Relacorilant plus nab-paclitaxel improves survival in platinum-resistant ovarian cancer patients

1. Progression-free and overall survival were greater in relacorilant plus nab-paclitaxel compared to nab-paclitaxel alone.

2. The rate of adverse events was comparable between groups.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Ovarian cancer that no longer responds to platinum-based therapies poses a significant treatment challenge. Relacorilant, a selective glucocorticoid receptor antagonist, may help overcome this by enhancing tumour sensitivity to treatment by reducing cortisol signalling. This randomized controlled trial aimed to evaluate whether adding relacorilant to nab-paclitaxel could improve survival outcomes in patients with platinum-resistant ovarian, peritoneal, or fallopian tube cancer. The primary outcome of this study was progression-free survival, while the key secondary outcome was overall survival. According to study results, the addition of relacorilant significantly improved both progression-free and overall survival compared to nab-paclitaxel alone, without introducing new safety concerns. Although this study was well done, it was limited by its open-label design, which could introduce potential bias despite blinded endpoint assessments.

Click to read the study in The Lancet

Relevant Reading: Nab-Paclitaxel plus Gemcitabine and FOLFOX in Metastatic Pancreatic Cancer

In-depth [randomized controlled trial]: Between Jan 5, 2023, and Apr 8, 2024, 498 patients were assessed for eligibility across 117 hospitals in 14 countries. Included were patients aged ≥ 18 years with high-grade ovarian, peritoneal, or fallopian tube cancer. Altogether, 381 patients (188 in relacorilant plus nab-paclitaxel and 193 in nab-paclitaxel alone) were included in the final analysis. The primary outcome of progression-free survival was significantly improved in the combination group compared to monotherapy (median 6.54 vs. 5.52 months; hazard rate [HR] 0.70; p<0.05). This was also true for the secondary outcome of overall survival (median 15.97 vs. 11.50 months; HR 0.69; p<0.05). Overall, findings from this study suggest that relacorilant combined with nab-paclitaxel may offer a more effective treatment option for patients with platinum-resistant ovarian cancer.

Image: PD

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