# OMAHA-004 (opevesostat): what clinicians are saying

> 61 statements from 9 sources (1 podcast, 2 videos, 4 posts, 1 paper, 1 registry record), 10 of them from 2 confirmed clinicians, each linked to its source. Commentary checked Nov 14, 2026.

## Report

- Trial: MK-5684-004: A Phase 3, Randomized, Open-label Study of Opevesostat Versus Alternative Abiraterone Acetate or Enzalutamide in Participants With Metastatic Castration-resistant Prostate Cancer (mCRPC) That Progressed On or After Prior Treatment With One Next-generation Hormonal Agent (NHA) (OMAHA-004)
- NCT ID: NCT06136650
- Registry: https://clinicaltrials.gov/study/NCT06136650
- Sponsor: Merck Sharp & Dohme LLC
- Phase: Phase 3
- Status: Recruiting
- Drugs tested: opevesostat
- Indication: metastatic castration-resistant prostate cancer post one NHA
- Version: v1.0.0, edition 1
- Accepted: 2026-11-14 UTC
- Last checked: 2026-11-14 UTC
- Release hash: 964256a45296bdaf9a0012c39cbe94b1d0b58ef67a7050f27793c8b8aa8cdfc6

## Counts

- Commentary sources screened: 20
- Sources cited by verified statements: 9
- Verified statements: 61
- From speakers with a confirmed clinical role (verified by the NPI registry or their own institution's staff page): 10
- Findings: 5
- Named people in screened sources (unnamed speakers and accounts not counted): 3
- Speakers cited: 3
- Cited speakers with a verified identity: 3
- Cited clinicians, speakers with a confirmed clinical role (the abstract's clinicians): 2
- Of them physicians, whose confirmed role is a physician's, not a physician assistant's, nurse's or pharmacist's (the abstract's physicians): 2
- By role and specialty (the abstract's specialty counts):
  - 1 physician, Medical oncology
  - 1 physician, Urology
- Organisational or shared accounts (not counted as people): 1

A verified identity says who a speaker is. A cited clinician also has a clinical role confirmed by the NPI registry or their own institution's staff page. Verified speakers without such a role, such as researchers, advocates, company staff, or clinicians whose role only a source or their own profile states, are not counted as clinicians.

Counts describe the retained sources. They do not estimate how many HCPs hold a view.

## Abstract

In one discussion, a speaker hopes OMAHA-004 could become standard care for AR-LBD-mutated disease because of earlier subgroup activity, not demonstrated trial benefit. In separate discussion, a speaker describes earlier activity without AR mutations, leaving mutation status unproven as a selection rule for opevesostat. A medical oncologist described in the sources as involved in the trial stresses that broad steroid suppression requires hormone replacement. The sources reviewed for this edition provide no comparative benefit or safety outcomes.

## Question clinicians left open

What do clinicians say OMAHA-004 needs to show on radiographic progression-free and overall survival before considering opevesostat instead of ARPI switching in AR-LBD mutation-negative as well as mutation-positive mCRPC after one ARPI without prior mCRPC taxane?

From findings F1 (11 statements in 3 sources) and F4 (17 statements from 2 speakers in 7 sources). The report shows what clinicians said and the sources behind it; it does not settle the question.

## Findings (titles)

- F1. One video calls OMAHA-004 mutation-specific; another presentation describes testing both mutation groups
  - 11 statements in 3 sources, 2 of them podcasts or videos.
- F2. Two named contributors stress steroid replacement; one video asks about major side effects
  - 9 statements from 2 speakers in 5 sources, 3 of them podcasts or videos.
- F3. Two named contributors see upstream steroid blockade as a strategy for hormonal resistance
  - 19 statements from 3 speakers in 7 sources, 3 of them podcasts or videos.
- F4. One X account frames OMAHA-004 as earlier testing against ARPI switching
  - 17 statements from 2 speakers in 7 sources, 2 of them podcasts or videos.
- F5. One LinkedIn account presents recruitment as access and anticipates another treatment option
  - 8 statements from 1 speaker in 2 sources.

The full report also has 1 finding about other patients, lines of treatment or settings, after these trial findings under “Beyond the trial population”. They are not counted or listed on this page.

## What sits behind each finding

Counts describe what the report retained, not how many clinicians hold a view. A statement can support more than one finding. Speakers are the named people a finding's statements cite, of any role, counted as the report counts its cited speakers; unnamed speakers and accounts are not counted.

| Finding | Statements | Passages | Sources | Speakers | Limitations |
| --- | ---: | ---: | ---: | ---: | ---: |
| F1 | 11 | 12 | 3 | 0 | 3 |
| F2 | 9 | 8 | 5 | 2 | 3 |
| F3 | 19 | 13 | 7 | 3 | 3 |
| F4 | 17 | 11 | 7 | 2 | 4 |
| F5 | 8 | 4 | 2 | 1 | 3 |

### What the statements are

| Finding | Views | Questions and uncertainty | Clinical experience | Comparisons | Restated results and context | Statement links to supporting passages | Statement links to context passages | Sources by kind |
| --- | ---: | ---: | ---: | ---: | ---: | ---: | ---: | --- |
| F1 | 8 | 1 | 0 | 0 | 2 | 12 | 4 | 2 podcasts and video, 1 publication |
| F2 | 4 | 1 | 0 | 0 | 4 | 10 | 3 | 1 post or article, 3 podcasts and video, 1 publication |
| F3 | 8 | 2 | 0 | 1 | 8 | 21 | 1 | 4 posts and articles, 3 podcasts and video |
| F4 | 2 | 0 | 0 | 2 | 13 | 26 | 1 | 3 posts and articles, 2 podcasts and video, 1 publication, 1 registry |
| F5 | 3 | 1 | 1 | 0 | 3 | 8 | 0 | 1 post or article, 1 publication |

### Trial dimensions

- Primary endpoint: Overall Survival (OS): F1 (1 shared claims), F4 (3 shared claims)
- Secondary endpoints: F1 (1 shared claims), F4 (3 shared claims)
- Population and setting: F1 (8 shared claims), F4 (5 shared claims), F5 (4 shared claims)
- The comparison: F4 (6 shared claims)
- Safety and tolerability: F2 (8 shared claims)
- Design and conduct: F1 (1 shared claims), F4 (9 shared claims), F5 (2 shared claims)

## Abbreviations

- ARPI: androgen receptor pathway inhibitor
- HCP: healthcare professional
- MCP: Model Context Protocol, how AI agents read the report
- NPI: National Provider Identifier, the US registry number for clinicians
- OS: overall survival

## What's inside

| Section | Items | Access |
| --- | ---: | --- |
| Findings with interpretation, counterviews and limits | 5 | Titles free |
| Detailed analysis | 8 sections | Paid |
| Verified statements with short source quotes and links | 61 | Paid |
| Who said each statement: the cited speakers | 3 | Every edition |
| Speakers with a clinical role confirmed by the NPI registry or a staff page | 2 | Every edition |
| Speakers with verified IDs as data (NPI, ORCID, staff page) | 3 | Every edition |
| CMS-reported financial relationships (Open Payments, by company) for NPI-linked speakers | Included | Every edition |
| Trial aspects mapped | 9 | Free |
| Sources with links | 9 | Counts free |
| MCP access for your AI agent, same license key | Included | Every edition |

Every edition, the free report included, names who said each statement, as the source shows them. Each named speaker's card gives a clinical role only when the NPI registry or the person's own institution's staff page confirms it, and says which; a role only a source states is labelled as the source's. Here 2 of the 3 cited speakers have a role confirmed that way. Every edition also comes with MCP access, so your AI agent reads the same evidence with your license key, and with verified IDs for each identity-checked speaker (the NPI, ORCID and OpenAlex IDs, and their institution's staff page), so your team can check each attribution itself. Social accounts are not included. The IDs are for checking attribution inside your organization. Allowed: advisory boards, scientific exchange and finding investigators, under your own compliance process. Not allowed: sales or marketing to clinicians.

## Trial aspects

9 discussed · 0 no commentary found · 0 assessment incomplete.

| Aspect | Coverage | Statements | Sources |
| --- | --- | ---: | ---: |
| Primary endpoint: Overall Survival (OS) | discussed | 3 | 3 |
| Secondary endpoints | discussed | 3 | 3 |
| Population and setting | discussed | 16 | 5 |
| The comparison (The registered arms and what clinicians said about how they compare.) | discussed | 6 | 4 |
| Safety and tolerability | discussed | 8 | 4 |
| Design and conduct | discussed | 11 | 6 |
| Resistance biology and upstream steroid blockade in mCRPC | discussed | 19 | 7 |
| Mutation-guided selection and ctDNA interpretation | discussed | 11 | 3 |
| Recruitment, access and anticipated treatment role | discussed | 4 | 1 |

Discussed means at least one verified statement addresses the aspect, not that every question in it is covered: gaps inside a discussed aspect are listed under Scope and limits, and the full report gives each aspect its own limitations. No commentary found means none in the sources read. Assessment incomplete marks an aspect with no statement found while known source limits apply.

## Sources

| Channel | Statements | Cited | Screened |
| --- | ---: | ---: | ---: |
| **Video & audio · 32 statements · 52%** (from 3 videos and episodes · about 11 per source) | | | |
| YouTube | 28 | 2 | 2 |
| Podcasts | 4 | 1 | 1 |
| **Posts · 18 statements · 30%** (from 4 posts · about 5 per source) | | | |
| X threads | 9 | 3 | 16 |
| LinkedIn posts | 9 | 1 | 1 |
| **Primary sources · 11 statements · 18%** (cited for context, not screened · from 2 sources · about 6 per source) | | | |
| Publications (primary source, cited for context) | 10 | 1 | not screened |
| Registry (primary source, cited for context) | 1 | 1 | not screened |

- Screened window: 2024-01-05 to 2026-11-06
- Cited window: 2025-04-30 to 2026-10-23
- Retrieved: 2026-11-14

Statements count each verified statement once, split evenly over the sources it cites. Screened sources were retrieved for this trial. Cited sources back at least one verified statement and include primary sources used for context.

## The trial

From ClinicalTrials.gov.

- Title: MK-5684-004: A Phase 3, Randomized, Open-label Study of Opevesostat Versus Alternative Abiraterone Acetate or Enzalutamide in Participants With Metastatic Castration-resistant Prostate Cancer (mCRPC) That Progressed On or After Prior Treatment With One Next-generation Hormonal Agent (NHA) (OMAHA-004)
- Registry: NCT06136650 (https://clinicaltrials.gov/study/NCT06136650)
- Study IDs: 5684-004 · MK-5684-004 (MSD) · jRCT2031240030 (Japan Registry of Clinical Trial (jRCT)) · 2023-504957-11-00 (EU CT) · U1111-1288-5002 (UTN)
- Sponsor: Merck Sharp & Dohme LLC
- Design: Phase 3 · interventional, randomized, parallel, phase3
- Status: Recruiting
- Enrollment: 1,314 (estimated)
- Start: 2023-12-18 (actual)
- Primary completion: 2028-05-10 (estimated)
- Primary endpoint: Overall Survival (OS) (Up to approximately 82 months)
- Intervention: Opevesostat (drug)
- Intervention: Dexamethasone (drug)
- Intervention: Fludrocortisone acetate (drug)
- Intervention: Hydrocortisone (drug)
- Intervention: Abiraterone acetate (drug)
- Intervention: Prednisone acetate (drug)
- Intervention: Enzalutamide (drug)

## Scope and limits

This report does not judge efficacy, estimate HCP prevalence or consensus or give treatment advice.

- Discussion that does not name the trial may be missing from this edition.
- 52 statements in the sources reviewed for this edition are about other patients or topics, or only mention the trial, and are not counted.
- Further source limits: 18 sources about other trials or topics are not included.
- The sources reviewed describe selected public discussion, not a representative sample of HCP opinion or treatment practice.
- Discussion that does not use the trial identifier or recognized trial names may be missing.
- Some speakers' identities or clinical roles are not established in the sources used in this report; each statement is attributed only as far as its source shows.
- No OMAHA-004 comparative efficacy or safety outcomes are provided. Earlier-study response figures, mechanistic assertions and future treatment expectations must remain separate from phase 3 findings.
- The registry and publication describe different endpoint hierarchies. The registry records the OS amendment sequence, but the descriptions should not be collapsed into one undated account.
- Earlier-study populations, response definitions and mutation-prevalence estimates are not sufficiently aligned to support direct numerical comparisons.
- The video names an earlier study C-Beta; other sources name CYPIDES. Their identity should not be assumed from similar subject matter.
- Recruitment and access statements describe what was reported at the time, not current site availability or access outside research.

How reports are built and checked: https://www.erudio.com/methods

## Editions and corrections

- v1.0.0, edition 1, accepted 2026-11-14 UTC: current edition

Each new edition gets a new version: a new or changed finding raises the middle number (1.0.0 to 1.1.0), added evidence or newly verified speakers alone the last number (1.0.0 to 1.0.1), and a change of report format the first number. A correction fixes the published edition in place without making a new edition, so the version stays the same. Changes are corrections that add, remove or change a statement or finding, or withdraw a source; routine maintenance (people cards, names and spellings, recounts, tags and page wording) changes none. Every correction is listed here with its date. Last checked for new commentary 2026-11-14 UTC. No changes.

## Offer

- Size: Focused · 61 verified statements · 10 from 2 confirmed clinicians
- Not for sale: This edition is below our minimum for clinicians and sources, so it is not for sale yet. Contact us if you are still interested. No order can be placed for it, by any route; a later edition that reaches the minimum is for sale at its normal price. Follow the change feed: https://www.erudio.com/reports/omaha-004-nct06136650/feed.json
- Talk to Audun Utengen and Tom Lee (invoice, PO, questions): https://www.erudio.com/contact?report=omaha-004-nct06136650

## Cite

Erudio Health. OMAHA-004 (NCT06136650): HCP commentary report. Edition 1, v1.0.0. Accepted Nov 14, 2026. https://www.erudio.com/reports/omaha-004-nct06136650

## Questions

### How much does the OMAHA-004 report cost?

This edition is below our minimum for clinicians and sources, so it is not for sale yet. Contact us if you are still interested.

### What does the OMAHA-004 report cover?

61 statements from 9 sources (1 podcast, 2 videos, 4 posts, 1 paper, 1 registry record), 10 of them from 2 confirmed clinicians, each linked to its source. Commentary checked Nov 14, 2026. The report separates what clinicians said from what primary sources establish; it does not judge efficacy or estimate consensus.

### Can my AI agent read or buy the OMAHA-004 report?

Its preview, yes: get_report_card({ "slug": "omaha-004-nct06136650" }) on https://mcp.erudio.com/free, with no sign-in. It cannot be ordered yet. [Connect your AI client](https://www.erudio.com/developers/connect)

### How current is the OMAHA-004 report?

Edition 1 (version 1.0.0), accepted Nov 14, 2026 UTC; last checked for new commentary Nov 14, 2026 UTC. Your plan includes every new edition published during its term. We automatically check subscribed trials for new commentary every week.

## Machine access

- JSON: https://www.erudio.com/reports/omaha-004-nct06136650.json
- Markdown: https://www.erudio.com/reports/omaha-004-nct06136650.md
- Change feed (JSON Feed: new editions and changes): https://www.erudio.com/reports/omaha-004-nct06136650/feed.json
- MCP, no sign-in: https://mcp.erudio.com/free, tool `get_report_card` with `{"slug": "omaha-004-nct06136650"}`