Part 2e: Number of Participants With Any TEAEs and Treatment-Related TEAEs
From the date of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 825 days)

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.

Secondary Endpoints

All Study Parts - observing the safety of each treatment regimen.
Approximately 48 months
Part 1a, Part 1b, Part 2 - Overall Survival (OS)
Approximately 48 months
Part 1a, Part 1b, Part 2 - Objective Response Rate (ORR)
Approximately 48 months
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Part 1aEXPERIMENTALCGT9486 plus sunitinib 37.5 mg QD
Part 2 - Experimental GroupEXPERIMENTALCGT9486 plus sunitinib 37.5 mg QD
Part 2 - Control GroupACTIVE_COMPARATORsunitinib 37.5 mg QD
Part 1b - DDI Cohort 1EXPERIMENTALCGT9486 plus sunitinib 37.5 mg QD
Part 1b - DDI Cohort 2EXPERIMENTALsunitinib 37.5 mg QD plus CGT9486
DDI Substudy (Midazolam)EXPERIMENTALMidazolam, CGT9486, sunitinib
GIST 1L SubstudyEXPERIMENTALCGT9486, sunitinib
Part 1: CGT9486 250 mg QDEXPERIMENTALParticipants 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 QDEXPERIMENTALParticipants 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 QDEXPERIMENTALParticipants 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 QDEXPERIMENTALParticipants 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 BIDEXPERIMENTALParticipants 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)EXPERIMENTALParticipants 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)EXPERIMENTALParticipants 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 mgEXPERIMENTALParticipants 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 mgEXPERIMENTALParticipants 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 mgEXPERIMENTALParticipants 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.

Interventions

NameTypeDescription
CGT9486DRUGParticipants will receive CGT9486 orally until study stopping rules are met.
SunitinibDRUGParticipants will receive sunitinib until steady state then both sunitinib and CGT9486 orally until study stopping rules are met.
MidazolamDRUGParticipants will receive a single-dose of midazolam on Day 1 and Day 16
PexidartinibDRUGPexidartinib capsules will be administered per dose and schedule specified in the arm.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites126

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...

Countries:United StatesArgentinaAustraliaBrazilCanadaChileCzechiaDenmarkFranceGermanyHong KongHungaryItalyMexicoNetherlandsNorwayPolandSouth KoreaSpainSwedenTaiwanUnited Kingdom
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Recent Changes (Last 90 Days)

MEDIUMJun 16, 2026NCT05208047Status: ACTIVE_NOT_RECRUITING → RECRUITING
MEDIUMJun 16, 2026NCT05208047Status: ACTIVE_NOT_RECRUITING → RECRUITING
MEDIUMJun 16, 2026NCT05208047Status: ACTIVE_NOT_RECRUITING → RECRUITING
MEDIUMMay 26, 2026NCT05208047Enrollment: 442 → 482
LOWMay 24, 2026NCT05208047studyFirstPostDate: changed

Frequently asked questions about CGT9486

What is CGT9486 used for in gastrointestinal stromal tumors?

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.

What does CGT9486 target?

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.

Who makes CGT9486?

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.

What phase is CGT9486 in?

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.

What clinical trials is CGT9486 in?

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.

Is CGT9486 the same as PLX9486?

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.