NCT06551324 is a phase III trial to investigate an experimental drug, mevrometostat (PF-06821497), in men with metastatic castration-resistant prostate cancer (mCRPC) who have previously been treated with abiraterone acetate. The trial is scheduled to be completed in December 2025.

The MEVPRO-1 study aims to enroll 600 patients across 25 sites in the US, Australia, and Asia. The primary endpoint is radiographic progression-free survival (rPFS) for up to two years. Patients in the treatment arm will receive mevrometostat twice daily plus enzalutamide daily.

In the active comparator arm, patients will receive either enzalutamide or docetaxel, as determined by their physician.

Mevrometostat works by blocking the effects of a protein called enhancer of zeste homolog 2 (EZH2), which is involved in prostate cancer cell growth. One of the targets in this process is a protein called H3K27Me3, which inhibits cancer cell growth.

When mutated, EZH2 can function as a co-activator for the androgen receptor. Therefore, targeting this pathway offers an alternative approach to overcoming resistance to the androgen receptor pathway.

Furthermore, EZH2 is considered one of the major drivers of neuroendocrine prostate cancer, and this new drug could help preventing the differentiation of prostate cancer into neuroendocrine.

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