CLINICAL TRIALS PROFILE FOR COBENFY

All Clinical Trials for COBENFY

Trial ID	Title	Status	Sponsor	Phase	Start Date	Summary
NCT07084831 ↗	A Prospective, Open-label, Single-arm, Multicenter Study Evaluating the Efficacy of One Year Treatment With Xanomeline/Trospium on Cognitive Impairment in Clinically Stable Adult Participants With Schizophrenia.	NOT_YET_RECRUITING	Bristol-Myers Squibb	PHASE3	2026-01-01	Schizophrenia is a chronic, severe psychiatric disorder affecting approximately 1% of the global population. Symptoms are usually treated with antipsychotics (AP). All currently available APs work by blocking dopamine receptors in the brain. This is effective to treat the symptoms, but also leads to side-effects. Side effects contribute to poor medication adherence, resulting in frequent relapses and hospitalizations. In addition, the cognitive symptoms are not treated by the current APs. Xanomeline/Trospium (US brand name: COBENFY) is a novel combination of xanomeline tartrate (a muscarinic agonist) and trospium chloride (a muscarinic antagonist). It offers significant therapeutic benefits through its unique mechanism of action, selectively targeting central muscarinic acetylcholine receptors while mitigating peripheral side effects. This makes Xanomeline/Trospium a promising alternative to existing antipsychotics. This combination has demonstrated robust efficacy in reducing psychotic symptoms in recent trials, with a favorable side-effect profile. These findings led to the FDA approval of Xanomeline/Trospium (Cobenfy) in 2024 for the treatment of schizophrenia. Preliminary exploratory cognitive assessments in these trials have suggested potential pro-cognitive effects, particularly in domains such as attention and working memory, although these were not powered to detect changes in cognition 1,2. Most antipsychotic trials include only superficial cognitive assessments, often limited to brief screening tools or exploratory endpoints. Furthermore, few studies explore the longitudinal course of cognition over extended treatment periods. In the current study, we propose to conduct a deep-dive into cognitive functioning in patients with schizophrenia who are treated with Xanomeline/Trospium for a one-year period. Cognitive functioning is highly integrated within the study design with other relevant domains, such as clinical symptoms, functioning, and quality of life, offering a more holistic picture of treatment impact. By focusing on cognition as a primary outcome in a naturalistic yet rigorous study design, this trial addresses a critical unmet need in schizophrenia research and has the potential to inform a paradigm shift in treatment strategies beyond symptom stabilization toward cognitive and functional recovery. By investing in this level of cognitive phenotyping, the study aligns with calls from both scientific and regulatory bodies for precision in cognitive outcomes and contributes to a growing body of work aimed at establishing cognition as a co-primary treatment target in schizophrenia.
NCT07084831 ↗	A Prospective, Open-label, Single-arm, Multicenter Study Evaluating the Efficacy of One Year Treatment With Xanomeline/Trospium on Cognitive Impairment in Clinically Stable Adult Participants With Schizophrenia.	NOT_YET_RECRUITING	University Medical Center Groningen	PHASE3	2026-01-01	Schizophrenia is a chronic, severe psychiatric disorder affecting approximately 1% of the global population. Symptoms are usually treated with antipsychotics (AP). All currently available APs work by blocking dopamine receptors in the brain. This is effective to treat the symptoms, but also leads to side-effects. Side effects contribute to poor medication adherence, resulting in frequent relapses and hospitalizations. In addition, the cognitive symptoms are not treated by the current APs. Xanomeline/Trospium (US brand name: COBENFY) is a novel combination of xanomeline tartrate (a muscarinic agonist) and trospium chloride (a muscarinic antagonist). It offers significant therapeutic benefits through its unique mechanism of action, selectively targeting central muscarinic acetylcholine receptors while mitigating peripheral side effects. This makes Xanomeline/Trospium a promising alternative to existing antipsychotics. This combination has demonstrated robust efficacy in reducing psychotic symptoms in recent trials, with a favorable side-effect profile. These findings led to the FDA approval of Xanomeline/Trospium (Cobenfy) in 2024 for the treatment of schizophrenia. Preliminary exploratory cognitive assessments in these trials have suggested potential pro-cognitive effects, particularly in domains such as attention and working memory, although these were not powered to detect changes in cognition 1,2. Most antipsychotic trials include only superficial cognitive assessments, often limited to brief screening tools or exploratory endpoints. Furthermore, few studies explore the longitudinal course of cognition over extended treatment periods. In the current study, we propose to conduct a deep-dive into cognitive functioning in patients with schizophrenia who are treated with Xanomeline/Trospium for a one-year period. Cognitive functioning is highly integrated within the study design with other relevant domains, such as clinical symptoms, functioning, and quality of life, offering a more holistic picture of treatment impact. By focusing on cognition as a primary outcome in a naturalistic yet rigorous study design, this trial addresses a critical unmet need in schizophrenia research and has the potential to inform a paradigm shift in treatment strategies beyond symptom stabilization toward cognitive and functional recovery. By investing in this level of cognitive phenotyping, the study aligns with calls from both scientific and regulatory bodies for precision in cognitive outcomes and contributes to a growing body of work aimed at establishing cognition as a co-primary treatment target in schizophrenia.
NCT07084831 ↗	A Prospective, Open-label, Single-arm, Multicenter Study Evaluating the Efficacy of One Year Treatment With Xanomeline/Trospium on Cognitive Impairment in Clinically Stable Adult Participants With Schizophrenia.	NOT_YET_RECRUITING	European Group for Research In Schizophrenia	PHASE3	2026-01-01	Schizophrenia is a chronic, severe psychiatric disorder affecting approximately 1% of the global population. Symptoms are usually treated with antipsychotics (AP). All currently available APs work by blocking dopamine receptors in the brain. This is effective to treat the symptoms, but also leads to side-effects. Side effects contribute to poor medication adherence, resulting in frequent relapses and hospitalizations. In addition, the cognitive symptoms are not treated by the current APs. Xanomeline/Trospium (US brand name: COBENFY) is a novel combination of xanomeline tartrate (a muscarinic agonist) and trospium chloride (a muscarinic antagonist). It offers significant therapeutic benefits through its unique mechanism of action, selectively targeting central muscarinic acetylcholine receptors while mitigating peripheral side effects. This makes Xanomeline/Trospium a promising alternative to existing antipsychotics. This combination has demonstrated robust efficacy in reducing psychotic symptoms in recent trials, with a favorable side-effect profile. These findings led to the FDA approval of Xanomeline/Trospium (Cobenfy) in 2024 for the treatment of schizophrenia. Preliminary exploratory cognitive assessments in these trials have suggested potential pro-cognitive effects, particularly in domains such as attention and working memory, although these were not powered to detect changes in cognition 1,2. Most antipsychotic trials include only superficial cognitive assessments, often limited to brief screening tools or exploratory endpoints. Furthermore, few studies explore the longitudinal course of cognition over extended treatment periods. In the current study, we propose to conduct a deep-dive into cognitive functioning in patients with schizophrenia who are treated with Xanomeline/Trospium for a one-year period. Cognitive functioning is highly integrated within the study design with other relevant domains, such as clinical symptoms, functioning, and quality of life, offering a more holistic picture of treatment impact. By focusing on cognition as a primary outcome in a naturalistic yet rigorous study design, this trial addresses a critical unmet need in schizophrenia research and has the potential to inform a paradigm shift in treatment strategies beyond symptom stabilization toward cognitive and functional recovery. By investing in this level of cognitive phenotyping, the study aligns with calls from both scientific and regulatory bodies for precision in cognitive outcomes and contributes to a growing body of work aimed at establishing cognition as a co-primary treatment target in schizophrenia.
NCT07228338 ↗	Cholinergic Enhancement of Theta	NOT_YET_RECRUITING	University of Texas Southwestern Medical Center	EARLY_PHASE1	2026-01-01	The goal of this study is to learn about the effects of Cobenfy KarXT (xanomeline and trospium chloride) on episodic memory processing, including specific effects on areas of the brain involved in memory and changes it may have on brain activity. The investigators will do this by testing epileptic patients who are already undergoing intracranial surgery for seizure monitoring, and measuring the activity from the brain areas being assessed. The main questions it aims to answer are 1) whether Cobenfy KarXT changes memory activity based on its agonist effect on muscarinic receptors and acetylcholine, and 2) what the nature of these brain activity changes are. This work builds on previous experiments evaluating cholinergic antagonists. Participants will complete two treatment arms. One of these will be with the drug, and the other will be with a placebo pill, so that the participants are unaware which session the actual drug has been received. Patients will complete a verbal serial recall and/or associative recognition task each of the two days. An anesthesiologist or patient nurse will administer either the drug or the placebo at a critical point which addresses both of the research questions. Researchers will compare the brain activity between the two treatment arms to determine what brain activity changes, and whether there is an additional behavioral effect on memory.

Clinical Trial Conditions for COBENFY

Condition Name

Condition Name for COBENFY
Intervention	Trials
Schizophrenia; Psychosis	1
Seizures	1
Cognitive Impairment	1
Cognitive Impairment, Mild	1

Condition MeSH

Condition MeSH for COBENFY
Intervention	Trials
Cognitive Dysfunction	2
Schizophrenia	1
Psychotic Disorders	1
Seizures	1

Clinical Trial Locations for COBENFY

Trials by Country

Trials by Country for COBENFY
Location	Trials
Netherlands	1
Israel	1
United States	1

Trials by US State

Trials by US State for COBENFY
Location	Trials
Texas	1

Clinical Trial Progress for COBENFY

Clinical Trial Phase

Clinical Trial Phase for COBENFY
Clinical Trial Phase	Trials
PHASE3	1
EARLY_PHASE1	1

Clinical Trial Status

Clinical Trial Status for COBENFY
Clinical Trial Phase	Trials
NOT_YET_RECRUITING	2

Clinical Trial Sponsors for COBENFY

Sponsor Name

Sponsor Name for COBENFY
Sponsor	Trials
Bristol-Myers Squibb	1
University Medical Center Groningen	1
European Group for Research In Schizophrenia	1

Sponsor Type

Sponsor Type for COBENFY
Sponsor	Trials
OTHER	3
INDUSTRY	1

Last updated: May 8, 2026

COBENFY (futibatinib): Clinical Trials Update and Market Outlook

What is COBENFY and what approvals drive the commercial baseline?

COBENFY is the brand name for futibatinib. It is an oral, irreversible inhibitor of FGFR1/2/3 designed for FGFR-driven cancers, with commercialization anchored in metastatic/advanced settings where FGFR alterations are actionable.

Commercial baseline factors that shape near-term revenue projections

• Treatment setting specificity: Futibatinib’s uptake is constrained by the requirement for FGFR alteration testing and the indication’s eligibility criteria.
• Line-of-therapy placement: Uptake depends on how clinicians sequence it versus chemotherapy, targeted therapies, and immunotherapy where available.
• Access and dosing: Oral dosing and toxicity-management complexity affect adherence and payer coverage.

Key market driver

• The market size grows as the share of diagnosed patients with eligible FGFR alterations increases and as dosing tolerability enables sustained treatment.

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What is the current clinical trials landscape for futibatinib (COBENFY)?

COBENFY’s development strategy centers on expanding use across:

• Additional tumor types with FGFR pathway activation
• Combination regimens (commonly with checkpoint inhibitors and other targeted agents)
• Trials exploring earlier lines and biomarker-defined subgroups

How to read the development pipeline for market impact

• Phase 3 readouts and label expansions are the primary catalysts for revenue step-changes.
• Early-phase combination signals matter only if they produce registrational outcomes or clear differentiation that improves standard-of-care positioning.

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Which trial readouts most influence market projections?

Market projections for COBENFY depend on three types of clinical events:

1. Label-expanding Phase 3 outcomes
   • If a new indication captures a meaningful patient pool and shows a survival advantage or strong response durability, adoption accelerates quickly through guideline-driven prescribing.
2. Combination efficacy that changes sequencing
   • If combinations move futibatinib upward in line-of-therapy, the addressable market expands even without entirely new indications.
3. Safety/tolerability evidence that improves dose continuity
   • Real-world fit can outperform trial efficacy if toxicity is manageable and adherence improves.

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What are the market dynamics shaping near-term demand?

COBENFY’s near-term demand is shaped by payer and provider behavior around targeted oncology agents:

Market adoption mechanics

• Biomarker testing availability: FGFR testing infrastructure determines eligible population capture.
• Formulary access: Payers typically require evidence of clinically meaningful benefit versus alternatives in the same line.
• Switching behavior: Patients who fail prior therapy create a funnel, but only if prescribers see consistent outcomes in real-world populations.

Competitive pressure profile

• Futibatinib competes with:
  • Other FGFR-targeted therapies and next-generation kinase inhibitors
  • Standard-of-care chemo-immunotherapy regimens (depending on tumor type and setting)
• Competitive differentiation hinges on:
  • Durable response rate
  • Safety profile that reduces discontinuation
  • Ability to maintain treatment in practice

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How large is the addressable market and how will it evolve?

A credible projection requires mapping three components:

• Eligible population with FGFR alterations
• Proportion of those patients reaching the tested line-of-therapy where futibatinib is positioned
• Expected uptake rate versus alternatives after reimbursement and guideline adoption

Market expansion levers

• New tumor indications increase the addressable base.
• Earlier line positioning increases annual treated prevalence.
• Combination strategies can increase the proportion of eligible patients who choose futibatinib as part of front-line or mid-line regimens.

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What market projection should business planners use for COBENFY?

COBENFY revenue modeling should use a scenario framework anchored on:

• Peak-uptake trajectory post-label expansion
• Discontinuation rates linked to real-world toxicity
• Widening biomarker diagnosis over time

Projection framework (inputs that directly change forecast outcomes)

• Scenario A (conservative): Uptake remains niche due to limited label scope and slower guideline penetration.
• Scenario B (base): Steady uptake in labeled population; modest expansion from ongoing trials that refine sequencing.
• Scenario C (aggressive): Faster label expansion and/or combination adoption that moves futibatinib earlier.

Outputs planners should generate

• Treated patient count by indication and line of therapy
• Net price trajectory after rebates and contracting
• Revenue by market (US, EU5, Japan, Rest of World) if modeled regionally

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What does a 12- to 24-month commercial watchlist look like?

The watchlist that drives decisions on R&D resourcing, partnering, and inventory planning should focus on:

• Registrational-grade trial readouts that expand labeled use (Phase 3 and similar)
• Regulatory updates on supplement approvals or label clarifications
• Safety updates that change dose modification frequency and discontinuation rates
• Competing therapy approvals that alter sequencing in the same clinical niche

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Key Takeaways

• COBENFY (futibatinib) commercial outcomes depend on label scope, biomarker-diagnosed eligibility, and line-of-therapy placement.
• The clinical pipeline’s biggest revenue effect comes from registrational Phase 3 results, combination strategies that shift sequencing, and real-world tolerability evidence.
• Market projections should be built from a scenario model using eligible patient funnel, uptake speed, and net pricing dynamics, with a 12- to 24-month watchlist focused on regulatory and readout catalysts.

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FAQs

1) What drives COBENFY uptake in oncology clinics?
Eligibility through FGFR biomarker testing, formulary access, and perceived positioning versus chemo and other targeted agents.

2) Which clinical events most impact COBENFY revenue forecasts?
Phase 3 outcomes that support label expansions, plus combination data that shifts line-of-therapy earlier.

3) How should discontinuation risk be handled in market models?
Model discontinuation using observed trial safety plus dose-modification rates, then adjust for real-world adherence and toxicity management.

4) What competitive factors matter most for futibatinib?
Sequencing pressure from other FGFR inhibitors and standards like chemo-immunotherapy in overlapping settings.

5) What is the highest-leverage market expansion path?
Expanding use into new tumor types or earlier lines where the eligible population is larger and adoption accelerates through guideline updates.

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References

[1] APA: No sources were provided in the request, and no verifiable citations are included above.