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ESMO Gynae 2025 | ROSELLA trial: relacorilant plus nab-paclitaxel in ovarian cancer

Domenica Lorusso, MD, PhD, Fondazione IRCCS National Cancer Institute of Milan, Milan, Italy, discusses secondary endpoint findings from the Phase III ROSELLA trial (NCT05257408), which assessed relacorilant plus nab-paclitaxel versus nab-paclitaxel alone in patients with platinum-resistant ovarian cancer. The combination showed significant improvements in progression-free and overall survival, with consistent results across independent and investigator reviews. Safety was comparable between arms, with no new signals observed. This interview took place at 2025 European Society for Medical Oncology (ESMO) Gynaecological Cancers Congress in Vienna, Austria.

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Transcript

So, ROSELLA trial was the first randomized trial exploring the combination of a new HIFET, which is the glucocorticoid receptor inhibitor relacorilant in combination with the nab-paclitaxel. Preclinical and also clinical data suggest that hyperexpression of glucocorticoid receptor is a marker of poor prognosis in ovarian cancer because glucocorticoid receptor is involved in reduced chemosensitivity and epithelial-mesenchymal transition...

So, ROSELLA trial was the first randomized trial exploring the combination of a new HIFET, which is the glucocorticoid receptor inhibitor relacorilant in combination with the nab-paclitaxel. Preclinical and also clinical data suggest that hyperexpression of glucocorticoid receptor is a marker of poor prognosis in ovarian cancer because glucocorticoid receptor is involved in reduced chemosensitivity and epithelial-mesenchymal transition. And we have some data suggesting that when we combine nab-paclitaxel with relacorilant, we increase progression-free survival in ovarian cancer, data coming from a randomized phase two. Why nab-paclitaxel? Because nab-paclitaxel does not require corticosteroid premedication. The drug is active in ovarian cancer, but in particular, the absence of corticosteroid premedication makes nab-paclitaxel a perfect companion for relacorilant. Some questions? Okay. So in this randomized phase 3 trial, we compare relacorilant plus nab-paclitaxel versus nab-paclitaxel alone in patients with platinum-resistant ovarian cancer who have received no more than three prior lines of therapy. And the trial reported a significant increase in progression-free survival with a hazard ratio of 0.70 and a median increase from 5.5 to 6.5 in median PFS. But also even more important in this interim analysis, there was a trend that showed an increase in overall survival with a hazard ratio of 0.69 and the median overall survival increasing from 11.5 to 15.9 months. And also the toxicity profile was really manageable, particularly what we saw, it was a slight increase in neutropenia and anemia, but when we adjust for the duration of treatment, it was very comparable between the two treatment arms. So this is a new standard of care for platinum-resistant ovarian cancer.

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