A Phase II Randomized Study to Evaluate Measures for Endpoint Derivation in Patients With Progressive or Refractory Disseminated Coccidioidomycosis (DCM ) Treated With Olorofim Plus Baseline SOC or Placebo Plus Baseline SOC

Valley Fever (coccidioidomycosis) is a serious fungal infection that can cause long-lasting symptoms.

Currently marketed antifungal drugs have limitations including limited dosage forms, drug-drug interactions (DDIs), and significant adverse reactions.

Olorofim is an antifungal candidate with a novel mechanism of action offering activity against resistant organisms, differences in safety profile, along with oral route of administration, predictable and reliable pharmacokinetic (PK) profile and limited potential for DDIs.

This study tests whether the Valley Fever-Patient Reported Outcome (VF-PRO) questionnaire can reliably measure symptom impacts and changes over time in patients with severe forms of the disease (disseminated coccidioidomycosis (DCM)). The study will also assess symptoms of DCM and their severity, and whether olorofim, is safe and can help people with DCM when given together with standard antifungal medications (also known as standard-of-care or SOC).

Inclusion criteria

• Male and female patients, English- or Spanish-speaking, aged ≥18 years and weighing ≥40 kg.
• Patients with progressive or refractory disseminated coccidioidomycosis (DCM) involving extra-pulmonary sites with or without ongoing active disease in lungs.
• Standard of Care therapy for DCM to date has included 2 different triazoles (with or without a course of intravenous amphotericin B).

Exclusion criteria

• Patients who are unconscious.
• Women who are pregnant or breastfeeding.
• Known history of allergy, hypersensitivity, or any serious reaction to any component of the study drug.
• Patients with or planned placement of indwelling CNS devices.
• Patients receiving intrathecal amphotericin B at the time of study enrolment.
• Coccidioidomycosis limited to fibro-cavitary pulmonary disease.
• All bothersome DCM-related symptoms at study entry are due to irreversible damage (e.g., neurologic deficits due to stroke).
• Other than cutaneous fungal infections treated topically and Pneumocystis jirovecii infections, patients with a second fungal infection requiring systemic antifungal treatment or prophylaxis.
• Patients with microbiological findings or other potential conditions that are temporally related and suggest a different than study indication etiology for the clinical features.
• Patients living with Human immunodeficiency virus (HIV) unless for at least 6 months prior to enrollment:

• Are receiving antiretroviral therapy AND
• Have no evidence of current clinical progression resulting from HIV infection.
• Patients who have received prior treatment with olorofim/F901318.
• Patients receiving treatment limited to supportive care due to predicted short survival time.
• Patients with a baseline prolongation of QT using Fridericia's Correction Formula (QTcF) ≥500 msec, or at high risk for QT/QTc prolongation.
• Evidence of hepatic dysfunction.