Phase 2
N=24
CGT9486 (Formerly Known as PLX9486) as a Single Agent and in Combination With PLX3397 (Pexidartinib) or Sunitinib in Participants With Advanced Solid Tumors
Gastrointestinal Stromal Tumors
Bottom Line
View on ClinicalTrials.gov: NCT02401815 ↗Enrolled (actual)
24
Serious AEs
27.8%
Results posted
Feb 2025
Primary outcome: Primary: Part 1: Recommended Phase 2 Dose (RP2D) of CGT9486 — 1000 mg
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- CGT9486 (Drug); Pexidartinib (Drug); Sunitinib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Cogent Biosciences, Inc.
- Primary completion
- May 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Part 1: Recommended Phase 2 Dose (RP2D) of CGT9486 |
1000 | — |
| PRIMARY Part 1: Number of Participants With Treatment Emergent Adverse Events (TEAEs) |
3; 4; 3; 7; 7 | — |
| PRIMARY Part 1: Area Under The Concentration Time Curve From Time Zero to 24 Hours After Dosing (AUC0-24) of CGT9486 |
9240; 7200; 5980; 11000; NA; 18500 | — |
| PRIMARY Part 1: Maximum Observed Plasma Concentration (Cmax) of CGT9486 |
499; 332; 382; 558; 331; 869 | — |
| PRIMARY Part 1: Time to Reach Cmax (Tmax) of CGT9486 |
9; 16.5; 15; 9; 7; 3 | — |
| PRIMARY Part 1: Half Life (T1/2) of PLX9486 |
75.4 | — |
| PRIMARY Part 2e: RP2D of CGT9486 in Combination With Sunitinib |
1000 | — |
| PRIMARY Part 2b: RP2D of PLX9486 in Combination With Pexidartinib |
NA; NA | — |
| PRIMARY Part 2b: Number of Participants With Any TEAEs and Treatment-Related TEAEs |
4; 8; 4; 7 | — |
| PRIMARY Part 2e: Number of Participants With Any TEAEs and Treatment-Related TEAEs |
3; 5; 10; 3; 5; 9 | — |
| SECONDARY Part 1: Overall Response Rate (ORR): Percentage of Participants With Best Overall Response of Complete Response (CR) or Partial Response (PR), as Assessed Using RECIST V1.1 |
0; 0; 0; 14.3; 0 | — |
| SECONDARY Part 1: Progression-Free Survival (PFS), as Assessed Using RECIST V1.1 |
54; 53; 48; 144; 186 | — |
| SECONDARY Part 1: Duration of Response (DOR), as Assessed Using RECIST V1.1 |
224 | — |
| SECONDARY Part 2: Overall Response Rate (ORR): Percentage of Participants With Best Overall Response of Complete Response (CR) or Partial Response (PR), as Assessed Using RECIST V1.1 |
33.3; 0; 33.3; 0; 28.6 | — |
| SECONDARY Part 2: Clinical Benefit Rate (CBR): Percentage of Participants With Clinical Benefit, as Assessed Using RECIST V1.1 |
100; 37.5; 100; 60.0; 85.7 | — |
| SECONDARY Part 2: Progression-Free Survival (PFS), as Assessed Using RECIST V1.1 |
333; 128; NA; 319; NA | — |
| SECONDARY Part 2: Overall Survival |
853; 414; NA; 362; NA | — |
| SECONDARY Part 2: Overall Survival at Month 12 |
66.7; 55.6; 100; 40.0; 68.6 | — |
| SECONDARY Part 2: PFS at Month 6 |
100; 25.0; 100; 60.0; 85.7 | — |
| SECONDARY Part 2: Duration of Response (DOR), as Assessed Using RECIST V1.1 |
169; NA; NA | — |
| SECONDARY Part 2: AUC0-24 of CGT9486 in Combination With Pexidartinib or Sunitinib |
7810; 7910; 9800; 14800; 12700; 20300 | — |
| SECONDARY Part 2: Cmax of CGT9486 in Combination With Pexidartinib or Sunitinib |
384; 412; 512; 866; 681; 991 | — |
| SECONDARY Part 2: Tmax of CGT9486 in Combination With Pexidartinib or Sunitinib |
8; 9; 9; 24; 9; 5 | — |
Summary
The goal of this clinical research study is to learn how CGT9486 (fka PLX9486) may affect cancer cells with certain mutations in the KIT gene, specifically in participants with types of advanced solid tumors including gastrointestinal stromal tumor (GIST).
CGT9486 (fka PLX9486) is designed to block KIT gene mutations. These mutations can cause cancer and cancer cell growth. By blocking these mutations, the drug may kill the cancer cells with the mutation and/or stop the tumor from growing. By combining CGT9486 (fka PLX9486) with PLX3397 and CGT9486 (fka PLX9486) with sunitinib, the investigators hope to block most KIT gene mutations that drive cancer growth.
Eligibility Criteria
Inclusion Criteria
- Male or female ≥18 years old.
- Part 1, Part 2b, Part 2d, and Part 2e: Participants with advanced solid tumors who have tumor progression following standard therapy, have treatment-refractory disease, or for whom there is no effective standard of therapy.
- Part 2d: Participants with non GIST solid tumors with KIT mutations, who are TKI naïve or have been previously treated with KIT directed TKI therapy who are appropriate for KIT directed TKI therapy
- Part 2a, Part 2c, and Part 2f (GIST participants): Histologically confirmed locally advanced, metastatic and/or unresectable GIST.
- Women of child-bearing potential (WOCBP) must have a negative serum pregnancy test at Screening (≤7 days prior to the first dose of study drug) and must agree to use an effective form of contraception from the time of the negative pregnancy test up to 6 months after the last dose of study drug.
- Fertile men must agree to use an effective method of birth control during the study and for up to 6 months after the last dose of study drug.
- All associated toxicity from previous or concurrent cancer therapy must be resolved (to ≤ Grade 1 or Baseline) prior to study treatment administration.
- Willing and able to provide written informed consent prior to any study related procedures and to comply with all study requirements.
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
- Life expectancy ≥3 months.
- Adequate hematologic, hepatic, and renal function:
- Left ventricular ejection fraction (LVEF) >50% per echocardiogram (ECHO) or multiple-gated acquisition (MUGA) for participants on the sunitinib arms (Parts 2e and f).
Exclusion Criteria
- Known or demonstrated wild type KIT or platelet-derived growth factor receptors (PDGF-R), or known or demonstrated mutations of PDGF R, sorbitol dehydrogenase (SDH), or neurofibromin 1 (NF 1) that are causative for the observed malignancy.
- For Part 1 (phase 1, single agent): Participants with a known or presumed pathogenic KIT exon 13 or 14 resistance mutation.
- Parts 2a and 2d: Participants with known or presumed pathogenic KIT exon 13 or 14 resistance mutations. (However, such participants are permitted on the combination arms of Parts 2b, 2c, 2e, or 2f.)
- Presence of symptomatic or uncontrolled brain or central nervous system metastases. Participants with stable, treated brain metastases are eligible for this trial. However, participants must not have required steroid treatment for their brain metastases within 30 days of Screening.
- Known or suspected allergy to the investigational agent or any agent given in association with this trial.
- Clinically significant cardiac disease
- Inability to take oral medication or significant nausea and vomiting, malabsorption, external biliary shunt, or significant bowel resection that would preclude adequate absorption.
- Ongoing infection of ≥ Grade 2 severity.
- Non-healing wound, ulcer, or bone fracture.
- Known human immunodeficiency virus (HIV)-positive individuals on combination antiretroviral therapy, participants with known active hepatitis B or C, or chronic hepatitis B or C requiring treatment with antiviral therapy
- Hepatobiliary diseases including biliary tract diseases, autoimmune hepatitis, inflammation, fibrosis, or cirrhosis of liver caused by viral, alcohol, or genetic reasons. Gilbert's disease is allowed if total bilirubin is ≤1.5 * upper limit of normal (ULN).
- Interstitial lung disease with ongoing signs and symptoms at the time of informed consent.
- Females who are pregnant or nursing.
- Any psychological, familial, sociological, or geographical condition that could hamper compliance with the study protocol.
- Strong CYP3A4 inhibitors or inducers within 14 days or 5 drug half-lives of the agent, whichever is longer, of study drug initiation or the need to continue these drugs during this study.
- Major surgery or significant traumatic injury within 14 days of Cycle 1 Day 1.
- History (within 2 years pri
Data sourced from ClinicalTrials.gov (NCT02401815). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.