Cogent Biosciences FY Conference Summary Company Overview - **Company**: Cogent Biosciences (NasdaqGS:COGT) - **Lead Asset**: Bezuclastinib, a potent and selective KIT mutant inhibitor - **Focus**: Treatment of gastrointestinal stromal tumors (GIST) and systemic mastocytosis Key Points Industry and Market Opportunity - **Market Size**: The combined annual opportunity for non-advanced systemic mastocytosis and advanced systemic mastocytosis is approximately **$8 billion** [5] - **Competition**: Limited competition exists, primarily from Sanofi's Ayvakit for systemic mastocytosis and no competition in second-line GIST [5][10] - **Second-Line GIST Market**: Expected to be a **$4 billion** market with about **6,000 patients** annually becoming resistant to imatinib [10] Clinical Trials and Regulatory Submissions - **Pivotal Trials**: Three pivotal trials for bezuclastinib were positive in 2025, leading to NDA submissions: - **SUMMIT**: Non-advanced systemic mastocytosis (NDA submitted December 2025) - **PEAK**: GIST (NDA expected in April 2026) - **APEX**: Advanced systemic mastocytosis (NDA to follow PEAK) [2][3] - **Expected Launch**: Anticipated launch in the U.S. in the second half of 2026 for at least the non-advanced systemic mastocytosis indication [3] Financial Position - **Cash Reserves**: Approximately **$900 million** on the balance sheet, providing a cash runway into 2028 [4] - **Profitability Outlook**: Positioned to discuss profitability based on the timing of commercializations [4] Intellectual Property - **Patent Protection**: Strong intellectual property position with protection extending into the mid-2040s, including composition of matter and formulation patents [6][7] Clinical Efficacy - **GIST Trial Results**: - **Median Progression-Free Survival**: **16.5 months** - **Objective Response Rate**: Nearly **50%**, significantly higher than historical drugs [8][9] - **Symptomatic Improvement**: Notable improvements in overall symptoms and mast cell burden in systemic mastocytosis patients [11][12] Commercial Strategy - **Commercial Organization**: Building a team of approximately **100 employees** focused on access and patient community engagement [22][23] - **Expanded Access Program**: Ongoing program to provide access to bezuclastinib for patients, enhancing experience prior to full commercial launch [21] Future Developments - **Pipeline Expansion**: Plans to initiate trials for additional indications, including first-line GIST and combination therapies [18][19] - **New Assets**: Development of a selective JAK2 V617F inhibitor and a pan-KRAS inhibitor, with IND filings expected in 2026 [25][26] Pricing Strategy - **Benchmarking**: Pricing will be informed by existing KIT inhibitors, with current benchmarks around **$41,000 to $46,000** per month [39][40] International Expansion - **Partnerships**: Actively exploring partnerships for commercialization outside the U.S., particularly in Europe and other regions [41][42] Conclusion Cogent Biosciences is positioned for significant growth with its lead asset, bezuclastinib, targeting substantial market opportunities in rare diseases. The company is on track for multiple NDA submissions and a potential launch in 2026, backed by a strong financial position and a robust clinical pipeline.