FDA grants Breakthrough Designation to bezuclastinib for nonadvanced SM

This FDA designation may speed approval and patient access through Priority Review.

Cogent Biosciences’ bezuclastinib received Breakthrough Therapy Designation from the U.S. Food and Drug Administration (FDA) for patients with nonadvanced systemic mastocytosis (SM) previously treated with avapritinib and patients with smoldering SM, according to a press release published recently by Cogent Biosciences.

“We are excited to announce Breakthrough Therapy Designation for bezuclastinib, which highlights the FDA’s recognition of the unmet need for patients with non-advanced systemic mastocytosis and the potential for bezuclastinib to redefine the treatment paradigm for this disease,” said Andrew Robbins, Cogent’s president and chief executive officer.

This designation is based on strong results from the SUMMIT trial, where bezuclastinib met all primary and key secondary endpoints. The FDA’s Breakthrough Therapy status is granted to drugs that treat serious conditions and demonstrate early evidence of substantial improvement over existing therapies. 

For patients, this could translate to faster access and a review process designed to bring the treatment to market more efficiently. Benefits of the designation include eligibility for Priority Review, rolling submission of the application and guidance from the FDA to help streamline approval.

Read more about therapies for SM

Cogent Biosciences plans to submit a new drug application for bezuclastinib for nonadvanced SM by the end of 2025. The company recently completed a pre-New Drug Application meeting with the FDA to review SUMMIT results and discuss regulatory steps, emphasizing the agency’s ongoing collaboration.

Beyond nonadvanced SM, Cogent plans to report results from additional trials of bezuclastinib later this year. The Phase 3 PEAK trial studying the treatment in patients with gastrointestinal stromal tumors (GIST) is expected in November 2025, and the registration-directed APEX trial in patients with advanced SM will report top-line results in December 2025. These studies may further expand the potential uses of bezuclastinib.

Patients and families may view the FDA designation as a hopeful development, as it highlights both the urgent unmet needs in these rare conditions and the potential for a new therapy that could improve quality of life. While full approval is still pending, the Breakthrough Therapy status signals that the regulatory process is moving quickly to provide another option where few currently exist.

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