Efficacy, tolerability, and safety of teverelix DP in patients with advanced prostate cancer: A multicenter, open‐label, phase 2 trial

Author:

Ulys Albertas1,Jankevicus Feliksas2,Jievaltas Mindaugas3,Venckus Raimundas4,Auskalnis Stasys3,Kardelis Zygimantas1,Barisiene Marija2,MacLean Carol M.5ORCID,van Os Steve5,Larsen Finn5

Affiliation:

1. Departments of Urology National Cancer Institute Vilnius Lithuania

2. Faculty of Medicine, Departments of Urology Vilnius University Vilnius Lithuania

3. Urology Department, Medicine Academy Lithuanian University of Health Sciences Kaunas Lithuania

4. Department of Surgery Klaipeda University Hospital Klaipeda Lithuania

5. Antev Ltd London UK

Abstract

AbstractBackgroundTeverelix drug product (DP) is a novel injectable gonadotropin‐releasing hormone antagonist.MethodsAn adaptive phase 2, open‐label, multicenter trial was conducted in patients with advanced prostate cancer to evaluate the efficacy and safety of a combined subcutaneous (SC) and intramuscular (IM) loading dose regimen of teverelix DP of 120 mg SC + 120 mg IM (Group 1; N = 9) or 180 mg SC + 180 mg IM (Group 2; N = 41) administered at a single visit, followed by 6‐weekly SC maintenance doses of 120 mg (Group 1) or 180 mg (Group 2), up to Day 168. The primary endpoint was the proportion of patients achieving castration levels with serum testosterone <0.5 ng/mL at Day 28 with a target castration rate of 90%. Injection sites were inspected by the investigator at every visit and reactions (ISRs) were proactively recorded.ResultsThe target castration rate was reached in Group 2 (97.5%) but not in Group 1 (62.5%). The castration rates were not maintained to Day 42 (Group 2: 82.5%; Group 1: 50.0%). Suppression of testosterone to castrate levels occurred rapidly (median time: 2 days for both groups). Suppression of testosterone, prostate‐specific antigen, follicle‐stimulating hormone, and luteinizing hormone was sustained throughout the treatment period, being more prominent with the higher dose. The adverse event (AE) profile was similar between groups. The most common AEs were injection‐site induration (n = 40: 80.0%), injection‐site erythema (n = 35: 70.0%), and hot flush (n = 21: 42.0%). Most ISRs were Grade 1.ConclusionOverall, the teverelix DP doses were generally well‐tolerated but did not adequately maintain castration levels.

Publisher

Wiley

Reference52 articles.

1. Considerations for the use of gonadotropin‐releasing hormone agonists and antagonists in patients with prostate cancer

2. The role of FSH and LH in prostate cancer and cardiometabolic comorbidities;Crawford ED;Can J Urol,2020

3. The potential role of follicle-stimulating hormone in the cardiovascular, metabolic, skeletal, and cognitive effects associated with androgen deprivation therapy

4. Center for Drug Evaluation and Research (CDER). FDA Drug Safety Communication: update to ongoing safety review of GnRH agonists and notification to manufacturers of GnRH agonists to add new safety information to labeling regarding increased risk of diabetes and certain cardiovascular diseases. Accessed May 2023.https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-update-ongoing-safety-review-gnrh-agonists-and-notification

5. Assessment and Mitigation of Cardiovascular Risk for Prostate Cancer Patients: A Review of the Evidence

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