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Bezuclastinib for Nonadvanced systemic mastocytosis

Cogent Biosciences · NDA
FDA DECISION EXPECTED
December 30, 2026
82
days away
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The FDA is expected to decide on Bezuclastinib for Nonadvanced systemic mastocytosis by December 30, 2026, under an NDA from Cogent Biosciences.

What is being decided

Cogent Biosciences has an NDA under FDA review for Bezuclastinib in Nonadvanced systemic mastocytosis. Selective KIT D816V inhibitor for the most common form of systemic mastocytosis.

Who this decision matters to

Systemic Mastocytosis is a rare hematologic disorder characterized by accumulation and proliferation of abnormal mast cells in bone marrow, lymphoid tissues, and other organs. Most cases involve a KIT D816V mutation. Symptoms result from mast cell mediator release and range from mild to life-threatening, including anaphylaxis, flushing, diarrhea, and bone pain.

Prevalence: Approximately 1 case per 10,000 to 20,000 people; can occur at any age but more common in adults. See our full Systemic Mastocytosis page for current treatments, recruiting trials, and community resources.

What each outcome would mean

An approval starts a second race rather than ending the first one: specialty pharmacy setup, insurance review, and patient assistance typically take weeks even when everything goes right. Our guide to the 90 days after a rare disease approval explains the timeline and the moves families can make on day 1.

A complete response letter would mean the FDA declined to approve in the application's current form. CRLs are often about manufacturing or data presentation rather than efficacy, and resubmission is common. Either way, this page updates with the outcome and what it means.

Where Systemic Mastocytosis treatment stands today

FDA approved for Systemic Mastocytosis
Trial Friend's drug list has no FDA-approved drug for Systemic Mastocytosis yet. The Systemic Mastocytosis page also checks FDA drug labels for approved treatments.
Read our full Systemic Mastocytosis treatment summary

Research in Systemic Mastocytosis continues expanding treatment options for different subtypes and genetic profiles. Kinase inhibitors like midostaurin, already FDA-approved for advanced forms, are part of a growing arsenal of targeted therapies.

Newer trials are investigating additional kinase inhibitors and combination approaches designed to both reduce mast cell burden and manage the troublesome mediator symptoms that impact quality of life. Because some cases involve genetic mutations other than KIT, research is increasingly exploring alternative therapeutic targets for broader patient populations.

Given the complexity of this disease and the expanding treatment landscape, consulting with a mast cell disease specialist is valuable for understanding which trials might be appropriate for your specific disease subtype and genetic profile. Participating in disease registries helps track long-term outcomes and keeps you informed as therapies evolve.

The Systemic Mastocytosis page has every treatment and trial →

Meanwhile, 11 Systemic Mastocytosis trials are recruiting

Whatever the FDA decides here, research on Systemic Mastocytosis does not stop. A few currently enrolling studies, US sites first:

(HARBOR) Study to Evaluate Efficacy and Safety of BLU-263 Versus Placebo in Patients With Indolent Systemic Mastocytosis
NCT04910685 · has US sites
(Apex) Bezuclastinib in Patients With Advanced Systemic Mastocytosis
NCT04996875 · has US sites
Depletion of CD45RA Positive Naive T Cells for the Prevention of Graft Versus Host Disease in Older Patients Undergoing Allogeneic Hematopoi
NCT07819396 · has US sites
See all 11 recruiting trials →
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Frequently asked questions

When will the FDA decide on Bezuclastinib?

The FDA's target date (PDUFA date) for Bezuclastinib in Nonadvanced systemic mastocytosis is December 30, 2026.

Who disclosed it: Cogent Biosciences. The FDA does not publish these dates.

Can it move: the FDA can act early, and a major amendment to the application can push the date back 3 months.

Source: Cogent press release

What is Bezuclastinib being reviewed for?

Cogent Biosciences submitted an NDA for Bezuclastinib in Nonadvanced systemic mastocytosis.

What to know: Selective KIT D816V inhibitor for the most common form of systemic mastocytosis.

Is there already an FDA-approved treatment for Systemic Mastocytosis?

Trial Friend's drug list has no FDA-approved drug for Systemic Mastocytosis yet.

Check: the Systemic Mastocytosis page also searches FDA drug labels for approved treatments.

Can I get Bezuclastinib before the FDA decides?

Usually only through a clinical trial or an expanded access program, and the company decides whether to offer one.

Trials: 11 Systemic Mastocytosis trials are recruiting now. See them.

Check your fit: Match Me compares your details with every open trial.

Expanded access: your doctor can ask Cogent Biosciences directly. Registered programs are listed on ClinicalTrials.gov.

How much will Bezuclastinib cost?

Cogent Biosciences has not announced a price. Drugmakers usually set it around approval.

Help paying: drugmaker programs and charity funds usually open at launch.

Find help: the patient assistance finder lists programs by insurance type.

What happens after the Bezuclastinib decision?

This page updates with the outcome the day it is announced.

If approved: getting the drug still takes time. Specialty pharmacy setup, insurance review and patient assistance often take weeks. Our guide covers what families can do on day 1.

If not approved: a complete response letter means the FDA declined the application in its current form. Many are about manufacturing or how data were presented, and companies often resubmit.

Where this date comes from

The FDA does not publish PDUFA dates; companies disclose them. This one comes from Cogent press release. Dates can move, and the FDA can act early or late. This page rechecks against our calendar, which is re-verified daily.