Title

Study of VERU-944 to Ameliorate Hot Flashes in Men With Advanced Prostate Cancer
Randomized, Double-blind, Placebo Controlled, Dose Finding Phase 2 Study Comparing Oral Daily Dosing of VERU-944 to Ameliorate the Vasomotor Symptoms Resulting From ADT in Men With Advanced Prostate Cancer
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Indication/Condition

    Prostate Cancer Metastatic
  • Intervention/Treatment

    Veru-944 ...
  • Study Participants

    93
Randomized, double-blind, placebo controlled, dose finding Phase 2 study comparing oral daily dosing of VERU-944 after a week of loading (daily dosing) with placebo to ameliorate the vasomotor symptoms resulting from androgen deprivation therapy in men with advanced prostate cancer
This study is a multicenter, randomized, double-blind, placebo controlled, dose finding study of VERU-944 to treat hot flashes (vasomotor symptoms) in men with advanced prostate cancer on ADT. The study will have four arms with 30 subjects per arm. The subjects participating in the study will have advanced prostate cancer and will be undergoing androgen deprivation therapy (ADT) with a luteinizing hormone releasing hormone (LHRH) therapy (agonist or antagonist) for at least the three months prior to randomization and be experiencing regular moderate to severe hot flashes while on ADT. Subjects will all continue to receive ADT and will be randomized to receive, for the first four days, a loading dose followed by daily doses of placebo or VERU-944 (10 mg, 50 mg or 100 mg) orally for a total period of 12 weeks.
Study Started
Sep 14
2018
Primary Completion
Apr 30
2020
Study Completion
Oct 15
2020
Results Posted
Jun 18
2021
Last Update
Dec 03
2021

Drug Veru-944

Treat hot flashes (vasomotor symptoms) in men with advanced prostate cancer on ADT

  • Other names: Zuclomiphene citrate

Drug Placebo

Placebo

Veru-944 10 mg Experimental

Veru-944 10 mg daily

Veru-944 50 mg Experimental

Veru-944 50 mg daily

Placebo Placebo Comparator

Placebo daily

Criteria

Inclusion Criteria

Be over 18 years of age;
Be able to communicate effectively with the study personnel;
Have histologically confirmed prostate cancer;
Have been treated with an LHRH agonist or LHRH antagonist for at least the 3 months prior to randomization;
Be continued on an LHRH agonist or LHRH antagonist throughout this study;
Have experienced hot flashes for at least one month prior to study entry;
Have moderate or severe vasomotor symptoms (hot flashes) (defined as a minimum of 4 moderate to severe hot flashes per day or 12 per week at baseline);
ECOG performance status of 0 to 2

Be willing to uses electronic data capture for the relevant medical events

• Must be at least 80% compliant during the screening period

Subjects must agree to use acceptable methods of contraception:

If their female partners are pregnant or lactating, acceptable methods of contraception from the time of the first administration of study medication until 6 months following administration of the last dose of study medication must be used. Acceptable methods are: Condom used with spermicidal foam/gel/film/cream/suppository. If the subject has undergone surgical sterilization (vasectomy with documentation of azospermia), a condom with spermicidal foam/gel/film/cream/suppository should be used.
If the male subject's partner could become pregnant, use acceptable methods of contraception from the time of the first administration of study medication until 6 months following administration of the last dose of study medication. Acceptable methods of contraception are as follows: Condom with spermicidal foam/gel/film/cream/suppository [i.e., barrier method of contraception], surgical sterilization (vasectomy with documentation of azospermia) and a barrier method {condom used with spermicidal foam/gel/film/cream/suppository}, the female partner uses oral contraceptives (combination estrogen/progesterone pills), injectable progesterone or subdermal implants and a barrier method (condom used with spermicidal foam/gel/film/cream/suppository).
If the female partner has undergone documented tubal ligation (female sterilization), a barrier method (condom used with spermicidal foam/gel/film/cream/suppository) should also be used.
If the female partner has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used.
Subject is willing to comply with the requirements of the protocol through the end of the study.

Exclusion Criteria

Have a serum total testosterone concentration > 50 ng/dL at screening;
Known hypersensitivity or allergy to estrogen or estrogen like drugs;
Any disease or condition (medical or surgical) which might compromise the hematologic, cardiovascular, endocrine, pulmonary, renal, gastrointestinal, hepatic, or central nervous system; or other conditions that may interfere with the absorption, distribution, metabolism or excretion of study drug, or would place the subject at increased risk;
Subjects with a personal history of abnormal blood clotting or thrombotic disease, including venous or arterial thrombotic events such as a history of stroke, deep vein thrombosis (DVT), and/or pulmonary embolus (PE);

Any subjects, as determined by a central laboratory, that have a:

Factor V Leiden gene mutation
Prothrombin gene mutation
Uncontrolled symptomatic congestive heart failure (NYHA Class III - IV), unstable angina pectoris, cardiac arrhythmia, or uncontrolled atrial fibrillation;
History of MI
The presence of consistently abnormal laboratory values which are considered clinically significant. In addition, any subject with liver enzymes (ALT or AST) above 2 times the upper limit of normal, total bilirubin above 2 times the upper limit of normal, or serum creatinine above 1.5 times the upper limit of normal will NOT be admitted to the study;
Received an investigational drug within a period of 90 days prior to enrollment in the study;
Received the study medication (VERU-944) previously;
Have previously taken within 6 months prior to screening or are currently taking diethylstilbestrol, other estrogens;
Currently taking gabapentin, estrogen, diethylstilbestrol, medroxyprogesterone acetate, clomiphene, selective serotonin reuptake inhibitors (SSRIs), other treatments for hot flashes
Recent hospitalization for more than 24 hours (within 30 days of screening);
Recent surgery (within 30 days of screening);
Have been previously diagnosed or treated for active cancer (other than prostate cancer or non-melanoma skin cancer) within the previous five years;
Have a BMI >40.

Summary

Placebo

Veru-944 10 mg

Veru-944 50 mg

All Events

Event Type Organ System Event Term Veru-944 10 mg Veru-944 50 mg Placebo

Change in Frequency of Moderate to Severe Hot Flashes at 6 Weeks

Percentage of change in frequency of moderate to severe hot flashes at 6 weeks

Veru-944 10 mg

-19.72
Percentage of change in frequency (Mean)
Standard Deviation: 8.840

Veru-944 50 mg

-42.24
Percentage of change in frequency (Mean)
Standard Deviation: 8.196

Placebo

-46.59
Percentage of change in frequency (Mean)
Standard Deviation: 7.760

Percentage Change in Severity of Moderate to Severe Hot Flashes at 6 Weeks

Change in severity of moderate to severe hot flashes compared to baseline at 6 weeks

Placebo

-0.35
percentage of change (Mean)
Standard Deviation: 0.508

Veru-944 10 mg

-0.21
percentage of change (Mean)
Standard Deviation: 0.386

Veru-944 50 mg

-0.31
percentage of change (Mean)
Standard Deviation: 0.416

Change of Frequency of Moderate to Severe Hot Flashes at Week 12

Mean change in frequency of moderate to severe hot flashes compared to baseline at weeks 12

Veru-944 10 mg

-39.94
percentage of change (Mean)
Standard Error: 8.458

Veru-944 50 mg

-51.95
percentage of change (Mean)
Standard Error: 8.574

Placebo

-52.7
percentage of change (Mean)
Standard Error: 7.881

Change in Severity of Moderate to Severe Hot Flashes at Week 12

Mean change in severity of moderate to severe hot flashes compared to baseline at week 12

Veru-944 10 mg

-12.05
percentage of change (Mean)
Standard Error: 5.014

Veru-944 50 mg

-16.93
percentage of change (Mean)
Standard Error: 5.061

Placebo

-22.48
percentage of change (Mean)
Standard Error: 4.674

Change in Bone Turnover Markers C-telopeptide (CTX)

Change in C-telopeptide concentration at day 84 compared to baseline

Veru-944 10 mg

419.7
ng/L (Mean)
Standard Deviation: 262

Veru-944 50 mg

362.1
ng/L (Mean)
Standard Deviation: 305.44

Placebo

466.0
ng/L (Mean)
Standard Deviation: 347.3

Change in Bone Turnover Markers Alkaline Phosphatase

Change in bone specific alkaline phosphatase at day 84 compared to baseline

Veru-944 10 mg

13.89
ug/L (Mean)
Standard Deviation: 4.598

Veru-944 50 mg

15.72
ug/L (Mean)
Standard Deviation: 22.468

Placebo

13.12
ug/L (Mean)
Standard Deviation: 6.074

Post-hoc Analysis on the Percentage Change in Frequency of Moderate and Severe Hot Flashes From Baseline to Week 12; Exposure Response Assessment

Post-hoc exploratory MMRM analysis was conducted to explore the effect of trough plasma concentration at Week12 on the change in frequency of moderate and severe hot flashes from Baseline to Week 12 in subjects with a BMI >25 kg/m2.

PK ≥195ng/mL

-77.6
percentage of change (Mean)
Standard Deviation: 14.542

PK <195 ng/mL

-50.14
percentage of change (Mean)
Standard Deviation: 5.842

Change in Serum Total Testosterone

Change in serum total testosterone concentration comparing baseline to day 30, baseline to day 60 and baseline to day 84 for each treatment group

Outcome Measure Data Not Reported

Change in Serum Free Testosterone

Change in serum free testosterone concentration comparing baseline to day 84

Veru-944 10 mg

1.16
ng/L (Mean)
Standard Deviation: 0.895

Veru-944 50 mg

1.38
ng/L (Mean)
Standard Deviation: 4.873

Placebo

1.0
ng/L (Mean)
Standard Deviation: 1.635

Change in Serum SHBG

Change in serum SHBG concentration comparing baseline to day 30, baseline to day 60 and baseline to day 84 for each treatment group

Veru-944 10 mg

55.7
nmol/L (Mean)
Standard Deviation: 28.27

Veru-944 50 mg

113.5
nmol/L (Mean)
Standard Deviation: 60.53

Placebo

54.1
nmol/L (Mean)
Standard Deviation: 24.98

Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability)Sess Safety

Incidence of Treatment-Emergent Adverse Events will be tabulated by MedDRA terms and system organ class. The incidence of AEs and the maximum intensity and frequency of AEs will be summarized. The intensity of AE will be graded according to CTCAE version 4. Changes from baseline will be computed and tested for significant change from baseline to day 114

Outcome Measure Data Not Reported

Change in Serum PSA

Change in serum PSA concentration comparing baseline to day 30, baseline to day 60 and baseline to day 84 for each treatment group

Outcome Measure Data Not Reported

Total

91
Participants

Age, Continuous

70.2
years (Mean)
Standard Deviation: 7.50

Moderate to Severe Hot Flashes

34.9
Percentage hot flashes moderate severe (Mean)
Standard Deviation: 26.25

Age, Categorical

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

Veru-944 10 mg

Veru-944 50 mg

Placebo