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    Clinical Trial Results:
    An Open-label, Single-arm, Phase 2 Study to Evaluate Efficacy and Safety of Avapritinib (BLU-285), a Selective KIT Mutation-targeted Tyrosine Kinase Inhibitor, in Patients with Advanced Systemic Mastocytosis

    Summary
    EudraCT number
    2017-004836-13
    Trial protocol
    NL   GB   NO   DE   DK   ES   PL   FR   AT   IT  
    Global end of trial date
    18 Dec 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Jan 2026
    First version publication date
    02 Jan 2026
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    BLU-285-2202
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03580655
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Blueprint Medicines Corporation
    Sponsor organisation address
    45 Sidney Street, Cambridge, MA, United States, 02139
    Public contact
    Medical Information, Blueprint Medicines Corporation, +31 85 064 4001, medinfoeurope@blueprintmedicines.com
    Scientific contact
    Medical Information, Blueprint Medicines Corporation, +31 85 064 4001, medinfoeurope@blueprintmedicines.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    18 Dec 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Dec 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to determine adjudicated overall response rate (ORR) (complete remission [CR], complete remission with partial recovery of peripheral blood counts [CRh], partial remission [PR], or clinical improvement [CI]) based on modified international working group-myeloproliferative neoplasms research and treatment and European competence network on mastocytosis (mIWG-MRT-ECNM) consensus response criteria in participants with advanced systemic mastocytosis (AdvSM) treated with avapritinib.
    Protection of trial subjects
    This trial was designed and monitored in accordance with Sponsor procedures, which comply with the ethical principles of Good Clinical Practice (GCP) as required by the major regulatory authorities, and in accordance with the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Oct 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 1
    Country: Number of subjects enrolled
    United States: 45
    Country: Number of subjects enrolled
    Austria: 1
    Country: Number of subjects enrolled
    France: 6
    Country: Number of subjects enrolled
    Germany: 21
    Country: Number of subjects enrolled
    Italy: 8
    Country: Number of subjects enrolled
    Netherlands: 1
    Country: Number of subjects enrolled
    Norway: 2
    Country: Number of subjects enrolled
    Poland: 5
    Country: Number of subjects enrolled
    Spain: 8
    Country: Number of subjects enrolled
    United Kingdom: 9
    Worldwide total number of subjects
    107
    EEA total number of subjects
    52
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    37
    From 65 to 84 years
    67
    85 years and over
    3

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    The avapritinib group (N=107) includes all participants treated at a starting dose of 200 milligrams (mg) once daily (QD) (N=105) and 2 participants treated at a starting dose of 100 mg QD.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avapritinib (100 mg)
    Arm description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.
    Arm type
    Experimental

    Investigational medicinal product name
    Avapritinib
    Investigational medicinal product code
    Other name
    BLU-285
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Administered as an immediate release tablet for oral administration.

    Arm title
    Avapritinib (200 mg)
    Arm description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.
    Arm type
    Experimental

    Investigational medicinal product name
    Avapritinib
    Investigational medicinal product code
    Other name
    BLU-285
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Administered as an immediate release tablet for oral administration.

    Number of subjects in period 1
    Avapritinib (100 mg) Avapritinib (200 mg)
    Started
    2
    105
    Received at Least 1 Dose of Study Drug
    2
    105
    Response-evaluable
    2
    81
    Pure Pathologic Response-evaluable
    2
    105
    Completed
    0
    0
    Not completed
    2
    105
         Adverse event, serious fatal
    1
    33
         Physician decision
    -
    5
         Consent withdrawn by subject
    -
    19
         Sponsor Decision
    1
    43
         Participant Non-compliance
    -
    2
         Intracranial Haemorrhage
    -
    1
         Lost to follow-up
    -
    1
         Disease Progression
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Avapritinib (100 mg)
    Reporting group description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.

    Reporting group title
    Avapritinib (200 mg)
    Reporting group description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.

    Reporting group values
    Avapritinib (100 mg) Avapritinib (200 mg) Total
    Number of subjects
    2 105 107
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    1 36 37
        From 65-84 years
    1 66 67
        85 years and over
    0 3 3
    Sex: Female, Male
    Units:
        Female
    1 44 45
        Male
    1 61 62
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    0 2 2
        Not Hispanic or Latino
    2 89 91
        Unknown or Not Reported
    0 14 14
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    0 1 1
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    0 0 0
        White
    2 89 91
        More than one race
    0 0 0
        Unknown or Not Reported
    0 15 15

    End points

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    End points reporting groups
    Reporting group title
    Avapritinib (100 mg)
    Reporting group description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.

    Reporting group title
    Avapritinib (200 mg)
    Reporting group description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.

    Subject analysis set title
    Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All participants who received ≥1 dose of avapritinib.

    Subject analysis set title
    Response-evaluable (RE) Population
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All participants who received ≥1 dose of avapritinib, were deemed evaluable per mIWG-MRT-ECNM criteria at baseline as assessed by study steering committee review (SSC) and had 1 of the following conditions: ≥2 complete postbaseline bone marrow assessments and had been on study for ≥6 cycles; had an end of study visit.

    Subject analysis set title
    Pure Pathologic Response-evaluable (PPRE) Population
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All participants who received ≥1 dose of avapritinib and had 1 of the following conditions: ≥2 complete postbaseline bone marrow assessments and had been on study for ≥6 cycles; had an end of study visit.

    Subject analysis set title
    Pharmacokinetic Population
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    All participants who received ≥1 dose of avapritinib and had had >3 post-dose concentrations collected.

    Primary: ORR Based on mIWG-MRT-ECNM Response Criteria

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    End point title
    ORR Based on mIWG-MRT-ECNM Response Criteria [1]
    End point description
    ORR was defined as percentage of participants with a confirmed best response of CR, CRh, PR, or CI by mIWG-MRT-ECNM criteria. The mIWG-MRT-ECNM criteria were based on findings from bone marrow biopsy and aspirate, and peripheral blood smear; bone marrow cytogenetics; other extracutaneous tissue biopsies (when available); liver and spleen imaging; and other clinical and laboratory parameters. Statistical test on binomial proportion of ORR against a null hypothesis of 28%, 1 sided alpha=0.025, gave p <0.0001 (Wald test).
    End point type
    Primary
    End point timeframe
    Baseline through Month 65
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive statistics (percentage of participants plus confidence interval) are reported for this primary end point, as prespecified in the statistical analysis plan.
    End point values
    Response-evaluable (RE) Population
    Number of subjects analysed
    83
    Units: Percentage of Participants
        number (confidence interval 95%)
    73.5 (62.7 to 82.6)
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in Advanced Systemic Mastocytosis-Symptom Assessment Form (AdvSM-SAF) Total Symptom Score (TTS)

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    End point title
    Mean Change From Baseline in Advanced Systemic Mastocytosis-Symptom Assessment Form (AdvSM-SAF) Total Symptom Score (TTS)
    End point description
    The AdvSM-SAF is a 10-item questionnaire that assesses eight symptoms specific to AdvSM. All eight symptoms are scored on a scale of 0 (absence of symptoms) to 10 (more severe symptoms) (up to 80 points maximum). Each symptom contributes to the TSS equally. The TSS was generated based on average scores for each 7-day period. An increase in score from 0 (no symptoms) to 80 (worst symptoms represents a worse symptoms outcome. Participants completed the AdvSM-SAF daily using an electronic diary (eDiary). Here, ‘Number of Subjects Analyzed’ signifies those participants evaluable for this end point at the specified time points. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 6 (Cycle 6, Day 1)
    End point values
    Safety Population
    Number of subjects analysed
    92
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    -6.40 ( 9.158 )
    No statistical analyses for this end point

    Secondary: ORR Based on mIWG-MRT-ECNM Response Criteria as Assessed by Local Investigator

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    End point title
    ORR Based on mIWG-MRT-ECNM Response Criteria as Assessed by Local Investigator
    End point description
    Due to the complexity of response evaluation according to the mIWG-MRT-ECNM criteria, data analysis was not carried out. Summary-level data not available as data analysis was not performed.
    End point type
    Secondary
    End point timeframe
    Baseline through Month 48
    End point values
    Response-evaluable (RE) Population
    Number of subjects analysed
    0 [2]
    Units: Percentage of Participants
        number (confidence interval 95%)
    ( to )
    Notes
    [2] - Due to the complexity of response evaluation data analysis was not carried out.
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    DOR was defined as the time from initial documentation of a CI or better to the time of initial documentation of confirmed progressive disease (PD) or death due to any cause, whichever occurred first. For responders who had not progressed or died at the time of analysis, DOR was censored at the last response assessment that was stable disease (SD) or better. Here, ‘Number of subjects analysed’ signifies those participants with a confirmed best response of CR, CRh, PR, and CI by mIWG-MRT-ECNM criteria. '9999' = Values were non-estimable (insufficient number of participants with events).
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Response-evaluable (RE) Population
    Number of subjects analysed
    61
    Units: Months
        median (confidence interval 95%)
    57.8 (46.1 to 9999)
    No statistical analyses for this end point

    Secondary: Time-to-Response (TTR)

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    End point title
    Time-to-Response (TTR)
    End point description
    TTR was defined as the time from first dose to the time of initial evaluation of clinical improvement (CI) or better. Here, ‘Number of subjects analysed’ signifies those participants with a confirmed best response of CR, CRh, PR and CI by mIWG-MRT-ECNM criteria.
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Response-evaluable (RE) Population
    Number of subjects analysed
    61
    Units: Months
        median (full range (min-max))
    2.30 (0.3 to 20.3)
    No statistical analyses for this end point

    Secondary: Objective Response Rate

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    End point title
    Objective Response Rate
    End point description
    The objective response rate was defined as the number of participants with a confirmed best response of morphologic complete remission (mCR), morphologic complete remission with partial recovery of peripheral blood counts (mCRh), or morphologic partial remission (mPR) by pure pathologic response (PPR) criteria. The PPR criteria are a modification of the mIWG-MRT-ECNM criteria that define deep responses where direct measure of the disease burden determined the response and focus on objective changes (bone marrow mast cell burden, serum tryptase, and complete blood count).
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Pure Pathologic Response-evaluable (PPRE) Population
    Number of subjects analysed
    107
    Units: Percentage of Participants
        number (confidence interval 95%)
    73.8 (64.4 to 81.9)
    No statistical analyses for this end point

    Secondary: Progression-free Survival (PFS)

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    End point title
    Progression-free Survival (PFS)
    End point description
    PFS was defined as time from first dose to the time of initial documentation of confirmed PD or death due to any cause, whichever occurred first. Participants who had not progressed or died at the time of analysis were censored at the last response assessment that was SD or better. '9999' = Values were non-estimable (insufficient number of participants with events).
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Response-evaluable (RE) Population
    Number of subjects analysed
    83
    Units: Months
        median (confidence interval 95%)
    51.3 (38.7 to 9999)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    OS was defined as time from first dose to the time of death due to any cause. Participants who were known to be alive or are lost to follow-up were censored at the last time point they were known to be alive. '9999' = Values were non-estimable (insufficient number of participants with events).
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Safety Population
    Number of subjects analysed
    107
    Units: Months
        median (confidence interval 95%)
    61.6 (60.1 to 9999)
    No statistical analyses for this end point

    Secondary: Clinical Benefit Rate

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    End point title
    Clinical Benefit Rate
    End point description
    The clinical benefit rate was defined as the percentage of participants with a confirmed best response of CR, CRh, PR, CI, and SD by mIWG-MRT-ECNM criteria.
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Response-evaluable (RE) Population
    Number of subjects analysed
    83
    Units: Percentage of Participants
        number (confidence interval 95%)
    89.2 (80.4 to 94.9)
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Bone Marrow Mast Cells

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    End point title
    Percent Change From Baseline in Bone Marrow Mast Cells
    End point description
    Bone marrow biopsies and aspirates and peripheral blood smears were obtained for systemic mastocytosis response assessment according to mIWG-MRT-ECNM criteria. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    84
    Units: Percent Change
    arithmetic mean (standard deviation)
        Cycle 3, Day 1 (N=84)
    -63.74 ( 39.445 )
        Cycle 7, Day 1 (N=84)
    -71.12 ( 35.602 )
        Cycle 11, Day 1 (N=69)
    -73.10 ( 49.885 )
        Cycle 17, Day 1 (N=61)
    -81.33 ( 32.377 )
        Cycle 23, Day 1 (N=54)
    -80.84 ( 29.283 )
        Cycle 29, Day 1 (N=40)
    -78.90 ( 29.181 )
        Cycle 35, Day 1 (N=34)
    -83.53 ( 28.316 )
        Cycle 41, Day 1 (N=25)
    -83.32 ( 21.374 )
        Cycle 47, Day 1 (N=19)
    -81.38 ( 21.656 )
        Cycle 53, Day 1 (N=16)
    -75.83 ( 29.094 )
        Cycle 59, Day 1 (N=10)
    -79.55 ( 21.921 )
        Cycle 65, Day 1 (N=3)
    -68.03 ( 26.781 )
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Serum Tryptase

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    End point title
    Percent Change From Baseline in Serum Tryptase
    End point description
    Blood samples were collected to characterize the change in serum tryptase concentration during treatment with avapritinib. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    98
    Units: Percent Change
    arithmetic mean (standard deviation)
        Cycle 1, Day 15 (N=98)
    -64.54 ( 41.191 )
        Cycle 2, Day 1 (N=96)
    -68.54 ( 42.091 )
        Cycle 3, Day 1 (N=89)
    -71.76 ( 40.023 )
        Cycle 7, Day 1 (N=75)
    -75.18 ( 45.822 )
        Cycle 11, Day 1 (N=77)
    -78.69 ( 36.038 )
        Cycle 17, Day 1 (N=67)
    -85.22 ( 26.070 )
        Cycle 23, Day 1 (N=58)
    -85.61 ( 30.510 )
        Cycle 29, Day 1 (N=48)
    -83.50 ( 40.716 )
        Cycle 35, Day 1 (N=43)
    -83.39 ( 45.603 )
        Cycle 41, Day 1 (N=40)
    -90.64 ( 14.206 )
        Cycle 47, Day 1 (N=33)
    -90.64 ( 12.581 )
        Cycle 53, Day 1 (N=25)
    -68.65 ( 85.482 )
        Cycle 59, Day 1 (N=13)
    -92.23 ( 6.8211 )
        Cycle 65, Day 1 (N=5)
    -82.01 ( 14.529 )
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in V-kit Hardy-Zuckerman 4 Feline Sarcoma Viral Oncogene Homolog Aspartate 816 Valine (KIT D816V) Mutation Burden

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    End point title
    Percent Change From Baseline in V-kit Hardy-Zuckerman 4 Feline Sarcoma Viral Oncogene Homolog Aspartate 816 Valine (KIT D816V) Mutation Burden
    End point description
    Bone marrow aspirate and PB samples were collected to characterize the KIT D816V mutation allele fraction. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    97
    Units: Percent Change
    arithmetic mean (standard deviation)
        Cycle 1, Day 15 (N=92)
    -14.65 ( 21.049 )
        Cycle 2, Day 1 (N=87)
    -41.68 ( 23.171 )
        Cycle 3, Day 1 (N=97)
    -54.32 ( 31.272 )
        Cycle 7, Day 1 (N=85)
    -65.46 ( 32.953 )
        Cycle 11, Day 1 (N=85)
    -67.77 ( 30.802 )
        Cycle 17, Day 1 (N=72)
    -77.25 ( 26.783 )
        Cycle 23, Day 1 (N=63)
    -77.09 ( 29.838 )
        Cycle 29, Day 1 (N=52)
    -80.97 ( 29.775 )
        Cycle 35, Day 1 (N=39)
    -81.93 ( 31.110 )
        Cycle 41, Day 1 (N=41)
    -85.31 ( 24.911 )
        Cycle 47, Day 1 (N=31)
    -81.76 ( 28.490 )
        Cycle 53, Day 1 (N=25)
    -76.27 ( 34.561 )
        Cycle 59, Day 1 (N=10)
    -64.42 ( 37.677 )
        Cycle 65, Day 1 (N=5)
    -47.58 ( 47.893 )
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Liver Volume by Imaging

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    End point title
    Percent Change From Baseline in Liver Volume by Imaging
    End point description
    Assessment of liver volume was performed using serial imaging with magnetic resonance imaging (MRI). Response was defined as resolution of palpable hepatomegaly (CR). Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    85
    Units: Percent Change
    arithmetic mean (standard deviation)
        Cycle 3, Day 1 (N=85)
    -12.45 ( 10.103 )
        Cycle 7, Day 1 (N=69)
    -18.53 ( 12.376 )
        Cycle 11, Day 1 (N=74)
    -22.07 ( 11.603 )
        Cycle 17, Day 1 (N=63)
    -27.92 ( 11.949 )
        Cycle 23, Day 1 (N=57)
    -29.50 ( 12.983 )
        Cycle 29, Day 1 (N=45)
    -29.84 ( 13.588 )
        Cycle 35, Day 1 (N=36)
    -29.81 ( 16.764 )
        Cycle 41, Day 1 (N=36)
    -31.77 ( 16.694 )
        Cycle 47, Day 1 (N=30)
    -34.31 ( 13.973 )
        Cycle 53, Day 1 (N=20)
    -35.86 ( 14.147 )
        Cycle 59, Day 1 (N=11)
    -31.74 ( 18.020 )
        Cycle 65, Day 1 (N=4)
    -26.88 ( 21.594 )
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Spleen Volume by Imaging

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    End point title
    Percent Change From Baseline in Spleen Volume by Imaging
    End point description
    Assessment of spleen volume was performed using serial imaging with MRI. Response was defined as ≥35% reduction in spleen volume (PR) or resolution of palpable splenomegaly (CR). Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    84
    Units: Percent Change
    arithmetic mean (standard deviation)
        Cycle 3, Day 1 (N=84)
    -28.47 ( 26.817 )
        Cycle 7, Day 1 (N=67)
    -35.77 ( 26.770 )
        Cycle 11, Day 1 (N=73)
    -38.71 ( 28.700 )
        Cycle 17, Day 1 (N=62)
    -47.53 ( 23.957 )
        Cycle 23, Day 1 (N=56)
    -44.89 ( 24.377 )
        Cycle 29, Day 1 (N=44)
    -44.30 ( 32.952 )
        Cycle 35, Day 1 (N=36)
    -45.00 ( 32.274 )
        Cycle 41, Day 1 (N=36)
    -51.33 ( 25.812 )
        Cycle 47, Day 1 (N=30)
    -52.45 ( 24.580 )
        Cycle 53, Day 1 (N=20)
    -42.85 ( 45.498 )
        Cycle 59, Day 1 (N=11)
    -40.35 ( 28.396 )
        Cycle 65, Day 1 (N=4)
    -40.27 ( 11.884 )
    No statistical analyses for this end point

    Secondary: Mean Change from Baseline in AdvSM-SAF Skin and Gastrointestinal Domain Scores at Month 10

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    End point title
    Mean Change from Baseline in AdvSM-SAF Skin and Gastrointestinal Domain Scores at Month 10
    End point description
    The AdvSM-SAF is a 10-item questionnaire that assesses symptoms and functional domains specific to AdvSM. Eight symptoms are scored on a scale of 0 to 10 for severity and 2 symptoms (vomiting and diarrhoea) are scored for number of episodes. Skin and gastrointestinal domain scores were generated based on average scores for each 7-day period. An increase in score represents a worse symptoms outcome. Participants completed the AdvSM-SAF daily using an e-Diary. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified time points.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 10
    End point values
    Safety Population
    Number of subjects analysed
    93
    Units: Score on a Scale
    arithmetic mean (standard deviation)
        Skin Domain
    -2.52 ( 5.362 )
        Gastrointestinal Domain
    -2.81 ( 5.172 )
    No statistical analyses for this end point

    Secondary: Mean Change from Baseline in AdvSM-SAF Individual Symptom Scores at Month 10

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    End point title
    Mean Change from Baseline in AdvSM-SAF Individual Symptom Scores at Month 10
    End point description
    The AdvSM-SAF is a 10-item questionnaire that assesses symptoms and functional domains specific to AdvSM. Individual symptom scores are generated based on average scores for each 7-day period. Eight symptoms are scored on a scale of 0 to 10 for severity and 2 symptoms (vomiting and diarrhoea) are scored for number of episodes. An increase in score represents a worse symptoms outcome. Participants completed the AdvSM-SAF daily using an eDiary. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point (at the specified time points).
    End point type
    Secondary
    End point timeframe
    Baseline, Month 10
    End point values
    Safety Population
    Number of subjects analysed
    93
    Units: Score on a Scale
    arithmetic mean (standard deviation)
        Fatigue
    -1.12 ( 2.836 )
        Spots
    -0.80 ( 2.099 )
        Itching
    -0.94 ( 2.302 )
        Flushing
    -0.78 ( 2.351 )
        Abdominal Pain
    -1.51 ( 2.439 )
        Nausea
    -0.75 ( 1.723 )
        Vomiting Severity
    -0.03 ( 1.004 )
        Diarrhoea Severity
    -0.53 ( 1.970 )
    No statistical analyses for this end point

    Secondary: Change From Baseline in Patient’s Global Impression of Symptom Severity (PGIS)

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    End point title
    Change From Baseline in Patient’s Global Impression of Symptom Severity (PGIS)
    End point description
    The PGIS is a single-item scale that assesses a participant’s perception of disease symptoms at a point in time. Scores range from 0 to 4 points, with higher values representing worse symptom outcomes. It is widely used to evaluate a participant’s overall sense of whether a treatment has been beneficial. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    87
    Units: Score on a Scale
    arithmetic mean (standard deviation)
        Cycle 1, Day 15 (N=87)
    -0.7 ( 1.23 )
        Cycle 2, Day 1 (N=82)
    -0.9 ( 1.24 )
        Cycle 3, Day 1 (N=85)
    -1.0 ( 1.20 )
        Cycle 5, Day 1 (N=73)
    -1.0 ( 1.32 )
        Cycle 7, Day 1 (N=71)
    -1.1 ( 1.46 )
        Cycle 9, Day 1 (N=65)
    -1.3 ( 1.50 )
        Cycle 11, Day 1 (N=67)
    -1.3 ( 1.36 )
        Cycle 14, Day 1 (N=56)
    -1.4 ( 1.65 )
        Cycle 17, Day 1 (N=56)
    -1.5 ( 1.41 )
    No statistical analyses for this end point

    Secondary: Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)

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    End point title
    Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)
    End point description
    Quality of life was assessed using EORTC QLQ-C30, which is a 30-item questionnaire that includes 5 functional domains (physical, cognitive, role, emotional, and social) and a global health status scale. Twenty-eight questions are scored from 1 (not at all) to 4 (very much), while the other 2 are scored from 1 (very poor) to 7 (excellent). The calculated average is standardized using a linear transformation to a standardized scale of 0 to 100, with a decrease in score representing a decrease in quality of life. Here, ‘Number of subjects analysed’ signifies those participants evaluable for this end point at the specified timepoint. Each cycle is 28 days long.
    End point type
    Secondary
    End point timeframe
    Baseline up to Month 65
    End point values
    Safety Population
    Number of subjects analysed
    87
    Units: Score on a Scale
    arithmetic mean (standard deviation)
        Cycle 1, Day 15 (N=87)
    14.66 ( 23.397 )
        Cycle 2, Day 1 (N=82)
    14.33 ( 24.855 )
        Cycle 3, Day 1 (N=85)
    15.00 ( 28.516 )
        Cycle 5, Day 1 (N=73)
    14.04 ( 30.042 )
        Cycle 7, Day 1 (N=71)
    15.85 ( 30.575 )
        Cycle 9, Day 1 (N=65)
    17.95 ( 29.801 )
        Cycle 11, Day 1 (N=67)
    18.78 ( 28.179 )
        Cycle 14, Day 1 (N=56)
    22.32 ( 31.346 )
        Cycle 17, Day 1 (N=57)
    21.49 ( 29.207 )
    No statistical analyses for this end point

    Secondary: Maximum Plasma Concentration (Cmax) of a Single Dose of Avapritinib

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    End point title
    Maximum Plasma Concentration (Cmax) of a Single Dose of Avapritinib
    End point description
    Blood samples were collected at specified timepoints. Results reported as nanograms/millilitre (ng/mL).
    End point type
    Secondary
    End point timeframe
    Up to 4 hours post dose on Day 1 of Cycle 1 (28 days/cycle)
    End point values
    Pharmacokinetic Population
    Number of subjects analysed
    1
    Units: ng/mL
        arithmetic mean (full range (min-max))
    191 (191 to 191)
    No statistical analyses for this end point

    Secondary: Number of Participants Experiencing Treatment-emergent Adverse Events (TEAE)

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    End point title
    Number of Participants Experiencing Treatment-emergent Adverse Events (TEAE)
    End point description
    A TEAE was defined as any adverse events that occurred between the first dose of a study drug through 30 days after the last dose of any study drug. A summary of all Serious Adverse Events and Non Serious Adverse Events regardless of causality is located in the ‘Adverse Events’ Section.
    End point type
    Secondary
    End point timeframe
    Baseline through Month 65
    End point values
    Safety Population
    Number of subjects analysed
    107
    Units: Participants
    107
    No statistical analyses for this end point

    Secondary: Correlation Between TSS and Serum Tryptase

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    End point title
    Correlation Between TSS and Serum Tryptase
    End point description
    The change in baseline for AdvSM-SAF TSS was correlated with the change in baseline for serum tryptase. Spearman correlation coefficients were performed with corresponding scatter plots on change from baseline.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 65
    End point values
    Safety Population
    Number of subjects analysed
    107
    Units: Spearman Coefficient
        number (not applicable)
    0.1043
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Day 1 through Month 65
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Avapritinib
    Reporting group description
    Avapritinib was administered once daily as an immediate-release tablet, orally, in 28-day cycles.

    Serious adverse events
    Avapritinib
    Total subjects affected by serious adverse events
         subjects affected / exposed
    69 / 107 (64.49%)
         number of deaths (all causes)
    34
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Colon cancer
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Papillary thyroid cancer
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malignant melanoma
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bladder cancer
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Benign neoplasm
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Angiosarcoma
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Angiodysplasia
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphangiectasia
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Embolism
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Pyrexia
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oedema
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Thoracic haemorrhage
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary mass
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemothorax
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchial haemorrhage
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Mental status changes
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Confusional state
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bipolar disorder
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Haemoglobin decreased
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Procedural haemorrhage
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Procedural nausea
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural hypotension
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural haematuria
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femur fracture
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fall
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cystitis radiation
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Radiation proctitis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 1
    Atrial fibrillation
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery dissection
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Haemorrhage intracranial
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    4 / 107 (3.74%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Polyneuropathy
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorder
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Migraine
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dementia
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Encephalopathy
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Haemorrhagic diathesis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Leukocytosis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Anaemia
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Mast cell activation syndrome
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal haemorrhage
         subjects affected / exposed
    4 / 107 (3.74%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Ascites
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Intra-abdominal haemorrhage
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    Small intestinal obstruction
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatic fistula
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphangiectasia intestinal
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ileus paralytic
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematemesis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastritis erosive
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Duodenal ulcer haemorrhage
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Acute cholecystitis necrotic
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Budd-Chiari syndrome
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin lesion
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Hypertonic bladder
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Chronic kidney disease
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    2 / 5
         deaths causally related to treatment / all
    1 / 2
    Nephrolithiasis
         subjects affected / exposed
    4 / 107 (3.74%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Obstructive nephropathy
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis intestinal perforated
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    COVID-19 pneumonia
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Appendicitis
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    4 / 107 (3.74%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    COVID-19
         subjects affected / exposed
    4 / 107 (3.74%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    3 / 107 (2.80%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Endocarditis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Fournier's gangrene
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Gastroenteritis astroviral
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Appendiceal abscess
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Peritonitis
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis viral
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    2 / 107 (1.87%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Groin abscess
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intervertebral discitis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Otitis media
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Parapharyngeal space infection
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Paraspinal abscess
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Septic endocarditis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Septic shock
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Spontaneous bacterial peritonitis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Stoma site cellulitis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Submandibular abscess
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection bacterial
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    1 / 107 (0.93%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Avapritinib
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    106 / 107 (99.07%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    9
    Hypertension
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    16
    General disorders and administration site conditions
    Oedema peripheral
         subjects affected / exposed
    49 / 107 (45.79%)
         occurrences all number
    73
    Fatigue
         subjects affected / exposed
    24 / 107 (22.43%)
         occurrences all number
    33
    Face oedema
         subjects affected / exposed
    18 / 107 (16.82%)
         occurrences all number
    19
    Asthenia
         subjects affected / exposed
    13 / 107 (12.15%)
         occurrences all number
    27
    Pyrexia
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    11
    Swelling face
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    9
    Oedema
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Cough
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    10
    Dyspnoea
         subjects affected / exposed
    12 / 107 (11.21%)
         occurrences all number
    38
    Epistaxis
         subjects affected / exposed
    20 / 107 (18.69%)
         occurrences all number
    25
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    8
    Insomnia
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    9
    Investigations
    Blood alkaline phosphatase increased
         subjects affected / exposed
    17 / 107 (15.89%)
         occurrences all number
    22
    Blood creatinine increased
         subjects affected / exposed
    16 / 107 (14.95%)
         occurrences all number
    19
    Blood bilirubin increased
         subjects affected / exposed
    15 / 107 (14.02%)
         occurrences all number
    38
    Weight increased
         subjects affected / exposed
    15 / 107 (14.02%)
         occurrences all number
    29
    Neutrophil count decreased
         subjects affected / exposed
    14 / 107 (13.08%)
         occurrences all number
    85
    Platelet count decreased
         subjects affected / exposed
    17 / 107 (15.89%)
         occurrences all number
    82
    White blood cell count decreased
         subjects affected / exposed
    12 / 107 (11.21%)
         occurrences all number
    57
    Aspartate aminotransferase increased
         subjects affected / exposed
    10 / 107 (9.35%)
         occurrences all number
    15
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    16
    Alanine aminotransferase increased
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    9
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    8
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    10 / 107 (9.35%)
         occurrences all number
    11
    Nervous system disorders
    Paraesthesia
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    7
    Taste disorder
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    9
    Disturbance in attention
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    8
    Memory impairment
         subjects affected / exposed
    10 / 107 (9.35%)
         occurrences all number
    12
    Dysgeusia
         subjects affected / exposed
    10 / 107 (9.35%)
         occurrences all number
    13
    Dizziness
         subjects affected / exposed
    13 / 107 (12.15%)
         occurrences all number
    16
    Headache
         subjects affected / exposed
    16 / 107 (14.95%)
         occurrences all number
    23
    Cognitive disorder
         subjects affected / exposed
    19 / 107 (17.76%)
         occurrences all number
    31
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    56 / 107 (52.34%)
         occurrences all number
    205
    Neutropenia
         subjects affected / exposed
    25 / 107 (23.36%)
         occurrences all number
    131
    Leukopenia
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    32
    Thrombocytopenia
         subjects affected / exposed
    48 / 107 (44.86%)
         occurrences all number
    282
    Eye disorders
    Periorbital oedema
         subjects affected / exposed
    46 / 107 (42.99%)
         occurrences all number
    79
    Eyelid oedema
         subjects affected / exposed
    14 / 107 (13.08%)
         occurrences all number
    15
    Lacrimation increased
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    9
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    38 / 107 (35.51%)
         occurrences all number
    62
    Nausea
         subjects affected / exposed
    29 / 107 (27.10%)
         occurrences all number
    36
    Vomiting
         subjects affected / exposed
    25 / 107 (23.36%)
         occurrences all number
    30
    Abdominal pain
         subjects affected / exposed
    16 / 107 (14.95%)
         occurrences all number
    22
    Constipation
         subjects affected / exposed
    16 / 107 (14.95%)
         occurrences all number
    20
    Dyspepsia
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    10
    Ascites
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    14
    Abdominal distension
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Abdominal pain upper
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    10
    Gastrooesophageal reflux disease
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Hepatobiliary disorders
    Hyperbilirubinaemia
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    10
    Skin and subcutaneous tissue disorders
    Night sweats
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    8
    Rash
         subjects affected / exposed
    18 / 107 (16.82%)
         occurrences all number
    24
    Hair colour changes
         subjects affected / exposed
    18 / 107 (16.82%)
         occurrences all number
    19
    Pruritus
         subjects affected / exposed
    19 / 107 (17.76%)
         occurrences all number
    35
    Rash maculo-papular
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Petechiae
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Alopecia
         subjects affected / exposed
    12 / 107 (11.21%)
         occurrences all number
    12
    Musculoskeletal and connective tissue disorders
    Neck pain
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    6
    Bone pain
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    9
    Back pain
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    9
    Pain in extremity
         subjects affected / exposed
    14 / 107 (13.08%)
         occurrences all number
    19
    Arthralgia
         subjects affected / exposed
    28 / 107 (26.17%)
         occurrences all number
    45
    Infections and infestations
    COVID-19
         subjects affected / exposed
    20 / 107 (18.69%)
         occurrences all number
    23
    Urinary tract infection
         subjects affected / exposed
    14 / 107 (13.08%)
         occurrences all number
    33
    Upper respiratory tract infection
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    8
    Herpes zoster
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    7
    Metabolism and nutrition disorders
    Hyperuricaemia
         subjects affected / exposed
    14 / 107 (13.08%)
         occurrences all number
    19
    Hypophosphataemia
         subjects affected / exposed
    9 / 107 (8.41%)
         occurrences all number
    11
    Hypomagnesaemia
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    8
    Hypokalaemia
         subjects affected / exposed
    8 / 107 (7.48%)
         occurrences all number
    13
    Hypocalcaemia
         subjects affected / exposed
    7 / 107 (6.54%)
         occurrences all number
    10
    Folate deficiency
         subjects affected / exposed
    6 / 107 (5.61%)
         occurrences all number
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Jul 2018
    - Based on new safety and efficacy data from Phase 1 study BLU 285-2101, starting dose of avapritinib was reduced from 300 mg QD to 200 mg QD - Dosing guidelines were updated to include information regarding dose reduction in the event of toxicity, with the lowest permitted dose being 50 mg QD - Exclusion criteria added to clarify participant eligibility requirements and confirmation of diagnosis - Option to use archival samples for bone marrow (BM) biopsy was removed - Intensive pharmacokinetics (PK) sampling in a subset of participants was removed - Clarification of the study steering SSC’s adjudicated review process added - Study objectives and efficacy endpoints were updated to reflect that mean change from baseline in AdvSM-SAF TSS and mean change from baseline in AdvSM-SAF domain and individual symptom scores will be assessed, rather than mean percent reduction from baseline.
    18 Jun 2019
    - Enrollment was expanded to include participants with AdvSM (aggressive systemic mastocytosis or systemic mastocytosis with an associated hematologic neoplasm) but lacking an evaluable C-finding at baseline in Cohort 2 based on SSC review - An interim analysis was added for efficacy - To manage thrombocytopenia and bleeding risk, participants with platelets < 25,000/microlitre (µL) at baseline were excluded from study, starting dose of avapritinib was changed to 100 mg for participants with 25,000 to 50,000/µL platelets, and the following was introduced: new dose modifications for severe thrombocytopenia, new precautions around concomitant coagulopathy, and use of antithrombotic and anticoagulant therapy and increased monitoring for risk factors and signs and symptoms of intracranial bleeding; - An exploratory objective of assessing platelet aggregation defects as potential mechanisms for bleeding events was added - Intensive PK sampling for a subset of up to 15 participants was added - Dose reduction to 25 mg QD daily is now permitted in the event of toxicity - Requirement for prolonged washout period prior to bone marrow assessment was removed for participants with PD
    24 Oct 2019
    - To reduce the incidence of participants experiencing severe thrombocytopenia, the following changes were introduced: * Participants with any degree of thrombocytopenia at Screening had to repeat a complete blood count (CBC) with differential twice before study drug initiation * Participants with platelets < 50,000/µL within 28 days before dosing or requiring platelet transfusion were excluded. Participants enrolled before Protocol Amendment 5 were allowed to continue on study if they benefited from treatment. * Dose modification guidance for thrombocytopenia was updated, CBC monitoring on study was increased to at least every cycle, and coagulation studies were updated to include fibrinogen and increased monitoring of coagulation.
    28 Feb 2020
    - Participants who experienced intracranial bleeding had to permanently discontinue treatment - Inclusion criterion #5 was clarified. To be eligible in Cohort 1, participants had to have documented mast cell aggregates in BM and/or other extracutaneous organs and had to be willing to have follow-up biopsies of other affected organs.
    21 Apr 2020
    - Definition of the RE population was clarified

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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